2 at-yeacolid ican American female presets inthe 6" week fan uncomplicated pregnancy wih rursaness and burng nine ist pam. She eye te saneton se comforts tat reausmy Fakes taffeutte seep. Which of follings the best ntl eatmnt or ts patent? © A ndomeracn © B Onlcoricosteids © © Lasaleanicontaasnesten © D.Wrst pining © E Decompression sugey PootA 2.yeacold femal at SO weeks gestion camplains ef ificuty hearing especialy on he ight side She once ary car pan or dcharge. Her pregnancy was complicated acute pylorepiits 322 weeks {estan wach wos ead th antics. She does ot sake ar consume lca, a she ets 2 Eaureed sot She has no prenising meaca problems an aka ne medoaions aside om 3 ‘utcarn. Her lead pressure 160/10] mig ara hear rats 73min. Cardia ar pulmarary SSammatone = ineraiate. No fora sonormalce ms found an neralage examination, When 3 ing Tori ces en te igi mastad aooese se agrees he tone louder tan fang Meld nee ‘Stumal auton atis Audamety shave ght lve tequencyNewing ose, Wh te flange the ‘ost hay cause of is pans corglarts? (© A Arb weatmant © B Hypatensin of esnancy © C.Meriee's disease © 0 Otsceross © E Chrancotts meda © F Acoust neuroma © 6 Presbycusis PootBlock 2 28 yeacold woman presets fore fest prenatal ist Sheis 1D ech presrant as detemned by herlast ‘menstualpered. She does nathave any macl protims and das nttaka any mecicabans. She Sevetyeigous and nas been ma monogamous reasons her hustand since getng maried§ ‘eas ayn They em aause bul Taa3.hate she ware asa homemater Het husbans's 21 Secaumart. She does nat smoke cigaretes er nk aeahal. Her physical exam sin normal ts. ic the falloning screeing ets is ndash tr (© A Rapid plasma reagntest © B Hepatitis C arttady © Serum ead ive (© D Redlood calanoid ve © E Chlamydia Po aioete 2 3S. yeacoi female complains of ipl dschaiga_ The dschatgei fom bth breasts, brown in clr and , cccursmsmigeny. She as yo chicran who are § an 6 years ald. She has nt been rary pregnant Herlastmenstival pers was one eek ao, She describes a aber mpm. Exarinain shows oval ueaus wither palpale lms or ple strarmaltes. Elonnish charges copessea am te bles anditisquaacnepanve. Which afte flavin isthe rast ppropate Rod Sep n Panagemert? © A Mammogram (© 8 Utasonagrom (© C.Cytaeic examination (© D.Serum plain and TSH levels © E Sugealeaiaton © F Nofutherwerkap Poot2 1Byeacoli pimigra woman at St weeks gestation presents fo arouine rectal st. Her preanancy has been uncempleatedta cate. Her pastmedalristoryis urremarttle. She takes ane muttamin and (ne rn tet sty. She hes no kn tug allergies. Physics examination shows asus constant Ske wt 34 weak pesttonel age Route lear-atch ume cuture rows rete ta 10.000 obnieunt of Eschovehacol. Which ofthe folawng isthe mast pprepnate pharmactherapy? © AAmorcin © B Cirotoxacn © ©.cinsamyen © D.Dageysine © E Trmehopir-sufarethorazle Block aioe‘A 22yeacoldwoman beng flowed by her fat physician cing het rst pregnancy, She is curerty at 28 eck! gestan, feline and gang an apponite amount cf weight. She has nat had veel intercourse forthe past ISreeis. Her stprenatal ex mas a 12 weeks gestation, at wrch me her HV, {humyas gorarmes, Rh artbady,andunne cures ware negehve. He! pe negate She {oes not ina who hefner tne chit but excite ato roses sisatn che nea ot hee stor She ‘eunaie ta rcallor cfm her mmiieston sit for arumar of vaccines Which th olo0ng ‘measures is warartex ath ta? ‘© A MN vaccination © B.Ume cure © CHD) ant test © 0 Hv anenoay et © E Preumacozcalvacsine Block aioe| 28 yearold woman resets a her obstticin fr hers prenatal vt, Sha is at @vsshs gestation 35 {etormnc ty nerlace mercial goad. she hae na medal grotleme and ies no madestone, Sho Goes not ske cigarties