Acute Pyelonephritis

Asymptomatic bacteriuria is defined by the absence of symptoms in the presence of at least 100,000 colonies per milliliter of urine from a single uropathogen.

A 23-year-old pregnant patient in her third trimester presents with a clinical picture characterized by fever of 39 degrees Celsius, chills, nausea, and vomiting for several days.

Gynecological examination shows no cervical changes or uterine contractions, but her general condition shows signs of dehydration.

The fist percussion maneuver reveals pain in the right costovertebral angle.

The most likely diagnosis is acute pyelonephritis.

In the case of acute pyelonephritis, after deciding on admission and empirical treatment with broad-spectrum antibiotic therapy, and after taking a sample for blood and urine culture, the evolution of the patient in the first 48 hours reflects a clear trend towards clinical improvement manifested by the remission of fever, nausea, vomiting, and pain in the costovertebral angle, as well as the hydroelectrolytic condition, however, the preliminary report of the urine culture reflects resistance to treatment, the correct attitude is to continue treatment.

In the strategy for early detection of asymptomatic bacteriuria in pregnant patients, screening of the first urine sample for culture should be performed between 12-16 weeks of gestational age.

The stage of greatest critically in vertical transmission of HIV is during childbirth.

From a clinical perspective, mucocutaneous manifestations like macules, papules, erythemas, and roseolas in syphilis correspond to the secondary stage.

For a pregnant woman who is seropositive for HIV to be considered as having acquired immunodeficiency syndrome, a laboratory criterion is leukocytes less than 200 per field.

An 18-year-old patient, 30 weeks pregnant, primigravida, integrates into the prenatal care system from week 12. Her condition of previous positive HIV is detected in her first visit after counseling, which leads to the prescription of antiretrovirals from week 14.

Monitoring reports a viral load greater than 1000 copies and leukocytes greater than 350 per field despite not having clinical manifestations.

This interpretation indicates virological instability.

Of the following vaginal infections, trichomoniasis is the one that corresponds to a vertical transmission infection.

In countries where adolescents have their first sexual intercourse at a very early age, the strategy to reduce cervical cancer through the application of the human papillomavirus vaccine in girls should apply the first dose at 9 years of age.

The enzyme responsible for the degradation of cyclic AMP during uterine contraction is phosphodiesterase.

In a 35-year-old multiparous patient with compensated heart disease, 39 weeks pregnant, with 2 to 3 contractions in 10 minutes, 2 cm of dilation, the correct course of action is to allow labor to progress.

The recommended oral contraceptive for breastfeeding mothers is one based on levonorgestrel alone.

The presence of fever of 38 degrees Celsius between the second and tenth day postpartum is known as Puerperal Fever or Standard Febrile Puerperal Morbidity.

The rupture of the amniotic membranes that occurs before the onset of labor is known as Premature Rupture.

Fetal erythroblastosis can occur when the mother is Rh negative and the father is Rh positive.

The most frequent cause of postpartum hemorrhage is uterine atony.

The toconomic point that allows identification, through vaginal examination, of the presentation, whether cephalic or face, in a patient in labor is the glabella.

In a pregnant patient, if an evaluation via vaginal examination reveals the presentation position is left occiput posterior, and another evaluation later identifies the presentation as direct occiput pubic, the head has rotated 135 degrees.

The Leopold maneuver that allows determining the engagement of the cephalic presentation is the Fourth maneuver.

The KOH test can be positive for bacterial vaginosis among the vaginal infections.

The microorganisms that cause mucopurulent endocervicitis are gonococcus and chlamydia.

The spatula of Ayre should be rotated 360 degrees on the clock face for the Papanicolaou smear.

The pH of the vagina is usually acidic.

At the end of pregnancy, the uterus measures 35 centimeters in length.

Physiological flow is characterized by being without any of the following: fetid, pruriginous, or different colors.

The most advisable management for fibrocystic breast disease is vitamin E and sonomammography at 3 months.

Choriocarcinoma most often appears after a hydatidiform mole.

The metastatic ovarian tumor proceeding from the digestive tract is known as Krukenberg tumor.

The most frequent location of breast cancer is in the upper outer quadrant.

Tears are a traumatic neck injury.

Congenital syphilis is transmitted to the fetus after 18 weeks.

The most frequent location for ectopic pregnancy is the fallopian tube.

The most commonly used medication for treating bacterial vaginosis is metronidazole.

The main symptom for which menopausal women seek medical attention is hot flashes.

The most serious problem associated with menopause is osteoporosis.

Fibroids are more common in nulliparous patients over 30 years.

The following hyperplastic endometrial conditions may be a predisposing factor, they're: Estrogen therapy without progesterone, obesity, estrogen-producing tumors.

The temporal or permanent absence of menstrual flow is known as amenorrhea.

Neisseria gonorrhea and Trichomonas is considered a sexually transmitted infection (STI).

The best maneuver for intrauterine resuscitation in case of fetal distress is maternal lateralization.

The factor most related to cervical cancer is human papillomavirus.

The correct management for a patient with a Papanicolaou report of severe dysplasia would be colposcopy and biopsy.

The organ affected in Fitz-Hugh-Curtis syndrome is the liver.

A cytobrush or brush should not be applied when taking a Papanicolaou test on pregnant patients.

The interventions that can be used as measures to prevent hypertensive disorders of pregnancy, with scientific evidence of their utility are the use of calcium and aspirin in low doses.

Submucosal myomas are the ones that clinically cause the most bleeding.

Vaginal monilia infection is characterized by being white, lumpy with itching.

The sign of fetal death consisting of crepitation of the cranial bones is known as Baldi Margulies sign (overlapping of the skull bones between 2-14 days after fetal death).

