5. Obstetrics and Gynecology Flashcards

A hydatidiform mole is also known by what name?

Gestational trophoblastic disease (GTD) is characterized by abnormal proliferation of what?

Following aberrant fertilization, which condition is most likely to occur, representing a type of gestational trophoblastic disease?

Which of the following processes is central to the etiology of both complete and partial molar pregnancies?

A patient is diagnosed with gestational trophoblastic disease (GTD). Histopathological examination reveals widespread villous edema and trophoblastic proliferation with no identifiable embryonic or fetal tissue. Which specific type of GTD is most consistent with these findings?

A patient presents with abnormal uterine bleeding and significantly elevated hCG levels. Which condition is MOST likely?

Which of the following is the MOST common location for an ectopic pregnancy?

A 38-year-old female with a history of pelvic inflammatory disease (PID) and previous tubal surgery presents with amenorrhea, vaginal bleeding, and right lower quadrant abdominal pain. Which of the following conditions should be HIGHLY suspected?

A patient is diagnosed with a complete hydatidiform mole. What is the MOST appropriate initial treatment?

Which of the following serum progesterone levels would suggest a nonviable pregnancy?

A 36-year-old female presents with vaginal bleeding, a uterus larger than expected for her gestational age, and absence of fetal heart tones. Her quantitative beta-hCG is >100,000 mU/mL. Which of the following ultrasound findings is MOST suggestive of a complete hydatidiform mole?

A 28-year-old woman is diagnosed with a partial hydatidiform mole. Which of the following is the recommended initial management?

Following evacuation of a complete hydatidiform mole, which of the following monitoring protocols is MOST crucial?

A 30-year-old patient who recently had a complete hydatidiform mole evacuated is asking about future pregnancies. What is the MOST appropriate recommendation regarding contraception?

Which of the following scenarios presents the HIGHEST risk of developing gestational trophoblastic neoplasia (GTN)?

A 40-year-old woman is diagnosed with gestational trophoblastic neoplasia (GTN) following a complete hydatidiform mole. She has persistent elevated beta-hCG levels despite D&C. Which of the following is the MOST appropriate next step in management?

A 25-year-old RhD-negative woman undergoes D&C for a suspected complete hydatidiform mole. What additional intervention should be considered after the procedure?

A 32-year-old patient presents with symptoms suggestive of hyperthyroidism, including tachycardia, warm skin, and tremors, during the second trimester of a pregnancy that was later diagnosed as a complete hydatidiform mole. What is the underlying mechanism MOST likely contributing to these symptoms?

A 24-year-old G1P0 presents to the clinic complaining of vaginal bleeding and abdominal cramping. She reports that her last menstrual period was approximately 8 weeks ago, but she has not had a positive pregnancy test. Which of the following is the MOST important next step in evaluating this patient?

Which of the following signs or symptoms is LEAST likely to be associated with a spontaneous abortion?

A 32-year-old G2P1 presents to the emergency department with complaints of severe abdominal pain and vaginal bleeding. She reports a history of a previous ectopic pregnancy treated with salpingectomy. Her vital signs are stable. A bedside ultrasound reveals no intrauterine pregnancy, and a moderate amount of free fluid in the cul-de-sac is noted. Her beta-hCG level is 1500 mIU/mL. What is the MOST appropriate next step in management?

A patient experiencing early pregnancy loss at 7 weeks gestation reports passing a large amount of tissue at home and is now experiencing heavy bleeding. Upon examination, the cervical os is open, and tissue is visible. Vital signs are stable. What is the MOST appropriate next step in management?

A 26-year-old G1P0 presents with a suspected ectopic pregnancy. Her beta-hCG is 1800 mIU/mL. Transvaginal ultrasound reveals no intrauterine pregnancy, and a 1.5 cm adnexal mass is seen. She is hemodynamically stable and reports minimal pain. Which of the following factors would be an ABSOLUTE contraindication to methotrexate therapy?

A 29-year-old G1P0 presents to the emergency department complaining of vaginal bleeding and lower abdominal pain. She reports that she is approximately 8 weeks pregnant based on her last menstrual period, but she has not had a positive pregnancy test. Besides obtaining a pregnancy test, which of the following is the MOST crucial next initial step in evaluating this patient?

