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Category: Obstetrics & Gynecology--->The Puerperium, Lactation, and Immediate Care of the Newborn
Page: 3

Question 11# Print Question

A 24-year-old who delivered her first baby 5 weeks ago calls your office and asks to speak to you. She states that she is feeling very overwhelmed and anxious about taking care of her newborn son. She feels she cannot do anything right, and feels sad throughout the day. She tells you that she cries on most days, and is having difficulty sleeping at night. She also states she doesn’t feel like eating or doing any of her normal activities. She reports no suicidal or homicidal ideation.

Which of the following accurately describes this patient’s condition?

A. A history of depression is not a risk factor for developing postpartum depression
B. Prenatal preventive intervention for patients at high risk for postpartum depression is best managed alone by a mental health professional
C. Young, multiparous patients are at highest risk
D. Postpartum depression is a self-limiting process that lasts for a maximum of 3 months
E. Women should be screened for depression at least once during the perinatal period using a standard, validated assessment tool


Question 12# Print Question

A 35-year-old G3P3 presents to your office 3 weeks after an uncomplicated vaginal delivery. She has been successfully breastfeeding. She reports chills and a fever up to 38.3°C (101°F) at home. She states that she feels like she has flu, but has not had any sick contacts. She has no medical problems, prior surgeries, or allergies to medications. On examination, she has a temperature of 38°C (100.4°F) and generally appears in no distress. Head, ear, throat, lung, cardiac, abdominal, and pelvic examinations are all normal. A triangular area of erythema and tenderness is noted in the upper outer quadrant of the left breast. No masses or axillary lymphadenopathy are noted.

Which of the following is the best option for treatment of this patient?

A. Admission to the hospital for intravenous antibiotics
B. Bromocriptine to suppress breast milk production
C. Incision and drainage
D. Oral dicloxacillin for 10 to 14 days
E. Oral erythromycin for 7 to 10 days


Question 13# Print Question

A 22-year-old G1 at 34 weeks is tested for tuberculosis because her father, with whom she lives, was recently diagnosed with tuberculosis. Her skin test is positive and her chest x-ray demonstrates a granuloma in the upper left lobe.

Which of the following is true concerning infants born to mothers with active tuberculosis? 

A. The risk of active disease during the first year of life may approach 90% without prophylaxis
B. Bacille Calmette-Guérin (BCG) vaccination of the newborn infant without evidence of active disease is not appropriate
C. Future ability for tuberculin skin testing is lost after BCG administration to the newborn
D. Neonatal infection is most likely acquired by aspiration of infected amniotic fluid
E. Congenital infection is common despite therapy


Question 14# Print Question

A 23-year-old G2P1 develops chorioamnionitis during labor and is started on ampicillin and gentamicin. She requires a cesarean delivery for arrest of active phase labor.

What is the most optimal way to reduce her chance of developing postoperative endometritis?

A. Add 2 g of cefazolin to her antibiotic regimen
B. Add clindamycin 900 mg IV to her antibiotic regimen
C. Continue her antibiotics for 1 week following delivery
D. She only needs to add a third antibiotic agent if she develops a fever postpartum
E. Add vancomycin 1 g IV to her antibiotic regimen


Question 15# Print Question

A 21-year-old G2P2 calls her physician 7 days postpartum because she is concerned that she is still experiencing vaginal bleeding. She describes the bleeding as light pink to bright red, and less heavy than the first few days postdelivery. She reports no fever or pain. On examination, she is afebrile and has an appropriately sized, nontender uterus. The vagina contains about 10 cc of old, dark blood. The cervix is closed.

Which of the following is the most appropriate treatment?

A. Antibiotics for endometritis
B. High-dose oral estrogen for placental subinvolution
C. Oxytocin for uterine atony
D. Suction dilation and curettage for retained placenta
E. Reassurance




Category: Obstetrics & Gynecology--->The Puerperium, Lactation, and Immediate Care of the Newborn
Page: 3 of 7