Obstetrics and Gynecology Flashcards
7 cards from real NBME practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Obstetrics and Gynecology flashcards as text
A 28-year-old G2P1 at 39 weeks presents with painless vaginal bleeding. Ultrasound confirms the placenta completely covers the internal cervical os. What is the most appropriate management?
Answer: Immediate cesarean delivery
Complete placenta previa with active bleeding at term requires immediate cesarean delivery because vaginal delivery is contraindicated.
A 32-year-old G1P0 at 34 weeks develops sudden severe abdominal pain, a board-like rigid uterus, and fetal bradycardia. What is the most likely diagnosis?
Answer: Placental abruption
Sudden severe pain with uterine rigidity and fetal distress is the classic presentation of placental abruption (premature separation of the placenta).
A postpartum patient on day 3 has a temperature of 38.6°C, uterine tenderness on palpation, and foul-smelling lochia. What is the most appropriate antibiotic regimen?
Answer: IV clindamycin plus gentamicin
Postpartum endometritis is treated with IV clindamycin plus gentamicin, which provides coverage for gram-negative and anaerobic organisms.
A 55-year-old postmenopausal woman presents with vaginal bleeding. Endometrial biopsy shows complex atypical hyperplasia. What is the recommended next step?
Answer: Total hysterectomy
Complex atypical hyperplasia carries a 25–30% risk of concurrent endometrial carcinoma, so total hysterectomy is the definitive treatment.
During a total abdominal hysterectomy, the ureter is inadvertently injured. At which anatomical location is the ureter most vulnerable during this procedure?
Answer: Where it passes beneath the uterine artery
The ureter passes directly beneath the uterine artery ('water under the bridge'), making this the most common site of ureteral injury during hysterectomy.
A neonate is delivered by emergency cesarean for non-reassuring fetal heart tones. Apgar scores are 3 at 1 minute and 6 at 5 minutes. Which intervention has the strongest evidence for improving neurological outcomes in this setting?
Answer: Therapeutic hypothermia initiated within 6 hours
Therapeutic hypothermia (whole-body cooling to 33–34°C) initiated within 6 hours of birth reduces neurological injury and mortality in neonatal hypoxic-ischemic encephalopathy.
A 38-year-old woman has progressive dysmenorrhea, dyspareunia, and pelvic pain. Transvaginal ultrasound reveals a 5-cm ovarian cyst with diffuse low-level internal echoes (ground glass appearance). What is the most likely diagnosis?
Answer: Endometrioma
An endometrioma ('chocolate cyst') presents with endometriosis symptoms and the classic ground-glass ultrasound appearance from accumulated old blood.