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Prometric - OBG - Rapid - 2
1 / 50
A woman with severe pre-eclampsia is given MgSO4 and hydralazine. Her respiratory rate drops, and deep tendon reflexes are absent. What is the treatment?
Calcium gluconate is the antidote for magnesium sulfate toxicity.
2 / 50
A 30-year-old primigravida with headaches, sweating, and high BP at 18 weeks. What is the next best step?
Abdominal ultrasonography is indicated to investigate hypertension in pregnancy.
3 / 50
A 38-year-old woman presents with foul-smelling vaginal discharge. Wet mount shows clue cells. What is the treatment of choice?
Metronidazole is the treatment of choice for bacterial vaginosis (clue cells).
4 / 50
A 35-year-old woman with watery discharge and a punctate cervix. What is the most likely diagnosis?
Trichomonas infection presents with watery discharge and a punctate (strawberry) cervix.
5 / 50
A 43-year-old woman at 38 weeks after IVF, reports good fetal movement, no bleeding, or contractions. Fundal height is 36 cm. What is the next step?
The decrease in fundal height is normal due to fetal engagement. A routine visit is appropriate.
6 / 50
What is the most common sexually transmitted disease in the U.S.?
Human papillomavirus (HPV) is the most common STD in the U.S.
7 / 50
A 22-year-old woman at 32 weeks presents with fever, dysuria, and flank pain. What is the most likely causative organism?
E. coli is the most common organism responsible for pyelonephritis.
8 / 50
A 30-year-old woman presents with lower abdominal pain, cervical discharge, and bilateral tenderness. What is the diagnosis?
Gonorrhea often presents with mucopurulent discharge and cervical tenderness.
9 / 50
A 30-year-old woman presents with low abdominal pain and spotting. A pregnancy test is positive, but the ultrasound does not show an intrauterine pregnancy. What is the most likely diagnosis?
Ectopic pregnancy is suspected when there is a positive pregnancy test but no intrauterine pregnancy visible on ultrasound.
10 / 50
A woman at 30 weeks gestation with previous C-section presents with sudden-onset severe abdominal pain and vaginal bleeding. What is the most likely diagnosis?
Uterine rupture is more likely in women with a previous C-section presenting with acute pain and bleeding.
11 / 50
A 28-year-old woman at 34 weeks presents with vaginal bleeding. Ultrasound shows the placenta covering the cervical os. What is the diagnosis?
Placenta previa occurs when the placenta covers the cervix and presents with painless vaginal bleeding.
12 / 50
A 35-year-old woman with hypertension at 28 weeks gestation develops proteinuria and elevated liver enzymes. What is the most likely diagnosis?
Preeclampsia is defined by the presence of hypertension and proteinuria in pregnancy.
13 / 50
A 30-year-old woman with a history of DVT presents at 16 weeks of pregnancy. What is the best treatment option?
LMWH is the safest anticoagulant during pregnancy. Warfarin is teratogenic.
14 / 50
A 28-year-old primigravida at 38 weeks gestation reports constant vaginal leakage and a sweet odor. What is the most likely cause?
PROM is suspected with constant leakage of amniotic fluid and a sweet smell.
15 / 50
A 30-year-old woman presents with severe pain and spotting after intercourse. On exam, there is a friable, erythematous cervical lesion. What is the most likely diagnosis?
Cervical cancer commonly presents with postcoital bleeding and a friable lesion.
16 / 50
A 32-year-old woman presents with painless vaginal bleeding at 28 weeks gestation. What is the most likely cause?
Placenta previa presents with painless vaginal bleeding in the second or third trimester.
17 / 50
A 25-year-old G1P0 woman at 39 weeks gestation is admitted with regular contractions. On examination, her cervix is 8 cm dilated. What stage of labor is she in?
The active phase of labor begins at 6 cm dilation, and the cervix progresses more rapidly during this stage.
18 / 50
A 33-year-old woman at 37 weeks gestation presents with fever, uterine tenderness, and foul-smelling amniotic fluid. What is the most likely diagnosis?
Chorioamnionitis presents with fever, uterine tenderness, and foul-smelling amniotic fluid.
19 / 50
A 40-year-old woman at 38 weeks presents with a large-for-gestational-age baby on ultrasound. What is the most likely risk factor?
Maternal diabetes increases the risk of having a large-for-gestational-age (LGA) baby.
20 / 50
A 22-year-old woman presents with heavy menstrual bleeding, dysmenorrhea, and a boggy uterus on exam. What is the most likely diagnosis?
Adenomyosis presents with heavy bleeding, dysmenorrhea, and an enlarged, boggy uterus.
21 / 50
A 26-year-old woman has been trying to conceive for 2 years without success. Her menstrual cycles are irregular. What is the most likely cause of her infertility?
PCOS is a common cause of infertility in women with irregular menstrual cycles.
22 / 50
A 35-year-old woman presents with sudden onset of severe lower abdominal pain. Ultrasound shows a ruptured ovarian cyst. What is the management?
Most ruptured ovarian cysts are managed expectantly unless there is severe bleeding or infection.
23 / 50
A woman at 34 weeks presents with regular contractions every 10 minutes and cervical dilation of 2 cm. What is the diagnosis?
Preterm labor is diagnosed when regular contractions lead to cervical dilation before 37 weeks gestation.
24 / 50
A 24-year-old woman at 12 weeks gestation presents with severe vomiting, dehydration, and electrolyte imbalance. What is the most likely diagnosis?
Hyperemesis gravidarum is severe vomiting leading to dehydration and electrolyte imbalance in early pregnancy.
25 / 50
A 36-year-old woman with multiple sexual partners presents with cervical discharge, abdominal pain, and fever. What is the diagnosis?
