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  #1  
Old 03-07-2016
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Default OB GYN form 4 clinical mastery

a 23 year old primigravid woman at 33 weeks gestation is admitted to the hospital b/c she has not felt fetal movement for 2 day. Pregnancy had been uncomplicated. She has no history of serious illness. Her sister had 3 spontaneous abortions The patient's temp is 37C, pulse 80/min, BP 110/60. Examination shows a soft uterus consistent in size w/ a 33-week gestation. Fundal height is 34cm. Fetal heart tones cannot be auscultated. Ultrasonography confirms intrauterine fetal demise. Labarotory studies show the patient to be a homozygote for the factor V Leiden mutation. Thrombosis of which of the following is the most likely cause of the fetal demise?

a) fetal cerebral arteries
b) fetal ductus arteriosus
c) maternal lower extremity
d) umbilical cord
e) uteroplacental artery

a 32-year-old woman, gravida 5, para 4, at 40 weeks gestation is brought to the emergency department b/c of bright red vaginal bleeding for 1 hr. Contractions have occured every 2 to 3 min for 5hrs. her pregancy had been uncomplicated. ultrasonography at 22 weeks showed no evidence of placenta previa. The physician informs the patient and her husband that emergency cesarean delivery is recommended. The patient and her husband state that, b/c of their religious beliefs, the elders of their church must agree to a surgical delivery before they can give their consent. Which of the following is the most appropriate course of action?

a) Ask the patient to convene a meeting of the church elders to discuss cesarean delivery
b) transfer the patient to another physician
c) appoint a guardian ad litem for the fetus to consent to cesarean delivery
d) obtain approval from the hospital administrator to perform emergency cesarean delivery.
e) obtain approval from the pediatric staff to perform emergency cesarean delivery

a 32 year old primigravid woman at 10 weeks gestation comes for her first prenatal visit. She has a history of two to three seizures yearly, but she has had two seizures over the past 2 weeks. Medications include phenytoin. Examination shows uterus consistent in size w/ a 10-week gestation. Her serum phenytoin concentration is 5 ug/mL (N=10-20) which of the following is the most appropriate next step in management?

a) routine prenatal care
b) adding valproic acid to the medication regimen
c) increasing her current anticonvulsant medication
d) switching to carbamazepine
e) termination of the pregnancy

a 27 year old woman who is a long-distance runner comes to the physician b/c of a 1-month history of postcoital spotting lasting 1 to 2 days. Menses have occurred at regular intervals since menarche at the age of 14 years. she underwent a bilateral tubal ligation 9 months ago. She is sexually active w/ a new partner. Which of the following is the most likely diagnosis?

a) blood dyscrasia
b) broad-ligament leiomyomata uteri
c) cervicitis
d) exercise-related menstrual irregularity
e) ovarian cancer
f) pcos
g) pregnancy
H) premature ovarian failure
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  #2  
Old 03-09-2016
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How long will it take to finish all subjects in Kaplan except pathology?
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  #3  
Old 03-09-2016
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Quote:
Originally Posted by gandulo View Post
How long will it take to finish all subjects in Kaplan except pathology?
depends how fast you go
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  #4  
Old 03-14-2016
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Quote:
Originally Posted by chiefcomplaint View Post
a 23 year old primigravid woman at 33 weeks gestation is admitted to the hospital b/c she has not felt fetal movement for 2 day. Pregnancy had been uncomplicated. She has no history of serious illness. Her sister had 3 spontaneous abortions The patient's temp is 37C, pulse 80/min, BP 110/60. Examination shows a soft uterus consistent in size w/ a 33-week gestation. Fundal height is 34cm. Fetal heart tones cannot be auscultated. Ultrasonography confirms intrauterine fetal demise. Labarotory studies show the patient to be a homozygote for the factor V Leiden mutation. Thrombosis of which of the following is the most likely cause of the fetal demise?