and stopped snkngacchs when she decdedto become pregnant. She has no oy orice drug ue ang has never ween daynosea wena semua ansmted dscase’ Sha Nas been ‘smonogamavsrelstansh wth her rustandfar the past one year. Herfariy isos unremarkable Her {Mig 23 gma. Her physica examinaton, Mclain vl sis, shin normals. Which ofthe Taloning preven measuresie warand t svt? © A wtuenza vane © 8 Hemogoon lecrosnoress © C Hepat Canteooytestng © D.chiamwaaPoR © E Goronnea PCR (© F Fasting Hood sugar Block aioe‘A at.yeacoli ican American female presets inthe 36! week af an unconpcated pregnancy wth rurnessangbumng nies par. She eye te saneton se unconforatie tat reusmy Fakes tafeutte seep. Whi of fllaings the best nt treatment or hs patent? dometraen| Cralcotcortersie © Lees eorcosteoiinection | vo mvs spireng LEE Decompression surgery ‘This pert presente win paresnesios nine clemson tne mean ners, naling earl uonel syndrome (CTS), amedian neve compression neuropaty, te mostkeWycagrosis. CTS symptoms fe \osenes by marl scity and ater wake t= paterc or sie. Repettve vit Henan entensins theusualcguse of TS. The neidence is ncleasedm pregnancy secondary a an estogen mediate {fpalymerizatn of raund subeance vhich causes terstal edemain he hands (and face) ands Increased pressure win the carpal tune. Prolonged or repetive vst eon ad tension aso ncrese Carpal tunel pressure. Theor, te ntl tesmert nal postan ne pi, {hoice ) Whe NSCs may decrease te poh associaed wth carpal tunnel syctore, the use ding Drepiancy 1s associa anmcreasee ik of miscamaye and may roma gremeture clsute othe feta oust aenosus (hoices 8 86) Wren spntna and aalgesis tlt reteve CTS symgtoms, rect recon of Comostrege nto the carpal une may Pa, {choice €) Fo: CTS symptoms resistant consewatveintevertons or Fhend weakness and tear ‘muscle avopy proyesses, Den open or endoszone surpeal decompression a te carpal umelis inseana object te pani the dcibton of he mesian neve du is eyo be duetB Cralconcostesis Loca conastoisinecton © Ds spining E Decampressen surgery Explanation “This pater resets win paresnesos nthe dition ofthe man nerve, any earl tunel synarame (CTS), median neve compression saurepary, me mast aagrass. CTS spams re ‘sand by manual acvty and ota wake he pater rm sleep. Ropstive writ Neon and eansins theusual cause a'cTS. The nagenoe i ncreasedn pregnancy Seconoay oan eSropen medaes {tpalymeraaton of raundsufsance which cavses estal edema inthe hands (an fece] and is Increased pressure within he carpal tunno. Prclongedarrepeive wrt aon ad itansion asoincrease Carpaltunel pressure. Threors te tl tepmert so neal poston ar spit, (holee A) yihie SSAC may decrease he pan associate wth carpal tunnel synrome tai use dung rogancy is asacited nih anincresed isk of miscamage and may pomas premature sure othe fesa ate aenosus (holees 8 &.¢) Viren spintng and analgesics falta rateve CTS symptoms, rect recon of Coricosteraids nto he cara urn may hep (Gholee £) Fo: CTS symptoms resistant conservative intrvertans or fhand weakness and nar ‘ruscle avopy proyesses, ten open o endoscope surpeal decompression of he carpal tunel = Inseaea éucatona objective: Paresthesias er pan ithe dsrbutin ofthe median neve dng pregrancy shel tbe due carpal {umelsyndrme (CTS) ialtieatments far CTS cave nal poston wat pining and SADE Local Cconicostriéecton indicted n cases whete wis splting minsificenttaeleve symptoms. Sura Secompression othe carpal nels reseved fer cases when corsenave management as ances queston curacy astute (1/2209 Copyigt© USMLENORLD LLC. CBr ver. 2000002A 27-yearols female ot 30 weeks gesatin complains of cuty nearing especay on ne it side Ste enc arycar pan ar dacharge Her pregnancy was