OB

Question 1

At what week breech presentation will self-correct?

Answer 1

37th week of gestation

Question 2

When should external cephalic version be attempted?

Answer 2

After the 37th week without any contraindications; if unsuccessful, consider C-section

Question 3

What is the cutoff for distinguishing gestational HTN vs chronic HTN

Answer 3

20 weeks

Question 4

What are the signs of preeclampsia?

Answer 4

elevated BP after 20 weeks AND proteinuria or signs of end-organ damage

Question 5

What are signs of eclampsia?

Answer 5

preeclampsia AND grand mal seizures

Question 6

What are signs of chronic HTN with superimposed preeclampsia?

Answer 6

Chronic HTN AND 1 of the following: proteinuria or worsening of existing proteinuria after 20 weeks, sudden worsening of HTN, or signs of end-organ damage

Question 7

Pregnant patient of 38 weeks comes in with HTN, 340 mg of protein, and facial edema. What is the next step of management?

Answer 7

Induce labor with IV oxytocin

Question 8

True or False: ACE-I or diuretics are the best drug to control BP during pregnancy

Answer 8

False: ACEIs are known to lead to uterine ischemia and diuretics can aggravate low plasma volume to the point of uterine ischemia

Question 9

What is HELLP?

Answer 9

hemolysis, elevated LFTs, and low platelets

Question 10

What hormone causes uterine involution during the postpartum period and help with the expulsion of milk from lactiferous glands

Answer 10

oxytocin

Question 11

What role does hPL play during pregnancy

Answer 11

it has an insulin antagonist effect and provides nutrition of fetus by causing maternal lipolysis and insulin resistance thus increasing delivery of fatty acids and glucose to fetus

Question 12

What’s the next management for 12 week pregnant woman with urine culture of 100,000 CFUs of E coli

Answer 12

Amoxicillin or Nitrofurantoin x 3-7 days

*disclaimer: no fluoroquinolones becuz of potential association with bone deformities and arthropathy in unborn fetus

Question 13

What are some contraindications for treating UTIs in pregnancy?

Answer 13

• fluoroquin’s (bone deformities)
• tetracycline (fetal bone and tooth deform; gray discoloration of teeth)
• TMX-SMX (1st trimester with folic acid metabolism; 3rd with kernicterus in newborn)

Question 14

This type of tumor can present in a perimens. woman with intermittent blood staining her bra.

Answer 14

Intraductal papilloma

Question 15

This is the worse malignant breast cancer to have and it’s firm, fibrous, and rock hard with stellate morphology

Answer 15

Invasive ductal

Question 16

This is the most common cause of postpartum hemorrhage within 24 hours of delivery

Answer 16

uterine atony

Question 17

This type of illness has profuse frothy vaginal discharge with vaginal erythema, showing flagellates under wet mount. This is used to treat it.

Answer 17

Trichomonas; metronidazole for patient and partner

Question 18

This is used to treat a patient with thick cottage cheese discharge and vaginal inflammation

Answer 18

fluconazole

Question 19

This represents the initial workup for an adnexal mass.

Answer 19

CA125 and Transvag US

Question 20

These are features that would cause suspicion for malignant adnexal mass

Answer 20

elevated CA125, greater than 10 cm in size, nodular or fixed pelvic mass, ascites, metastasis

Question 21

These are the indications for GBS prophylaxis when GBS is unknown

Answer 21

Delivery less than 37 w (preterm premature ROM), duration of memb ruture greater than 18 hr, GBS bacteruria, prior hx of infant with GBS sepsis

Question 22

These are the painless vaginal bleeds during pregnancy

Answer 22

Placenta previa and vasa previa

Question 23

A pregnant lady who has painless bleeding with rapid fetal deterioration and preceded by ROM should be dx then tx this way.

Answer 23

transvag Doppler; cesarean delivery

Question 24

This test is used to differentiate maternal and fetal blood during vag bleed

Answer 24

Apt test or Kleihauer-Betke test (for vasa previa)

Question 25

This has painless bleeding but not rapid deterioration to fetus.

Answer 25

Placenta previa

Question 26

This is used for infertility and PCOS by being a partial agonist at estrogen receptors in hypothalamus, thus prevent negative feedback and increase LH and FSH

Answer 26

clomiphene

Question 27

A patient who has anovulation and galactorrhea has an increase of this.

Answer 27

prolactin

Question 28

This should not be taken while taking metronidazole.

Answer 28

alcohol

Question 29

This is the week range where you check for quad screen.

Answer 29

15-22 w

Question 30

This is the week range where you do a gestational DM screen

Answer 30

24-28 w