CEN Obstetric and Gynecologic Emergencies 3

Question 1

A patient presents with severe unilateral pelvic pain that started suddenly, and ultrasound shows an enlarged ovary with absence of blood flow on Doppler. What is the diagnosis?

Accepted Answer

Ovarian torsion

Answer

Ruptured ectopic pregnancy

Answer

Hemorrhagic ovarian cyst

Answer

Tubo-ovarian abscess

Question 2

A woman at 38 weeks presents in active labor and the fetal head is delivered but shoulders cannot be delivered. The obstetrician calls for help. What maneuver is performed first?

Accepted Answer

McRoberts maneuver with suprapubic pressure

Answer

Zavanelli maneuver

Answer

Fundal pressure

Answer

Immediate cesarean section

Question 3

A 22-year-old sexually active woman presents with a right adnexal mass, acute pelvic pain, and a negative pregnancy test. Doppler shows absent blood flow to the right ovary. What is the next step?

Accepted Answer

Emergency surgical consultation for ovarian torsion

Answer

IV antibiotics for tubo-ovarian abscess

Answer

Laparoscopic cystectomy as scheduled surgery

Answer

Observation and repeat ultrasound in 24 hours

Question 4

In a patient with severe preeclampsia, which antihypertensive agent is most commonly used IV to acutely lower blood pressure?

Accepted Answer

Labetalol IV or hydralazine IV

Answer

Lisinopril 10 mg oral

Answer

Metoprolol 25 mg oral

Answer

Nifedipine ER 30 mg oral

Question 5

A 28-year-old presents with amenorrhea for 8 weeks, sudden lower abdominal pain, and a positive urine pregnancy test. A beta-hCG is 2500 mIU/mL with no intrauterine pregnancy on transvaginal ultrasound. What is the management?

Accepted Answer

Methotrexate or surgical treatment for ectopic pregnancy

Answer

Discharge and repeat ultrasound in 48 hours only

Answer

Progesterone supplementation for threatened abortion

Answer

Observation and weekly hCG levels outpatient

Question 6

A patient in the third trimester develops epigastric pain, nausea, thrombocytopenia, elevated LFTs, and hemolysis. What syndrome is present?

Accepted Answer

HELLP syndrome

Answer

Acute fatty liver of pregnancy

Answer

Cholestasis of pregnancy

Answer

Hyperemesis gravidarum