complicated sce planets st 22 ees (gestion which war vested wth abies. she dos nat smoke of consume alcahol, ad sh eas 3 Eabreed det She has no preenstng medical probiers ang takes ne meicaons aside rom 3 ‘mutitaran. Her lead pressures 1/10) mg ar heat rates man” Cadac ar pulanary [Samnatons uremaraeleNotoes stnermales ar found an neulags sxaminaton, When 3 nna fark paced onthe git masta process, she aprrecites the tone louder tan hen ts Held neat te ‘extemal austen meaus Audlomeny eraws rah ev egsency hein loss. Won oe alone ‘ost hay cause of his patent's camplants? [S Antbote mesment B Hypanansion of regnancy Meniere's dase ve D.oweckrace Chron ata mesa F aout neuoma 5 Presoycuss ‘The above gna describes the Rinne tstin which aturng fers placed ovr the mastaid process and thanto he et. areal pate th tone fs pay louder when placed ot th ea 25 opposed on the masin paces. Inacaingncieased ar eonducihn compared to tone conduct. Bane eonducton thats gfeaterhan af cangucton man eat leaning lass & suagestve of conducive heafiglass. The ‘oral ning a areater van bane conducton can alee found neoneorneuralrezing os. Tie et Cane used nconuncton wih he Wieber test, whchhpsto localize the sd of Geceased hea by facia eturng fakin re min te tace na asking he pabert when ise saunas aude The most, Wey agnos= mins carer aase = coscerse ante pater’ gragnansy decent enaode ct pysloneprte eal unltedOtsscleei the moet commen cause ef conducive earn lace in Sts, ng most common gatertsin Bey 208 9d 303. Theres a sight femalepedoranancs. I ‘osclrst th stages octpate becomes feedta the oval wind, resutng mlaes cfs pan acon THs (dearer is sometimes ako refanodts as clospongioss because CT may show acer (ae opposed 12“Tha above inate describes he Fine etin which a turing forks laced oer the mastoid process and thento he ear arora pater the tone istpealy louder when placed net inte et as opposedtoon themasing pacers indeaingnsiesred ar conduchen compared to bone conduction. Bane eandacton ‘hati eater han ar canauchan nan ea wh heang ase Is suggesbve of canducbvhearng ss. The ‘oral ning rene tam bone conduction can alse found sensarneral ening oes This est, Cane used nconuncton wi he Weber test, whchhexsto locale the side of Geceased heang Oy facing he turing fakin he mine of he face and asking he pabert whch side saunds nude. ‘The most lke agnosis me pateuar cave‘ ctoecerace andthe pater’ pregnancy and acon epcode of bconenins ae unratedOtosleots the mest common cause ef conductve earn los5 9 [Bute andi most camman pater nar 208 nd a's. ‘Tare's 2 sight female pedoranancs. In Gosclrass te stapes ops becomes festa tne ov vandnn,reeutng miges cee pean aceon Ths Gisarder is somebmes also refered ts as clospangioss because CT may shaw acer (as opposed fo ‘scbrote focus inte tempor tone near he oval inaoe Therefore, CT cout be used to comm de agrose nthe case {holes A) Otsoscantbicics such a aminogcosies usualy esutinsensornaura 35 opposed to contvetvenesrng oss (Gholee 8 This pater’ gh bond pressure wiikey requre futher evaluation and estment, butts Ul tobe cotmutng tar hearhigoss (holes 6) Meneres ascaseatexs he mer ea ansticaly resents ut aural Tuness rus and Sersoreutal hes ors. (holes ) rors ote mada may cause conducts heating los tut ie ical accompany pan sndear easiy be dagrosesby ooseaee xara, {hotee An acousti neuroma, age known as a vestbule schwannoma, tpiclyresutsin sensorineural howing oss (hotee 6) Prestycussis sensoneutal nearing oss that occurs nants wir advanced age Eeueational asjeceve: Sone cenducton tee greater hana conduction ont Ris tects euggestve of conducive heath loss. The mest commen cause of contuctve hesongloss mn adults patiuaryyoura slut) sesso