Download Prenatal Rosh Exam Questions & Answers (Grade A+) and more Exams Obstetrics in PDF only on Docsity!
Answers (Grade A+)
A 33-year-old G1P0 woman at 43 weeks gestation presents to the labor and delivery unit for induction of labor. Which of the following physical characteristics is most likely to be seen in her infant? - correct answer ✅Meconium staining postterm infants - correct answer ✅> 42 weeks gestation RF: previous posterm preg, nulliparity, male fetus, obesity, older maternal age, maternal personal hx of postterm birth, Macrosomia (> 4,500 grams) CM -small for gestational age if there is fetal growth restriction secondary to a poorly functioning placenta. These infants will appear long, thin, and malnourished -Meconium staining -decreased Vernix caseosa and lanugo hair -Dry and parchment-like peeling skin -loose skin over the thighs and buttocks. -increased scalp hair, long nails -alert or wide-eyed appearance
Answers (Grade A+)
A 27-year-old G1P0 woman at 12 weeks gestation presents to her obstetrician for a routine prenatal visit. Ultrasound confirms the presence of a twin pregnancy. Which of the following is the most likely complication of multiple gestation? - correct answer ✅Twin-twin transfusion syndrome -serious complication of monochorionic multiple gestations -recipient: polycythemia, HTN, polyuria, polyhydraminos, circulatory overload, HF, hydrops fetalis, fetal demise -donor: anemia, hypotension, oliguia, oligohydraminos, circulatory insufficency, growth restriction, kidney failure, fetal demise A 24-year-old pregnant woman presents to the obstetrics clinic for routine prenatal care at 36 weeks gestation. She is Rh negative. Which of the following prenatal diagnostic or therapeutic tests is appropriate at this visit? - correct answer ✅Group B Streptococcus screening
Answers (Grade A+)
of azithromycin. Which of the following is the best next step in the management of this patient? - correct answer ✅Test of cure in 4 weeks tx of cha,mydia in preg is 1g PO azithromycin Furthermore, due to high rates of reinfection, repeat testing for chlamydia and gonorrhea is recommended 3 months after the test of cure. Which of the following fetal abnormalities is associated with an elevated alpha-fetoprotein level? maternal serum AFP is measured at 15-20 weeks gestation normal AFP concentration is typically < 500 ng/mL - correct answer ✅· Neural tube defects What class of medications is associated with neural tube defects? - correct answer ✅Antiepileptic medications, such as carbamazepine and valproic acid.
Answers (Grade A+)
Which of the following skin surgical incisions is the preferred approach for most cesarean section deliveries? - correct answer ✅Pfannenstiel Which type of pelvis is characterized by convergent side walls of the pelvic midcavity, forward inclination of the sacrum, and a narrow subpubic arch of the pelvic outlet that will most likely lead to labor arrest? - correct answer ✅Android (MC in males) gynecoid - correct answer ✅most common pelvis type in females and is considered normal. It is characterized by a wide forepelvis, straight side walls of the pelvic midcavity, and a wide subpubic arch of the pelvic outlet. Anthropoid and gynecoid pelvis types are the least likely to be associated with labor arrest. platypelloid - correct answer ✅associated with increased risk of labor arrest.
Answers (Grade A+)
embryo/fetus: seen by TVUS as thickening of yolk at 6 weeks gestational age presence of cardiac activity: usually see around the time fetal pole is present, further confirming viability, 6 weeks What is Naegele rule? - correct answer ✅A calculation to estimate the date of delivery: first day of the last menstrual period + 7 days − 3 months + 1 year. A 21-year-old G1P0 woman at 8 weeks gestation presents to her obstetrician for her first prenatal visit. She has been taking multiple over-the-counter vitamin supplements. Which of the following vitamins, if taken in excess, is teratogenic in the first trimester and is associated with spontaneous abortion and fetal malformation? - correct answer ✅Vitamin A Vitamin A toxicity has the most effect on the fetus during the first trimester and may result in
Answers (Grade A+)
spontaneous abortion or fetal malformation (e.g., microcephaly, cardiac A 26-year-old G3P1102 pregnant woman presents to the obstetric clinic for a routine prenatal visit. Physical examination reveals a uterine fundal height near the umbilicus. Which of the following gestational ages is most consistent with this fundal height, assuming a normal pregnancy? - correct answer ✅20 weeks Fundal height - correct answer ✅12 weeks: pubic symphysis 20 weeks: umbilicus 36 weeks: xiphoid process 37-40 weeks: regression of fundal height below 36- cm postpartum: umbilicus A 28-year-old woman presents to the clinic reporting amenorrhea. She states her last period was 6 weeks ago. Vital signs are within normal limits, and urinalysis is negative. Which of the following is most consistent
Answers (Grade A+)
· RF for low score: Premature birth, cesarean delivery, and perinatal complications. 7-10 excellent condition 4-6 moderately depressed 0-3 severely depressed A 25-year-old G1P0 woman at 20 weeks gestation presents to her obstetrician for a routine prenatal visit. She is concerned because her hemoglobin is 11.0 g/dL, which is lower than normal for her. Which of the following physiologic changes of pregnancy is most likely responsible for the patient's low hemoglobin level? - correct answer ✅Increase in plasma volume physiologic changes in prengnacy - correct answer ✅CV: -increased CO, blood volume, resting HR -decreased peripheral vascular resistence, BP (early- mid preg) -widended pulse pressure -loud and exagerated S
Answers (Grade A+)
-systolic ejection flow murmur over tricuspid and pulmonic areas -presence of S Pulm -decreased functional residual capacity -increased tidal volume -increased minute ventrilation -respiratory ALKALOSIS -decreased sale apnea time GI -decreased gastric motility -decreased esophageal sphincter tone MSK: increased ligament laxity A 24-year-old G1P0 woman presents to the clinic for her first prenatal exam. Based on her last menstrual period, she is 6 weeks pregnant. The patient asks when she will start feeling her baby move. At which of
Answers (Grade A+)
T: full term pregnancies 37-40 wks P: preterm preg 20-36 wks A: abortions and miscarriages before 20 weeks L; living children Methotrexate - correct answer ✅solutely contraindicated during pregnancy due to their confirmed teratogenic effects -avoided in women of childbearing age unless two methods of contraception are used antagonizes folate, leading to spontaneous abortion or congenital anomalies-->growth retardation, microcephaly, meningomyelocele, hypoplastic supraorbital ridges, small low-set ears, micrognathia, and limb defects What are some of the teratogenic effects of angiotensin-converting enzyme inhibitors? - correct answer ✅Fetal kidney hypoperfusion, fetal hypotension, fetal growth restriction, and fetal demise.