PID is characterized by cervical discharge, lower abdominal pain, and fever, often related to sexually transmitted infections.
26 / 50
A 28-year-old woman with a history of PID presents with infertility. What is the most likely cause of her infertility?
PID can cause tubal scarring, leading to infertility.
27 / 50
A 29-year-old G1P0 woman presents with painless vaginal bleeding at 20 weeks. What is the most likely cause?
Placenta previa typically presents with painless vaginal bleeding in the second trimester.
28 / 50
A 22-year-old woman with a 10-year history of diabetes presents with worsening proteinuria and hypertension in pregnancy. What is the most likely diagnosis?
Diabetic nephropathy can worsen in pregnancy, presenting with proteinuria and hypertension.
29 / 50
A 30-year-old woman at 20 weeks presents with a mass in the left breast. What is the next best step?
Ultrasound is the preferred initial imaging modality for breast masses in pregnancy.
30 / 50
A 25-year-old G1P0 woman presents with a blood pressure of 150/90 at 16 weeks gestation. What is the diagnosis?
Hypertension diagnosed before 20 weeks of gestation is considered chronic hypertension.
31 / 50
A 28-year-old woman at 38 weeks gestation presents with decreased fetal movement. What is the next best step?
A nonstress test is the first step in evaluating decreased fetal movement.
32 / 50
A 30-year-old woman with twins at 32 weeks presents with regular contractions and cervical dilation. What is the best management?
Steroids are given in preterm labor to enhance fetal lung maturity.
33 / 50
A 33-year-old woman presents at 28 weeks with fever, uterine tenderness, and foul-smelling discharge. What is the next best step?
Broad-spectrum antibiotics are indicated in cases of chorioamnionitis.
34 / 50
A 35-year-old woman presents with heavy bleeding and severe pelvic pain. Ultrasound reveals a mass in the uterine wall. What is the most likely diagnosis?
Uterine fibroids can cause heavy bleeding and pelvic pain and are visible on ultrasound.
35 / 50
A 30-year-old woman at 36 weeks gestation presents with swelling, headache, and proteinuria. What is the diagnosis?
Preeclampsia is diagnosed with hypertension and proteinuria after 20 weeks gestation.
36 / 50
A 32-year-old woman at 30 weeks presents with vaginal bleeding and abdominal pain. Ultrasound shows a retroplacental clot. What is the diagnosis?
Abruptio placentae involves placental separation and bleeding, often seen as a retroplacental clot on ultrasound.
37 / 50
A 34-year-old woman with a history of cesarean section presents with severe abdominal pain and loss of fetal station during labor. What is the diagnosis?
Uterine rupture is a complication of previous C-sections and presents with severe pain and loss of fetal station.
38 / 50
A 22-year-old woman at 10 weeks presents with vaginal bleeding and cramping. Ultrasound shows an intrauterine pregnancy with a closed cervix. What is the diagnosis?
A missed abortion refers to an intrauterine pregnancy that has ceased to develop without passing tissue.
39 / 50
A 30-year-old woman presents with vaginal spotting and cramping at 10 weeks. Ultrasound shows an empty gestational sac. What is the diagnosis?
An anembryonic pregnancy (blighted ovum) is when an empty gestational sac is present without an embryo.
40 / 50
A 35-year-old woman presents with severe nausea, vomiting, and weight loss at 14 weeks. Labs show ketonuria. What is the most likely diagnosis?
Hyperemesis gravidarum involves severe nausea and vomiting with dehydration and weight loss in early pregnancy.
41 / 50
A 26-year-old woman presents with pelvic pain, a history of infertility, and dyspareunia. What is the most likely diagnosis?
Endometriosis commonly presents with chronic pelvic pain, dyspareunia, and infertility.
42 / 50
A 30-year-old woman presents with lower abdominal pain, fever, and cervical motion tenderness. What is the most likely diagnosis?
PID presents with lower abdominal pain, fever, and cervical motion tenderness due to an upper genital tract infection.
43 / 50
A 33-year-old woman at 28 weeks presents with hypertension, proteinuria, and elevated liver enzymes. What is the diagnosis?
HELLP syndrome is diagnosed with hemolysis, elevated liver enzymes, and low platelets in a hypertensive pregnant woman.
44 / 50
A 28-year-old woman at 32 weeks presents with decreased fetal movement. What is the next best step?
45 / 50
A 35-year-old woman at 36 weeks presents with new-onset hypertension and 3+ proteinuria. What is the most likely diagnosis?
Preeclampsia is defined by hypertension and proteinuria after 20 weeks gestation.
46 / 50
A 30-year-old woman presents with severe abdominal pain and signs of shock after a C-section 2 years ago. What is the most likely cause?
Uterine rupture can occur after a previous C-section and presents with severe pain and shock.
47 / 50
A 28-year-old woman with a history of DVT presents at 24 weeks gestation. What is the safest anticoagulant during pregnancy?
LMWH is the preferred anticoagulant during pregnancy due to its safety profile.
48 / 50
A 24-year-old woman at 30 weeks presents with vaginal bleeding and an ultrasound showing placenta covering the cervical os. What is the most likely diagnosis?
Placenta previa involves the placenta covering the cervix and causing painless vaginal bleeding.
49 / 50
A 33-year-old woman at 32 weeks presents with contractions and cervical dilation of 3 cm. What is the diagnosis?
Preterm labor is diagnosed when regular contractions lead to cervical dilation before 37 weeks.
50 / 50
A 35-year-old woman at 38 weeks presents with painless vaginal bleeding. What is the most likely cause?
Placenta previa presents with painless vaginal bleeding in the late second or third trimester.
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