Podcast
Questions and Answers
A 28-year-old pregnant woman is screened for gestational diabetes mellitus (GDM) at 26 weeks gestation. Her 1-hour glucose screen is 145 mg/dL. According to the guidelines, what is the appropriate next step in management?
A 28-year-old pregnant woman is screened for gestational diabetes mellitus (GDM) at 26 weeks gestation. Her 1-hour glucose screen is 145 mg/dL. According to the guidelines, what is the appropriate next step in management?
- Schedule a 3-hour glucose tolerance test (GTT) with a 100-g loading dose (correct)
- Reassure the patient that the value is within normal limits
- Start the patient on a diabetic diet and recheck glucose in 2 weeks
- Initiate insulin therapy immediately
A patient is diagnosed with gestational diabetes. Which of the following fasting blood glucose levels, if attained through treatment, would be considered within the recommended goal range?
A patient is diagnosed with gestational diabetes. Which of the following fasting blood glucose levels, if attained through treatment, would be considered within the recommended goal range?
- 100 mg/dL
- 90 mg/dL (correct)
- 105 mg/dL
- 98 mg/dL
A 32-year-old woman presents with a positive pregnancy test. An ultrasound reveals a gestational sac but no fetal pole. Serial hCG titers are followed. Which of the following best describes the appropriate next step in management if a viable pregnancy cannot be confirmed?
A 32-year-old woman presents with a positive pregnancy test. An ultrasound reveals a gestational sac but no fetal pole. Serial hCG titers are followed. Which of the following best describes the appropriate next step in management if a viable pregnancy cannot be confirmed?
- Recommend expectant management with pelvic exams and TVUS. (correct)
- Prescribe a course of high-dose progestins to support the pregnancy.
- Administer methotrexate to terminate the presumed ectopic pregnancy.
- Schedule immediate dilation and curettage (D&C).
Which of the following is NOT a contraindication for prescribing combination oral contraceptive pills?
Which of the following is NOT a contraindication for prescribing combination oral contraceptive pills?
Which of the following is a benefit associated with the use of combination oral contraceptive pills?
Which of the following is a benefit associated with the use of combination oral contraceptive pills?
A 42-year-old lactating woman requests contraception. Which of the following contraceptive methods would be MOST appropriate?
A 42-year-old lactating woman requests contraception. Which of the following contraceptive methods would be MOST appropriate?
A patient reports that their last menstrual period (LMP) started on July 14, 2023. Using Nägele's rule, what is their estimated date of delivery (EDD)?
A patient reports that their last menstrual period (LMP) started on July 14, 2023. Using Nägele's rule, what is their estimated date of delivery (EDD)?
A pregnant patient at 30 weeks' gestation reports feeling dizzy and nauseous when lying flat on their back during an ultrasound. What is the most likely cause of these symptoms?
A pregnant patient at 30 weeks' gestation reports feeling dizzy and nauseous when lying flat on their back during an ultrasound. What is the most likely cause of these symptoms?
A patient using the progestin-only pill calls the office stating she took her pill 5 hours late. What advice should the provider give regarding back-up contraception?
A patient using the progestin-only pill calls the office stating she took her pill 5 hours late. What advice should the provider give regarding back-up contraception?
A 25-year-old patient is using a transdermal contraceptive patch. She reports that the patch keeps falling off. What counseling should the provider give regarding this issue?
A 25-year-old patient is using a transdermal contraceptive patch. She reports that the patch keeps falling off. What counseling should the provider give regarding this issue?
During a prenatal visit at 22 weeks' gestation, a patient's fundal height measures 20 cm. Which of the following is the MOST appropriate next step?
During a prenatal visit at 22 weeks' gestation, a patient's fundal height measures 20 cm. Which of the following is the MOST appropriate next step?
A patient is starting the contraceptive vaginal ring. Which of the following instructions is MOST accurate regarding its use?
A patient is starting the contraceptive vaginal ring. Which of the following instructions is MOST accurate regarding its use?
A first-time pregnant patient asks about the purpose of fetal shunts. Which of the following correctly describes the function of the ductus venosus?
A first-time pregnant patient asks about the purpose of fetal shunts. Which of the following correctly describes the function of the ductus venosus?
A patient at 10 weeks gestation presents for initial prenatal labs. All of the following labs are typically performed EXCEPT:
A patient at 10 weeks gestation presents for initial prenatal labs. All of the following labs are typically performed EXCEPT:
Which of the following instructions is MOST important to emphasize to a patient when prescribing a diaphragm for contraception?
Which of the following instructions is MOST important to emphasize to a patient when prescribing a diaphragm for contraception?
A pregnant patient at 35 weeks' gestation undergoes a biophysical profile (BPP). Which of the following parameters is assessed during this test?
A pregnant patient at 35 weeks' gestation undergoes a biophysical profile (BPP). Which of the following parameters is assessed during this test?
In the context of fetal heart rate (FHR) monitoring, the mnemonic VEAL CHOP is used to remember associations between FHR patterns and potential causes. VEAL CHOP stands for Variable decelerations, Early decelerations, ________ decelerations, Cord compression, Head compression, Okay, and Placental insufficiency. Fill in the blank:
In the context of fetal heart rate (FHR) monitoring, the mnemonic VEAL CHOP is used to remember associations between FHR patterns and potential causes. VEAL CHOP stands for Variable decelerations, Early decelerations, ________ decelerations, Cord compression, Head compression, Okay, and Placental insufficiency. Fill in the blank:
A 28-year-old patient with a history of well-controlled hypertension and migraine headaches presents requesting contraception. She is concerned about estrogen-related side effects. Which of the following contraceptive methods is MOST appropriate, considering her medical history?
A 28-year-old patient with a history of well-controlled hypertension and migraine headaches presents requesting contraception. She is concerned about estrogen-related side effects. Which of the following contraceptive methods is MOST appropriate, considering her medical history?
A 24-year-old presents for emergency contraception 78 hours after unprotected intercourse. Her BMI is 32. Which of the following is the BEST option?
A 24-year-old presents for emergency contraception 78 hours after unprotected intercourse. Her BMI is 32. Which of the following is the BEST option?
Which of the following statements is TRUE regarding emergency contraception?
Which of the following statements is TRUE regarding emergency contraception?
A 34-year-old patient with a history of heavy menstrual bleeding and a strong family history of breast cancer is seeking long-term contraception. Which of the following contraceptive options is MOST contraindicated?
A 34-year-old patient with a history of heavy menstrual bleeding and a strong family history of breast cancer is seeking long-term contraception. Which of the following contraceptive options is MOST contraindicated?
A 29-year-old woman presents requesting an etonogestrel implant. Which of the following conditions would be a CONTRAINDICATION to the placement of this contraceptive method?
A 29-year-old woman presents requesting an etonogestrel implant. Which of the following conditions would be a CONTRAINDICATION to the placement of this contraceptive method?
A 28-year-old primigravida at 32 weeks gestation presents with a blood pressure of 150/95 mmHg, and a urine dipstick reveals 1+ protein. Which of the following is the most accurate classification of her hypertensive disorder?
A 28-year-old primigravida at 32 weeks gestation presents with a blood pressure of 150/95 mmHg, and a urine dipstick reveals 1+ protein. Which of the following is the most accurate classification of her hypertensive disorder?
A 36-year-old woman, currently 26 weeks pregnant, has a history of hypertension well-managed with medication prior to conception. Her blood pressure remains elevated above 140/90 mmHg despite being on the same medication. Which of the following is the most appropriate classification?
A 36-year-old woman, currently 26 weeks pregnant, has a history of hypertension well-managed with medication prior to conception. Her blood pressure remains elevated above 140/90 mmHg despite being on the same medication. Which of the following is the most appropriate classification?
A pregnant patient at 38 weeks gestation presents with a blood pressure of 165/115 mmHg and 5.2 g of protein in a 24-hour urine collection. She also complains of a severe headache and blurred vision. Which of the following is the most likely diagnosis?
A pregnant patient at 38 weeks gestation presents with a blood pressure of 165/115 mmHg and 5.2 g of protein in a 24-hour urine collection. She also complains of a severe headache and blurred vision. Which of the following is the most likely diagnosis?
A pregnant patient at 22 weeks gestation is diagnosed with gestational hypertension. Which of the following findings would necessitate a reclassification of her diagnosis to preeclampsia?
A pregnant patient at 22 weeks gestation is diagnosed with gestational hypertension. Which of the following findings would necessitate a reclassification of her diagnosis to preeclampsia?
A 30-year-old G2P1 at 34 weeks gestation presents with elevated blood pressure readings. Her history is unremarkable, and she denies any significant symptoms. A 24-hour urine collection reveals 280 mg of protein. What is the most appropriate diagnosis?
A 30-year-old G2P1 at 34 weeks gestation presents with elevated blood pressure readings. Her history is unremarkable, and she denies any significant symptoms. A 24-hour urine collection reveals 280 mg of protein. What is the most appropriate diagnosis?
A 25-year-old primigravida at 28 weeks gestation is diagnosed with preeclampsia. Her blood pressure is 155/100 mmHg, and she has 350 mg of protein in her urine. She is being managed as an outpatient. Which of the following findings would necessitate immediate hospitalization?
