Reproductive Disorders
A 28-year-old woman at 18 weeks gestation presents with pelvic pressure and increased vaginal discharge. She previously had two painless pregnancy losses at 19 and 21 weeks. Which additional finding would most strongly support cervical insufficiency?
What is painless cervical dilation and effacement?
A newborn has hydrocephalus, chorioretinitis, and diffuse intracranial calcifications. The mother reports frequent exposure to cat feces during pregnancy. Which congenital infection is most likely?
What is Congenital toxoplasmosis?
A 26-year-old woman at 19 weeks gestation presents with painless cervical dilation. Before diagnosing physical examination-based cervical insufficiency, which competing condition should be excluded?
What is Preterm labor?
A nonimmune pregnant woman has significant exposure to a patient with chickenpox. Which intervention is most appropriate to reduce her risk of severe infection?
What is Administer varicella-zoster immune globulin?
A woman with gestational diabetes asks why insulin is preferred when lifestyle modification fails. Which explanation is most appropriate?
What is Insulin effectively controls maternal glucose and does not cross the placenta?
A 29-year-old woman at 20 weeks gestation has a previous spontaneous preterm birth. Transvaginal ultrasound demonstrates a cervical length of 21 mm. Which finding is most consistent with cervical insufficiency?
What is Shortened cervical length with funneling?
Infections in the newborn identified as TORCH infections.
What are Toxoplasmosis, Other (syphilis, HIV, chickenpox, parvovirus B19/fifth disease, and Zika ), Rubella, Cytomegalovirus (CMV) and Herpes Simplex virus?
A 33-year-old woman at 18 weeks gestation has painless cervical dilation of 3 cm with exposed fetal membranes. Cerclage is being considered. Which diagnostic procedure is most appropriate to evaluate for subclinical intraamniotic infection before cerclage?
What is amniocentesis?
A pregnant woman asks why she cannot receive the live varicella vaccine during pregnancy. Which response is most appropriate?
What is Live varicella vaccination is contraindicated during pregnancy?
A 34-year-old woman with gestational diabetes has an estimated fetal weight significantly above that expected for gestational age. Which fetal complication is most directly associated with this finding during vaginal delivery?
What is Shoulder dystocia?
A parent asks why HPV vaccination is recommended before sexual debut. Which explanation is most appropriate?
What is Vaccination is most effective before exposure and helps prevent HPV-associated malignancy?
A neonate is born with microcephaly, petechiae, hepatosplenomegaly, and sensorineural hearing loss. Cranial imaging demonstrates periventricular calcifications. Which diagnosis is most likely?
What is Congenital cytomegalovirus infection?
A 30-year-old woman with two previous painless second-trimester pregnancy losses is now 12 weeks pregnant. Which intervention is most appropriate based on her obstetric history?
What is History-indicated cervical cerclage?
A newborn is found to have flesh-colored papules in the perianal region that develop a cauliflower appearance. The mother has a history of genital warts. Which infection is most likely?
What is Human papillomavirus?
A 32-year-old woman at 30 weeks gestation undergoes a fetal nonstress test because of a high-risk pregnancy. Fetal heart rate accelerations occur with fetal movement. How should this result be interpreted?
What is Reactive, suggesting fetal well-being?
A pregnant woman undergoes a 3-hour 100-g oral glucose tolerance test. Her values are fasting 97 mg/dL, 1 hour 184 mg/dL, 2 hours 150 mg/dL, and 3 hours 132 mg/dL. Which interpretation is most appropriate?
The study confirms gestational diabetes because at least two values are abnormal?
A newborn has cataracts, sensorineural hearing loss, and a patent ductus arteriosus. Which maternal infection during pregnancy most likely caused these findings?
What is Rubella?
A 27-year-old woman with a previous spontaneous preterm birth undergoes transvaginal ultrasonography at 21 weeks gestation. Her cervical length is 20 mm. Which intervention is most appropriate?
What is Ultrasound-indicated cervical cerclage?
A mother with genital HPV asks how her newborn most commonly acquires the infection. Which route of transmission is most likely?
What is Vertical transmission during birth?
A 35-year-old woman with a high-risk pregnancy is scheduled for a contraction stress test. Which medication is used to temporarily induce uterine contractions during this test?
What is Oxytocin?
A 30-year-old woman at 27 weeks gestation is diagnosed with gestational diabetes. Which pathophysiologic change most directly contributes to this disorder?
What is Pregnancy-related hormones increase maternal insulin resistance?
A newborn has severe microcephaly, craniofacial disproportion, hypertonia, arthrogryposis, and intracranial calcifications. The mother reports a mosquito-borne febrile illness during early pregnancy. Which diagnosis is most likely?
What is congenital zika syndrome?
A pregnant woman has her first episode of genital herpes near the time of delivery. Compared with a woman who has recurrent HSV, why is her neonate at greater risk for infection?
What is Primary maternal infection at delivery has a substantially higher transmission risk?
A child has persistent anogenital warts caused by HPV. Which viral types are most strongly associated with genital warts?
What is HPV 6 and 11?
A woman is currently pregnant for the fourth time. Her history includes one term singleton delivery, one preterm twin delivery at 32 weeks with both children living, and one spontaneous abortion at 9 weeks. Which TPAL designation is correct?
What is T1 P1 A1 L3?