MSFinals-3581
During a routine examination of a woman who is 35 weeks pregnant, she reports feeling short of breath. Which of the following cardiac examination findings would require further evaluation and not be considered normal?
Med Student Finals Category: Obstetrics
MSFinals-3597
A 35-year-old woman who is 8 weeks pregnant with twins presents to the early pregnancy unit with a 3-day history of vomiting and postural dizziness. The patient is gravida 2, parity 0, and never had such severe sickness in her previous pregnancy. No one else in the family is sick.
She has a past medical history of hypothyroidism and takes levothyroxine.
During examination, her BMI is 16 kg/m² and she has lost >5% of her body weight in the last 3 days. She is visibly dehydrated and her blood pressure is 98/75 mmHg.
What aspect of the patient’s history poses the highest risk for the development of this condition?
MSFinals-3582
You are urgently called to the labour ward to attend to a 23-year-old woman who has undergone an artificial rupture of membranes. She is at 39-weeks gestation and has had an uneventful pregnancy thus far. The midwife reports an abnormal foetal heart rate. Upon examination, you detect the presence of the umbilical cord. You promptly order a caesarean section. What medication can you administer while waiting to prevent any complications?
MSFinals-3598
A 27-year-old primigravida woman presents to the maternity centre in labour at 39 weeks. She has been diagnosed with HIV and has been on regular antiretroviral therapy. Her viral load at 37 weeks is as follows:
HIV Viral Load 35 RNA copies/mL (0-50)
What delivery plan would be most suitable for this patient?
MSFinals-3583
A 34-year-old multiparous patient has an uncomplicated delivery at 39 weeks gestation. One hour following delivery, the patient experiences severe postpartum hemorrhage that is immediately managed in the labor ward. After seven weeks, the patient reports difficulty breastfeeding due to insufficient milk production. What is the most probable explanation for this medical history?
MSFinals-3599
A Cardiotocogram (CTG) is conducted on a 32-year-old woman at 39 weeks gestation who has arrived at the labor ward in spontaneous labor. The CTG reveals a fetal heart rate of 150 bpm with good variability, and it is a low-risk pregnancy. The midwife contacts you with worries about the presence of late decelerations on the CTG trace. What is the most suitable course of action for management?
MSFinals-3584
A 26-year-old primigravida at 32 weeks gestation presents with vaginal bleeding and severe abdominal pain. The abdominal pain started suddenly in the night, about 3 hours ago. It is a severe dull pain in the suprapubic region and doesn’t radiate anywhere. The pain has not settled at all since onset and is not positional. She rates the pain as 10/10 in severity. She passed about 2 cupfuls of blood 1 hour previously. She reports that the bleeding has soaked through 2 sanitary pads. She also complains of back pain and is exquisitely tender on suprapubic palpation. She has not noticed any decreased foetal movements, although says that her baby is not particularly active usually. What is the most likely diagnosis?
MSFinals-3585
A 35-year-old woman arrives at 28 weeks gestation for her third pregnancy. During an ultrasound at 12 weeks, it was discovered that she was carrying dichorionic diamniotic twins. She is admitted to the hospital due to painless, bright red bleeding per vaginum. She has undergone two previous caesarian sections. What is the probable diagnosis?
MSFinals-3586
A 28-year-old primigravida arrives at 39 weeks with ruptured membranes and bleeding. She reports a rush of cloudy fluid followed by persistent vaginal bleeding. Despite feeling anxious, she denies experiencing any localized pain or tenderness. Although her pregnancy has been uneventful, she has not attended her prenatal scans. The cardiotocography reveals late decelerations and bradycardia. What is the probable diagnosis?
MSFinals-3571
A 28-year-old woman attends the antenatal clinic at 41 weeks of gestation, worried that she has not yet gone into labour. She reports normal foetal movements and has not been recently ill. She has no significant medical history and this is her first pregnancy. On examination, her abdomen is soft and a palpable uterus is consistent with a term pregnancy. Her Bishop’s score is calculated as 5. What is the first step in managing this patient?