Step 2-Ob/Gyne

Mr. Histamine

Answer the questions below and then click "submit" to send your answers.

  1. 37 year old G2P2 patient comes in to clinic with bilateral nipple discharge, non-bloody, clear. Pt has no past medical history. Pt's mother died of breast Ca. Lilkely diagnosis?

    2. Your answer:
    Prolactinoma.
    Fibrocystic Disease
    Breast Ca
    Staph cellulitis

  2. What is the DOC/treatment in the case?

    3. Your answer:
    Mastectomy
    Bromocriptine
    Pen G
    Breast biopsy

  3. 23 year old primagravid female delivers pre-mature neonate. Has history of drug abuse, diabetes, and STD. Past has bleeding after delivery. Postpartum hemorrhage of a patient with LGA neonate is due to.

    4. Your answer:
    Cocaine induced hemorrhage
    Placenta Abrupto
    Gestational DM
    Uterine Atony.

  4. A couple has a history of infertility for 3 years. Wife has 2 kids from previous marraige. Wife has history of miscarrige. The husband had mumps when he was a child. Next step in management?

    5. Your answer:
    Pelvic Ultrasound
    Invitro fertilization
    Semen analysis-Male Factor
    Chomosome analysis

  5. 42 year old drug drug abuser delivers neoonate with meningomyelocele. What could have prevented this?

    6. Your answer:
    Chromosome analysis
    Folate
    Amniocentesis at 16 weeks
    Regular pre natal check ups

  6. 32 year old female comes in clinic for normal prenatal bloodwork. Everything is within normal limits except positive titers for HbsAg. What is the management for the neonate after birth?

    7. Your answer:
    Hepatitis Vaccine at 6 months plus HBIG at birth.
    Hepatitis Vaccine at 0, 1, and 6 months plus HBIG at birth.
    HBIG at birth.
    Hepatitis Vaccine at 0, 1, and 6 months

  7. 25 year old drug abuser delivers normal neonate. HIV+ mother on AZT during pregnancy. Mgmnt for neonate?

    8. Your answer:
    AZT for first 6 years of life until undetectable HIV titers
    AZT for 6 months.
    AZT only after reactive Southern Blot test for neonate
    AZT for 6 weeks

  8. A 23 year old privagravid comes into ER complaining of painful vaginal bleeding after lifting a box of books. The pt has history of STD and marijuana abuse. Upon PE you feel her uterus hard as a rock. What is the diagnosis?

    9. Your answer:
    Cervical Ca
    Placenta Previa
    Drug induced hemorrhage
    Placenta Abruptio

  9. 23 year old fashion model delivers neonate w/ facial palsy, deafness, heart defects. Cause?

    10. Your answer:
    Isotretinoin
    Alcohol consumption during pregnancy
    Chromosome anomoly
    Metronidazole

  10. A 19 year old female come into your office and complaints of extreme vaginal pruritus with white discharge. You suspect Candida vaginitis. How to diagnose?

    11. Your answer:
    culture
    Vaginal discharge in saline and 10% KOH
    pap smear
    just treat empirically

  11. A 32 year old single female with multiple sexual partners comes to your office complaining of green vaginal discharge. On P.E. you dicsover strawberry cervix. Upon microscopic investagation you see pear shape organism on wet mount. You suspect Trichomonas. What will your treatment consist of?

    12. Your answer:
    Tetracycline
    Metronidazole
    Pen G
    Mebendizole

  12. A 55 year old G6P5 Pt comes into your office complaining of constipation and urinary incontinence. You suspect rectocele. What is cause of symptoms?

    13. Your answer:
    Uterine atony
    Chrons Disease
    prolapse of rectum into upper anterior vaginal wall
    prolapse of rectum into lower posterior vaginal wall

  13. A 21 year old drug abuser comes into the ER complaining of severe 3rd trimester painful bleeding. What is most likely cause. (abruptio is not an option)

    14. Your answer:
    Placenta Previa
    Ectopic prenancy
    cocaine abuse
    DIC

  14. 16 year old pt comes into your office, accompanied by her parents, complaining of ammenorrhea of 3 months. Upon PE you discover adnexal tenderness and blood in cul-de-sac. You ask her if she has any sexual partners and she denies. What do you suspect?