A 25-year-old primigravida at 28 weeks gestation is diagnosed with preeclampsia. Her blood pressure is 155/100 mmHg, and she has 350 mg of protein in her urine. She is being managed as an outpatient. Which of the following findings would necessitate immediate hospitalization?
In the classification of hypertensive disorders during pregnancy, differentiate between transient hypertension and gestational hypertension. Transient hypertension is characterized by hypertension occurring __________ without __________ and with normalization of blood pressure __________. Gestational hypertension, on the other hand, develops __________ without __________. Fill in the blanks.
In the classification of hypertensive disorders during pregnancy, differentiate between transient hypertension and gestational hypertension. Transient hypertension is characterized by hypertension occurring __________ without __________ and with normalization of blood pressure __________. Gestational hypertension, on the other hand, develops __________ without __________. Fill in the blanks.
A 33-year-old pregnant patient with pre-gestational diabetes is being monitored closely for signs of preeclampsia. Which of the following clinical findings is most indicative of superimposed preeclampsia in this patient?
A 33-year-old pregnant patient with pre-gestational diabetes is being monitored closely for signs of preeclampsia. Which of the following clinical findings is most indicative of superimposed preeclampsia in this patient?
Which of the following situations presents the highest risk for the development of preeclampsia?
Which of the following situations presents the highest risk for the development of preeclampsia?
Which of the following is the MOST significant risk associated with leaving a diaphragm in place for longer than 24 hours?
Which of the following is the MOST significant risk associated with leaving a diaphragm in place for longer than 24 hours?
A 17-year-old female is seeking contraception and desires a method that is highly effective and reversible. According to the American Academy of Pediatrics (AAP), which of the following is an ideal option?
A 17-year-old female is seeking contraception and desires a method that is highly effective and reversible. According to the American Academy of Pediatrics (AAP), which of the following is an ideal option?
A patient is considering the use of a cervical cap for contraception. What instructions should MOST appropriately be given regarding the duration of time the cap should remain in place after intercourse?
A patient is considering the use of a cervical cap for contraception. What instructions should MOST appropriately be given regarding the duration of time the cap should remain in place after intercourse?
A 25-year-old nulliparous woman is seeking contraception and is interested in using a contraceptive sponge. What is the maximum amount of time this method can safely remain in place?
A 25-year-old nulliparous woman is seeking contraception and is interested in using a contraceptive sponge. What is the maximum amount of time this method can safely remain in place?
Which IUD releases levonorgestrel?
Which IUD releases levonorgestrel?
A 30-year-old patient with a history of irregular bleeding and painful periods is seeking contraception. She is not planning to have children in the future. Which of the following IUDs might be MOST appropriate for this patient?
A 30-year-old patient with a history of irregular bleeding and painful periods is seeking contraception. She is not planning to have children in the future. Which of the following IUDs might be MOST appropriate for this patient?
When initiating depot medroxyprogesterone acetate (DMPA) injections for contraception, the injection should be administered within the first _____ days of menses.
When initiating depot medroxyprogesterone acetate (DMPA) injections for contraception, the injection should be administered within the first _____ days of menses.
Which of the following is a relative contraindication to the use of intrauterine devices (IUDs)?
Which of the following is a relative contraindication to the use of intrauterine devices (IUDs)?
According to the FDA, the use of depot medroxyprogesterone acetate (DMPA) has a limitation of 2 years due to what side effect?
According to the FDA, the use of depot medroxyprogesterone acetate (DMPA) has a limitation of 2 years due to what side effect?
A patient presents with irregular bleeding while using a levonorgestrel-releasing IUD. Which of the following is the MOST appropriate initial step in managing this side effect?
A patient presents with irregular bleeding while using a levonorgestrel-releasing IUD. Which of the following is the MOST appropriate initial step in managing this side effect?
A 31-year-old primigravida presents at 37 weeks gestation with a blood pressure of 142/92 mmHg. She denies headache, visual changes, or abdominal pain. A urine dipstick is negative for protein. According to the diagnostic criteria, what is the most appropriate diagnosis?
A 31-year-old primigravida presents at 37 weeks gestation with a blood pressure of 142/92 mmHg. She denies headache, visual changes, or abdominal pain. A urine dipstick is negative for protein. According to the diagnostic criteria, what is the most appropriate diagnosis?
A 29-year-old woman, G1P0 at 30 weeks' gestation, has a history of well-controlled hypertension prior to pregnancy. At today's appointment, her blood pressure is 150/98 mmHg. Urinalysis is negative for protein. How would you classify her condition?
A 29-year-old woman, G1P0 at 30 weeks' gestation, has a history of well-controlled hypertension prior to pregnancy. At today's appointment, her blood pressure is 150/98 mmHg. Urinalysis is negative for protein. How would you classify her condition?
In differentiating between chronic hypertension and gestational hypertension, which of the following is a key distinguishing factor?
In differentiating between chronic hypertension and gestational hypertension, which of the following is a key distinguishing factor?
A 35-year-old G3P2 presents at 36 weeks gestation with a blood pressure of 162/112 mmHg. She also reports a persistent headache and visual disturbances. A 24-hour urine collection reveals 5.3 grams of protein. Which of the following is the most likely diagnosis?
A 35-year-old G3P2 presents at 36 weeks gestation with a blood pressure of 162/112 mmHg. She also reports a persistent headache and visual disturbances. A 24-hour urine collection reveals 5.3 grams of protein. Which of the following is the most likely diagnosis?
A 26-year-old primigravida at 29 weeks gestation presents with new onset hypertension and is diagnosed with mild preeclampsia. Which of the following findings would elevate her diagnosis to severe preeclampsia?
A 26-year-old primigravida at 29 weeks gestation presents with new onset hypertension and is diagnosed with mild preeclampsia. Which of the following findings would elevate her diagnosis to severe preeclampsia?
A 38-year-old G5P4 at 39 weeks gestation is admitted with a blood pressure of 158/100 mmHg and proteinuria of 350mg, and is diagnosed as mild preeclampsia. During her admission, which of the following findings would be most concerning and warrant immediate intervention?
A 38-year-old G5P4 at 39 weeks gestation is admitted with a blood pressure of 158/100 mmHg and proteinuria of 350mg, and is diagnosed as mild preeclampsia. During her admission, which of the following findings would be most concerning and warrant immediate intervention?
A 24-year-old nulliparous woman presents for her initial prenatal visit at 9 weeks gestation. Her past medical history is significant for obesity (BMI 34) and pre-gestational diabetes, well-controlled with metformin. Which of the following factors presents the highest risk for the development of preeclampsia during her pregnancy?
A 24-year-old nulliparous woman presents for her initial prenatal visit at 9 weeks gestation. Her past medical history is significant for obesity (BMI 34) and pre-gestational diabetes, well-controlled with metformin. Which of the following factors presents the highest risk for the development of preeclampsia during her pregnancy?
A 32-year-old woman is interested in the etonogestrel implant for contraception. Which of the following conditions, if present in her medical history, would be a contraindication to the use of this contraceptive method?
A 32-year-old woman is interested in the etonogestrel implant for contraception. Which of the following conditions, if present in her medical history, would be a contraindication to the use of this contraceptive method?
A patient asks about the mechanism of action of Plan B One-Step for emergency contraception. Which of the following best describes how Plan B One-Step prevents pregnancy?
A patient asks about the mechanism of action of Plan B One-Step for emergency contraception. Which of the following best describes how Plan B One-Step prevents pregnancy?
A 28-year-old woman with a BMI of 35 is seeking emergency contraception 48 hours after unprotected intercourse. Considering her BMI, which of the following emergency contraception options would be the most effective?
A 28-year-old woman with a BMI of 35 is seeking emergency contraception 48 hours after unprotected intercourse. Considering her BMI, which of the following emergency contraception options would be the most effective?
A patient is scheduled to receive an etonogestrel implant. Which of the following statements accurately describes the correct timing for insertion of the etonogestrel implant?
A patient is scheduled to receive an etonogestrel implant. Which of the following statements accurately describes the correct timing for insertion of the etonogestrel implant?
A patient presents to the clinic seeking emergency contraception 60 hours after unprotected intercourse. She is considering different options. Which of the following statements accurately compares the effectiveness timelines of ulipristal acetate (Ella) and levonorgestrel (Plan B One-Step)?
A patient presents to the clinic seeking emergency contraception 60 hours after unprotected intercourse. She is considering different options. Which of the following statements accurately compares the effectiveness timelines of ulipristal acetate (Ella) and levonorgestrel (Plan B One-Step)?
A 22-year-old nulliparous woman is seeking contraception. She is interested in using a contraceptive sponge. She asks how long it can safely remain in place. Which of the following is the MOST accurate response?
A 22-year-old nulliparous woman is seeking contraception. She is interested in using a contraceptive sponge. She asks how long it can safely remain in place. Which of the following is the MOST accurate response?
A patient is using a diaphragm for contraception and asks how long it should remain in place after intercourse. Which of the following is the MOST appropriate response?
A patient is using a diaphragm for contraception and asks how long it should remain in place after intercourse. Which of the following is the MOST appropriate response?
A patient is considering using a cervical cap for contraception. What is the MOST appropriate instruction regarding the duration of time the cap should remain in place after intercourse?