a) fetal cerebral arteries
b) fetal ductus arteriosus
c) maternal lower extremity
d) umbilical cord
e) uteroplacental artery

a 32-year-old woman, gravida 5, para 4, at 40 weeks gestation is brought to the emergency department b/c of bright red vaginal bleeding for 1 hr. Contractions have occured every 2 to 3 min for 5hrs. her pregancy had been uncomplicated. ultrasonography at 22 weeks showed no evidence of placenta previa. The physician informs the patient and her husband that emergency cesarean delivery is recommended. The patient and her husband state that, b/c of their religious beliefs, the elders of their church must agree to a surgical delivery before they can give their consent. Which of the following is the most appropriate course of action?

a) Ask the patient to convene a meeting of the church elders to discuss cesarean delivery
b) transfer the patient to another physician
c) appoint a guardian ad litem for the fetus to consent to cesarean delivery
d) obtain approval from the hospital administrator to perform emergency cesarean delivery.
e) obtain approval from the pediatric staff to perform emergency cesarean delivery

a 32 year old primigravid woman at 10 weeks gestation comes for her first prenatal visit. She has a history of two to three seizures yearly, but she has had two seizures over the past 2 weeks. Medications include phenytoin. Examination shows uterus consistent in size w/ a 10-week gestation. Her serum phenytoin concentration is 5 ug/mL (N=10-20) which of the following is the most appropriate next step in management?

a) routine prenatal care
b) adding valproic acid to the medication regimen
c) increasing her current anticonvulsant medication
d) switching to carbamazepine
e) termination of the pregnancy

a 27 year old woman who is a long-distance runner comes to the physician b/c of a 1-month history of postcoital spotting lasting 1 to 2 days. Menses have occurred at regular intervals since menarche at the age of 14 years. she underwent a bilateral tubal ligation 9 months ago. She is sexually active w/ a new partner. Which of the following is the most likely diagnosis?

a) blood dyscrasia
b) broad-ligament leiomyomata uteri
c) cervicitis
d) exercise-related menstrual irregularity
e) ovarian cancer
f) pcos
g) pregnancy
H) premature ovarian failure
e) uteroplacental artery
a) ask the pt to convene a meeting
c) increasing her dose of anticonvulsant
c) cervicitis
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  #5  
Old 03-18-2016
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Quote:
Originally Posted by chiefcomplaint View Post
a 23 year old primigravid woman at 33 weeks gestation is admitted to the hospital b/c she has not felt fetal movement for 2 day. Pregnancy had been uncomplicated. She has no history of serious illness. Her sister had 3 spontaneous abortions The patient's temp is 37C, pulse 80/min, BP 110/60. Examination shows a soft uterus consistent in size w/ a 33-week gestation. Fundal height is 34cm. Fetal heart tones cannot be auscultated. Ultrasonography confirms intrauterine fetal demise. Labarotory studies show the patient to be a homozygote for the factor V Leiden mutation. Thrombosis of which of the following is the most likely cause of the fetal demise?

a) fetal cerebral arteries
b) fetal ductus arteriosus
c) maternal lower extremity
d) umbilical cord
e) uteroplacental artery

Correct answer is EE

a 32-year-old woman, gravida 5, para 4, at 40 weeks gestation is brought to the emergency department b/c of bright red vaginal bleeding for 1 hr. Contractions have occured every 2 to 3 min for 5hrs. her pregancy had been uncomplicated. ultrasonography at 22 weeks showed no evidence of placenta previa. The physician informs the patient and her husband that emergency cesarean delivery is recommended. The patient and her husband state that, b/c of their religious beliefs, the elders of their church must agree to a surgical delivery before they can give their consent. Which of the following is the most appropriate course of action?

a) Ask the patient to convene a meeting of the church elders to discuss cesarean delivery
b) transfer the patient to another physician
c) appoint a guardian ad litem for the fetus to consent to cesarean delivery
d) obtain approval from the hospital administrator to perform emergency cesarean delivery.
e) obtain approval from the pediatric staff to perform emergency cesarean delivery


Correct answer is AA


a 27 year old woman who is a long-distance runner comes to the physician b/c of a 1-month history of postcoital spotting lasting 1 to 2 days. Menses have occurred at regular intervals since menarche at the age of 14 years. she underwent a bilateral tubal ligation 9 months ago. She is sexually active w/ a new partner. Which of the following is the most likely diagnosis?

a) blood dyscrasia
b) broad-ligament leiomyomata uteri
c) cervicitis
d) exercise-related menstrual irregularity
e) ovarian cancer
f) pcos
g) pregnancy
H) premature ovarian failure

Correct answer is CC
Answers are below each question in red font.
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  #6  
Old 03-18-2016
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Quote:
Originally Posted by Sowji yenigalla View Post
e) uteroplacental artery
a) ask the pt to convene a meeting
c) increasing her dose of anticonvulsant
c) cervicitis
Didn't see you already answered
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Old 03-18-2016
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Didn't see you already answered
hey its fine
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  #8  
Old 03-20-2016
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Here are some additional ones I missed. Any help with the correct answers is much appreciated!