Which of the following signs and symptoms would be LEAST likely associated with a spontaneous abortion?

A 35-year-old female presents to the clinic complaining of vaginal bleeding and right-sided abdominal pain. She reports a positive pregnancy test 6 weeks ago based on her last menstrual period but has not had an ultrasound. She denies any prior history of ectopic pregnancy or pelvic inflammatory disease. Her vital signs are stable. A bedside ultrasound reveals no intrauterine pregnancy. Her beta-hCG level is 1,200 mIU/mL. Which of the following diagnoses is LEAST likely on the differential?

A patient at 10 weeks gestation presents with heavy vaginal bleeding, severe abdominal cramping, and passage of grape-like vesicles. Her beta-hCG level is significantly elevated. Which of the following conditions is MOST likely?

A 28-year-old female presents to the emergency department with severe lower abdominal pain and vaginal bleeding. She reports a history of irregular menstrual cycles and has not had a positive pregnancy test. On examination, she has significant abdominal tenderness, and her vital signs are stable. A bedside ultrasound reveals no intrauterine pregnancy and a small amount of free fluid in the cul-de-sac. Her beta-hCG level is 1,000 mIU/mL. What is the MOST appropriate next step in management?

A patient at 8 weeks gestation presents to the clinic with mild vaginal spotting and lower abdominal cramping. On examination, the cervical os is closed, and the ultrasound reveals a viable intrauterine pregnancy with a fetal heartbeat. What is the MOST likely diagnosis?

A 30-year-old female presents to the clinic with a history of irregular menstrual cycles and difficulty conceiving. She reports a positive pregnancy test 5 weeks ago but has now started experiencing vaginal bleeding and lower abdominal pain. An ultrasound reveals no intrauterine pregnancy, and her beta-hCG level is 800 mIU/mL. Which of the following statements is the MOST accurate regarding the next appropriate step in management?

Which of the following is the MOST important risk factor associated with spontaneous abortion in the first trimester?

A 25-year-old G1P0 patient presents to the emergency department complaining of vaginal bleeding that started approximately 2 hours prior to arrival, and abdominal cramping. She reports that her last menstrual period was 7 weeks ago. She denies ever having a positive pregnancy test. On exam you see the cervical os is open. What is the MOST likely type of abortion this patient is experiencing?

A 32-year-old G2P1 patient presents to the emergency department complaining of severe abdominal pain and vaginal bleeding. She reports a history of missed abortion 6 months prior. She denies any other significant medical history. The patient's vital signs are concerning for hypotension and tachycardia. Pelvic exam reveals a closed cervical os and significant cervical motion tenderness. Which of the following is the MOST concerning finding?

A 19-year-old G0 presents to the ED complaining of bright red vaginal bleeding and abdominal cramping over the last 8 hours. She states she feels pregnant but has not taken a pregnancy test. She believes her LNMP was approximately 12 weeks ago. When considering the initial differential diagnosis, which of the following is the LEAST likely?

A patient presents with vaginal bleeding, abdominal pain, and the passage of tissue. She reports a history of feeling pregnant but has not had a pregnancy test. Besides obtaining a pregnancy test, which of the following is the MOST critical next step?

A patient presents to the emergency department with vaginal bleeding and abdominal pain. Her last menstrual period was approximately 7 weeks ago, and she has not had a positive pregnancy test. The physician suspects an early pregnancy complication. Which test needs to be ordered FIRST?

A 28-year-old G1P0 patient at 9 weeks gestation presents with vaginal bleeding and lower abdominal pain. On examination, the cervical os is closed. An ultrasound reveals a gestational sac with a yolk sac but no visible fetal pole. Beta-hCG levels are declining. Which of the following is the MOST likely diagnosis?

A 31-year-old female presents with vaginal bleeding, cramping, and passage of tissue. She reports having a positive pregnancy test two weeks prior. Examination reveals an open cervical os with tissue in the cervical canal. Her vital signs are stable. What type of abortion is she MOST likely experiencing?

A 25-year-old female presents to the clinic complaining of vaginal bleeding and abdominal cramping. She reports a positive pregnancy test approximately 6 weeks ago. On examination, the cervical os is closed, and the ultrasound reveals a viable intrauterine pregnancy. What is the MOST appropriate next step in management??

Which of the following findings would be LEAST consistent with inevitable abortion?