A patient is considering using a cervical cap for contraception. What is the MOST appropriate instruction regarding the duration of time the cap should remain in place after intercourse?
A 27-year-old patient is starting depot medroxyprogesterone acetate (DMPA) injections for contraception. Within how many days of the start of menses should the first injection be administered to ensure effective contraception?
A 27-year-old patient is starting depot medroxyprogesterone acetate (DMPA) injections for contraception. Within how many days of the start of menses should the first injection be administered to ensure effective contraception?
A 32-year-old patient is using a levonorgestrel-releasing IUD, and is experiencing persistent, unscheduled spotting. Which of the following is the MOST appropriate FIRST-LINE management strategy?
A 32-year-old patient is using a levonorgestrel-releasing IUD, and is experiencing persistent, unscheduled spotting. Which of the following is the MOST appropriate FIRST-LINE management strategy?
A 23-year-old patient is interested in using a copper IUD for contraception. Which of the following is the MOST accurate mechanism of action of the copper IUD?
A 23-year-old patient is interested in using a copper IUD for contraception. Which of the following is the MOST accurate mechanism of action of the copper IUD?
A 16-year-old is asking about contraception. According to the American Academy of Pediatrics (AAP), which of the following contraceptive methods is considered an ideal first-line option for adolescents?
A 16-year-old is asking about contraception. According to the American Academy of Pediatrics (AAP), which of the following contraceptive methods is considered an ideal first-line option for adolescents?
A 36 year old patient is on the injectable depot medroxyprogesterone acetate (DMPA). She is concerned about the FDA's boxed warning about the medication. What is the warning?
A 36 year old patient is on the injectable depot medroxyprogesterone acetate (DMPA). She is concerned about the FDA's boxed warning about the medication. What is the warning?
A 29-year-old patient presents for an IUD insertion. Which of the following historical findings is a CONTRAINDICATION to the placement of an IUD?
A 29-year-old patient presents for an IUD insertion. Which of the following historical findings is a CONTRAINDICATION to the placement of an IUD?
A 34-year-old G0 patient is interested in long-acting reversible contraception. She reports a nickel allergy. Which of the following is the MOST appropriate choice?
A 34-year-old G0 patient is interested in long-acting reversible contraception. She reports a nickel allergy. Which of the following is the MOST appropriate choice?
A 30-year-old primigravida at 35 weeks gestation presents with a blood pressure of 160/110 mmHg and is diagnosed with severe preeclampsia. After initiating magnesium sulfate and hydralazine, which of the following blood pressure readings would necessitate immediate delivery, regardless of gestational age?
A 30-year-old primigravida at 35 weeks gestation presents with a blood pressure of 160/110 mmHg and is diagnosed with severe preeclampsia. After initiating magnesium sulfate and hydralazine, which of the following blood pressure readings would necessitate immediate delivery, regardless of gestational age?
A 29-year-old G1P0 at 36 weeks gestation is diagnosed with mild preeclampsia. Her blood pressure is consistently around 145/95 mmHg, and she has 1+ protein on urine dipstick. Which of the following findings would be MOST concerning and indicate a progression to severe preeclampsia, warranting immediate intervention?
A 29-year-old G1P0 at 36 weeks gestation is diagnosed with mild preeclampsia. Her blood pressure is consistently around 145/95 mmHg, and she has 1+ protein on urine dipstick. Which of the following findings would be MOST concerning and indicate a progression to severe preeclampsia, warranting immediate intervention?
A 32-year-old pregnant woman at 30 weeks gestation presents with new-onset hypertension and proteinuria. Her labs reveal elevated liver enzymes and thrombocytopenia. Which of the following is the MOST appropriate initial management step?
A 32-year-old pregnant woman at 30 weeks gestation presents with new-onset hypertension and proteinuria. Her labs reveal elevated liver enzymes and thrombocytopenia. Which of the following is the MOST appropriate initial management step?
A 31-year-old G2P1 at 38 weeks gestation with gestational diabetes is being induced due to macrosomia. Her initial blood glucose is 110 mg/dL. During labor, her blood glucose rises to 180 mg/dL. Which of the following is the MOST appropriate next step in managing her blood glucose?
A 31-year-old G2P1 at 38 weeks gestation with gestational diabetes is being induced due to macrosomia. Her initial blood glucose is 110 mg/dL. During labor, her blood glucose rises to 180 mg/dL. Which of the following is the MOST appropriate next step in managing her blood glucose?
A 26-year-old G1P0 is diagnosed with gestational diabetes at 28 weeks gestation. She has been adhering to a diabetic diet but her fasting blood glucose levels remain elevated above 95 mg/dL. What is the MOST appropriate next step in management?
A 26-year-old G1P0 is diagnosed with gestational diabetes at 28 weeks gestation. She has been adhering to a diabetic diet but her fasting blood glucose levels remain elevated above 95 mg/dL. What is the MOST appropriate next step in management?
A 27-year-old woman is diagnosed with gestational diabetes during her second pregnancy. Which of the following pathophysiological mechanisms BEST explains the insulin resistance observed in gestational diabetes?
A 27-year-old woman is diagnosed with gestational diabetes during her second pregnancy. Which of the following pathophysiological mechanisms BEST explains the insulin resistance observed in gestational diabetes?
A 33-year-old G1P0 at 26 weeks gestation is undergoing a 1-hour glucose challenge test. The result is 190 mg/dL. Following the American Diabetes Association guidelines, what is the MOST appropriate next step?
A 33-year-old G1P0 at 26 weeks gestation is undergoing a 1-hour glucose challenge test. The result is 190 mg/dL. Following the American Diabetes Association guidelines, what is the MOST appropriate next step?
A 34-year-old patient with a history of gestational diabetes during a previous pregnancy is now 7 weeks postpartum. When should she be screened to assess for persistent diabetes?
A 34-year-old patient with a history of gestational diabetes during a previous pregnancy is now 7 weeks postpartum. When should she be screened to assess for persistent diabetes?
A 28-year-old female with gestational diabetes (GDM) managed with diet and exercise alone delivers a healthy baby at term. She asks about her future risk of developing type 2 diabetes mellitus (T2DM). Which of the following statements is MOST accurate regarding her long-term risk?
A 28-year-old female with gestational diabetes (GDM) managed with diet and exercise alone delivers a healthy baby at term. She asks about her future risk of developing type 2 diabetes mellitus (T2DM). Which of the following statements is MOST accurate regarding her long-term risk?
A patient is diagnosed with Gestational Diabetes Mellitus (GDM) based on a 3-hour Oral Glucose Tolerance Test (OGTT). Which set of values, if two or more are met or exceeded, confirms this diagnosis?
A patient is diagnosed with Gestational Diabetes Mellitus (GDM) based on a 3-hour Oral Glucose Tolerance Test (OGTT). Which set of values, if two or more are met or exceeded, confirms this diagnosis?
A lactating woman requests contraception. Considering the mechanism of action and specific instructions, which of the following requires the MOST diligent adherence to timing for optimal efficacy?
A lactating woman requests contraception. Considering the mechanism of action and specific instructions, which of the following requires the MOST diligent adherence to timing for optimal efficacy?
A patient using a combined hormonal transdermal patch for contraception reports inconsistent adhesion, especially during physical activity. Which of the following is the MOST appropriate recommendation?
A patient using a combined hormonal transdermal patch for contraception reports inconsistent adhesion, especially during physical activity. Which of the following is the MOST appropriate recommendation?
A patient is considering using a diaphragm for contraception. Which of the following statements reflects the MOST accurate and complete instructions regarding its use?
A patient is considering using a diaphragm for contraception. Which of the following statements reflects the MOST accurate and complete instructions regarding its use?
A 30-year-old patient with a history of migraines with aura is seeking contraception. Which of the following contraceptive methods would be most appropriate?
A 30-year-old patient with a history of migraines with aura is seeking contraception. Which of the following contraceptive methods would be most appropriate?
A woman using combination oral contraceptive pills reports experiencing increased blood pressure and worsening migraines since starting the medication. What is the MOST appropriate course of action?
A woman using combination oral contraceptive pills reports experiencing increased blood pressure and worsening migraines since starting the medication. What is the MOST appropriate course of action?
Which of the following laboratory results would necessitate a 3-hour Glucose Tolerance Test (GTT) for Gestational Diabetes Mellitus (GDM) in a pregnant woman who had a 50-g 1-hour glucose screen?
Which of the following laboratory results would necessitate a 3-hour Glucose Tolerance Test (GTT) for Gestational Diabetes Mellitus (GDM) in a pregnant woman who had a 50-g 1-hour glucose screen?
A patient is prescribed combination oral contraceptive pills. Which of the following conditions is an absolute contraindication to taking combination oral contraceptive pills?
A patient is prescribed combination oral contraceptive pills. Which of the following conditions is an absolute contraindication to taking combination oral contraceptive pills?
A patient is interested in using the progestin-only pill for contraception. What is the MOST important instruction to emphasize for effective use?
A patient is interested in using the progestin-only pill for contraception. What is the MOST important instruction to emphasize for effective use?
A 29-year-old G1P0 patient at 34 weeks gestation presents for a routine antepartum visit. Which of the following physical exam findings MOST accurately reflects the expected location of the uterine fundus?
