A 19-year-old woman at 32 weeks’ gestation is the driver in a front-end motor vehicle crash. The air bags did not inflate, and the patient sustained blunt trauma to the abdomen. The patient is taken to a nearby ED in stable condition, where she notes a small amount of bright red blood on her underwear. Maternal vital signs are significant for a heart rate of 110/min and a blood pressure of 110/55 mm Hg. What is next most appropriate step in management?

A 19-year-old G1P0 woman presents to the ED in active labor and delivers a full-term male infant. The infant appears healthy with the exception of jaundice (bilirubin 10 mg/dL, > 95th percentile). The mother does not speak any English, but a cousin states that she has seen the mother taking pills prescribed by her doctor, although she does not know the reason she was taking medication. Based on the newborn’s jaundice, which drug was she most likely taking?

A 16-year-old girl presents to the ED complaining of fever, chills, abdominal pain, and vaginal bleeding. She gives a history of unprotected sexual activity with her 17-year-old boyfriend over the past several months. Her last menstrual period was 8 weeks ago. She reports having a dilatation and curettage procedure at an unlicensed abortion clinic recently to try to abort her pregnancy. Vital signs are significant for a fever of 38.7°C (101.7°F), a heart rate of 120/min, and a blood pressure of 100/70 mm Hg. Pelvic examination reveals cervical motion tenderness, tissue in the internal os, and foul-smelling vaginal discharge. Urine β-human chorionic gonadotropin is positive. What is the most likely diagnosis?

A 24-year-old woman presents to her primary care physician with a complaint of 1 week of increased vaginal discharge with an unpleasant odor. She is sexually active with one partner and uses oral contraception for birth control. A pregnancy test is negative. Gynecologic examination reveals a pink cervix and a thin white discharge. The discharge has a positive amine “whiff” test and a pH of 6; results of wet saline mount microscopy are shown in the image. Which of the following is the most likely diagnosis?

A 30-year-old obese G3P2 woman with no significant past medical history is in active labor at 41 weeks’ gestation. She had an uncomplicated pregnancy with appropriate prenatal evaluation. The patient ruptured membranes spontaneously 30 minutes ago. Contractions occur regularly every 2–3 minutes. Early decelerations are noted on the fetal heart rate monitor with each of the past five contractions. Which is the most appropriate next step in management?

A 25-year-old G2P1 woman who is 36 weeks pregnant presents to her obstetrician complaining of restlessness and weakness for the past month. She states that her boyfriend recently left her and their 2-year-old son, and she feels overwhelmed with this pregnancy. She denies feeling depressed but does report that she has trouble sleeping. She had an upper respiratory infection last month, “caught from my son,” and states that she still has a sore throat. Which of the following is the next step in management?

A 19-year-old G0 woman presents to her family physician complaining of dysmenorrhea for the past year. She reports severe right-sided pain that coincides with days 1–5 of her menstrual cycle. Her menses occur regularly every 28 days, and she requires three to four pads per day for the first two days of her bleeding and one to two pads per day for the remainder. She has never had surgery. She is not sexually active and does not smoke. Her last menstrual period was 1 week ago. Vital signs are temperature 36.7°C (98.1°F), blood pressure 121/74 mm Hg, heart rate 80/min, and respiratory rate 14/min. Physical examination reveals a thin, healthy-appearing young female. Pelvic examination reveals a normal sized uterus and no cervical motion tenderness. What is the most likely diagnosis?

A 36-year-old G1P0 woman pregnant with twins presents to her obstetrician for her routine 32-week appointment. She has gained 5.4 kg (12 lb) in the past 2 weeks. When questioned about her weight gain, she states that she has had headaches and some blurred vision for the past 2 weeks, which she thinks is secondary to dehydration. To circumvent this she has been drinking a lot of water, which she claims “is not really working, and is making me swell, even my hands!” She also has had some epigastric pain for the past 2 weeks, which she attributes to “all the water I’ve been drinking.” Her vitals are blood pressure 142/90 mm Hg, pulse 105/min, and respiratory rate 18/min. Her urine reveals 1+ glucosuria and 4+ proteinuria. What is the next best step in management?

A 24-year-old woman with chronic hypothyroidism presents to her gynecologist for her annual examination. She recently got married, and she and her husband would like to conceive. Her hypothyroidism is well controlled and stable on thyroxine, and she has no other medical conditions. She is healthy and does not smoke or drink alcohol. She would like to know if she should keep taking her thyroxine. Which is the most correct advice to give this patient?