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Category: Obstetrics & Gynecology--->The Puerperium, Lactation, and Immediate Care of the Newborn
Page: 1

Question 1# Print Question

A 34-year-old G3P2 delivers a baby by spontaneous vaginal delivery. She had scant prenatal care and no ultrasound, so she is anxious to know the sex of the baby. At first glance you notice female genitalia, but on closer examination the genitalia are ambiguous.

Which of the following is the best next step in the evaluation of this neonate?

A. Chromosomal analysis
B. Evaluation at 1 month of age
C. Pelvic ultrasound
D. Thorough physical examination
E. Laparotomy for gonadectomy


Question 2# Print Question

A 24-year-old primigravid woman, who plans to breastfeed, decides to have a home delivery. Immediately after the birth of a 4.1-kg (9-lb) newborn, the patient experiences massive hemorrhage from extensive vaginal and cervical lacerations. She is brought to the nearest hospital in shock. Over the course of 2 hours, nine units of blood are transfused, and the patient’s blood pressure returns to a reasonable level. A hemoglobin value the next day is 7.5 g/dL, and three more units of packed red blood cells are given.

The most likely late sequela to consider in this woman is which of the following?

A. Hemochromatosis
B. Stein-Leventhal syndrome
C. Sheehan syndrome
D. Simmonds’ syndrome
E. Cushing syndrome


Question 3# Print Question

A 27-year-old G4P3 at 37 weeks presents to labor and delivery with heavy vaginal bleeding and painful uterine contractions. A bedside ultrasound demonstrates a fundal placenta. The patient’s vital signs are: blood pressure 140/92 mm Hg, pulse 118 beats per minute, respiratory rate 20 breaths per minute, and temperature 37°C (98.6°F). The fetal heart rate tracing reveals tachycardia with decreased variability and intermittent late decelerations. She is taken to the OR for an emergency cesarean, and delivers a male infant with Apgar scores of 4 and 9. When the placenta is delivered, a large retroplacental clot is noted. The patient becomes hypotensive, and bleeding is noted from the wound edges and her IV catheter sites.

Which of the following blood products will most quickly resolve her cause of hemorrhage?

A. Cryoprecipitate
B. Fresh frozen plasma (FFP)
C. Packed red blood cells
D. Platelets
E. Recombinant factor VII


Question 4# Print Question

A 30-year-old G5P3 has undergone a repeat cesarean delivery. She wants to breastfeed. Her past medical history is significant for hepatitis B infection, hypothyroidism, depression, and breast reduction. She is receiving intravenous antibiotics for endometritis. The baby latches on appropriately and begins to suckle.  

In the mother, which of the following is a response to newborn suckling?

A. Decrease of oxytocin
B. Increase of prolactin-inhibiting factor (PIF)
C. Increase of hypothalamic dopamine
D. Increase of hypothalamic prolactin
E. Increase of luteinizing hormone—releasing factor


Question 5# Print Question

A 30-year-old G5P3 has undergone a repeat cesarean delivery. She wants to breastfeed. Her past medical history is significant for hepatitis B infection, hypothyroidism, depression, and breast reduction. She is receiving intravenous antibiotics for endometritis. The baby latches on appropriately and begins to suckle.  

Which of the following aspects of her history might prevent this patient from breastfeeding?

A. Maternal reduction mammoplasty with transplantation of the nipples
B. Maternal treatment with ampicillin
C. Maternal treatment with fluoxetine
D. Maternal treatment with levothyroxine
E. Past hepatitis B infection




Category: Obstetrics & Gynecology--->The Puerperium, Lactation, and Immediate Care of the Newborn
Page: 1 of 7