SPEX Obstetrics and Gynecology 2

Question 1

A 28-year-old at 32 weeks gestation presents with sudden painless vaginal bleeding. Fetal heart tones are normal. What is the most likely diagnosis?

Accepted Answer

Placenta previa

Answer

Painless vaginal bleeding in the third trimester is the classic presentation of placenta previa, where the placenta overlies the cervical os.

Question 2

Which tocolytic agent is contraindicated in a patient with gestational hypertension requiring treatment for preterm labor?

Accepted Answer

Terbutaline

Answer

Terbutaline (a beta-agonist) can worsen hypertension and cause significant cardiovascular side effects, making it contraindicated in hypertensive patients.

Question 3

A multipara at 38 weeks has a Bishop score of 8. What does this indicate?

Accepted Answer

The cervix is favorable for induction

Answer

A Bishop score ≥8 indicates a favorable cervix with high likelihood of successful labor induction without the need for cervical ripening agents.

Question 4

What is the recommended management for a pregnant patient diagnosed with primary genital herpes at 36 weeks gestation?

Accepted Answer

Acyclovir suppressive therapy until delivery

Answer

Acyclovir suppressive therapy from 36 weeks reduces viral shedding and the risk of recurrent outbreak at delivery, decreasing the need for cesarean section.

Question 5

A woman at 10 weeks gestation is found to have a TSH of 0.05 mIU/L and elevated free T4. She has no symptoms. What is the most appropriate next step?

Accepted Answer

Reassure and repeat labs in 4 weeks

Answer

Gestational hyperthyroidism from hCG stimulation is common in the first trimester and typically resolves spontaneously; reassurance and follow-up is appropriate for asymptomatic cases.

SPEX Exam Practice Test

SPEX Exam Practice Test

SPEX Obstetrics and Gynecology 2