-21yo primigravida @41wks is admitted in labor. Uncomplicated pregnancy. Contractions every 3min. Cervix 100% effaced, 4cm dilated, vertex +1. Membranes rupture yielding moderately thick meconium stained fluid. Fetal HR baseline of 130/min with variable decelerations lasting 45s and decreasing to 60/min. Most appropriate next step in management.
A)External cephalic version
B)Forceps
C)Amnioinfusion
D)Amniocentesis
E)Cordo centesis

-27yo G3P3 has sudden onset severe, sharp pain in RLQ, pain in right shoulder, light headedness, nausea, and rectal pressure 6hrs ago. Uses diaphragm for contraception, LMP 24 days ago. BP=120/70, pulse=80 with no orthostatic changes. There is moderate tenderness of RLQ without guarding or rebound, bowel sounds active. Culdocentesis shows 15ml of non clotting, serosanguineous fluid with a hematocrit of 5%. Pregnancy test negative. Most likely diagnosis?
A) Adenomyosis, B) Adnexal torsion, C) Appendicitis, D) Diverticulitis, E) Ectopic preg, F) Endometriosis, G) Endometritis, H) IBD, I) Leiomomata uteri, J) Ovarian carcinoma, K) PID, L) Primary dysmenorrhea, M) Renal calculus, N) Ruptured corpus luteum cyst, O) Spontaneous abortion

-42yo with 3mo hx of urinary urgency and frequency and occasional incontinence and a 2mo hx of numbness below her waist. Gets up 3x/night to void. Has not had fever, pain with urination, or cloudy urine. She has MS, symptoms have included double vision 10 years ago, and right leg weakness 3 years ago. Sensation to vibration is decreased over both feet. DTRs are 3+ at the knees. UA is within normal limits. Her postpaid residual volume is 45ml. Which of the following is the most likely cause of the pt's urinary findings?
A) Detrusor hyperreflexia
B) Detrusor hypotonia
C) External sphincter hyperactivity
D) External sphincter incompetence
E) Overflow incontinence secondary to bladder outlet obstruction

- An asymptomatic 52yo nulligravid woman comes for routine health maintenance. Her last visit was 4yr ago. Menses occur at regular 30day intervals with no bleeding between menses. She smoked 1ppd, but quit 5years ago; drinks 1-2 glasses of wine per week. In addition to PAP smear mammography, and cholesterol testing, which of the following is most appropriate?
A) Chest Xray
B) Pelvic ultrasound
C) Sputum cytology
D) Bone densitometry
E) Colonoscopy

-A 36yo G2P1 @41wks has had ruptured membranes without contractions for 8hrs. Her first infant weighed 9 pounds 12 oz at birth. This pregnancy has been uncomplicated except for gestational diabetes which was diagnosed at 26wks and is well controlled with diet. Fundal height 40cm. Estimated fetal weight is 8 pounds 3oz. Cervix is 2cm dilated and 50% effaced. Fetal HR is within normal limits. Labor is induced with IV oxytocin. 4hrs later her cervix is 4cm dilated and completely effaced. Continuous epidural anesthesia is administered. 2hrs later the fetal HR demonstrates late decelerations with each contraction. The contractions occur every minute, last 45s, and are 75mmHg at their peak. Which of the following is the most likely explanation for this pattern?
A) Epidural anesthesia
B) Fetal macrosomia
C) Gestational diabetes
D) Oxytocin administration
E) Postdates pregnancy
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  #9  
Old 04-07-2016
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- An asymptomatic 52yo nulligravid woman comes for routine health maintenance. Her last visit was 4yr ago. Menses occur at regular 30day intervals with no bleeding between menses. She smoked 1ppd, but quit 5years ago; drinks 1-2 glasses of wine per week. In addition to PAP smear mammography, and cholesterol testing, which of the following is most appropriate?
A) Chest Xray
B) Pelvic ultrasound
C) Sputum cytology
D) Bone densitometry
E) Colonoscopy