ea ee Copyrght@) UVLEWORLD LLC. OBarkver 200802‘A 28 yeacoldwoman reserts fore frst prenatal ist Sheis 1 wees pregnant as dstemined by herlast Imenstual need. Se does nathave any matical poems and dae notte any meets. She Gevoutyreigous and hasbeen ina monogamous elatenshp rh er hustand nce getng maried = Years age. They Ween arause bull 1333 where she nas a5 anamemaber Het huseand.s ar Secaumart. She does nat smoke cigaretes er nk aeahal. Her physical exam is bin normal ts. Which othe faloning screeing ets is inestd 2 sti vo A Rape plasma reagntest 5 Hepatic © atitady C.Senum lead vel 1. Rea los cette aod evel E Charman ine resamnmence he al pregnant wenn be aceenes fr aype regardless ota tatars. Sereening ‘shouldbe performed ate frst prenatal vist and is call azeorplsied athe rapid lama reagh (FPR) renee! disease esearch tory (VDF) test en te scleening ests poste. te gros can be corfmed wth ne uatescerttepanemal body asorgien @TAABS) lest. Treats wth perce {hotee 8 Tete sno ndicson forneratsC screening noes as, regnaror tense, Tis Pater does hat hae ay cous isk acs fr hepa Ceca {hotee 6) The Lnitad States Preventive Senices Tash Farce (USPSTF) recammands agains testnglead levels n asympiomate pregrantwamen. The inedence of ead toeiyin the Unted States so and here [Seno sudan to suggett ta siraenng and basimer of enympamac ragnat women is bene (eee Dy Eo ac! dafcenyeayn pregnancy ie asacted it neu ue dacs natn, TheSeam ens eve! 1 Red bod elf aed evel E Chammdiarcr — a itis recornmended the ll pregnart aman be screened fraps regardless of ik fatrs, Screening shouldbe performed at he frst prenatal vit ands peal accomplice vibe rapid lama rag (FPR) Grvenerel disease esearch tort (VORL)tst When the scteening ects poste te do9ss can Ee cortmed whine uatescertepanemal anboiy asorgien (PTAABS) est. Teament swith pencitn (Choice 8) Therein indication forhepabis © screening in ers acts, pregnaréor ens. Tis Pater does hat hae ay caus ik acs fr hepa ¢ectan {Cholee c) The United states Frevantve Sentces Task Farce (USPSTF) recammands aganettestngiead levee aeyrpiome:prgnontwomen, The nedence a ea txetyin the Unted States lo anther ‘reno sudes to suagee a sxrening an vaaimert of asympiomate pregnant women is beet {holee 0) Fic ci decency ety pregnancy is associated wih neural tie detects innenoams. The USPSTE andtheregansabone recommend hat women sf chisiemng age et etch nfo 928 anor tae fle cig supa. Rovtnetestng of ole acs evs snot rica, weer. (Gholee €) The USPSTF recommends serzeing for Chlamydia fection nal women age 24 2d younger Sndthose 2 nereseed rk stay of onal anamed inacore neu or mus paere) The regrant ‘roman not at nerease sk and us does na equ Soeenng éueational abjeive: ‘Screening for syphilis song recommended il pregnant amen, regardless ofthe isk actors for senualyVoremtedifectors orate stupa (00/208 JORLD.LLC. Oberk ver 2009.02| 36-year oso complains of mole dschaig2_ Te decharg® is Tom bon breasts, oan in clr and ‘ccursimrmenty.Shehas to chisfn who are Sar 8 years eld. She has nt been reer preghant Herlastmonsal pared was one ack ago. She describes na abe symp. Exarinain shows oral breasts witheutplpatle Lures orrprieabrarmaltes. Eronrish discharges expressed rom the ‘rigples,andit'squaac nagave. Which ate falovang the mast appropiate st Sle in anagemer? A amragiam | B uivasonogam © Oytagic exarinaton © D.Senum paiactn and TSH ives Sugea evaluation 4 FNofuthor worn ‘The woman's nope charge ia most coristert wih galatanhea. Galactrhes presents as biteral ripple cecnarg: tots most aen mayor lear nek, Bt can asa be yeloo tron, or geen. Further ‘rauaton forte causes of altos sould Tus be pursued Ms pale via tshg of serum pralatn