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167 questions
A 16-year-old nulligravid high school student is on your afternoon office schedule for a "talk visit." She was seen last year by one of your colleagues for an initial GYN evaluation. She is healthy and has no medical problems. Today she tells you that she and her new boyfriend had intercourse the night before, and the condom they were using broke. The patient requests a prescription for "Plan B" emergency contraception. You tell her which of the following?
A 30-year-old woman with a prior history of depression is attending her postpartum followup appointment after the birth of her first child. She has no physical complaints and her examination demonstrates no significant problems. She appears anxious. When asked, she describes intrusive thoughts of wanting to harm her baby but quickly states, "I'm not like that. I would never do anything to hurt him." Which of the following is the most appropriate next step in her management?
You are called by the labor and delivery nurse to evaluate the fetal monitoring strip of a patient. She is a 24-year-old G1 female at 40 weeks' gestation that went into spontaneous labor earlier today. She is currently on IV oxytocin (Pitocin). You review the fetal monitoring strip shown in figure below. What physiologic process causes this to occur?
A healthy 38-year-old G4P3003 presents for amniocentesis. The karyotype returns as shown in the Figure You counsel the patient that which of the following was likely her biggest risk factor for the development of this karyotype?
A 16-year-old nulligravid high school student is on your afternoon office schedule for a "talk visit." She was seen last year by one of your colleagues for an initial GYN evaluation. She is healthy and has no medical problems. Today she tells you that she and her new boyfriend had intercourse the night before, and the condom they were using broke She tells you that earlier in the day she had called her family doctor, who wouldn't call in a prescription because it was "against his personal beliefs." Your response should be which of the following?
A 19-year-old newly married female presents to the emergency room, accompanied by her spouse. She states that she awoke this morning to find that she could not move her legs. She denies any pain but claims that she is unable to feel anything below her abdomen. She denies any trauma or past medical history. She is 24 weeks' pregnant, has had an uneventful pregnancy, and only takes prenatal vitamins. She is concerned if her symptoms will get better and wonders whether the "baby is pulling on my spinal cord." Her neurologic examination is remarkable for 0/5 motor strength in her lower extremities bilaterally, with decreased sensation to light touch and pinprick below the level of her umbilicus. Her cranial nerves and reflexes are normal, and she does not display any upper motor neuron signs. A STAT MRI performed is read as normal. Which of the following is the most likely explanation for her current symptoms?
A 37-year-old multiparous White female, s/p bilateral tubal ligation, reports a family history remarkable for a mother diagnosed with bilateral breast cancer at the age of 43, from which she ultimately died, and a sister diagnosed with epithelial ovarian cancer at the age of 47, for which she is currently undergoing chemotherapy. Secondary to this worrisome family history, the patient elected to undergo genetic testing and was found to be a BRCA1 carrier. In view of her carrier status, you inform her of which of the following?
You are called by the labor and delivery nurse to evaluate the fetal monitoring strip of a patient. She is a 24- year-old G1 female at 40 weeks' gestation that went into spontaneous labor earlier today. She is currently on IV oxytocin (Pitocin). You review the fetal monitoring strip shown in figure below. What fetal heart rate condition does this monitor strip reveal?
You are called by the labor and delivery nurse to evaluate the fetal monitoring strip of a patient. She is a 24-year-old G1 female at 40 weeks' gestation that went into spontaneous labor earlier today. She is currently on IV oxytocin (Pitocin). You review the fetal monitoring strip shown in figure below. What is the most appropriate management at this point?
A healthy 38-year-old G4P3003 presents for amniocentesis. The karyotype returns as shown in the Figure. What is the diagnosis?
A meta-analysis of randomized-controlled trials was published comparing two methods of managing postterm pregnancies. The question studied was whether the routine induction of labor at 41 weeks' gestation would result in improved maternal or fetal outcomes compared with expectant management. The authors reported that the odds ratio for caesarian delivery rate in the induction group compared to the expectant management group was 0.88 with a 95% confidence interval (CI) of 0.780.99. A second outcome studied was perinatal mortality. For this outcome, the odds ratio for the induction group compared to the expectant management group was 0.41 with a 95% CI of 0.141.18. Which of the following statements is true?