got this one right
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  #10  
Old 04-09-2016
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Is kaplan good enough for gynae?
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  #11  
Old 04-14-2016
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Quote:
Originally Posted by ManUtd View Post
Is kaplan good enough for gynae?
i personally dont recommend kaplan. it's just unnecessarily too difficult, to the point where it picks out "too" subtle details that wont come out on the exam. if it's too difficult or overly detailed then you forget about the main "high-yield" topic that you should be learning. i recommend going through the usmleRX qbank or the clinical mastery NBME series for OB/GYN and reviewing that. I
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  #12  
Old 04-26-2016
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uworld is probably the best qbank that has answers for ob/gyn however I would do more q's from other banks if you have the time to get a better grasp on the subject matter. good luck!
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  #13  
Old 04-27-2016
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Quote:
Originally Posted by Sowji yenigalla View Post
e) uteroplacental artery
a) ask the pt to convene a meeting
c) increasing her dose of anticonvulsant
c) cervicitis
I marked same answers except (c) increasing her dose of phenytoin becoz it has many adverse effects that's y I was thnkng about option (A)
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Old 04-27-2016
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Quote:
Originally Posted by awal View Post
Here are some additional ones I missed. Any help with the correct answers is much appreciated!

-21yo primigravida @41wks is admitted in labor. Uncomplicated pregnancy. Contractions every 3min. Cervix 100% effaced, 4cm dilated, vertex +1. Membranes rupture yielding moderately thick meconium stained fluid. Fetal HR baseline of 130/min with variable decelerations lasting 45s and decreasing to 60/min. Most appropriate next step in management.
E)Cordo centesis

-27yo G3P3 has sudden onset severe, sharp pain in RLQ, pain in right shoulder, light headedness, nausea, and rectal pressure 6hrs ago. Uses diaphragm for contraception, LMP 24 days ago. BP=120/70, pulse=80 with no orthostatic changes. There is moderate tenderness of RLQ without guarding or rebound, bowel sounds active. Culdocentesis shows 15ml of non clotting, serosanguineous fluid with a hematocrit of 5%. Pregnancy test negative. Most likely diagnosis?
K) PID

-42yo with 3mo hx of urinary urgency and frequency and occasional incontinence and a 2mo hx of numbness below her waist. Gets up 3x/night to void. Has not had fever, pain with urination, or cloudy urine. She has MS, symptoms have included double vision 10 years ago, and right leg weakness 3 years ago. Sensation to vibration is decreased over both feet. DTRs are 3+ at the knees. UA is within normal limits. Her postpaid residual volume is 45ml. Which of the following is the most likely cause of the pt's urinary findings?

B) Detrusor hypotonia

- An asymptomatic 52yo nulligravid woman comes for routine health maintenance. Her last visit was 4yr ago. Menses occur at regular 30day intervals with no bleeding between menses. She smoked 1ppd, but quit 5years ago; drinks 1-2 glasses of wine per week. In addition to PAP smear mammography, and cholesterol testing, which of the following is most appropriate?

E) Colonoscopy

-A 36yo G2P1 @41wks has had ruptured membranes without contractions for 8hrs. Her first infant weighed 9 pounds 12 oz at birth. This pregnancy has been uncomplicated except for gestational diabetes which was diagnosed at 26wks and is well controlled with diet. Fundal height 40cm. Estimated fetal weight is 8 pounds 3oz. Cervix is 2cm dilated and 50% effaced. Fetal HR is within normal limits. Labor is induced with IV oxytocin. 4hrs later her cervix is 4cm dilated and completely effaced. Continuous epidural anesthesia is administered. 2hrs later the fetal HR demonstrates late decelerations with each contraction. The contractions occur every minute, last 45s, and are 75mmHg at their peak. Which of the following is the most likely explanation for this pattern?