During an evaluation for early pregnancy loss, a patient's beta-hCG level is 1,500 mIU/mL. A transvaginal ultrasound fails to visualize an intrauterine pregnancy. What is the MOST appropriate next step?

A 34-year-old patient presents with a history of vaginal bleeding and the passage of tissue. Ultrasound confirms the presence of some, but not all, products of conception in the uterus. What is the MOST appropriate diagnosis?

A patient presents to the emergency department complaining of vaginal bleeding and abdominal pain. She reports that her last menstrual period was 6 weeks ago and had a positive pregnancy test 1 week prior. She denies passing any tissue. On examination, the cervical os is closed. The patient is hemodynamically stable. An ultrasound reveals an intrauterine pregnancy. Which of the following is the MOST likely diagnosis?

What is the primary objective when managing preterm labor?

Which of the following is LEAST likely a neonatal consequence of preterm delivery?

What is the primary concern regarding premature rupture of membranes (PROM)?

What is the significance of the discriminatory zone in the context of ectopic pregnancy?

In Rh alloimmunization, what fetal condition results in severe edema and fluid accumulation?

What is the Kleihauer-Betke test used for in the context of Rh-negative pregnancies?

What is the most immediate risk associated with placenta abruptio?

In the management of placenta previa, what is the primary determinant of the delivery method?

What laboratory finding is most indicative of significant postpartum hemorrhage?

Which clinical scenario would MOST strongly suggest the need for Anti-D immune globulin administration?

Preterm labor is clinically defined as regular uterine contractions occurring between which gestational age ranges?

Which of the following maternal factors is considered a risk factor for preterm labor?

Which class of medications is NOT typically used in the management of preterm labor according to the provided information?

Corticosteroids are administered to women in preterm labor to accelerate fetal lung maturity. Which of the following corticosteroid regimens involves a total of four doses?

Which of the following is a potential neonatal consequence specifically associated with preterm delivery?

Respiratory Distress Syndrome (RDS) in neonates is primarily caused by a deficiency of which substance?

Which of the following interventions is a primary treatment strategy for Respiratory Distress Syndrome (RDS) in neonates?

A 28-year-old pregnant woman at 32 weeks gestation, with a history of smoking and a prior preterm birth at 34 weeks, presents with regular uterine contractions and documented cervical change. Considering her risk factors and presentation, which initial management strategy directly targets the acceleration of fetal lung maturity and is most beneficial for neonatal outcomes in this preterm scenario?

What is the standard intramuscular dose of Anti-D immune globulin given to Rh-negative mothers?

A 35-year-old G1P0 woman at 36 weeks gestation presents with leakage of clear fluid. She denies contractions or bleeding. What is an appropriate diagnostic test to confirm spontaneous rupture of membranes (SROM)?

Which of the following is considered a risk factor for PROM?

A 17-year-old G1 female at 34 weeks gestation presents with lower abdominal cramping and lower back pain. She reports 3-5 contractions per hour. Examination reveals the cervix is 1 cm dilated and 60% effaced. What is the MOST immediate concern in the management of this patient?

Which of the following is a potential complication associated with PROM?

In cases of confirmed PREMATURE RUPTURE OF MEMBRANES (PROM) without active labor, what medication is administered to the mother to help accelerate fetal lung maturity?

Which test, when positive, is MOST indicative of the presence of amniotic fluid?

A patient at 30 weeks gestation presents with PPROM. After administering corticosteroids, which of the following management strategies would be MOST appropriate?

Which of the following neonatal complications is MOST directly associated with chronic oligohydramnios resulting from prolonged PPROM before 26 weeks gestation?

A previously unsensitized Rh-negative woman delivers a healthy Rh-positive baby at term. Assuming standard protocols are followed, when should the mother receive Rh immune globulin to prevent alloimmunization?

A patient presents with abdominal pain, vaginal bleeding, and a positive pregnancy test. Her quantitative serum hCG is 3,000 mIU/mL. Transvaginal ultrasound shows no intrauterine pregnancy. Which of the following is the MOST likely diagnosis, considering the discriminatory zone?

A patient with a history of pelvic inflammatory disease presents with left lower quadrant abdominal pain, vaginal spotting, and a positive pregnancy test. Her last menstrual period was 6 weeks ago. Transvaginal ultrasound reveals an empty uterus. The quantitative beta-hCG level is 1800 mIU/mL. Which of the following management options is MOST appropriate?