A 29-year-old G1P0 patient at 34 weeks gestation presents for a routine antepartum visit. Which of the following physical exam findings MOST accurately reflects the expected location of the uterine fundus?
Which of the following BEST describes the physiological mechanism behind the cardiovascular changes observed during pregnancy relating to increased cardiac output (CO)?
Which of the following BEST describes the physiological mechanism behind the cardiovascular changes observed during pregnancy relating to increased cardiac output (CO)?
In a pregnant patient at 28 weeks gestation, which of the following antepartum findings would warrant the MOST immediate further evaluation?
In a pregnant patient at 28 weeks gestation, which of the following antepartum findings would warrant the MOST immediate further evaluation?
A pregnant patient is undergoing a Biophysical Profile (BPP). Which of the following parameters are assessed during a BPP?
- Fetal breathing movements
- Fetal tone
- Amniotic fluid volume
- Fetal presentation
A pregnant patient is undergoing a Biophysical Profile (BPP). Which of the following parameters are assessed during a BPP?
- Fetal breathing movements
- Fetal tone
- Amniotic fluid volume
- Fetal presentation
During antepartum care, a 26-year-old primigravida asks about the purpose of nuchal translucency screening. Which of the following is the MOST accurate explanation?
During antepartum care, a 26-year-old primigravida asks about the purpose of nuchal translucency screening. Which of the following is the MOST accurate explanation?
A 30-year-old G1P0 patient presents for her initial prenatal visit at 10 weeks gestation. Her history is notable for well-controlled asthma and a family history of neural tube defects. Based on this information, which of the following is MOST appropriate?
A 30-year-old G1P0 patient presents for her initial prenatal visit at 10 weeks gestation. Her history is notable for well-controlled asthma and a family history of neural tube defects. Based on this information, which of the following is MOST appropriate?
In assessing fetal well-being using a non-stress test (NST), reactivity is determined by the presence of accelerations. A reactive NST requires at least __________ accelerations, each at least __________ beats per minute above baseline, lasting at least __________ seconds, within a __________ minute period.
In assessing fetal well-being using a non-stress test (NST), reactivity is determined by the presence of accelerations. A reactive NST requires at least __________ accelerations, each at least __________ beats per minute above baseline, lasting at least __________ seconds, within a __________ minute period.
A 26-year-old patient presents to your clinic requesting contraception. She has a history of well-controlled hypertension, smokes less than half a pack of cigarettes daily, and reports occasional migraine headaches without aura. Which of the following contraceptive options would be the MOST appropriate initial choice, considering her medical history?
A 26-year-old patient presents to your clinic requesting contraception. She has a history of well-controlled hypertension, smokes less than half a pack of cigarettes daily, and reports occasional migraine headaches without aura. Which of the following contraceptive options would be the MOST appropriate initial choice, considering her medical history?
A patient is being fitted for a diaphragm. Which of the following instructions regarding diaphragm use is MOST critical to emphasize to the patient to prevent potential complications?
A patient is being fitted for a diaphragm. Which of the following instructions regarding diaphragm use is MOST critical to emphasize to the patient to prevent potential complications?
A 30-year-old presents for an etonogestrel (Nexplanon) implant insertion. The provider is reviewing her medical history and discovers a previously undocumented diagnosis. Which of the following conditions would be a contraindication to the placement of this contraceptive method?
A 30-year-old presents for an etonogestrel (Nexplanon) implant insertion. The provider is reviewing her medical history and discovers a previously undocumented diagnosis. Which of the following conditions would be a contraindication to the placement of this contraceptive method?
A 24-year-old patient presents requesting emergency contraception. She had unprotected intercourse 60 hours ago. She is concerned about the effectiveness of different options and asks for the MOST effective method. Which of the following is the MOST appropriate recommendation?
A 24-year-old patient presents requesting emergency contraception. She had unprotected intercourse 60 hours ago. She is concerned about the effectiveness of different options and asks for the MOST effective method. Which of the following is the MOST appropriate recommendation?
A patient is interested in using a cervical cap for contraception. The patient should be instructed to leave the cap in place for at least 6 hours post sex, but not longer than ______ hours.
A patient is interested in using a cervical cap for contraception. The patient should be instructed to leave the cap in place for at least 6 hours post sex, but not longer than ______ hours.
A patient presents to the clinic seeking emergency contraception. She had unprotected intercourse 4 days ago (96 hours). Which of the following emergency contraception options remains a viable option for her?
A patient presents to the clinic seeking emergency contraception. She had unprotected intercourse 4 days ago (96 hours). Which of the following emergency contraception options remains a viable option for her?
A patient is considering using a contraceptive sponge. What is the maximum amount of time this method can safely remain in place?
A patient is considering using a contraceptive sponge. What is the maximum amount of time this method can safely remain in place?
Emergency contraception primarily prevents pregnancy through which of the following mechanisms? Fill in the blank: Emergency contraception works to prevent __________ and __________; it has NO effect on __________.
Emergency contraception primarily prevents pregnancy through which of the following mechanisms? Fill in the blank: Emergency contraception works to prevent __________ and __________; it has NO effect on __________.
Which of the following intrauterine devices (IUDs) releases levonorgestrel?
Which of the following intrauterine devices (IUDs) releases levonorgestrel?
When initiating intramuscular depot medroxyprogesterone acetate (DMPA) injections for contraception, the injection should be administered within the first _____ days of menses.
When initiating intramuscular depot medroxyprogesterone acetate (DMPA) injections for contraception, the injection should be administered within the first _____ days of menses.
A 23-year-old patient is interested in using the copper IUD (ParaGard) for contraception. Which of the following is the MOST accurate mechanism of action of the copper IUD?
A 23-year-old patient is interested in using the copper IUD (ParaGard) for contraception. Which of the following is the MOST accurate mechanism of action of the copper IUD?
A 36-year-old patient is on the injectable depot medroxyprogesterone acetate (DMPA). She is concerned about the FDA's warning about the medication. What is the warning?
A 36-year-old patient is on the injectable depot medroxyprogesterone acetate (DMPA). She is concerned about the FDA's warning about the medication. What is the warning?
A patient presents to the clinic requesting initiation of injectable depot medroxyprogesterone acetate (DMPA) for contraception. Which point is MOST important to emphasize to the patient?
A patient presents to the clinic requesting initiation of injectable depot medroxyprogesterone acetate (DMPA) for contraception. Which point is MOST important to emphasize to the patient?
A patient presents with irregular bleeding while using a levonorgestrel-releasing IUD. Initial testing rules out infection and pregnancy. Which of the following is the MOST appropriate initial step in managing this side effect?
A patient presents with irregular bleeding while using a levonorgestrel-releasing IUD. Initial testing rules out infection and pregnancy. Which of the following is the MOST appropriate initial step in managing this side effect?
A 29-year-old primigravid patient at 34 weeks gestation presents with a blood pressure of 145/95 mmHg at two separate readings six hours apart. She denies headache, visual changes, or abdominal pain. A urine dipstick is negative for protein. Based on the provided information, which of the following is the most accurate diagnosis?
A 29-year-old primigravid patient at 34 weeks gestation presents with a blood pressure of 145/95 mmHg at two separate readings six hours apart. She denies headache, visual changes, or abdominal pain. A urine dipstick is negative for protein. Based on the provided information, which of the following is the most accurate diagnosis?
A 38-year-old G4P3 patient with a pre-pregnancy history of well-managed chronic hypertension presents at 28 weeks gestation. Her blood pressure today is 155/100 mmHg, which is an increase from her baseline. Urine protein is negative. Which of the following best describes her hypertensive classification at this visit?
A 38-year-old G4P3 patient with a pre-pregnancy history of well-managed chronic hypertension presents at 28 weeks gestation. Her blood pressure today is 155/100 mmHg, which is an increase from her baseline. Urine protein is negative. Which of the following best describes her hypertensive classification at this visit?
In the context of hypertensive disorders of pregnancy, fill in the blanks to accurately describe gestational hypertension: Gestational hypertension is defined as hypertension developing after _______ weeks of gestation in the absence of _______.
In the context of hypertensive disorders of pregnancy, fill in the blanks to accurately describe gestational hypertension: Gestational hypertension is defined as hypertension developing after _______ weeks of gestation in the absence of _______.
A 25-year-old nulliparous patient at 37 weeks gestation, diagnosed with mild preeclampsia, is being monitored as an outpatient. Which of the following new symptoms, if reported by the patient, would be most concerning and necessitate immediate evaluation for severe preeclampsia in the hospital setting?
A 25-year-old nulliparous patient at 37 weeks gestation, diagnosed with mild preeclampsia, is being monitored as an outpatient. Which of the following new symptoms, if reported by the patient, would be most concerning and necessitate immediate evaluation for severe preeclampsia in the hospital setting?
Which of the following scenarios presents the highest risk for the development of preeclampsia based on the provided information?
Which of the following scenarios presents the highest risk for the development of preeclampsia based on the provided information?
A 31-year-old patient at 8 weeks gestation reports experiencing nausea, vomiting, fatigue, and constipation. Which of these symptoms is considered most likely to be classified as hyperemesis gravidarum if it were severe and persistent?
A 31-year-old patient at 8 weeks gestation reports experiencing nausea, vomiting, fatigue, and constipation. Which of these symptoms is considered most likely to be classified as hyperemesis gravidarum if it were severe and persistent?