A) Epidural anesthesia
I am not sure about all answers but i tried to solve it according to ofline uw 2015 version
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Old 04-30-2016
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Quote:
Originally Posted by krishna_3228 View Post
I marked same answers except (c) increasing her dose of phenytoin becoz it has many adverse effects that's y I was thnkng about option (A)

phenytoin associated with fetal hydantoin syndrome: midifacial hypoplaisa,microchephaly,cleft lip and palate,digital hypoplasia,hirustism,development delay.
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  #16  
Old 05-29-2016
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detrusor hypotonia is incorrect
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Old 06-10-2016
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Quote:
Originally Posted by awal View Post
Here are some additional ones I missed. Any help with the correct answers is much appreciated!

-21yo primigravida @41wks is admitted in labor. Uncomplicated pregnancy. Contractions every 3min. Cervix 100% effaced, 4cm dilated, vertex +1. Membranes rupture yielding moderately thick meconium stained fluid. Fetal HR baseline of 130/min with variable decelerations lasting 45s and decreasing to 60/min. Most appropriate next step in management.
A)External cephalic version
B)Forceps
C)Amnioinfusion
D)Amniocentesis
E)Cordo centesis(wrong)

looked it up and found that if meconium is present during labor we should administer amnioinfusion therapy to reduce fetal distress & risk of MAS

-27yo G3P3 has sudden onset severe, sharp pain in RLQ, pain in right shoulder, light headedness, nausea, and rectal pressure 6hrs ago. Uses diaphragm for contraception, LMP 24 days ago. BP=120/70, pulse=80 with no orthostatic changes. There is moderate tenderness of RLQ without guarding or rebound, bowel sounds active. Culdocentesis shows 15ml of non clotting, serosanguineous fluid with a hematocrit of 5%. Pregnancy test negative. Most likely diagnosis?
A) Adenomyosis, B) Adnexal torsion, C) Appendicitis, D) Diverticulitis, E) Ectopic preg, F) Endometriosis, G) Endometritis, H) IBD, I) Leiomomata uteri, J) Ovarian carcinoma, K) PID, L) Primary dysmenorrhea, M) Renal calculus, N) Ruptured corpus luteum cyst, O) Spontaneous abortion

-42yo with 3mo hx of urinary urgency and frequency and occasional incontinence and a 2mo hx of numbness below her waist. Gets up 3x/night to void. Has not had fever, pain with urination, or cloudy urine. She has MS, symptoms have included double vision 10 years ago, and right leg weakness 3 years ago. Sensation to vibration is decreased over both feet. DTRs are 3+ at the knees. UA is within normal limits. Her postpaid residual volume is 45ml. Which of the following is the most likely cause of the pt's urinary findings?
A) Detrusor hyperreflexia
B) Detrusor hypotonia
C) External sphincter hyperactivity
D) External sphincter incompetence
E) Overflow incontinence secondary to bladder outlet obstruction

wasn't among incorrect

- An asymptomatic 52yo nulligravid woman comes for routine health maintenance. Her last visit was 4yr ago. Menses occur at regular 30day intervals with no bleeding between menses. She smoked 1ppd, but quit 5years ago; drinks 1-2 glasses of wine per week. In addition to PAP smear mammography, and cholesterol testing, which of the following is most appropriate?
A) Chest Xray
B) Pelvic ultrasound
C) Sputum cytology
D) Bone densitometry
E) Colonoscopy

-A 36yo G2P1 @41wks has had ruptured membranes without contractions for 8hrs. Her first infant weighed 9 pounds 12 oz at birth. This pregnancy has been uncomplicated except for gestational diabetes which was diagnosed at 26wks and is well controlled with diet. Fundal height 40cm. Estimated fetal weight is 8 pounds 3oz. Cervix is 2cm dilated and 50% effaced. Fetal HR is within normal limits. Labor is induced with IV oxytocin. 4hrs later her cervix is 4cm dilated and completely effaced. Continuous epidural anesthesia is administered. 2hrs later the fetal HR demonstrates late decelerations with each contraction. The contractions occur every minute, last 45s, and are 75mmHg at their peak. Which of the following is the most likely explanation for this pattern?
A) Epidural anesthesia
B) Fetal macrosomia
C) Gestational diabetes
D) Oxytocin administration
E) Postdates pregnancy

Uterine hyperstimulation in this patient presents with late deceleration
answers above
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Old 07-17-2016
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Can somebody help me with these questions? Got my shelf coming up in a few days. Thanks!