A 26-year-old G2P1 female comes to your office for her initial obstetric visit. The first day of her last menstrual period was 6 weeks ago. Other than some mild morning sickness, she is feeling fine. Her first pregnancy was 40 weeks in gestation and uncomplicated. She has no significant medical history. The result of the test that you ordered in question 60 is positive. What would be appropriate management for the neonate to reduce the risk of perinatal transmission of the hepatitis B virus?
A 34-year-old woman with a history of type 1 diabetes mellitus presents to your office for a routine follow-up visit. She is feeling well and has no complaints. Her fasting blood sugars usually run 140 160 and her HgbA1C was recently measured at 8.2. She tells you that she would like to become pregnant but wants to know if there are any risks for her and a baby due to her diabetes. Which of the following preconception counseling statements is true?
A 6-month-old male infant presents to your clinic because the mother is concerned that he is not eating well and he has been constipated. The mother tells you that her prenatal course and delivery were uneventful. On physical examination, the infant has a puffy face, large tongue, and persistent nasal drainage. Which of the following conditions is most likely to present with these findings?
A 6-month-old male infant presents to your clinic because the mother is concerned that he is not eating well and he has been constipated. The mother tells you that her prenatal course and delivery were uneventful. On physical examination, the infant has a puffy face, large tongue, and persistent nasal drainage The above condition can be caused by a deficiency of which of the following?
A27-year-old nulligravid single White female presents to your office for an annual examination. In taking her history, you learn that her mother died of ovarian cancer at the age of 63. There is no other family history ofbreast or ovarian cancer. The patient asks you to tell her what she can do to reduce her own ovarian cancer risk. What is the most effective strategy appropriate for this patient to reduce her risk?
A 62-year-old female with newly diagnosed International Federation of Gynecology and Obstetrics (FIGO) stage IIIC epithelial ovarian cancer is without evidence of visible remaining disease following a total abdominal hysterectomy, bilateral salpingo-oophorectomy, complete omentectomy, bilateral pelvic and paraaortic lymph node sampling, and rectosigmoid resection with reanastomosis. She is seen now for further treatment planning. The appropriate adjuvant therapy indicated in this setting is which of the following?
A 19-year-old newly married female presents to the emergency room, accompanied by her spouse. She states that she awoke this morning to find that she could not move her legs. She denies any pain but claims that she is unable to feel anything below her abdomen. She denies any trauma or past medical history. She is 24 weeks' pregnant, has had an uneventful pregnancy, and only takes prenatal vitamins. She is concerned if her symptoms will get better and wonders whether the "baby is pulling on my spinal cord." Her neurologic examination is remarkable for 0/5 motor strength in her lower extremities bilaterally, with decreased sensation to light touch and pinprick below the level of her umbilicus. Her cranial nerves and reflexes are normal, and she does not display any upper motor neuron signs. A STAT MRI performed is read as normal. Which of the following is the most appropriate approach for this patient?
A 16-year-old nulligravid high school student is on your afternoon office schedule for a "talk visit." She was seen last year by one of your colleagues for an initial GYN evaluation. She is healthy and has no medical problems. Today she tells you that she and her new boyfriend had intercourse the night before, and the condom they were using broke. Your initial course of action should include which of the following?
A25-year-old woman returns for her well-baby check 1 week after delivery. The baby has been gaining weight adequately and awakens several times per night to breast feed. Although the mother claims she enjoys being a mom overall, she looks sad and does reluctantly admit to feeling "down" quite a bit. While she feels a great deal of support by her husband, she finds herself crying when alone. Her sleep is erratic, and she often feels tired, but she is eating adequately. She denies significant guilt or any thoughts of suicide or infanticide. What is the appropriate treatment approach for this patient?