* Some Serious MUST KNOW OB High Yield Questions
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	drjiggy - 09/24/07 16:12
	I don't like to make promises, but in this case, I can promise that if you can answer these 55 questions, you are going to do well in the OB portion of the USMLE Step 2. Answer as many as you could. I will post the answers at around 6pm. Enjoy :) 1) Timeline: What weeks do you do prenatal testing? Triple Screen? Ultrasound? GBS culture? RhoGAM? Diabetes checkup (in a normal, non-high risk pt)? Chorionic Villous Sampling? 2) What tests makeup a normal prenatal visit? 3) What are the weeks of utmost teratogenicity in the fetus? 4) Where is progesterone made? At what weeks does it switch from one place to the other site of production? 5) What do you do NEXT if hCG or AFP levels comes back too high or too low? 6) What are some causes of HIGH hCG? Low hCG? 7) What are some causes of High AFP? Low AFP? 8) Mom says she doesnt feel the baby move anymore, what is the next step? 9) Ultrasound does not pick up fetal heart tones, what is the next step? 10) In fetal demise, at what weeks do you do D&C? then D&E? then labor induction? 11) Mom does not feel the baby move and after an ultrasound is done, fetal heart tones are heard, what is the next step? 12) NST comes back nonreactive, what is the next step? 13) BPP comes back 8-10, what is the next step? what about 4-6? what about 0-2? 14) At what amniotic fluid level do you consider oligohydramnios? Polyhydramnios? 15) A stress test comes back c late decelerations, what does that mean? what about early decelerations? what about variable decelerations? 16) A stress test comes back with any type of deceleration, what is the next step in management? 17) Besides (+) GBS culture, what are some other reasons to treat GBS at birth? What do you treat it with? 18) Give a cause, a diagnostic buzz-word and a treatment for Toxoplasmosis gondii in the fetus? 19) What is the worst time for mom to develop pruritis vesicles consistent with varicella? 20) What are 4 findings you would find in a neonate c congenital Rubella infection? How can you have prevented this? 21) What test do you do for congenital syphilis? How will a child with it present? How do you treat a mother who has syphilis while pregnant? What if she is allergic to the medication you prescribed? 22) What do you do if mother has vesicles consistent with HSV at 25 weeks gestation? what about 1 week prior to delivery? what about at the time of delivery? 23) Mother has (+) HbSAg while pregnant, what do you do? 24) If an ELISA test comes back positive, and then a southern-blot confirms HIV, what do you do next? 25) If a mother is on HIV medications and has a CD4 count of 275, which medications do you continue or discontinue? What about if her CD count was >500? 26) What is the 1st test you use to diagnose HIV in a child less than 6 weeks old? 27) What are the 4 major causes of 1st TM bleeding (for USMLE purposes of course)? What about the 4 major causes of 3rd TM bleeding? 28) A woman comes with vaginal bleeding in the 1st TM, what is the next step in management? 29) If her cervical os is open and she had vaginal bleeding, what is the diagnosis and tx? 30) If her cervical os is closed and she had vaginal bleeding, what is the next step in management? 31) If her cervical os is closed and you see a snowstorm pattern on u/s, what is your dx and tx? what if the u/s showed an intrauterine pregnancy? what if it showed no intrauterine pregnancy? 32) If you narrowed it down to a mole, and you decide to do a D&C , but her hCG levels stay very high (>100,000) and dont fall, what is your diagnosis? What is your next step in management? What is your treatment? 33) If you narrowed it down to an ectopic, and the woman is stable and does not want surgery, what is your treatment? what if she is unstable and does not want surgery? what if she is unstable and just wants to be treated, what is the best treatment then?? 34) A pt comes in with vaginal bleeding in her 3rd TM, what is your next step in management? What are you trying to rule OUT? 35) How will a woman with a placenta previa present? If it was preterm and it was mild how will you treat? if she was preterm and it was serious how will you treat? What type of delivery are you expected to do? 36) How will a woman with abruptio placenta present? Same questions as above? 37) How will a woman with Vasa previa present? What type of delivery should you do? 38) How will a woman with uterine rupture present? how can you differentiate it from a ruptured placenta? 39) If mom already has (+) Rh antibodies because of failed RhoGAM administration in the past and she now presents to you, what will you do? 40) If mom has PROM, how can you confirm its correct? What is the next step in management? Do you wait for results to start treatment? What do you do if she has an infection? What do you do if there is no fever and child is between 24-35 weeks gestational age? What about >24wks? 41) A woman comes in with labor contractions, how will you be certain she is in preterm labor and that the contractions are not Braxton-Hicks? What do you do next if you confirm that it is preterm labor? Would you use tocolytics, if so which one? 42) Give the 4 known tocolytics, and their adverse effect? How can you reverse the adverse reaction of the most common tocolytic used? 43) Pt is >40 weeks in gestation, what is the next step you do? What do you do if the cervix is favorable? unfavorable? 44) How do you know when its chronic HTN from gestational HTN? what is the best drugs for HTN in pregnancy? What is contraindicated? 45) How do you manage preeclampsia? severe preeclampsia? eclampsia? Do yo do vaginal or C/Sxn? 46) How do you manage prolonged latent phase? prolonged active phase? prolonged 2nd stage? prolonged 3rd stage? prolonged 4th stage? 47) What is the MCC of prolonged 4th stage? What are some other causes? 48) How do you manage shoulder distocia? 49) Post-partum fever, what cause are you suspecting at days 0-1? 2-3? 1 week later? 50) How do you treat endometritis? what do you suspect if that treatment does not stop the fevers? how do you manage that? 51) How do you manage mastitis? 52) Mom does not want to breastfeed, what do you tell her? 53) Mom wants OCPs while breastfeeding, which one do you give her? 54) How do you manage amniotic fluid embolism? 55) How do you manage acute fatty liver of pregnancy in the emergent setting?
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