1) A 32 yo primigravid woman at 10 wks gestation comes for her first prenatal visit. She has a hx of 2-3 seizures yearly, but she has had two seizures over the past 2 weeks. Medications include phenytoin. Examination shows a uterus consistent in size w/ a 10wk gestation. Her serum phenytoin concentration is 5ug/mL (N=10-20). Which of the following is the most appropriate next step in management?

a) Routine prenatal care (incorrect)
b) Adding valproic acid to the medication regimen
c) Increasing her current anticonvulsant medication
d) Switching to cabamazepine
e) Termination of the pregnancy


2) A 27yo primigravid woman at 37wks gestation is admitted to hte hospital in labor after an uncomplicated pregnancy. Fetal heart tones are reactive. Spontaneous rupture of membranes occurs with moderate blood-stained fluid, followed by a deep, persistent fetal heart bradycardia. The uterus is soft and nontender. The cervix is 3cm dilated; there is a vertext presentation. Which of the following is the most likely diagnosis?

a) Abruption
b) Cervical cancer
c) cervical polyp
d) ectopic pregnancy
e) hydatidiform mole
f) incomplete abortion
g) placenta previa (incorrect)
h) ruptured uterus
i) threatened abortion
j) vasa previa


3) A previously healthy 39yo woman at 38wks gestation comes to the ED 2hrs after the onset of acute pain in the left hemithorax. She says that the pain is exacerbated by breathing. Her temp is 38.2C, pulse 120, RR 24/min, and BP 110/70. Fetal heart tones are 170/min. Examination shows no abnormalities. An x-ray of the chest shows no abnormalities. An ECG shows nonspecific changes. Arterial blood gas analysis on room air shows: pH 7.43, PCO2 35mm Hg, PO2 70mmHg.

Which of the following is the most likely diagnosis?

a) Angina pectoris
b) Costochondritis (incorrect)
c) Myocardial infarction
d) PE
e) viral pneumonia
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Old 08-29-2016
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-21yo primigravida @41wks is admitted in labor. Uncomplicated pregnancy. Contractions every 3min. Cervix 100% effaced, 4cm dilated, vertex +1. Membranes rupture yielding moderately thick meconium stained fluid. Fetal HR baseline of 130/min with variable decelerations lasting 45s and decreasing to 60/min. Most appropriate next step in management.
A)External cephalic version
B)Forceps
C)Amnioinfusion
D)Amniocentesis
E)Cordo centesis(wrong)

I got this one right - emergency with a +1 station = forceps for vacuum delivery (B)
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  #20  
Old 08-29-2016
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Quote:
Originally Posted by awal View Post
Here are some additional ones I missed. Any help with the correct answers is much appreciated!

-21yo primigravida @41wks is admitted in labor. Uncomplicated pregnancy. Contractions every 3min. Cervix 100% effaced, 4cm dilated, vertex +1. Membranes rupture yielding moderately thick meconium stained fluid. Fetal HR baseline of 130/min with variable decelerations lasting 45s and decreasing to 60/min. Most appropriate next step in management.
A)External cephalic version
B)Forceps
C)Amnioinfusion
D)Amniocentesis
E)Cordo centesis

-27yo G3P3 has sudden onset severe, sharp pain in RLQ, pain in right shoulder, light headedness, nausea, and rectal pressure 6hrs ago. Uses diaphragm for contraception, LMP 24 days ago. BP=120/70, pulse=80 with no orthostatic changes. There is moderate tenderness of RLQ without guarding or rebound, bowel sounds active. Culdocentesis shows 15ml of non clotting, serosanguineous fluid with a hematocrit of 5%. Pregnancy test negative. Most likely diagnosis?
A) Adenomyosis, B) Adnexal torsion, C) Appendicitis, D) Diverticulitis, E) Ectopic preg, F) Endometriosis, G) Endometritis, H) IBD, I) Leiomomata uteri, J) Ovarian carcinoma, K) PID, L) Primary dysmenorrhea, M) Renal calculus, N) Ruptured corpus luteum cyst, O) Spontaneous abortion

