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Section V: Review Questions and Answers
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(92) A 29-year-old G1P0 presents to L & D after 3 hours of painful contractions occurring every 3 minutes Her initial cervical examination on the floor was 5/80%/ 2 Two hours later, no change is noted An IUPC is placed and her contractions are found to have 250 Montevideo units over the next 2 hours What is the most appropriate diagnosis (a) Normal latent labor (b) Arrest of labor (c) Protraction of labor (d) Inadequate contractions (93) An ultrasound is preformed at a 28-week prenatal visit, the fetus is found to be in breech presentation with its hips and knees flexed What type of breech presentation is this (a) Frank breech (b) Complete breech (c) Footling breech (94) For the above patient, which of the following are appropriate management options (a) Cesarean delivery (b) External cephalic version (c) Vaginal delivery (d) All of the above (95) A G2P1001 is in active labor with her last cervical examination 2 hours prior of 3/90%/ 1 You begin to notice decelerations on the monitor The decelerations rapidly drop approximately 20 bpm below baseline, quickly return to baseline, and appear unrelated to uterine contractions What causes this type of deceleration (a) Fetal scalp compression (b) Uteroplacental insufficiency
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11: Review Questions and Answers
(c) Umbilical cord compression (d) Fetal acidosis (96) The amniotic membranes in the above patient are artificially ruptured in order to accelerate labor The fluid is noted to be clear with a slightly greenish tint What is the fetus at risk of (a) Renal failure (b) Conjunctivitis (c) Toxoplasmosis (d) Chemical pneumonitis (97) Which method is used to reliably diagnose fetal alcohol syndrome prenatally (a) Cannot be diagnosed prenatally (b) Ultrasound (c) Amniocentesis (d) History of heavy alcohol consumption (98) A neonate who was born preterm is found to have hyperbilirubinemia Which antibiotic was most likely given to the mother near delivery (a) Cephalosporins (b) Macrolides (c) Penicillins (d) Sulfonamides (99) Which of the following antiviral drugs used to treat HIV infection is teratogenic (a) Zidovudine (b) Amprenavir (c) Didanosine (DDI) (d) None of the above Answer: d Answer: d Answer: a Answer: d
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(100) The double-bubble sign is an ultrasonographic finding of which of the following anomalies (a) Aqueductal stenosis (b) Cystic hygroma (c) Duodenal atresia (d) Two-vessel umbilical cord (101) A 23 year old GO presents to your office for an annual exam Her Pap comes back as ASCUS She has never had any other abnormal Pap smears Which of the following management options could you do (a) Repeat Pap in 6 12 months (b) Send a reflex HPV and triage based on those results (c) Send patient directly to colposcopy (d) All of the above
Answer: c
Answer: d
(102) A 32 year old female presents to the Answer: b ED with vaginal bleeding Her LMP was 4 weeks ago and her bhCG is 1200 An ultrasound is done and no intrauterine pregnancy is seen Her cevix is closed and the bleeding resolves Which of the following management options is most appropriate (a) Immediate laparoscopy for a presumed ectopic pregnancy (b) Repeat serum bhCG in 48 hours (c) Discharge home with prenatal follow up in 4 weeks (d) Dilation & curretage for missed abortion (103) Which of the following characteristics on US is most suspicious for malignancy when evaluating an ovarian mass (a) Size < 6 cm (b) Unilocular mass Answer: c
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(c) Complex mass (d) Minimal flow on Doppler (104) A 33 year old GIPO presents to L & D in labor She progresses to the second stage of labor and pushes for 3 hours with an epidural The decision is made to apply a vacuum as the fetal station is +3 The vacuum pops off 3 times Which of the following management options is most appropriate (a) Reapply to vacuum and reattempt delivery (b) Apply forceps (c) Immediate cesarean delivery (d) All of the above are appropriate (105) A 28-year-old patient presents to you with symptoms of a leiomyoma Which set of symptoms is most consistent with a leiomyoma (a) Hirsutism, acne, amenorrhea, virulization (b) Pelvic pain, dyspareunia, urinary incontinence, menorrhagia (c) Dysmenorrhea, dyspareunia, infertility, painful defecation (106) What disease is most associated with the symptoms listed under option (c) in the above question (a) Pelvic inflammatory disease (b) Endometriosis (c) Uterine sarcoma Answer: b Answer: b Answer: c
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