In the context of ectopic pregnancy, what does the 'discriminatory zone' refer to concerning serum hCG levels?

A 28-year-old female presents to the emergency department complaining of right lower quadrant abdominal pain and vaginal bleeding. She reports a positive pregnancy test one week ago. Her vital signs are stable. Transvaginal ultrasound reveals an empty uterus. Her beta-hCG level is 1600 mIU/mL. Considering the location of most ectopic pregnancies, where is the MOST likely location of this pregnancy?

A patient experienced a prior ectopic pregnancy treated with salpingectomy and is now presenting with symptoms suggestive of another ectopic pregnancy. The physician is considering both methotrexate and surgical management. Which of the following factors would MOST strongly favor surgical management over methotrexate in this scenario?

Which of the following is the MOST critical concern regarding premature rupture of membranes (PROM)?

A patient with two prior cesarean sections presents with painless vaginal bleeding at 32 weeks gestation. Ultrasound reveals the placenta completely covering the internal cervical os. Which condition is MOST likely?

During the third stage of labor, an Rh-negative mother is exposed to fetal Rh-positive blood. Which of the following is NOT an event that may lead to alloimmunization in this scenario?

A fetus experiencing hemolytic disease due to Rh alloimmunization is at risk for developing immune hydrops fetalis. What is the primary mechanism leading to this condition?

A 28-year-old Rh-negative (Rh-) woman delivers a healthy Rh-positive (Rh+) baby. She did not receive Rh immunoglobulin during her pregnancy. When should she receive Rh immunoglobulin to prevent alloimmunization?

In Rh genetics, if both parents are Rh-positive (Rh+), what is the likelihood that their child will be Rh-negative (Rh-)?

Cord compression is most likely associated with?

A 30-year-old G1P0 presents with vaginal bleeding and is diagnosed with placenta previa at 28 weeks gestation. Which of the following instructions should be given to the patient?

Which of the following ultrasound findings is MOST suggestive of placenta accreta spectrum?

A 32-year-old G3P2 presents at 35 weeks gestation with painless vaginal bleeding. Ultrasound confirms placenta previa. She is hemodynamically stable and not in labor. Which of the following is the MOST appropriate next step in management?

A 30-year-old female, G2P1, presents to the emergency department complaining of lower abdominal pain and vaginal bleeding. She states she is approximately 7 weeks pregnant based on her last menstrual period. Her vital signs are stable. Transvaginal ultrasound reveals no intrauterine pregnancy, and the adnexa are difficult to visualize due to patient discomfort. Her beta-hCG level is 1,800 mIU/mL. Which of the following is the MOST appropriate next step in managing this patient?

Which of the following patient profiles is MOST likely to develop an ectopic pregnancy?

A hemodynamically stable patient is diagnosed with an ectopic pregnancy and has a beta-hCG level of 800 mIU/mL. An ultrasound reveals a 2 cm unruptured ectopic mass. Which of the following is the MOST appropriate initial treatment option?

Which of the following findings would be MOST concerning in a patient presenting with painless bright red vaginal bleeding at 28 weeks gestation?

Which of the following factors is LEAST associated with an increased risk of postpartum hemorrhage (PPH)?

Which of the following is the MOST appropriate first-line intervention for uterine atony resulting in postpartum hemorrhage after vaginal delivery?

A 26-year-old G1P0 Rh-negative woman delivers a healthy, Rh-positive infant. She received Rhogam at 28 weeks gestation. However, a large fetal-maternal hemorrhage is suspected. Which of the following is the MOST appropriate next step to determine the correct dose of Anti-D immune globulin?

A 35-year-old G3P2 woman at 32 weeks gestation presents with painless vaginal bleeding. Ultrasound reveals a placenta completely covering the internal cervical os. Which of the following is the MOST appropriate management approach?

Which of the following is the MOST critical factor to consider when determining the route of delivery (vaginal vs. cesarean) in a patient diagnosed with placenta previa?

A 24-year-old G1P0 presents at 26 weeks gestation complaining of a gush of fluid from her vagina approximately 2 hours ago. On examination, you note pooling of clear fluid in the posterior fornix, and a nitrazine test is positive. Ferning is also noted. Which of the following is the MOST appropriate next step in management, assuming there are no signs of infection, labor, or fetal distress?