To meet the diagnostic criteria for chronic hypertension in pregnancy, a patient must have a blood pressure of ≥140 mmHg systolic or ≥90 mmHg diastolic, which is present either before pregnancy, before ______ weeks of gestation, or persists for more than ______ weeks postpartum.
To meet the diagnostic criteria for chronic hypertension in pregnancy, a patient must have a blood pressure of ≥140 mmHg systolic or ≥90 mmHg diastolic, which is present either before pregnancy, before ______ weeks of gestation, or persists for more than ______ weeks postpartum.
A 34-year-old G2P1 patient at 32 weeks gestation has been diagnosed with gestational hypertension. Her blood pressure is consistently around 148/98 mmHg, and she has no proteinuria. Which of the following findings would most strongly suggest a progression from gestational hypertension to preeclampsia?
A 34-year-old G2P1 patient at 32 weeks gestation has been diagnosed with gestational hypertension. Her blood pressure is consistently around 148/98 mmHg, and she has no proteinuria. Which of the following findings would most strongly suggest a progression from gestational hypertension to preeclampsia?
A 27-year-old primigravida at 10 weeks gestation reports experiencing persistent fatigue. While fatigue is a common symptom in the first trimester, which of the following factors would warrant further investigation to differentiate normal pregnancy fatigue from a potentially concerning underlying condition?
A 27-year-old primigravida at 10 weeks gestation reports experiencing persistent fatigue. While fatigue is a common symptom in the first trimester, which of the following factors would warrant further investigation to differentiate normal pregnancy fatigue from a potentially concerning underlying condition?
Gestational Diabetes Mellitus (GDM) diagnosis during pregnancy requires that at least two of the following 3-hour Oral Glucose Tolerance Test (OGTT) values are met or exceeded. Fill in the blanks with the correct glucose thresholds:
Fasting: > _____ mg/dL
1-hour: > _____ mg/dL
2-hour: > _____ mg/dL
3-hour: > _____ mg/dL
Gestational Diabetes Mellitus (GDM) diagnosis during pregnancy requires that at least two of the following 3-hour Oral Glucose Tolerance Test (OGTT) values are met or exceeded. Fill in the blanks with the correct glucose thresholds:
Fasting: > _____ mg/dL 1-hour: > _____ mg/dL 2-hour: > _____ mg/dL 3-hour: > _____ mg/dL
A 29-year-old woman with Gestational Diabetes Mellitus (GDM), despite consistent dietary modifications and regular exercise, continues to have fasting blood glucose levels above the recommended goal. According to the provided guidelines, what is the MOST appropriate initial pharmacological intervention?
A 29-year-old woman with Gestational Diabetes Mellitus (GDM), despite consistent dietary modifications and regular exercise, continues to have fasting blood glucose levels above the recommended goal. According to the provided guidelines, what is the MOST appropriate initial pharmacological intervention?
A patient using progestin-only pills (POPs) for contraception calls the clinic and states she usually takes her pill at 9:00 AM, but today it is 1:00 PM and she has not yet taken it. According to the guidelines, how long must she use a backup method of contraception?
A patient using progestin-only pills (POPs) for contraception calls the clinic and states she usually takes her pill at 9:00 AM, but today it is 1:00 PM and she has not yet taken it. According to the guidelines, how long must she use a backup method of contraception?
A patient is instructed on the proper use of a diaphragm for contraception. Which of the following statements reflects the MOST accurate timing for diaphragm insertion and removal in relation to intercourse?
A patient is instructed on the proper use of a diaphragm for contraception. Which of the following statements reflects the MOST accurate timing for diaphragm insertion and removal in relation to intercourse?
A 34-year-old patient weighing 210 lbs (95 kg) is seeking contraception and is interested in the transdermal contraceptive patch. What is the MOST appropriate counseling regarding the patch's effectiveness for this patient?
A 34-year-old patient weighing 210 lbs (95 kg) is seeking contraception and is interested in the transdermal contraceptive patch. What is the MOST appropriate counseling regarding the patch's effectiveness for this patient?
A patient is starting to use the contraceptive vaginal ring. Which of the following instructions is MOST accurate regarding the ring's recommended usage schedule?
A patient is starting to use the contraceptive vaginal ring. Which of the following instructions is MOST accurate regarding the ring's recommended usage schedule?
Beyond contraception, combination oral contraceptive pills (COCPs) are known to provide several health benefits. Which of the following gynecological conditions has a lower incidence associated with COCP use?
Beyond contraception, combination oral contraceptive pills (COCPs) are known to provide several health benefits. Which of the following gynecological conditions has a lower incidence associated with COCP use?
What is the PRIMARY mechanism by which progestin-only pills (POPs) prevent pregnancy?
What is the PRIMARY mechanism by which progestin-only pills (POPs) prevent pregnancy?
A 38-year-old patient who has been using combination oral contraceptive pills for 5 years presents with a blood pressure reading of 150/95 mmHg at a routine visit. She also reports a recent increase in migraine frequency and intensity, without aura, since her last refill. Which of the following is the MOST appropriate next step in managing her contraception?
A 38-year-old patient who has been using combination oral contraceptive pills for 5 years presents with a blood pressure reading of 150/95 mmHg at a routine visit. She also reports a recent increase in migraine frequency and intensity, without aura, since her last refill. Which of the following is the MOST appropriate next step in managing her contraception?
According to the provided content, which of the following factors would necessitate earlier screening for Gestational Diabetes Mellitus (GDM) in a pregnant patient?
According to the provided content, which of the following factors would necessitate earlier screening for Gestational Diabetes Mellitus (GDM) in a pregnant patient?
A 26-year-old patient presents requesting an etonogestrel implant. Which of the following conditions, if present in her medical history, would be a contraindication to the use of this contraceptive method?
A 26-year-old patient presents requesting an etonogestrel implant. Which of the following conditions, if present in her medical history, would be a contraindication to the use of this contraceptive method?
A pregnant patient at 37 weeks gestation presents with a blood pressure of 145/95 mmHg. She denies any headaches or visual disturbances, and a urine dipstick is negative for protein. She reports that her blood pressure has been trending upward for the past few weeks. What is the MOST likely diagnosis?
A pregnant patient at 37 weeks gestation presents with a blood pressure of 145/95 mmHg. She denies any headaches or visual disturbances, and a urine dipstick is negative for protein. She reports that her blood pressure has been trending upward for the past few weeks. What is the MOST likely diagnosis?
A 28-year-old primigravida is diagnosed with mild preeclampsia at 34 weeks gestation. Her blood pressure is controlled with oral labetalol, and she is being monitored as an outpatient. Which of the following findings would necessitate immediate hospitalization due to the progression of her condition?
A 28-year-old primigravida is diagnosed with mild preeclampsia at 34 weeks gestation. Her blood pressure is controlled with oral labetalol, and she is being monitored as an outpatient. Which of the following findings would necessitate immediate hospitalization due to the progression of her condition?
Distinguish between transient and gestational hypertension by completing the following statement: Transient hypertension is characterized by hypertension occurring __________ without __________ and with normalization of blood pressure __________. Gestational hypertension, on the other hand, develops __________ without __________.
Distinguish between transient and gestational hypertension by completing the following statement: Transient hypertension is characterized by hypertension occurring __________ without __________ and with normalization of blood pressure __________. Gestational hypertension, on the other hand, develops __________ without __________.
A 39-year-old G3P2 at 37 weeks gestation with a history of chronic hypertension presents with a blood pressure of 162/112 mmHg, persistent headache, and visual disturbances. Urinalysis reveals 3+ protein. What is the most likely diagnosis?
A 39-year-old G3P2 at 37 weeks gestation with a history of chronic hypertension presents with a blood pressure of 162/112 mmHg, persistent headache, and visual disturbances. Urinalysis reveals 3+ protein. What is the most likely diagnosis?
A 27-year-old previously healthy primigravida presents at 39 weeks' gestation with a blood pressure of 160/110 mmHg, severe headache, and visual disturbances. Which of the following is MOST likely diagnosis?
A 27-year-old previously healthy primigravida presents at 39 weeks' gestation with a blood pressure of 160/110 mmHg, severe headache, and visual disturbances. Which of the following is MOST likely diagnosis?
Which of the following scenarios presents the GREATEST risk for the development of preeclampsia?
Which of the following scenarios presents the GREATEST risk for the development of preeclampsia?
A 33-year-old G2P1 at 16 weeks of gestation with pre-gestational diabetes presents for a routine appointment. Her blood pressure is 130/80 mmHg and urine dipstick is negative. Which of the following, if newly present at 28 weeks, would be MOST indicative of superimposed preeclampsia?
A 33-year-old G2P1 at 16 weeks of gestation with pre-gestational diabetes presents for a routine appointment. Her blood pressure is 130/80 mmHg and urine dipstick is negative. Which of the following, if newly present at 28 weeks, would be MOST indicative of superimposed preeclampsia?
A 31-year-old G1P0 at 28 weeks gestation presents with a blood pressure of 152/96 mmHg. She denies headache, visual changes, or abdominal pain. A urine dipstick reveals 1+ protein. What is the most appropriate diagnosis?