Answers (Grade A+)
A 36-year-old woman is 13 weeks pregnant with twins. There are two distinct fetuses and the presence of a T sign on ultrasound. Which of the following most likely describes this patient's twin gestation? - correct answer ✅Monochorionic, diamniotic gestation The presence of a T sign represents the amnion coming off the placenta at a 90° angle between the two distinct amniotic sacs, which is indicative of a monochorionic, diamniotic gestation A 34-year-old woman who is 8 weeks pregnant presents for a routine prenatal examination and reports persistent vomiting up to six times a day, and she has been unable to tolerate anything by mouth for the past 2 days. Her weight today is 114 pounds compared to 120 pounds 2 weeks ago. A blood test is ordered. Which of the following electrolyte imbalances is associated with the most likely diagnosis? - correct answer ✅Hypokalemia Hyperemesis gravidarum is a condition where there is persistent vomiting during pregnancy that may become severe enough to require hospitalization.
Answers (Grade A+)
recommendation of calcium for this patient? - correct answer ✅1,000 mg A 31-year-old woman presents to her clinician. She and her partner are hoping to start a family soon, and she would like advice about having a successful and healthy pregnancy. Her family history is notable for asthma, and she has a personal history of hypothyroidism. Her partner has a child with spina bifida from a previous marriage. They are both otherwise healthy and make deliberate efforts to eat healthy and exercise. Which of the following recommendations should be made for supplementation during pregnancy for this patient, in addition to other recommendations for preconception health? - correct answer ✅folic acid 4mg daily TO PREVENT NEURAL TUBE DEFECTS IN PREG -should be started 1 mo prior to conception -continue throughout 1st trimester -0.4-0.8mg -high risk 4mg
Answers (Grade A+)
Additional benefits include prevention of cardiovascular malformations, including ventricular septal defects. naturally in foods like avocados, beef liver, eggs, milk, leafy vegetables, peas and beans, and foods like breads, cereals, cornmeal, flour, pasta, and rice are also fortified due to its benefits. Some oral contraceptive pills are also fortified to ensure adequate folate levels in the case of an unplanned pregnancy. A 25-year-old G1P0 woman at 9 weeks gestation by last menstrual period presents to her obstetrician with nausea and vomiting. The patient states that she has vomited at least 5 times each day for the past 4 weeks and has lost about 9 pounds over that time period. Which of the following is most likely to be associated with the patient's condition? - correct answer ✅Starvation ketosis A 26-year-old woman presents for routine prenatal care at 41 weeks gestation. You decide to induce labor. Which of the following is a known side effect of
Answers (Grade A+)
At which level of cervical dilation is a patient considered to be in active labor? - correct answer ✅≥ 6 cm. A 29-year-old woman who is 25 weeks pregnant presents to the office due to increased foul-smelling vaginal discharge over the past week. A physical exam reveals the presence of runny and milky discharge that has a fishy odor. The pH of the vaginal sample is 5.0, and there are clue cells identified on wet mount microscopy. Which of the following is a first-line treatment for this condition? - correct answer ✅Metronidazole 250 mg orally three times daily for 7 days pregnant symptomatic pt w/ BV -metronidazole 500mg PO bid x 7 days -metronidazole 250 mg PO tid x 7 days -clindamycin 300mg PO bid x 7 days A 25-year-old G2P1 pregnant woman is in labor. Her cervix is dilated to 7 cm and has been dilating quickly.
Answers (Grade A+)
Which of the following stages of labor is she in? - correct answer ✅first stages of labor - correct answer ✅1st: time from onset to complete cervical DILATION -latent phase: gradual cervical change ends at approx 5 cm -active phase rapid cervical change begins at approx 6 cm 2nd: time from complete cervical dilation to fetal expulsion 3rd: time between fetal expulsion and placental expulsion Which of the following is routinely given to neonates at birth to prevent ophthalmia neonatorum in the United States? - correct answer ✅· Erythromycin ophthalmic ointment (prophylaxis should be given within 2 hours ager birth)