    15. Your answer:
    Endometritis
    Uterine Fibroma
    Ectopic pregnancy
    Endometriosis

  15. G6P6 70 yo woman comes into your office complaining of vaginal mass of 3 months and recent development of incontinence. What is the reason for mass? (assumed it was a cystocele)43)

    16. Your answer:
    loss of uterine muscle tone
    age
    gravidity
    all of the above

  16. A 21 year old nulligravid comes into ER complianing of server right quadrant pain for 2 days. She denies having any sexual history and is currently on OCD. You suspect endometriosis at the uterosacral ligament. What technique can confirm your diagnosis?

    17. Your answer:
    Pelvic Ultrasound
    serum HCG
    laparoscopy
    CT Scan

  17. A 32 year old G2P1 with Gestational DM delivers big baby. What type of complication is the neonate at risk for?

    18. Your answer:
    DIC
    Diabetic ketoacidosis
    cervical plexus injury.
    mental retardation

  18. A 22 year old pt comes into your office complaining of amenorrhea, She is normal weight and stature but displays no secondary sexual characteristics. Upons PE you discover infantile genitalia. A chromosome study shows that the pt is XX. What is the Diagnosis?

    19. Your answer:
    Kallman's sydrome
    congenital adrenal hyperplasia
    Klinefelter's syndrome
    Turner's syndrome

  19. A female comes into your office complaing of burning, red, unilateral nipple. She just gave birth 2 months ago. You suspect mastitis and give her the proper antibiotics which covers Staph a. She then asks you if it is safe to continue to breat feed. What you do advise her?

    20. Your answer:
    Yes it is safe.
    No. You tell her that you can transfer the infection to her baby.
    You tell her to continue breast feeding after the course of meds
    You tell her to quit breast feeding and start with synthetic milk products.

  20. A 24 year old dancer comes into the ER with vaginal bleeding, abdominal pain. You ask her about her if she's pregnant and she doesn't know. She tells you that she's been on OCD's and practices safe sex. Upon PE you discover dilation of cervix? Dx?

    21. Your answer:
    INEVITABLE ABORTION.
    ENDOMETRIOSIS
    COMPLETED ABORTION
    ECTOPIC PREGNANCY

  21. A 22 year old G1P1 delivers a baby boy diagnosed w/ gestational diabetes. What is the next step in maangagement?

    22. Your answer:
    A GLUCOSE POSTPARTUM TOLERANCE TEST.
    INSULIN
    AGGRESIVE HYDRATION
    NEONATAL GLYCOHEMOGLOBIN (HB H1C)

  22. A 44 year old G4P3 has a MS-AFP test done at 15 weeks gestation . Her results showed a decrease in MS-AFP, this is associated with what?

    23. Your answer:
    NOTHING. THIS IS NORMAL AFP LEVELS FOR 15 WEEKS.
    DOWN’S SYNDROME.
    SPINA BIFIDA
    MENTAL RETARDATION

  23. An infant was born had limb defects. What was the mother most likely taking during her pregnancy?

    24. Your answer:
    PCP
    HERION
    LSD
    COCAINE

  24. A 23 year old college student comes into your office complaining of leg pains. She has one sexual partner for 7 years and is a cheerleader for the football team. She is a moderate alcohol drinker and smokes 1 pack of cigarettes per day. What do you suspect?

    25. Your answer:
    SLE
    DVT from OCD use
    ruptured baker's cyst
    muscle sprain

  25. A 27 year old G1P0 is ready to give birth next week. During her previous pre natal visits you discover that she has positive history of HSV. What will be your suggested route of delivery?

    26. Your answer:
    depends on dse at time of delivery (if lesions are present, do CS)
    CS
    Normal Vaginal delivery

  26. A 15 year old girl comes into your office with her parents. She comes in complaining of vaginal discharge. You suspect STD. Her parents asks you for diagnosis. What do you do?

