Multiple Choice Questions (MCQ)

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Category: Obstetrics & Gynecology--->Antepartum Care and Fetal Surveillance
Page: 6

Question 26# Print Question

An 18-year-old G2P1001 presents for her first OB visit at 10 weeks. She reports that the first day of her last menstrual period was May 7.

What is this patient’s estimated date of delivery?

A. February 10 of the next year
B. February 14 of the next year
C. December 10 of the same year
D. December 14 of the same year
E. December 21 of the same year

Question 27# Print Question

A 36-year-old G1P0 presents to your office for her first prenatal visit. By her last menstrual period she is 11 weeks’ pregnant. She has no medical problems. On physical examination, her uterus is palpable midway between the pubic symphysis and the umbilicus. No fetal heart tones are audible with the Doppler stethoscope.

Which of the following is the best next step in the management of this patient?

A. Reassure her that fetal heart tones are not yet audible with the Doppler stethoscope at this gestational age
B. Tell her the uterine size is appropriate for her gestational age and schedule her for routine ultrasonography at 20 weeks
C. Schedule genetic amniocentesis because of her advanced maternal age
D. Schedule her for a dilation and curettage, because she has a molar pregnancy since her uterus is too large and the fetal heart tones are not audible
E. Schedule an ultrasound as soon as possible to determine the gestational age and viability of the fetus

Question 28# Print Question

A healthy 30-year-old G2P1001 presents to her obstetrician’s office at 34 weeks for a routine prenatal visit. She has a history of a low transverse cesarean delivery performed secondary to fetal malpresentation (footling breech). Her current pregnancy has been uncomplicated. She tells her physician that she would like to undergo a trial of labor during this pregnancy. However, the patient is interested in permanent sterilization and wonders if it would be better to undergo another scheduled cesarean so she can have a bilateral tubal ligation performed at the same time.

How should the physician counsel this patient?

A. A history of a previous low transverse cesarean is a contraindication to TOLAC
B. Her risk of uterine rupture with TOLAC after one prior low transverse cesarean is 4% to 9%
C. Her chance of having a successful VBAC is less than 60%
D. The patient should schedule an elective induction if not delivered by 38 weeks
E. If the patient desires a bilateral tubal ligation, it is safer for her to undergo a vaginal delivery followed by a postpartum tubal ligation rather than an elective repeat cesarean with intrapartum bilateral tubal ligation

Question 29# Print Question

A 16-year-old primigravida presents to your office at 38 weeks’ gestation. Her first trimester blood pressure was 100/72 mm Hg. On the day of presentation it was 170/110 mm Hg and she has 4+ proteinuria on a clean catch specimen of urine. She has significant swelling of her face and extremities. She reports no contractions. Her cervix is closed and thick. The baby is breech by bedside ultrasonography. She reports the baby’s movements have decreased in the past 24 hours.

Which of the following is the best next step in the management of this patient?

A. Send her to labor and delivery for a BPP
B. Send her home with instructions to stay on strict bed rest until her swelling and blood pressure improve
C. Admit her to the hospital for enforced bed rest and diuretic therapy to improve her swelling and blood pressure
D. Admit her to the hospital for induction of labor
E. Admit her to the hospital for cesarean delivery

Question 30# Print Question

While you are on call at the hospital covering labor and delivery, a 32-year-old G3P2002, at 35 weeks’ gestation, presents with a chief complaint of lower back pain. You take her history, and learn that she had been lifting some heavy boxes while preparing the baby’s nursery. The patient’s pregnancy has been complicated by diet-controlled gestational diabetes. She reports no uterine contractions, rupture of membranes, vaginal bleeding, dysuria, fever, chills, nausea, or emesis. She states that the baby has been moving normally. She is afebrile and her blood pressure is normal. On physical examination, you note that she is obese. Her abdomen is soft and nontender, with no palpable contractions or uterine tenderness. No costovertebral angle tenderness can be elicited. On pelvic examination her cervix is closed and thick. The fetal heart tracing is reactive, and there are rare, irregular uterine contractions demonstrated on the tocometer. The patient’s urinalysis shows trace glucose, but is otherwise negative.

The patient’s most likely diagnosis is which of the following?

A. Preterm labor
B. Musculoskeletal pain
C. Urinary tract infection
D. Chorioamnionitis
E. Round ligament pain

Category: Obstetrics & Gynecology--->Antepartum Care and Fetal Surveillance
Page: 6 of 7