-42yo with 3mo hx of urinary urgency and frequency and occasional incontinence and a 2mo hx of numbness below her waist. Gets up 3x/night to void. Has not had fever, pain with urination, or cloudy urine. She has MS, symptoms have included double vision 10 years ago, and right leg weakness 3 years ago. Sensation to vibration is decreased over both feet. DTRs are 3+ at the knees. UA is within normal limits. Her postpaid residual volume is 45ml. Which of the following is the most likely cause of the pt's urinary findings?
A) Detrusor hyperreflexia
B) Detrusor hypotonia
C) External sphincter hyperactivity
D) External sphincter incompetence
E) Overflow incontinence secondary to bladder outlet obstruction

- An asymptomatic 52yo nulligravid woman comes for routine health maintenance. Her last visit was 4yr ago. Menses occur at regular 30day intervals with no bleeding between menses. She smoked 1ppd, but quit 5years ago; drinks 1-2 glasses of wine per week. In addition to PAP smear mammography, and cholesterol testing, which of the following is most appropriate?
A) Chest Xray
B) Pelvic ultrasound
C) Sputum cytology
D) Bone densitometry
E) Colonoscopy

-A 36yo G2P1 @41wks has had ruptured membranes without contractions for 8hrs. Her first infant weighed 9 pounds 12 oz at birth. This pregnancy has been uncomplicated except for gestational diabetes which was diagnosed at 26wks and is well controlled with diet. Fundal height 40cm. Estimated fetal weight is 8 pounds 3oz. Cervix is 2cm dilated and 50% effaced. Fetal HR is within normal limits. Labor is induced with IV oxytocin. 4hrs later her cervix is 4cm dilated and completely effaced. Continuous epidural anesthesia is administered. 2hrs later the fetal HR demonstrates late decelerations with each contraction. The contractions occur every minute, last 45s, and are 75mmHg at their peak. Which of the following is the most likely explanation for this pattern?
A) Epidural anesthesia
B) Fetal macrosomia
C) Gestational diabetes
D) Oxytocin administration
E) Postdates pregnancy

Medscape - most common uro finding in MS is detrusor hyperreflexia
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  #21  
Old 08-29-2016
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[QUOTE=marc2124;1238937]-21yo primigravida @41wks is admitted in labor. Uncomplicated pregnancy. Contractions every 3min. Cervix 100% effaced, 4cm dilated, vertex +1. Membranes rupture yielding moderately thick meconium stained fluid. Fetal HR baseline of 130/min with variable decelerations lasting 45s and decreasing to 60/min. Most appropriate next step in management.
A)External cephalic version
B)Forceps
C)Amnioinfusion
D)Amniocentesis
E)Cordo centesis(wrong)
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  #22  
Old 08-29-2016
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Quote:
Originally Posted by chiefcomplaint View Post
i personally dont recommend kaplan. it's just unnecessarily too difficult, to the point where it picks out "too" subtle details that wont come out on the exam. if it's too difficult or overly detailed then you forget about the main "high-yield" topic that you should be learning. i recommend going through the usmleRX qbank or the clinical mastery NBME series for OB/GYN and reviewing that. I
is it good enough
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  #23  
Old 12-04-2016
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Quote:
Originally Posted by marc2124 View Post
-21yo primigravida @41wks is admitted in labor. Uncomplicated pregnancy. Contractions every 3min. Cervix 100% effaced, 4cm dilated, vertex +1. Membranes rupture yielding moderately thick meconium stained fluid. Fetal HR baseline of 130/min with variable decelerations lasting 45s and decreasing to 60/min. Most appropriate next step in management.
A)External cephalic version
B)Forceps
C)Amnioinfusion
D)Amniocentesis
E)Cordo centesis(wrong)

I got this one right - emergency with a +1 station = forceps for vacuum delivery (B)
I put forceps and got it wrong :P
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  #24  
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Hi Boricua27,

Do you have the offline forms and comments? I would appreciate if you can forward it to me.
sergiomed2@hotmail.com
Thanks
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