    27. Your answer:
    treat the pt and tell the parents that she has been treated medically for her condition and suggest they talk to daughter at home.
    treat the pt and tell the parents that the daughter is fine.
    treat the pt and tell the parents she has STD
    do not treat the pt and tell the parents about her STD

  27. 20 year old comes into your office and complains that she never menstruated. She is tall with eunicoid features. Large breasts but no pubic hair. Karyotype XY. Dx? .

    28. Your answer:
    Testicular Feminization
    Turner's Syndrome
    Klinefelter's Syndrome
    Polycystic Ovarian Syndrome

  28. A 55 year old post menopausal woman comes into your office complaining of bleeding for 4 months. She is taking estrogen replacement therapy and has history of abnormal PAP smears. What is the next step in management?

    29. Your answer:
    Vaginal Ultrasound
    Endometrial Biopsy
    Laporascopy
    Conization of cervix

  29. A 29 year old patient comes into ER complaining of left lower quadrant pain. She hasn't had her period in 2 months. You suspect ectopic pregnancy. Which condition can increase likelyhood of ectopic pregnancy?

    30. Your answer:
    Cocaine abuse
    History of preterm
    History of PID
    Multiple sexual partners

  30. A 21 year old pt comes in for pre-natal visit. You disover that she has megaloblastic anemia. You suggest a treament plan to correct the anmeia. What is the most common cause of Megaloblastic anemia during pregnancy?

    31. Your answer:
    Ribroflavin deficiency
    iron deficiency
    folate deficiency
    SLE

  31. A 57 year old women comes into your office complaining of dryness, itching, dypareunia, and occational vaginal bleeding. Inspection of her vagina reveals a dry, think vaginal mucosa with little rugations. You suspect atrophic vaginitis. What is your next step in managment?

    32. Your answer:
    tetracycline for one week
    vaginal biopsy
    vaginal estrogen cream or oral estrogen
    metronidazole, 500mg p bid for 1 week

  32. A 17 year old pt comes into your office seeking relief for recuttent cramping that occurs with her menstrual flow. You suspect primary dysmenorrhea. What is the proposed cause of her pain?

    33. Your answer:
    Prostagladin production
    uterine ishchemia
    unknown
    both a and b

  33. A 30 year old G3P2 woman comes to your office complaining of vaginal bleeding, pressure, and pain. She recently started having constipation. You suspect leiomyoma. What is true about this condition?

    34. Your answer:
    They respond to GnRH analogs
    They occur most frequently after menopause
    These are highly aggresive malignancies
    This is a benign condition which requires no intervention.

  34. What are the contraindications of OCD use?

    35. Your answer:
    thrombophebitis
    Ca of the Breast
    imparied liver function
    all of the above

  35. A 35 year old obese woman comes to your office complaining of ammenorrhea. She says that she is infertile and appears to be very hirsut. You suspect polycystic ovarian syndrome and suggest that she lose weight. She comes back 20 pounds lighter but still has symptoms. What is your next step in management?

    36. Your answer:
    Estrogen therapy
    OCD therapy
    Tell her to lose more weight
    Clomiphene

  36. A 40 year old woman comes in complaining of back pain, leg pain, leg edema, hemauria, menorrhea, and post-coitus bleeding. She comes from a low-socioecomic status, has had multiple sexual partners, and has a history of having first sexual experience at a very young age (13 years old). You suggest a biopsy which will confirm your suspecion of...

    37. Your answer:
    uterine fibroid
    cervical Ca
    endometriosis
    ectopic pregnancy

  37. A 23 year old pt comes to your office complaining of vaginal bleeding and vomiting. She states that she hasn't had her period in 2 months. Based on her Uterine size, she looks 3-4 months pregnant. Her HCG is extremely elevated and confirms your suspecions. What is your diagnosis?

