Items 476480

A 25-year-old G1P0 presents to your office for a routine return OB visit at 30 weeks. On listening to the fetal heart tones, you notice that the patient has a number of bruises on the abdomen. You ask the patient what happened, and she tells you the bruises resulted from a fall she suffered several days earlier, when she slipped on the stairs. The patient returns to your office 3 weeks later for another routine visit, and you note that she has a black eye that she has tried to cover up with...

Items 388390

A 51-year-old G3P3 presents to your office with a 6-month history of amenorrhea. She complains of debilitating hot flashes that awaken her at night she wakes up the next day feeling exhausted and irritable. She tells you she has tried herbal supplements for her hot flashes, but nothing has worked. She is interested in beginning hormone replacement therapy, but is hesitant to do so because of its possible risks and side effects. The patient is very healthy. She denies any medical problems and is...

Questions

DIRECTIONS Each item below contains a question or incomplete statement followed by suggested responses. Select the one best response to each question. 181. Which of the following statements regarding management of labor in a low-risk pregnancy is true a. Amniotomy may shorten the length of labor slightly, but not as much as spontaneous rupture b. Universal electronic fetal monitoring improves perinatal outcome c. Food and oral fluids are acceptable if labor is progressing normally d. An...

Answers

The answer is b. (Adashi, pp 2245-2255.) An initial spontaneous abortion, irrespective of the karyotype or sex of the child, does not change the risk of recurrence in a future pregnancy. The rate is commonly quoted as 15 of all known pregnancies. 2. The answer is d. (Keye, pp 230-245. Speroff, 6 e, p 1045.) Chromosomal abnormalities are found in approximately 50 of spontaneous abortions, 5 of stillbirths, and 0.5 of live born babies. In spontaneous losses, trisomy 16 is the most common trisomy,...

Items 415420

An 18-year-old G0 comes to see you complaining of a 3-day history of urinary frequency, urgency, and dysuria. She panicked this morning when she noticed the presence of bright red blood in her urine. She also reports some midline lower abdominal discomfort. She had intercourse for the first time 5 days ago and reports that she used condoms. On physical exam, there is no discharge from the cervix or in the vagina and the cervix appears normal. Bimanual exam is normal except for mild suprapubic...

Kelmac Medical Obstetrics Answers

The answer is a. (Reece, 2 e, p 1630.) Amniotomy may shorten the labor slightly, but not as much as spontaneous rupture of membranes. There is no evidence whatsoever that shorter labor is beneficial to mother or fetus. Universal use of electronic fetal monitoring has not been found to reduce the incidence of perinatal asphyxia, low Apgar scores, or perinatal death. When a group of patients with universal fetal monitoring in labor was compared with one in which electronic fetal monitoring...

Items 402407

A 59-year-old G4P4 presents to your GYN office complaining of losing urine when she coughs, sneezes, or engages in certain types of strenuous physical activity. The problem has gotten increasingly worse over the past few years, to the point where the patient finds her activities of daily living compromised secondary to fear of embarrassment. She denies any other urinary symptoms such as urgency, frequency, or hematuria. In addition, she denies any problems with her bowel movements. Her prior...

Atrophic Vaginitis And Serosanguineous Discharge

The answer is d. (DiSaia, 5 e, pp 55-62.) The main routes of spread of cervical cancer include vaginal mucosa, myometrium, paracervical lymphatics, and direct extension into the parametrium. The prevalence of lymph node disease correlates with the stage of malignancy. Primary node groups involved in the spread of cervical cancer include the paracervical, parametrial, obturator, hypogastric, external iliac, and sacral nodes, essentially in that order. Less commonly, there is involvement in...

Overflow Incontinence After Lefort Surgery

The answer is b. (Scott, 8 e, pp 768-770.) Stress incontinence is the involuntary loss of urine when intravesical pressure exceeds the maximum urethral pressure in the absence of detrusor activity. The most common cause of urinary incontinence is incompetence of the urethral sphincter, termed genuine stress incontinence. The other major cause of incontinence is unstable bladder. An unstable bladder is the occurrence of involuntary, uninhibited detrusor contractions of greater than 15 cmH2O...

All Are Tocolytic Exept

Sarcoma Botryoides

DIRECTIONS Each item below contains a question or incomplete statement followed by suggested responses. Select the one best response to each question. 106. Which of the following statements concerning abdominal pregnancy is correct a. Gastrointestinal symptoms are quite often severe b. Fetal survival is approximately 50 c. Aggressive attempts should be made to remove the placenta at the time of initial surgery d. It may result in infectious morbidity prior to the diagnosis e. It is usually the...

Items 4243

Match each description with the correct drug. (Bactrim) 42. Safe in all trimesters (SELECT 3 DRUGS) 43. Unsafe in all trimesters (SELECT 2 DRUGS) 44. You see a healthy 40-year-old multiparous patient for preconception counseling. She is extremely worried about her risk of having a baby with spina bifida. Five years ago, this patient delivered a baby with anencephaly who died shortly after birth. How would you counsel this woman regarding future pregnancies a. She does not have a recurrence risk...

Xylocaine Infiltration For Marsupialization

Marsupialization For Pulmonary

DIRECTIONS Each item below contains a question or incomplete statement followed by suggested responses. Select the one best response to each question. 271. A 50-year-old woman is diagnosed with cervical cancer. Which lymph node group would be the first involved in metastatic spread of this disease beyond the cervix and uterus d. Paracervical or ureteral nodes 272. A 21-year-old woman presents with left lower quadrant pain. An anterior 7-cm firm adnexal cyst is palpated. Ultrasound confirms a...

What Is G3p3 On Medical Exam

DIRECTIONS Each item contains a question or incomplete statement followed by suggested responses. Select the one best response to each question. 216. A baby is born with ambiguous genitalia. Which of the following statements is true a. A karyotype is rarely needed b. Evaluation should be done by 1 month of age c. It is sometimes associated with a history of a previous sibling with congenital adrenal hyperplasia (CAH) d. A thorough physical examination can usually decide the true sex e....

Items 7882

Fetal Tracing Spontaneous Declarations

Match each description with the appropriate fetal heart rate tracing. If none of the tracings apply, answer e (none). a. 78. Hyperstimulation (SELECT 1 TRACING) 79. Early deceleration (SELECT 1 TRACING) 80. Acceleration with normal variability (SELECT 1 TRACING) 81. Variable deceleration with late component (SELECT 1 TRACING) 82. Late deceleration with flat baseline (SELECT 1 TRACING) 83. A 17-year-old primipara at 41 weeks wants an immediate cesarean section. She is being followed with...

Gonadotropin evaluation Select 1 DAY Items 381383

A 22-year-old G0P0 comes to your office with a chief complaint of being too hairy. She reports that her menses started at age 13 and have always been very irregular. She also complains of acne and is currently seeing a dermatologist for the skin condition. She denies any medical problems, and her only surgery was an appendectomy at age 8. Height is 5 ft, 5 in. weight is 150 lb BP is 100 60. On physical exam, there is sparse hair around the nipples, chin, and upper lip. No galactorrhea,...