A patient presents with vaginal bleeding, abdominal pain, and reports passing tissue. The patient has NOT taken a pregnancy test, so, besides that, what is the MOST critical next step?

A 17-year-old, G0 presents with a primary complaint of bright red vaginal bleeding and abdominal cramping of 6 hours duration. The patient reports feeling pregnant, but with no pregnancy test accomplished. Believes her LNMP was 3+ months ago, and the PMH and surgical history are non-contributory. Which of the following is the LEAST likely diagnosis?

A 32-year-old G2P1 patient presents to the emergency department complaining of severe abdominal pain and vaginal bleeding. She reports a history of missed abortion 6 months prior. She denies any other significant medical history. The patient's vital signs show hypotension and tachycardia. Pelvic exam reveals a closed cervical os and significant cervical motion tenderness. Which of the following is the MOST concerning finding?

A patient presents with vaginal bleeding, abdominal pain, and the passage of tissue. The patient gives a history of feeling pregnant, despite the lack of a pregnancy test. Besides obtaining a pregnancy test, which of the following is the MOST critical next step?

At which gestational age does spontaneous abortion typically occur?

A patient tests for serum beta-hCG, and the level is 1,500 mIU/mL. A transvaginal ultrasound fails to visualize an intrauterine pregnancy. What is the MOST appropriate next step?

A 34-year-old patient presents with both vaginal bleeding and the passage of tissue. Ultrasound confirms the presence of some, but not all, products of conception in the uterus. What is the MOST appropriate diagnosis?

A patient at 9 weeks gestation presents with vaginal bleeding and the passage of grape-like vesicles. Her beta-hCG level registers significantly elevated. Which condition is MOST likely?

A 28-year-old female presents to the emergency department complaining of severe lower abdominal pain and vaginal bleeding. She reports a history of irregular menstrual cycles and has not had a positive pregnancy test. On examination, she has significant abdominal tenderness. Her vital signs are stable. A bedside ultrasound reveals no intrauterine pregnancy and a small amount of free fluid in the cul-de-sac. Her beta-hCG level registers 1,000 mIU/mL. What is the MOST appropriate next step in management?

When a patient experiencing early pregnancy loss at 7 weeks gestation reports passing a large amount of tissue at home and is now experiencing heavy bleeding, and the examination reveals an open cervical os with tissue visible, what is the MOST appropriate next step in management?

A patient presents with vaginal bleeding, abdominal pain, and passage of tissue. The patient has felt pregnant but never took a pregnancy test. Besides ordering a pregnancy test, what is the MOST critical next step?

A 17-year-old, G0 presents with a primary complaint of bright red vaginal bleeding and abdominal cramping of 6 hours duration. The patient reports feeling pregnant, but states her LNMP was 3+ months ago, and no pregnancy test was accomplished. PMH and surgical history are non-contributory. Which of the following is the LEAST likely diagnosis?

What symptoms may indicate a spontaneous abortion?

A patient presents with bleeding and pain. What type of pregnancy can cause bleeding?

Vaginal bleeding and abdominal pain can occur in which of the following non-viable pregnancy condition?

The passing of a pregnancy at ________ weeks is considered a spontaneous abortion.

What is a symptom of spontaneous abortion mentioned?

What is considered an abnormality in pregnancies in reference to this presentation?

Spontaneous abortion is defined as the passing of a pregnancy at less than _____ weeks gestation?

A 17-year-old, G0 presents with a 6-hour history of bright red vaginal bleeding and abdominal cramping. She reports feeling pregnant, but has not taken a pregnancy test. The patient probably has which condition?

Which symptom is LEAST associated with spontaneous abortion?

Bright red vaginal bleeding and abdominal cramping are most indicative of _____.

The MOST common symptoms of early pregnancy abnormalities include vaginal __________ and abdominal __________.

In a non-viable intrauterine pregnancy, which of the following is UNLIKELY?

Which condition may present with vaginal bleeding but is NOT an abortion?

Which type of bleeding in early pregnancy is generally considered benign?

Loss of pregnancy symptoms is suggestive of which condition?

Symptoms of abortion include vaginal bleeding and what other symptom?