NBME OB / GYN Shelf Exam
27 y/o prima at 33 w comes for prenatal visit. has SLE x 8y. remission. preg normal besides lagging fundal ht 2 m ago. at 20 week things were normal on us. at 33w there is oligo and 30 w fetus. what is cause of olgio?
Correct Answer:
uteroplacental insufficiency ( SLE can mimic GHTN)
32 y/o with 6m of increasing frequent pelvic cramps, pain with urination, urgency relived with urination. regular menses. suprapubic tendenress. tender to palpation dx?
Correct Answer:
interstital cystitis
20 y/o with 3 yr of hirsutism wosrsening over last 2 years, cause of hair growth?
Correct Answer:
increased 5 alpha reductase activity..Testosterone-->DHT
27 y/o primagravid at 14 w comes for 24 hrs of n/v, right sided abd pain, loss of appetite x 2 d.no n/v. afebrile. RLQ tenderness without rigidity or rebound.WBC 16.5, leukocytosis in urine. Dx?
Correct Answer:
appendicitis (might be pyelo) but i think the loss of appetitie
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32 y/o nulligravid with no mentstural period since sottped taking OCP 6m ago.menses were regular before. also has incr libido, facial hair and acne. BMI=33.has clitoromegaly. 2 cm mass in right ovary. what hormone is likely abnormal?
Correct Answer:
testosterone ( DHEAS is from adrenals)
previously healthy 42 y/o comes with 6m of increasingly heavy periods and 2 months of prolonged flow. she has an irregular and smooth uterus. ABUS shows leimyoma uteri.Which is the most likely type of leiomyoma in this case?
Correct Answer:
submucosal
20 prima at 40 w is admitted in lobar. cervix is 4 cm dilate and 0 station. she gets 2 L of LR. epidural cath is placed and test dose of lido and epi is injected.she immediately has tinnutus and metaalic taste. pulse is now 110 what cuased it?
Correct Answer:
IV injection of the anastetic (epidural woundt cause these sx)
18 hr after c/s a 23 y/o g1 has a fever. her temp is 100.4. decr breath sounds are heard bilaterally with no crackles or rhonchi. ijncision site is dry and intact. 2+ pitting bilaterally. Most likely dx?
Correct Answer:
atelectasis
27 y/o prima at 34 comes with 1 day of anxiety, sweating, rapid heart beat.some disorientation. rapid pulse, low grade fever high b. diffusely enlarged 2 / 4
thyroid with 4+ clonus. along with a beta blocker what else should you give her?
Correct Answer:
propylthiuracil
a 32 y/o G5P4 at 18w comes for routine prenatal. Rh -. previos pregnancies reuqired c/s at33-35 for breech, She got rhogam for both pregnancies. her mother has T2DM. vitals normal. TVUS shows breech and bicornate uterus.What is she at incr risk for?
Correct Answer:
preterm labor (bicronate uterus)
42 y/o G3P3routine exam. iregular period varying length for the last yr. last period was 6 w ago. she has t2dm tx w metformin. BMI=32she has an irregular enlarged uterus. endometrial biops shows atypical complex hyperplasia.predisposing factor?
Correct Answer:
annovulation
27 y/o G2P1 at 36w comes w 2 hr of intermittent vag bleeding. no prenatal care and fundus at 35. fetal Hr =135. bleed is of uterine origin. she is O-.nst is reactive and BPP = 8. next step?
Correct Answer:
give rhogam for any bleed in Rh-
27 y/o philipino at 10 w comes for prenatal. 15 y hx of anemia. Hct at 28 for 7 yr desite iron. 5 days ago she visited relatives with a flu like illness. uterus is consitent with 10 w pregnancy. next step in management? 3 / 4
Correct Answer:
hemoglobin electrophoresis (thalassemia)
- d after c/s at term for failure to progress 27 y/o has 101.8 fever and mild
dysuria without frequency or urgency. incision site is intact. lungs are clear.breast are tense and tender. uterus firm20w size. she has no elevated WBC and hb and UA norm.Dx?
Correct Answer:
breast engrogement
25 y/o HIV + comes due to thin, clear vaginal discharge and increased urinary freq x 2w. last menses 6w ago. normally has 28 d intervals. uses cndoms irregularly and not on HAART. uterus is slightly enlarge and adnexa normal dx?
Correct Answer:
pregancy
24 y/o prima at 30 w admitted for birght red vaginal bleedfirst noted as spotting 12 h after sex, since then bleed has incr. otherwise uncomplicated.u/s at 20w has fundal placenta. most likely cause of bleeding?
Correct Answer:
cervical trauma (sex)
17 y/o comes in with moderate severe pelvic pain with n/v during menses since menarche. sx begin soon after onset of menses. nsaids help. never been sexually active. normal PE. DX?
Correct Answer:
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