A 31-year-old G1P0 at 28 weeks gestation presents with a blood pressure of 152/96 mmHg. She denies headache, visual changes, or abdominal pain. A urine dipstick reveals 1+ protein. What is the most appropriate diagnosis?
A 33-year-old G1P0 at 37 weeks gestation with no significant past medical history presents with a blood pressure of 144/94 mmHg. She reports mild swelling in her hands and feet but denies headache or visual changes. A urine dipstick reveals 1+ protein. The MOST appropriate diagnosis is:
A 33-year-old G1P0 at 37 weeks gestation with no significant past medical history presents with a blood pressure of 144/94 mmHg. She reports mild swelling in her hands and feet but denies headache or visual changes. A urine dipstick reveals 1+ protein. The MOST appropriate diagnosis is:
Which of the following best describes the primary pathophysiological mechanism leading to gestational diabetes mellitus (GDM)?
Which of the following best describes the primary pathophysiological mechanism leading to gestational diabetes mellitus (GDM)?
A 29-year-old patient diagnosed with gestational diabetes (GDM) asks what long-term implications GDM has for her child. Which of the following is the most accurate response?
A 29-year-old patient diagnosed with gestational diabetes (GDM) asks what long-term implications GDM has for her child. Which of the following is the most accurate response?
In a pregnant patient with severe preeclampsia at 32 weeks gestation, which of the following findings would be MOST indicative of the need for immediate delivery?
In a pregnant patient with severe preeclampsia at 32 weeks gestation, which of the following findings would be MOST indicative of the need for immediate delivery?
Which of the following signs and symptoms is most commonly associated with HELLP syndrome?
Which of the following signs and symptoms is most commonly associated with HELLP syndrome?
A pregnant patient at 34 weeks gestation reports experiencing lightheadedness and dizziness, particularly when lying supine during prenatal appointments. Which of the following physiological mechanisms BEST explains these symptoms?
A pregnant patient at 34 weeks gestation reports experiencing lightheadedness and dizziness, particularly when lying supine during prenatal appointments. Which of the following physiological mechanisms BEST explains these symptoms?
Following delivery, a patient who had gestational diabetes should be screened for persistent diabetes with a glucose tolerance test at:
Following delivery, a patient who had gestational diabetes should be screened for persistent diabetes with a glucose tolerance test at:
In fetal circulation, the ductus venosus, foramen ovale, and ductus arteriosus serve as crucial shunts. Which of the following statements BEST describes the primary physiological consequence of the ductus venosus?
In fetal circulation, the ductus venosus, foramen ovale, and ductus arteriosus serve as crucial shunts. Which of the following statements BEST describes the primary physiological consequence of the ductus venosus?
A patient, unsure of her last menstrual period, presents for her first prenatal visit. An abdominal ultrasound at what she believes to be 6 weeks gestation reveals only a gestational sac and no fetal pole. A transvaginal ultrasound is then performed. At which gestational age, calculated from the last menstrual period, would cardiac activity MOST reliably be expected via transvaginal ultrasound in a viable pregnancy?
A patient, unsure of her last menstrual period, presents for her first prenatal visit. An abdominal ultrasound at what she believes to be 6 weeks gestation reveals only a gestational sac and no fetal pole. A transvaginal ultrasound is then performed. At which gestational age, calculated from the last menstrual period, would cardiac activity MOST reliably be expected via transvaginal ultrasound in a viable pregnancy?
A 31-year-old primigravida at 38 weeks gestation is diagnosed with severe preeclampsia. While awaiting delivery, which medication is administered to prevent seizures?
A 31-year-old primigravida at 38 weeks gestation is diagnosed with severe preeclampsia. While awaiting delivery, which medication is administered to prevent seizures?
A 28-year-old primigravida undergoes first-trimester prenatal screening. The combined screening includes fetal nuchal translucency measurement and serum PAPP-A and free beta-hCG levels. Which of the following conditions is this screening panel PRIMARILY designed to assess the risk for?
A 28-year-old primigravida undergoes first-trimester prenatal screening. The combined screening includes fetal nuchal translucency measurement and serum PAPP-A and free beta-hCG levels. Which of the following conditions is this screening panel PRIMARILY designed to assess the risk for?
A 35-year-old G2P1 at 30 weeks gestation presents with a blood pressure of 150/90 mmHg, proteinuria, and new-onset thrombocytopenia. Which of the following is the MOST appropriate initial step in management?
A 35-year-old G2P1 at 30 weeks gestation presents with a blood pressure of 150/90 mmHg, proteinuria, and new-onset thrombocytopenia. Which of the following is the MOST appropriate initial step in management?
A patient with a history of gestational diabetes is planning a future pregnancy. Which of the following interventions is most effective in reducing the risk of recurrence?
A patient with a history of gestational diabetes is planning a future pregnancy. Which of the following interventions is most effective in reducing the risk of recurrence?
During a non-stress test (NST) at 32 weeks gestation, a fetal heart rate tracing demonstrates variable decelerations. According to the VEAL CHOP mnemonic, variable decelerations are MOST commonly associated with which of the following underlying fetal conditions or issues?
During a non-stress test (NST) at 32 weeks gestation, a fetal heart rate tracing demonstrates variable decelerations. According to the VEAL CHOP mnemonic, variable decelerations are MOST commonly associated with which of the following underlying fetal conditions or issues?
In the management of severe preeclampsia, at what gestational age is immediate delivery generally recommended, assuming maternal and fetal stability cannot be maintained?
In the management of severe preeclampsia, at what gestational age is immediate delivery generally recommended, assuming maternal and fetal stability cannot be maintained?
At a routine prenatal visit, a patient is 28 weeks pregnant. Palpation of the uterine fundus is noted to be approximately at the level of the umbilicus on her abdomen. Which of the following statements BEST describes the expected relationship between fundal height measurement in centimeters and gestational age in weeks after 20 weeks gestation?
At a routine prenatal visit, a patient is 28 weeks pregnant. Palpation of the uterine fundus is noted to be approximately at the level of the umbilicus on her abdomen. Which of the following statements BEST describes the expected relationship between fundal height measurement in centimeters and gestational age in weeks after 20 weeks gestation?
A 25-year-old primigravida at 27 weeks gestation presents with hypertension and proteinuria. Her labs show normal liver enzymes and platelets. Oral labetalol is initiated. What fetal surveillance should be ordered?
A 25-year-old primigravida at 27 weeks gestation presents with hypertension and proteinuria. Her labs show normal liver enzymes and platelets. Oral labetalol is initiated. What fetal surveillance should be ordered?
During the initial prenatal visit at 8 weeks gestation, which of the following laboratory tests is considered MOST essential to perform as part of routine antepartum screening for all pregnant women, irrespective of risk factors?
During the initial prenatal visit at 8 weeks gestation, which of the following laboratory tests is considered MOST essential to perform as part of routine antepartum screening for all pregnant women, irrespective of risk factors?
A patient diagnosed with Gestational Diabetes Mellitus (GDM) based on a 3-hour Oral Glucose Tolerance Test (OGTT) exhibits the following glucose levels: Fasting: 92 mg/dL, 1-hour: 175 mg/dL, 2-hour: 150 mg/dL, 3-hour: 135 mg/dL. According to Carpenter-Coustan criteria, what is the correct interpretation?
A patient diagnosed with Gestational Diabetes Mellitus (GDM) based on a 3-hour Oral Glucose Tolerance Test (OGTT) exhibits the following glucose levels: Fasting: 92 mg/dL, 1-hour: 175 mg/dL, 2-hour: 150 mg/dL, 3-hour: 135 mg/dL. According to Carpenter-Coustan criteria, what is the correct interpretation?
A 30-year-old lactating woman who is 6 weeks postpartum requests contraception. Considering the hormonal effects and safety profiles, which of the following contraceptive methods would be MOST appropriate and is associated with a strict adherence requirement regarding timing?
A 30-year-old lactating woman who is 6 weeks postpartum requests contraception. Considering the hormonal effects and safety profiles, which of the following contraceptive methods would be MOST appropriate and is associated with a strict adherence requirement regarding timing?
A 26-year-old patient using a combined hormonal transdermal patch reports inconsistent adhesion, particularly during exercise and hot weather. Despite proper application to clean, dry skin, the patch frequently detaches. Which of the following is the MOST appropriate recommendation to improve adherence and efficacy?
A 26-year-old patient using a combined hormonal transdermal patch reports inconsistent adhesion, particularly during exercise and hot weather. Despite proper application to clean, dry skin, the patch frequently detaches. Which of the following is the MOST appropriate recommendation to improve adherence and efficacy?
A patient is considering using a diaphragm for contraception. Which accurately describes how long it should remain in place after intercourse and the implications for extended use?
A patient is considering using a diaphragm for contraception. Which accurately describes how long it should remain in place after intercourse and the implications for extended use?
A 32-year-old with migraines with aura is seeking contraception. Considering contraindications, which method is MOST appropriate?
A 32-year-old with migraines with aura is seeking contraception. Considering contraindications, which method is MOST appropriate?
A 35-year-old patient on combined oral contraceptive pills reports increased blood pressure readings and worsening migraines since starting the medication. What is the MOST appropriate course of action?
A 35-year-old patient on combined oral contraceptive pills reports increased blood pressure readings and worsening migraines since starting the medication. What is the MOST appropriate course of action?
