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CMS Obstetric Complications & Emergency Management Flashcards

6 cards from real CMS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A G3P2 patient delivers and then hemorrhages 1,200 mL. She is tachycardic and her uterus feels boggy. After oxytocin fails, which second-line uterotonic is preferred if she has no contraindications?

    Answer: Carboprost IM if no asthma

    Carboprost (15-methyl PGF2α) is a potent uterotonic for refractory atony but is contraindicated in asthma; methylergonovine is contraindicated in hypertension.

  2. A patient with gestational diabetes has a blood glucose of 220 mg/dL at 28 weeks despite dietary modification. The next management step is:

    Answer: Initiate insulin therapy

    ACOG recommends insulin as the first-line pharmacologic treatment for GDM uncontrolled by diet, as it does not cross the placenta.

  3. A gravid patient at 34 weeks presents with sudden right upper quadrant pain, nausea, and vomiting. Labs show elevated ALT/AST and low platelets. The diagnosis is HELLP syndrome. What is the definitive treatment?

    Answer: Delivery of the fetus and placenta

    Delivery is the only definitive cure for HELLP syndrome; corticosteroids may temporize but do not reverse the underlying process.

  4. Which clinical sign indicates magnesium toxicity in a patient receiving magnesium sulfate for seizure prophylaxis?

    Answer: Loss of deep tendon reflexes (DTRs)

    Loss of DTRs is the earliest sign of magnesium toxicity; respiratory depression and cardiac arrest follow at higher serum levels.

  5. A patient at 30 weeks is diagnosed with preterm premature rupture of membranes (PPROM) without signs of infection. Which medication combination is most appropriate?

    Answer: Corticosteroids for fetal lung maturity and broad-spectrum antibiotics (latency)

    PPROM management at 30 weeks includes antenatal corticosteroids for fetal lung maturity and latency antibiotics (ampicillin + erythromycin) to prolong pregnancy and reduce infection.

  6. During a vaginal delivery, the midwife notes the fetal head delivers but the body does not follow. Suprapubic pressure is applied. What position should the mother be placed in simultaneously?

    Answer: McRoberts position (hyperflexion of the thighs onto the abdomen)

    McRoberts maneuver hyperflexes the maternal thighs, flattening the lumbar lordosis and increasing the relative AP diameter of the pelvis to relieve shoulder dystocia.