WorksheetsPage 1
Total questions: 7
Worksheet time: 4mins
An 18-year-old pregnant woman is noted to have vaginal bleeding. She is bleeding from venipuncture sites, IV sites, and from her gums. Which of the following is the most likely underlying diagnosis?
Placental abruption
Placenta previa
Gestational diabetes
Multifetal gestation
Gestational trophoblastic disease
A 28-year-old G1P0 woman at 28 weeks' gestation presents to the hospital with fever, nausea and vomiting, and anorexia of 2 days' duration. On examination, her temperature is 100.7°F (38.16°C), HR is 104 bpm, and BP is 100/60 mm Hg. Her abdomen reveals tenderness on the right lateral aspect at the level of the umbilicus. There is mild right flank tenderness. A urinalysis is normal. In consideration of the diagnostic possibilities, which of the following is most accurate regarding this patient?
Appendicitis should be considered since the appendix location changes during pregnancy.
Cholecystitis is best diagnosed by CT scan of the abdomen.
Pyelonephritis commonly presents with normal urinalysis findings.
Inflammatory bowel disease should strongly be considered in this patient.
Upon performing laparoscopy for a suspected ovarian torsion on an 18-year-old nulliparous woman, the surgeon sees that the ovarian vascular pedicle has twisted 1 to 1.5 times and that the ovary appears somewhat bluish. Which of the following is the best management at this point?
Oophorectomy with excision close to the ovary
Oophorectomy with excision of the vascular pedicle to prevent possible embolization of the thrombosis
Unwind the vascular pedicle to assess the viability of the ovary
Bilateral salpingo-oophorectomy
Intravenous heparin therapy
A 19-year-old G1P0 woman at 28 weeks’ gestation arrives to the obstetric triage area complaining of a 12-hour history of abdominal pain. She denies trauma, vaginal bleeding, or fever. On examination, her temperature is 99°F ( 37.2 ∘C ), heart rate is 100 bpm, and blood pressure is 100/70 mm Hg . Her abdominal examination reveals hypoactive bowel sounds and diffuse abdominal pain with guarding. Which of the following statements regarding the abdominal pain is most accurate?
The absence of vaginal bleeding rules out abruption as an etiology.
Ovarian torsion is typically characterized by constant pain.
The gallbladder typically moves superior and laterally with pregnancy.
Degenerating leiomyoma typically presents with localized tenderness over the fibroid.
A 24-year-old G2P1001 woman is at 34 weeks’ gestation and noted to be icteric. She also has nausea, vomiting, and malaise. A diagnosis of acute fatty liver of pregnancy is made, and the obstetrician recommends immediate delivery. Which of the following is most consistent with acute fatty liver of pregnancy?
Elevated serum bile acid levels
Hypoglycemia requiring multiple D50 injections
Proteinuria of 500 mg over 24 hours
Oligohydramnios noted on ultrasound
An 18-year-old woman, who had undergone a previous low-transverse cesarean delivery, is admitted for active labor. During labor, an intrauterine pressure catheter displays normal uterine contractions every 3 minutes with intensity up to 60 mm Hg . Fetal bradycardia ensues. Which of the following statements is most accurate?
The normal intrauterine pressure catheter display makes uterine rupture unlikely.
The most common sign of uterine rupture is a fetal heart rate abnormality.
If the patient has a uterine rupture, the practitioner should wait to see whether the heart tones return to decide on route of delivery.
The intrauterine pressure catheter has been found to be helpful in preventing uterine rupture.
A 32-year-old G1P0 woman at 29 weeks’ gestation presents with a 1-day history of severe midepigastric abdominal pain radiating to the back, and multiple episodes of nausea and vomiting. On examination, her BP is 100/60 mm Hg, HR is 110 bpm, and temperature is 99°F (36.6°C). Her abdominal examination has tenderness and diffuse rebound. The serum amylase level is markedly elevated. Which of the following is the next step?
Initiate a high-protein, low-fat diet
Immediate surgical excision of the inflamed aspect of the pancreas
Ultrasound imaging of the abdomen
Delivery of the infant
