Multiple Choice Questions (MCQ)

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Category: Obstetrics & Gynecology--->Medical and Surgical Complications of Pregnancy
Page: 2

Question 6# Print Question

A 24-year-old P1001 presents at 8 weeks’ gestation and reports a history of pulmonary embolism 3 years ago during her first pregnancy. She was treated with intravenous heparin followed by several months of oral warfarin (coumadin) and has had no further evidence of thromboembolic disease.

How should her current pregnancy be managed?

A. Since she has had no further events or problems for 3 years, her risk of thromboembolism is no longer increased, and she does not require therapy during this pregnancy
B. Because she has had no problems for 3 years, she may be treated only with a baby aspirin daily
C. She should be managed with Doppler ultrasonography of the bilateral lower extremities once per trimester to screen for deep vein thrombosis
D. The patient should be placed on low-dose unfractionated heparin therapy or low molecular weight heparin therapy throughout pregnancy and puerperium
E. She only requires anticoagulation during the third trimester

Question 7# Print Question

A 29-year-old G3P2 black woman in the 33 week of gestation is admitted to the emergency room because of acute abdominal pain that has been increasing during the past 24 hours. The pain is severe and is radiating from the epigastrium to the back. The patient has vomited a few times and has not eaten or had a bowel movement since the pain started. On examination, you observe an acutely ill patient lying on the bed with her knees drawn up. Her blood pressure is 100/70 mm Hg, her pulse is 110 beats per minute, and her temperature is 38.8°C (101.8°F). On palpation, the abdomen is somewhat distended and tender, mainly in the epigastric area, and the uterine fundus reaches 31 cm above the symphysis. Hypotonic bowel sounds are noted. Fetal monitoring reveals a normal pattern of fetal heart rate (FHR) without uterine contractions. On ultrasonography, the fetus is in vertex presentation and appropriate in size for gestational age; fetal breathing and trunk movements are noted, and the volume of amniotic fluid is normal. The placenta is located on the anterior uterine wall and no previa is seen. Laboratory values show mild leukocytosis (12,000 cells per mL); a hematocrit of 43%; mildly elevated serum glutamicoxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT), and bilirubin; and serum amylase of 180 U/dL. Urinalysis is normal.

Which of the following is the most likely diagnosis? 

A. Acute degeneration of uterine leiomyoma
B. Acute cholecystitis
C. Acute pancreatitis
D. Acute appendicitis
E. Severe preeclamptic toxemia

Question 8# Print Question

An 18-year-old G1 is diagnosed with asymptomatic bacteriuria (ASB) at her first prenatal visit at 15 weeks’ gestation, based on a urine culture performed as part of her routine new OB laboratory findings.

What is the next step in management?

A. Because she is asymptomatic, she does not require treatment
B. She will only require treatment for ASB if she has sickle cell trait
C. She only requires treatment if the culture is positive for group B streptococcus
D. Twenty-five percent of women with ASB subsequently develop an acute symptomatic urinary infection during the same pregnancy, and therefore she should be treated with antibiotics
E. She does not require treatment because ASB is not associated with adverse pregnancy outcomes

Question 9# Print Question

A 20-year-old G1 at 18 weeks of gestation is hospitalized for intravenous antibiotics for the treatment of acute pyelonephritis. She develops shortness of breath and is found to have tachypnea and decreased oxygen saturation. Chest x-ray reveals pulmonary infiltrates consistent with pulmonary edema.

What is the most likely cause of this complication?

A. Acute renal failure
B. Allergic reaction
C. Bacteremia
D. Endotoxin release
E. Intravenous hydration

Question 10# Print Question

A 30-year-old G1 at 6 weeks’ gestation by last menstrual period presents for prenatal care. Her past medical history is significant for type 1 diabetes, which was diagnosed at the age of 14.

What should you tell her about her insulin requirements during pregnancy?

A. Her insulin requirement will not change during pregnancy
B. She will require less insulin due to increased sensitivity to insulin during pregnancy
C. She will require less insulin during pregnancy because she will experience decreased insulin resistance
D. As long as her glycosylated hemoglobin A1c (Hb A1c) is less than 6%, she will not require any changes in her insulin management during pregnancy
E. She should expect her insulin requirement to increase throughout the pregnancy

Category: Obstetrics & Gynecology--->Medical and Surgical Complications of Pregnancy
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