OB GYN ROSH REVIEW GUARANTEED A+
Which of the following combination of lab findings is most suggestive of hemolysis, elevated liver
enzymes, and low platelet count syndrome of pregnancy?
A. Decreased total bilirubin, elevated aspartate aminotransferse and alanine aminotransferase > 500
U...
OB GYN ROSH REVIEW GUARANTEED A+
Which of the following combination of lab findings is most suggestive of hemolysis, elevated liver
enzymes, and low platelet count syndrome of pregnancy?
A. Decreased total bilirubin, elevated aspartate aminotransferse and alanine aminotransferase > 500
U/L, decreased hemoglobin
B. Increased total bilirubin, elevated aspartate aminotransferase and alanine aminotransferase levels <
500 U/L
C. Schistocytes, thrombocytopenia, and elevated aspartate aminotransferase and alanine
aminotransferase > 500 U/L
D. Schistocytes, thrombocytopenia, elevated aspartate aminotransferase and alanine aminotransferase
levels < 500 U/L ✔️C.
The patients present with nonspecific symptoms of weight gain, right upper quadrant pain, nausea, and
vomitting. Jaundice may or may not be present.
What does the management of HELLP syndrome include? ✔️Best rest, blood pressure management,
and mag sulfate for prevention of eclamptic seizures.
What is the definitive treatment of HELLP syndrome? ✔️Delivery of the fetus
What complication should be suspected in a patient with HELLP syndrome with clinically significant
bleeding and elevated prothrombin time (PT), partial thromboplastin time (PTT) and decreased
fibrinogen? ✔️disseminated intravascular coagulation (DIC)
A 41 year old woman suffers from heavy and irregular menses, which at time leads to fatigue,
lightheadedness and dyspnea. She had three hospitalizations in the past year for such episodes. Her
gynecological evaluation has not revealed any pathological cause. The heavy menses continue despite
hormonal therapy. Which of the following treatment options should be considered next?
A. Colposcopy
B. Hysterectomy
C. Hysteroscopy
D. Uterine ablation ✔️D.
,What is the most common cause of dysfunctional uterine bleeding in a post menopausal woman?
✔️Exogenous estrogens and or progesterone ( hormonal replacement therapy)
A 23 year old woman presents with vulvular itching and vaginal discharge. She in not currently sexually
active, and does not use contraceptives. She works in an office, drinks 3 alcoholic beverages a week and
recently took up long-distance running. Physical examination reveals reddened vulva without surface
ulcerations, the absence of lice or nits, normal appearing vaginal secretions and an unremarkable
vaginal cavity. There is no adnexal tenderness. Which important item is missing from this patient's
history?
A. Age of menarche
B. Family history of endometrial cancer
C. Prior deliveries
D. Use of local irritants ✔️D.
Name two treatments for secondary allergic vulvitis? ✔️Remove offending agent
1% hydrocortisone cream
A 14 year old woman presents to clinic with some frustration over never having a menstrual period. She
is short in stature and has Tanner stage 2 breast development. As you begin a gynecological exam, you
realize that you cannot pass a speculum into the vagina. Which of the following is the most likely
diagnosis?
A. DUB
B. Primary amenorrhea
C. Secondary dysmenorrhea
D. Sheehan's syndrome ✔️B.
What is the initial work up of a patient with primary amenorrhea? ✔️Breast and pelvic exam,
pregnancy test, pelvic ultrasound and serum follicle-stimulating hormone
A 39 year old woman in her third trimester presents with two days of bloody "spotting" on her
underwear. This is her third pregnancy, which thus far has been uncomplicated. Her initial delivery was
vaginal and her second delivery was via cesarean section. She is currently sexually active, and has a
history of trichomoniasis. She denies any pelvic pain. Lab examination reveals hematocrit of 32%, white
,blood cell count of 10,000, platelet count of 260,000 INR of 1.1 and aPTT of 32 seconds. Pelvic
examination show a nonerythematous cervix with clear mucus. Vaginal examination is normal, and
there is no discharge present. Which of the following is the most likely diagnosis?
A. Cervicitis
B. HELLP syndrome
C. Maternal Coagulopathy
D. Placenta Previa ✔️D.
MC cause of 3rd trimester bleeding is placenta previa
Other than peri peri partum hemorrhage, name a fetal complications of placenta previa? ✔️Congenital
malformations doubles with placenta previa
Which of the following is the most common cause of post-partum hemorrhage?
A. Laceration to the cervix
B. Retained placenta
C. Uterine Antony
D. Uterine rupture ✔️C.
What is the most common condition associated with placental abruption? ✔️Maternal hypertension
You are treating a patient for primary amenorrhea. Her diagnostic evaluation has determined that the
etiology is primary ovarian failure. Which of the following disorders is this patient at risk for?
A. Cluster headaches
B. Gastrointestinal bleeding
C. Menorrhagia
D. Osteoporosis ✔️D.
Which medications offer decent replacement therapy for hypoestrogenic women? ✔️Oral
contraceptive pills
, A 26 year old woman presents with abdominal cramping after a positive home pregnancy test. Her vitals
are T 98.7, HR 94, BP 110/66, RR 18, oxygen sat 97%. Her exam is unremarkable. Labs reveal a serum
beta HCG of 1000 mIU and she is Rh positive. An ultrasound shows the gestational sack. Which of the
following is an appropriate management for this patient?
A. Administer methotrexate
B. Administer Rhogam and discharge home with repeat beta HCG in 48 hrs
C. Administer Rhogam and methotrexate
D. Discharge home with repeat beta hCG in 48 hours ✔️D.
What is the success rate of methotrexate in the management of early ectopic pregnancy? ✔️85-93%
A woman presents with fever and foul-smelling vaginal discharge 3 days after delivery of a full-term
fetus. She is febrile, with uterine tenderness on pelvic exam. Which of the following is the strongest risk
factor for postpartum endometritis?
A. Cesarean section
B. Internal fetal monitoring
C. Multiple gestation
D. Premature rupture of membranes ✔️A.
What is the most common malpresentation in fetal delivery? ✔️Breech presentation
A 15 year old G1Po woman at 23 weeks presents with sharp, left lower quad abdominal pain for 1 hour.
She has had an ultrasound confirming the presence of a single intrauterine pregnancy. The pain is severe
and associated with nausea. Pelvic exam reveals tenderness of the left adnexa. The patient's urinalysis is
unremarkable. What test should be ordered to diagnose the patient?
A. Abdominal x-ray
B. CT scan of the abdomen and pelvis
C. Pelvic ultrasound
D. White blood cell count ✔️C.
History is concerning for ovarian torsion- more commonly seen on the right side
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