A pregnant woman has a 50-g 1-hour glucose screen result of 148 mg/dL. Which laboratory result from the subsequent 3-hour Glucose Tolerance Test (GTT) would necessitate a diagnosis of Gestational Diabetes Mellitus (GDM)?
A pregnant woman has a 50-g 1-hour glucose screen result of 148 mg/dL. Which laboratory result from the subsequent 3-hour Glucose Tolerance Test (GTT) would necessitate a diagnosis of Gestational Diabetes Mellitus (GDM)?
A patient is prescribed combination oral contraceptive pills. Which condition is an absolute contraindication?
A patient is prescribed combination oral contraceptive pills. Which condition is an absolute contraindication?
A patient opting for the progestin-only pill needs counseling. What is the MOST important instruction?
A patient opting for the progestin-only pill needs counseling. What is the MOST important instruction?
A 34-year-old G0 patient is interested in long-acting reversible contraception, but has a known Nickel allergy. Which of the following is the MOST appropriate choice?
A 34-year-old G0 patient is interested in long-acting reversible contraception, but has a known Nickel allergy. Which of the following is the MOST appropriate choice?
Which of the following is a routine first-trimester laboratory test for a pregnant woman?
Which of the following is a routine first-trimester laboratory test for a pregnant woman?
What is the medical term for the fluttering movements felt by a pregnant woman around 16 weeks gestation?
What is the medical term for the fluttering movements felt by a pregnant woman around 16 weeks gestation?
A patient at 28 weeks gestation undergoes a 1-hour glucose tolerance test (GTT). Which of the following results would require a follow-up 3-hour GTT?
A patient at 28 weeks gestation undergoes a 1-hour glucose tolerance test (GTT). Which of the following results would require a follow-up 3-hour GTT?
What is the most common cause of postpartum hemorrhage?
What is the most common cause of postpartum hemorrhage?
Which of the following is the most likely diagnosis for a 36-week pregnant woman presenting with painless vaginal bleeding?
Which of the following is the most likely diagnosis for a 36-week pregnant woman presenting with painless vaginal bleeding?
Which fetal heart rate pattern is most concerning for uteroplacental insufficiency?
Which fetal heart rate pattern is most concerning for uteroplacental insufficiency?
A 22-year-old pregnant woman presents with fever, uterine tenderness, and foul-smelling lochia three days postpartum. What is the most likely diagnosis?
A 22-year-old pregnant woman presents with fever, uterine tenderness, and foul-smelling lochia three days postpartum. What is the most likely diagnosis?
Which screening test is performed between 15-20 weeks to assess for neural tube defects?
Which screening test is performed between 15-20 weeks to assess for neural tube defects?
A 30-year-old woman presents at 10 weeks gestation with severe nausea, vomiting, and dehydration. What is the most likely diagnosis?
A 30-year-old woman presents at 10 weeks gestation with severe nausea, vomiting, and dehydration. What is the most likely diagnosis?
A 28-year-old woman at 36 weeks presents with a fundal height measuring at 30 cm. What is the most likely cause?
A 28-year-old woman at 36 weeks presents with a fundal height measuring at 30 cm. What is the most likely cause?
Which of the following is an indication for Rhogam administration at 28 weeks?
Which of the following is an indication for Rhogam administration at 28 weeks?
A 37-week pregnant woman experiences a "gush of fluid" followed by continuous leakage. Which test confirms rupture of membranes?
A 37-week pregnant woman experiences a "gush of fluid" followed by continuous leakage. Which test confirms rupture of membranes?
A patient with gestational diabetes is at increased risk for which neonatal complication?
A patient with gestational diabetes is at increased risk for which neonatal complication?
A 20-year-old woman at 38 weeks presents with painful contractions every 3 minutes and cervical dilation of 5 cm. She is in which stage of labor?
A 20-year-old woman at 38 weeks presents with painful contractions every 3 minutes and cervical dilation of 5 cm. She is in which stage of labor?
Which of the following is a contraindication to vaginal birth after cesarean (VBAC)?
Which of the following is a contraindication to vaginal birth after cesarean (VBAC)?
What is the gold standard for diagnosing gestational diabetes?
What is the gold standard for diagnosing gestational diabetes?
What is first line medication for treating eclampsia?
What is first line medication for treating eclampsia?
A pregnant patient has a positive Group B Strep (GBS) culture at 36 weeks. What is the appropriate management?
A pregnant patient has a positive Group B Strep (GBS) culture at 36 weeks. What is the appropriate management?
Which condition is characterized by hypertension, proteinuria, and hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome)?
Which condition is characterized by hypertension, proteinuria, and hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome)?
A 34-week pregnant woman has sudden severe abdominal pain, vaginal bleeding, and a firm, tender uterus. What is the most likely diagnosis?
A 34-week pregnant woman has sudden severe abdominal pain, vaginal bleeding, and a firm, tender uterus. What is the most likely diagnosis?
A 40-week pregnant woman is undergoing labor induction. Which is the most commonly used agent?
A 40-week pregnant woman is undergoing labor induction. Which is the most commonly used agent?
Which fetal heart rate tracing pattern is associated with umbilical cord compression?
Which fetal heart rate tracing pattern is associated with umbilical cord compression?
Which hormone is responsible for maintaining the corpus luteum and supporting pregnancy?
Which hormone is responsible for maintaining the corpus luteum and supporting pregnancy?
Which maneuver is used to determine fetal lie and position in late pregnancy?
Which maneuver is used to determine fetal lie and position in late pregnancy?
Which prenatal test is used to assess fetal lung maturity?
Which prenatal test is used to assess fetal lung maturity?
A 25-year-old primigravida at 30 weeks gestation presents with a blood pressure of 160/110 mmHg, 5 g of protein in a 24-hour urine collection, and complaints of headaches and visual disturbances. What is the most appropriate next step?
A 25-year-old primigravida at 30 weeks gestation presents with a blood pressure of 160/110 mmHg, 5 g of protein in a 24-hour urine collection, and complaints of headaches and visual disturbances. What is the most appropriate next step?
What is the primary function of the foramen ovale in fetal circulation?
What is the primary function of the foramen ovale in fetal circulation?
Which of the following statements about gestational trophoblastic disease (molar pregnancy) is true?
Which of the following statements about gestational trophoblastic disease (molar pregnancy) is true?
Which of the following increases the risk of ectopic pregnancy?
Which of the following increases the risk of ectopic pregnancy?
A 35-year-old G2P1 woman at 36 weeks gestation presents with severe upper abdominal pain, nausea, and headache. Her labs reveal hemolysis, elevated liver enzymes, and a platelet count of 85,000. What is the best management?
A 35-year-old G2P1 woman at 36 weeks gestation presents with severe upper abdominal pain, nausea, and headache. Her labs reveal hemolysis, elevated liver enzymes, and a platelet count of 85,000. What is the best management?
At what gestational age does fetal lung surfactant production become sufficient to support extrauterine life?
At what gestational age does fetal lung surfactant production become sufficient to support extrauterine life?
A pregnant patient is diagnosed with oligohydramnios. Which of the following is a potential cause?
A pregnant patient is diagnosed with oligohydramnios. Which of the following is a potential cause?
Which of the following is a normal adaptation of pregnancy?
Which of the following is a normal adaptation of pregnancy?
Which of the following tests should be performed at 35-37 weeks gestation?
Which of the following tests should be performed at 35-37 weeks gestation?
Flashcards
Chadwick's Sign
Chadwick's Sign
Bluish discoloration of the cervix, vagina, and labia during pregnancy.
Hegar's Sign
Hegar's Sign
Softening of the cervix, indicating pregnancy.
Quickening
Quickening
Patient's initial perception of fetal movements, usually between 16-20 weeks.
Patent Ductus Arteriosus (PDA)
Patent Ductus Arteriosus (PDA)
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Foramen Ovale
Foramen Ovale
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Ductus Venosus
Ductus Venosus
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Naegele's Rule
Naegele's Rule
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Transient Hypertension
Transient Hypertension
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Chronic Hypertension in Pregnancy
Chronic Hypertension in Pregnancy
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Pregnancy Induced Hypertension (PIH)
Pregnancy Induced Hypertension (PIH)
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Pre-eclampsia
Pre-eclampsia
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Severe Pre-eclampsia
Severe Pre-eclampsia
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Mild pre-eclampsia
Mild pre-eclampsia
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Gestational Hypertension
Gestational Hypertension
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Pre-eclampsia S&S
Pre-eclampsia S&S
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Multiple gestation
Multiple gestation
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Etonogestrel Implant (Nexplanon)
Etonogestrel Implant (Nexplanon)
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Etonogestrel Implant Side Effects
Etonogestrel Implant Side Effects
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Etonogestrel Implant Contraindications
Etonogestrel Implant Contraindications
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Emergency Contraception (EC)
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Ella (Ulipristal Acetate)
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Cervical Cap
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Contraceptive Sponge
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Long-Acting Reversible Contraceptives (LARCs)
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IUD Contraindications
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Hormonal IUD
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Copper IUD (ParaGard)
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Depot Medroxyprogesterone Acetate (DMPA)
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DMPA Side Effects
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Diaphragm Use
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Diaphragm
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3-Hour GTT
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GDM Diagnostic Values
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GDM Initial Treatment
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Progestin-Only Pills Mechanism
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Progestin-Only Pills Timing
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Progestin-Only Pills Indications
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Transdermal Patch Schedule
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Transdermal Patch Placement
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Transdermal Patch Efficacy
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Severe Pre-eclampsia Definition
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Mild Pre-eclampsia Definition
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HELLP Syndrome
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MgSO4 in Preeclampsia
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Pathophysiology of GDM
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HELLP Syndrome Treatment >34 Weeks
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Management of Mild Preeclampsia
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Insulin resistance during preg
Insulin resistance during preg
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Screening in women w/H/O GDM
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Signs of preeclampsia
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GDM: Diagnostic Criteria
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GDM: Treatment
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WHO Definition of Amenorrhea
WHO Definition of Amenorrhea
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Confirming Viable Pregnancy
Confirming Viable Pregnancy
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Treatment options for nonviable pregnancy.
