Obstetrics and Gynecology Self-Assessment Questions PDF

Exam Section : Item 1 of 50 National Board of Medical Examiners Time Remaining: Mark Obstetrics and Gynecology Self-Assessment 4 hr 59 min 57 sec 1. A previ...

Exam Section : Item 1 of 50 National Board of Medical Examiners Time Remaining: Mark Obstetrics and Gynecology Self-Assessment 4 hr 59 min 57 sec 1. A previously healthy 39-year-old woman at 37 weeks' gestation comes to the emergency department 2 hours after the onset of acute pain in the left hemithorax. She says that the pain is exacerbated by breathing. Her temperature is 38.2°C (100.8°F), pulse is 120/min, respirations are 24/min, and blood pressure is 110/70 mm Hg. Fetal heart tones are 170/min. Examination shows no abnormalities. An x-ray of the chest shows no abnormalities. An ECG shows nonspecific changes. Arterial blood gas analysis on room air shows: pH 7.43 PCOz 35 mm Hg Po 2 70 mm Hg Which of the following is the most likely diagnosis? Q A) Angina pectoris Q B) Costochondritis Q C) Myocardial infarction Q D) Pulmonary embolus Q E) Viral pneumonia "' ~ r-- , r ,,, Next Lab Values Calculator Review Help Pause Exam Section : Item 2 of 50 National Board of Medical Examiners Time Remaining: Mark Obstetrics and Gynecology Self-Assessment 4 hr 59 min 48 sec 2. A 52-year-old woman comes to the physician for a routine examination. She has mild hypothyroidism well controlled with levothyroxine. Five years ago, she was diagnosed with stage I breast cancer; she completed tamoxifen therapy 1 year ago and is currently in remission. Menopause occurred 4 years ago. Her mother sustained a femoral fracture in a bicycle collision at the age of 55 years. The patient has smoked two cigarettes weekly for 25 years. She is 150 cm (4 ft 11 in) tall and weighs 43 kg (95 lb); BMI is 19 kg/m 2 Examination shows no thyromegaly. There is a small, well-healed surgical scar over the upper outer quadrant of the left breast. The remainder of the breast and pelvic examinations show no abnormalities. Which of the following historical findings is the greatest risk factor for osteoporotic fracture in this patient? Q A) BMI 0 B) Family history of fracture 0 C) Levothyroxine therapy 0 D) Tamoxifen therapy 0 E) Tobacco use ,. "' ~ r-- , r ,,, Previous Next Lab Values Calculator Review Help Pause Exam Section : Item 3 of 50 National Board of Medical Examiners Time Remaining: Mark Obstetrics and Gynecology Self-Assessment 4 hr 59 min 44 sec 3. A 20-year-old woman comes to the physician because of a 1-week history of vaginal discharge. She is sexually active with one partner, and they use condoms inconsistently. She reports that he was recently treated for syphilis. Physical examination of the patient shows no abnormalities. Pelvic examination shows white verrucous lesions over the upper vaginal wall and cervix. A Pap smear is reported as atypical squamous cells. Human papillomavirus testing is negative for high-risk types. Which of the following is the most likely diagnosis? Q A) Bacterial vaginosis Q B) Cervical intraepithelial neoplasia (CIN) 2 0 C) Condylomata acuminata 0 D) Herpes simplex 0 E) Secondary syphilis ,. "' ~ r-- , r ,,, Previous Next Lab Values Calculator Review Help Pause Exam Section : Item 4 of 50 National Board of Medical Examiners Time Remaining: Mark Obstetrics and Gynecology Self-Assessment 4 hr 59 min 38 sec 4. A 25-year-old woman comes to the physician because of a 4-week history of right-sided pelvic pain. She has been sexually active with one partner for 3 years; they use condoms for contraception. Her last menstrual period was 3 weeks ago. She is afebrile. Pelvic examination shows a 12-cm, cystic, mobile, right adnexal mass. Her serum CA 125 concentration is 35 U/ml (N- >- FHR >- 240 --< 21· -, >- - -~ - >- --- ,r L -. _, -- 1 ,. 1 ~ ~ - -- --- - -- - _ ,_ , - - It'\ - 1110 1..... >- >- - - __ , 12 -- ,- -- >- - - ,- 12 ! >- - - - r- - 00 >- - >- -- - ,_ - r-- 3 - ,- -- ,- , - ,- - - 30 - - - -r- - -- - - ,- ,_ -._ -......... _,_ - >- >- ,- -- - - - - - = - ,- >- - - >- >- >-.-. >- >- - - - - -- ,_ - ~ UA - UA >- >- 48. A 22-year-old primigravid woman at 39 weeks' gestation has had ruptured membranes for 5 hours without contractions. Her prenatal course was uncomplicated. Her cervix is 80% effaced and 2 cm dilated. The fetal position is right occipitoposterior. The fetal heart rate pattern is shown. Which of the following is the most likely explanation for this pattern? 0 A) Chorioamnionitis Q B) Fetal sleep state Q C) Occipitoposterior position 0 D) Umbilical cord compression 0 E) Uteroplacental insufficiency ,. "' ~ r-- , r ,,, Previous Next Lab Values Calculator Review Help Pause Exam Section : Item 49 of 50 National Board of Medical Examiners Time Remaining: Mark Obstetrics and Gynecology Self-Assessment 4 hr 56 min 3 sec 49. A 42-year-old woman, gravida 5, para 5, comes to the physician requesting advice regarding contraception. Menses occur at regular 28-day intervals. Her last menstrual period was 3 days ago. She has hypertension treated with a '3-adrenergic blocking agent, but she often forgets to take it. At the age of 21 years, she was treated for Chlamydia trachomatis infection. During her second pregnancy, a Pap smear was reported as a low-grade squamous intraepithelial lesion; after delivery, a follow-up Pap smear showed no abnormalities. Since that time, she has had no abnormal Pap smears. She is sexually active and monogamous with her husband. Physical examination, including pelvic examination, shows no abnormalities. She desires the most effective contraception that she will easily remember to use. Which of the following is the most appropriate recommendation regarding contraception for this patient? O A) Condoms 0 B) Oral contraceptive O C) Diaphragm O D) Depot medroxyprogesterone 0 E) Placement of an IUD ,. "' ~ r-- , r ,,, Previous Next Lab Values Calculator Review Help Pause Exam Section : Item 50 of 50 National Board of Medical Examiners Time Remaining: Mark Obstetrics and Gynecology Self-Assessment 4 hr 55 min 58 sec 50. Two days after a cesarean delivery for fetal distress, a 27-year-old woman has temperatures to 38.2°C (100.8°F). She had an 8-hour labor complicated by mild meconium-stained amniotic fluid. Membranes ruptured 2 hours after admission. Breath sounds are decreased at both lung bases. Abdominal examination shows mild tenderness below the umbilicus and a well-healing incision. There is a moderate amount of lochia with no odor. Examination of the lower extremities shows edema and no tenderness. Her hemoglobin concentration is 10.8 g/dl, leukocyte count is 14,000/mm 3, and platelet count is 189,000/mm 3. A urine catheter specimen is negative. Which of the following is the most likely diagnosis? 0 A) Atelectasis Q G) Pulmonary embolism 0 B) Deep venous thrombosis 0 H) Pyelonephritis Q C) Endometritis 0 I) Septic pelvic thrombophlebitis Q D) Episiotomy infection 0 J) Ureteral obstruction 0 E) Mastitis 0 K) Urinary tract infection 0 F) Pneumonia ,. "' ~ r-- , r ,,, Previous Next Lab Values Calculator Review Help Pause