The myomatous degeneration that occurs in pregnancy is called Red or Carnous degeneration.

Proliferative endometrium is due to the action of oestrogens.

The toconome point of the pelvic presentation is: The sacrum.

Exclusive breastfeeding is known as giving only breast milk without any other liquid or solid food for 6 months.

The mammogram should be done both for women under 40 years with a strong family history of breast cancer and for all women over 40.

The mechanism by which the biparietal diameter of the fetal head passes through the upper strait of the pelvis and the toconomic point of the presentation is at the level of the ischial spines is known as: Engagement

The relationship between the toconomic point of the presentation and one of the 4 quadrants of the maternal pelvis is known as: Variety of presentation

The recommended distance between the cyto spray and the slide to fix the Papanicolaou sample is: 20 centimeters

Oxytocin is produced: In the paraventricular nucleus of the hypothalamus

The use of masks, gloves, glasses, gowns, caps, constitutes a barrier of protection: Physic

The procedure by which all pathogenic microorganisms are eliminated, including spores, is known as: Sterilization

A pregnant patient with 34 weeks of pregnancy presents arterial hypertension of 140/100mmHg, edema, absence of proteinuria. Her diagnosis would be: Gestational hypertension

To determine the engagement of the fetal head, the maneuver used is: Fourth maneuver.

The toconomic point of the presentation of the face is: The glabella

The duration in days of pregnancy from fertilization is: 280 days

Early auscultation of the fetal heart rate, before 10 weeks, can be achieved at the 7 weeks.

The set of interventions performed within the first minute after delivery, consisting of the administration of oxytocin or ergonovine to promote delivery and prevent postpartum hemorrhage is known as: Active management of the third stage of labor

Today it has been established that the gestational age of viability, the moment when the fetus reaches a weight of 500 grams and a crown-rump length of 25 cm., is: 21 weeks

All considerations are correct in relation to the management of hypovolemic shock, except: Transfusion of whole blood

All of the following are causes of maternal death, except: Epilepsy

The presence of chorioretinitis, hydrocephalus and cerebral calcifications in a newborn suggests: Congenital toxoplasmosis

In threatened abortion: None of the above

What is the average length of the menstrual cycle? : 25 a 35 dias.

Menstruation is a physiological process that begins with: Menarche.

What of the following hormones has the greatest importance for the diagnosis of pregnancy? :Gonadotropina coriónica

What of the following is the mechanism by which Toxoplasmosis is transmitted to the neonate? : Paso transplacentario de protozoario

What of the following causes severe embriopathy in the first 11 weeks of pregnancy? : Rubeola

What of the following microorganisms can produce lesion of the mucosa of the trompa? : Neisseria gonorrea

For the study of the unruptured ectopic pregnancy the most helpful test is: Ultra sonografia

What of the following microorganisms produces vaginal secretion with rotten fish smell? : Gardnerella vaginalis

What of the following is the factor most related to cervical cancer? : Virus del papiloma humano

Ectopic pregnancy is the one that is found : All of them are correct

What are the miomas that clinically cause more bleeding? : Sub mucoso

What is the characteristic of the vagibal infection moniliar? : B) Blanca, grumosa con picor

The proliferative endometrial is due to the action of : A) Los estrógenos

If a biopsy of the 23 day of the cycle reports proliferative endometrium, it is to be suspected:: C) Que está bajo efecto estrogenito (estrogénico)

The differential diagnostic of ectopic pregnancy, most establish : D) Todas son correctas

A 26 year old patient with history of infertility that is not using anticonceptives, one morning complains of acute pain in the hipogastrium , loss of consciusness, signs of shock on physical exam. The diagnostic to suspect is: C) Embarazo ectópico

The BHCG is used for diagnostic of : D) Embarazo y marcador para algunos tumores

The risk of infection with toxoplasma in the pregnant women :

The transmission pathway of citomegalovirus is : D) Todas las anteriores

The vacuna for the HPV, can be: D) Todas las anteriores

The vacuna for HPV, can prevent : D) cáncer cervicouterino (CACU)

The application of the vacuna for HVP is indicaded: C) A las mujeres mayores de 9 años y masculinos mayores de 9 años

The pregnant women are more vulnerables to the influenza by: D) Todas las anteriores

The vacuna for the influenza ser inoculada cada :: B) Cada año

The basic skills to start a goo ginecological consulta can be:: D) Todas las anteriores

The aumented of physiological vaginal flow oceurrs:: D) Todas las anteriores

Which of the following would be the best position adopted in bed by the pregnant woman in labor? C) Left side decubitus

What name receives the oxytocin transporter protein? D) Neurophysin

The duration of the recovery phase of the uterine contraction is: C) 40 seconds

The uterine activity required for delivery to occur is: B) 10 contractions in 10 minutes

What is the period of labor that includes from the expulsive to the output of the fetal adnexa?

Which is the supplement must be administered to pregnant woman to prevent tubal neural defects? C) Folic acid.

What is the type of anemia that occurs mostly in pregnancy? A) Ferropenic

Which is the stage of pregnancy must apply the first dose of tetanus toxoid, in a not vaccinated patient? D) In the first consultation

Which of the following is the most used medication for conduction of labor? C) Oxytocin

Which period of delivery labor course corresponds to expulsive? C)Second period.

How many doses of tetanus toxoid should be applied as minimum to a patient pregnant not vaccinated previously? C) Two dose

Which of the following is considered the minimum value of hemoglobin it should have a pregnant woman? C) 11 grams.

Point the microorganisms that cause mucopurulent endo cervicitis A) Gonococo and chlamydia

Which of the following is a sign of alarm during pregnancy? D)Rapid weight gain

Which of the following options is TRUE regarding postpartum hemorrhage? B) The high multiparity is a risk factor.