PANRE Obstetrics and Gynecology 5

Question 1

A 27-year-old woman at 12 weeks gestation is Rh-negative. Her partner is Rh-positive. She has no antibodies on indirect Coombs test. When should she receive Rh immunoglobulin (RhoGAM)?

Accepted Answer

At 28 weeks and within 72 hours of delivery

Answer

Unsensitized Rh-negative women receive RhoGAM at 28 weeks gestation and again within 72 hours of delivery to prevent alloimmunization.

Question 2

A 48-year-old woman presents with hot flashes, night sweats, and irregular menses for 14 months. FSH is 58 mIU/mL. She denies a history of VTE or breast cancer. What is the most effective treatment for her vasomotor symptoms?

Accepted Answer

Menopausal hormone therapy

Answer

Menopausal hormone therapy remains the most effective treatment for vasomotor symptoms in menopausal women without contraindications.

Question 3

A 30-year-old G2P1 at 38 weeks presents in active labor. On exam, the presenting part is at +2 station. After 2 hours of adequate pushing, the fetal head is visible and crowning. Suddenly you note the turtle sign. What does this indicate?

Accepted Answer

Shoulder dystocia

Answer

The turtle sign (retraction of the fetal head against the perineum after delivery) is pathognomonic for shoulder dystocia.

Question 4

A 23-year-old woman develops a new breast mass during pregnancy at 22 weeks. Ultrasound shows a solid, irregular hypoechoic lesion. What is the next appropriate step?

Accepted Answer

Core needle biopsy

Answer

A suspicious solid breast mass during pregnancy requires tissue diagnosis via core needle biopsy, which is safe in pregnancy.

Question 5

A 16-year-old girl has never had a menstrual period. Physical exam shows normal secondary sexual characteristics and a blind vaginal pouch. Karyotype is 46,XY. What is the diagnosis?

Accepted Answer

Androgen insensitivity syndrome

Answer

Complete androgen insensitivity syndrome (46,XY) presents with primary amenorrhea, normal female phenotype, breast development, and absent uterus/upper vagina.

PANRE Test Practice Test

PANRE Test Practice Test

PANRE Obstetrics and Gynecology 5