Treatment options for nonviable pregnancy.
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Transdermal Patch Use
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Rings Function
Rings Function
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Cervical Cap Placement
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Copper IUD
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Diaphragm Use Time Frame
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Hormonal IUDs Function
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Hormonal IUD Side Effects
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Hormonal IUD Types
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Etonogestrel Implant Placement Timing
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Etonogestrel Implant Common Side Effects
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Etonogestrel Implant Key Contraindications
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Emergency Contraception Mechanism
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Copper IUD for Emergency Contraception
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Prenatal Screening vs. Diagnostic Tests
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Biophysical Profile (BPP)
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Umbilical Vessels
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Non-Stress Test (NST)
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Contraction Stress Test (CST)
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Subjective Fetal Well-Being Assessment
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VEAL CHOP
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Chronic Hypertension
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Severe Pre-eclampsia Criteria
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Pre-eclampsia Symptoms
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Pre-eclampsia Risk Factors
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Mild Pre-eclampsia Criteria
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Plan B One-Step/Next Choice
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Copper IUD for EC
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GDM Screening vs. Diagnosis
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GDM Treatment Order
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Primary vs. Secondary Amenorrhea
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Contraceptive Ring Use Cycle
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Diaphragm Insertion and Removal
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Progestin-Only Pill: Missed Pill Protocol
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Progestin-Only Pills: Best Use Cases
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Diaphragm: Mechanism of Action
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Diaphragm: Proper Usage
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Transdermal Patch Cycle
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Normal CV changes in pregnancy
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Gestational Age
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First Trimester Screening
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Maternal serum AFP screens for:
Maternal serum AFP screens for:
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Patent Ductus Arteriosus (PDA) in Fetus
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Foramen Ovale in Fetus
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Pre-eclampsia Definition
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Etonogestrel Implant
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Emergency Contraception
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Severe Pre-eclampsia Management
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HELLP Syndrome Symptoms
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HELLP Syndrome Treatment
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Postpartum GDM Screening
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Lifelong Screening Post-GDM
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GDM Pathophysiology
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GDM Screening Test
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MgSO4: Monitoring
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Treating High BP
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GDM Screening Window
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GDM: When to use Insulin
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Combo Pill Benefits
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Progestin-Only Pill MOA
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Contraceptive Ring Schedule
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Diaphragm Timing
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Diaphragm Basics
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PCOS Symptoms
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hCG levels post pregnancy
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Estrogen OCP Contraindications
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1st Prenatal Visit Labs
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What is Quickening?
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GTT Follow-Up Value
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Uterine Atony
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Placenta Previa
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Late Decelerations
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Endometritis
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Maternal Serum AFP Test
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Hyperemesis Gravidarum
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Oligohydramnios
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Rhogam Indication
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Nitrazine/Ferning Test
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Shoulder Dystocia
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First Stage, Active Labor
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VBAC Contraindication
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Magnesium Sulfate
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IV Penicillin for GBS
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Placental Abruption
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Oxytocin
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Variable Decelerations
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hCG Function
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Leopold's Maneuvers
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Amniocentesis use
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Treatment of hypertension and proteinuria
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GTD or Molar Pregnancy
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PID
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Study Notes
Okay, I have updated the study notes below:
Antepartum Stress & Disparities
- Stress hypothesis focuses on how stressful events during pregnancy affect mother and fetus.
- Acute stress during pregnancy, lifetime stressors, and pre-pregnancy stressors affects perinatal outcomes.
- Non-Hispanic Black women face maternal mortality rates 3-4 times higher than White women.
- Hemorrhage, CV issues, cardiomyopathy, preeclampsia, embolism are the most common causes of death.
Late Pregnancy Changes & Labor
- Increased uterine contraction strength and frequency is expected.
- Braxton-Hicks contractions are normal contractions.
- "Lightening" is a shape change due to sensation of the baby "dropping".
- Ruptured Membranes (ROM) involves a gush/leak of fluid = Water Broke!
- Bloody show is passage of blood-tinged mucus as the cervix effaces.
- Cervical effacement is common before true labor.
- True labor: regular, painful uterine contractions that causes cervical dilation and birth.
Braxton Hicks vs True Labor
- Braxton Hicks is not associated with cervical dilation or intense discomfort.
- Braxton Hicks contractions are localized in the lower abdomen and is alleviated by hydration.
Fetal Positioning & Heart Tones
- Leopold maneuvers are 4-step palpations to the fetus to determine the fetal lie, presentation, and position.
- Variable decels: cord compression --> place pt in knee-chest position!
- Late Decels: worrisome --> Fetal Hypoxia
Pain Management
- Epidural Block: local anesthetic + opioid, administered via continuous IV infusion.
- Spinal Anesthesia: has more rapid onset than epidural, but is short lived, and preserves ambulation
Stages of Labor
- 1st stage: contractions lead to cervical dilation
- Latent stage = onset
- Active stage = active maternal pushing
- 2nd stage: complete cervical dilation
- Passive Stage = complete cervical dilation and no maternal pushing is occurring
- Active Stage = when pushing occurs
- 3rd stage: cord clamp or delivery of the placenta
- 4th stage: The first 1-2hrs post-delivery period
Assessment After Labor
- Stage 4 has complications
- Observe for spontaneous placental extrusion, ensure all pieces are present.
- Check the umbilical cord for 2 arteries and 1 vein.
- Evaluate lochia.
Postpartum Care
- Palpate uterus for tone
- Check Perineal pad
- Monitor vitals.
- Lochia changes: heavy for days then lasts wks with the following colors:
- rubra = blood
- serosa = less blood
- alba = white discharge
- Average time to ovulation occurs at day 45 non nursing, or 189 days while lactating.
Postpartum Depression & Anxiety
- Blues occur in 70-80% of women
- Depression in 10%
- Psychosis: weeks later
Metritis & Infant Care
- Metritis (endomyometritis) is infection of uterus
- Evaluation of infant includes wiping nose/face, clamping cord, keep warm, with Kangaroo care for preemies
- Ilotycin is antibacterial to prevent neonatal conjunctivitis gonorrhea
Abnormal & Difficult Labors - The3 Ps
- eval the Ps should be Evaled: Powers, Passengers, Pelvis
Passenger & Powers
- Passenger = Fetal wt
- passenger include w/ shoulder dystocia >4000g
Induction of Labor
- Stimulate uterine contractions before labor on its own: Aim for vaginal birth.
- Methods include Balloon, Membrane stripping, Cytotec
- With favorable cervix, it is centimeters, effaced, soft & anterior RIPE cervix
- In the inverse, use Prostaglandins, and DO NOT rupture sac
Group B STR
- V- test vaginal at/ after 4 weeks before delivery
- Positive test needs PCN ABX:
- indicators - preterm. rupture, GBS UTI
C/S and hydatidiform mole
- MC is failure to progress during labor is an indication.
- hydatidiform mole occurs after aberrant certificate
PP Hemorrhage
- Separation cords for separation, includes increased bleeding, Shape of change.
Pregnancy Loss
- Placenta Accreta. the placenta DOES penetrate uterus. Causes BLeeding
Ectopic Pregnancy - loss
- Often in the Fallo tubes!
- Assess pt reproductive age.
Contraception (sterilization)
- Male sterilization should Occlude Vas Deferens with SE.
- Female has Occlusion tubes where they apply clips (filshie clips).
Sterilization Stats
- Most women who didn't use OCP or OCs correctly are MC cause of unintended pregnancy
- Combo pills includes minipills
Sterilization Stats
- Sterilization comes in many form which includes implants and removals
IUDs
- adolescent canidates ideal
Contraindications to IUDs
- uterus, abnormal uterine, cancer/ infection to uterus, and pregnancy for these device.
side effects for IUDs
- IUD has increase PID< spont eruption to uterus.
Nex/ Inplaton
- approved for 3 years.
progesterone Injections
- caution on bone density should should consider benefit and risks.
Side effects injections
- injections Similar IUD
Some Stats w/ side effects
- Pt breast CA, vaginal bleed with undetermed cause
Sterization Side effects
- pt needs to be in the 5 dats to determine if preg or not
Side effects
- copper.
Contra
- contra breast MC females problem: ovulatory dysfunction can use ART
- If MC females problem: ovulatory dyfucntion and can use ART has high percent sucess.
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