    38. Your answer:
    H Mole
    twin pregnancy
    hyperemesis gravidum
    normal singleton pregnancy

  38. A 16 year old pt comes in to your office complaining of vomiting and no period of 2 months. She denies having any sexual contact. She is a thin girl and says that she plays on the volleyball team at school. You order labs and confirms your diagnosis. What is the most common cause of secondary ammenorrhea?

    39. Your answer:
    Turner's syndrome
    pregnancy
    Polycystic ovarian syndrom
    Athletic amenorrhea syndrome

  39. A 21 year old primagravid comes to the ER complaining of painless 2nd trimester bleeding. She is currently on antiboitics for an uncomplicated upper respiratory tract infection. She has had no pre-natal visits with her doctor. What is your diagnosis?

    40. Your answer:
    placenta abruptio
    drug reaction
    folate deficiency
    placenta previa

  40. A 33 year old pt ready to give birth has a fetal stress test done. It reveals late decelerations. You do scalp pH to confirm acidosis. What caused these symptoms?

    41. Your answer:
    Umbilical Cord Compression
    Drug abuse.
    Head Compression, No Fetal Distress
    Hypoxia, Placental Insufficiency, Maternal Hypotension,

  41. A patient who is 10 weeks AOG is worried that her baby will have spina bifida because her sister’s son has it. AFP is normal. What is the best next step to determine if her baby has neural defect.

    42. Your answer:
    MRI 3 months later
    MRI/USG at 18 weeks and re-take the AFP at 15-16 weeks
    USG 3 months later
    AFP at 6 months

  42. A 22 year old woman comes to your office and asks for some sort of contraception. She has a history of multiple STD's and PID. Which type of contraception will you NOT give to this pt?

    43. Your answer:
    IUD
    OCD
    latex Condom with spermacide
    Norplant

  43. Neonate with apgar of 7 and 6. Amniotic fluid is meconium stained. What management could have prevented this?

    44. Your answer:
    Folate during pregnancy
    C section
    Fetal stess test
    Suctioning

  44. A 33 year old G2P1 36wks woman comes into the ER and states that she hasn’t felt the fetus move. Next step in management?

    45. Your answer:
    Real-Time Ultrasound exam.
    Oxytocin drip
    cafeful monitoring for contractions
    Immediate CS

  45. 60 year old woman has cystocele and rectocele and says that she feels that her “innards are falling out”. What do you recommend?

    46. Your answer:
    Surgery
    pyschiaty consult
    Kegel Exercises.
    Estrogen therapy

  46. A 23 year old primagravid woman come to you for pre natal visit and complains of ankle edema. Labs show proteinuria and low platelets. Her BP is also elevated. What is your diagnosis?

    47. Your answer:
    Gestational DM
    DIC
    pre-eclamsia, HELLP syndrome.
    Eclampsia

  47. A 55 year old lady has vaginal itchiness. You give her fungal and estrogen creams just last week but the symptoms still persist. What is your next step in management?

    48. Your answer:
    keep on meds for at least 1 month
    antihistamine
    biopsy
    culture

  48. A 55 year old woman comes in for first health check up in 20 years. What 3 exams do want to order?

    49. Your answer:
    Pap smear, mammography, Ca-125
    Mammorgraphy, Ca-125, Lipid profile
    Pap smear, mammography, occult blood exam.
    Lipid profile, pap smear, ca-125

  49. A 24 year old woman is seen because of high fever, prostaction, vomiting, and diarrhea. Her pulse is rapid and thready, and her blodd pressure is at 60/40. A diffuse generalized macular rash is noted on PE. Culture of her cervical secretions will most likely lead to the diagnosis of....

    50. Your answer:
    Toxic Shock Syndrome
    SLE
    Early pregnancy
    dehydration

  50. A 20 year old woman presents with a solitary discrete, freely movable, firm rubbery, non-tender, well-cicumscribed lesion. Biopsy is done and demonstrates a pattern of compressed glands and yong fibrous stroma. The most frequent cause of a palpable mass in the bresat of young woman is...

    51. Your answer:
    intraductal carcinoma
    fibrocystic disease
    fibroadenoma
    medullary carcinoma

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