Sno To lsat ‘The red fags to watch cutfor in cases of pple sscharge are uisteral secretion, guia postive id, and least um. Inte case otal qua negane Useharge, andin the ateence of a treastrass, ‘marmagrahy ‘nat ncessary The ater canbe reared tha bret cancer vty ualy Pregnancy sroher common caus of batoral pple dschage is unl hen hat he patorchad her LMP one week 300, (Cholee A) Msmmograpy i used bath in sereenng for brest cancer arin evausbng cea cases of Sepa! ump ornpole Gechage. fhe pater had baad or quae poste Ma inher nse char, oF breast ump on exam rammoaray woul be rated (hotew 5) Uirssonagram sone test hat canbe usedin the evdustion cf breast mats itis must use a dsceringfuifiled massos Fam sold martes, valuatng he denser breast Sess f younger wer,‘The woman's nope discharge is most corsistet wih galstonhea. Galactorhes presents as biteral ‘le alsenaras ats most aten may area’ nob. tl ean aso le tron," aeen Further (Suton for ne auses of galectonnes hauls us be pursued Ws patent tego Serum pralctn snd TSH lava, “he red fag toate oun cases of poke sschare are unistealsactelon quae pose id, ond beast lump. Inthe case bzral quaac negave dschage, andinthe absence af atreastmass, ‘marmagraoy isnatnceseary. Ths pater canbe rescaues tha treat cancere vey unlay. Preprancy aroter common eae of bse] nop Ascharae, sunk en hat be pater had her LMP ‘ne wesk 390 {holes A) Marmosrapy is usd bth in screening for breast cancer, andin vauatng ceria cases of “reset ornnbe echatge. Five pater had baad or sar pose ad mher nose chars. oF beast Lp on sxam mammagrapy maul be ncaa {hotee Bp uieasonagram sone tetthatcan be ussdinthe evduaon of abreast mats. tis mast uso at ascering fused masses om sold masses, evaluating he denser breast bss of younger ween, andin gudeatuopsies. Utascund eno parte ne wat fo gacarhes (holes ¢) jaegs axamnabanienscetdin cases ot uniuctal ans ge post nile desma, blows he paelog te examine ces rom te dort to dings carenema, potest changes. ond Itarenatay processes. tis notndated for pur negate dsr De (holes €) Surges estsnon woud nave been neste er he paerthasher apple secharge inched [oss ot tested gubae postin, or been associated wah a reas me (choice) Gaacionnsa as may ptental causes. pening onthe esolay ean be ascites wih Inuniny and aernesth neues) Pumertesang ie neste Eéucatona objective GGasconea presets os pss negate blteralnigle discharge. Proletinoma,nypayro, (versimulaton atte nppe ord canacepve ls and medestens whic loner Sopamine els ae Corman causes. Watapincudes rung outpragancy, measuring serum poacin and TSH evel, and Bossbe MR of the tam oreo graoctname, HOUSMLEWORLDLLC Bark ver 200802 18.year ols ermal woman at 34 weeks gestation presents ora ovine rental vst. Het pregnancy has been uncampleatedta date. Her pastmedcalnistoyc unvemafhatle. She kas ane lbh and “a ne ron ttt daly. She has re kno tug allies. Physical xarinaon shows a usrus constant ‘See wth weet petal age Rovtne leareich ure cute rr rete hon 100.300 Connect a Eserenoni cot Which atthe olawng she mast apprenate phmacznerap/? ve AAmaxeiin 8 Oprofxaen ©. Cinsarycin D.Dasgeytne E Temsmnopim.sutamainovazae en | | ' ‘This woman has asymptomatic bacteria, a pase une cubute the sbeance of nay rack symptoms. Gudalnes date tat tegnant women vith asynctamal bacteria shoud be eaes wt lmtbotes in arger ta decrease invasive nar wat fechrs, elem delves, a law brth wig hidon. The evince fr teatmentis mast ratustfor nomen tetween IZ snd lb weak’ getaton, out Some auatbes etand his recommendation tmoughaupregnany. For awaman te thats of Drepianey, the recortmended srblcics ae amon, curatn ano cophaeepain, (holes 8) Crataxachn ea rains agertin he westantatpylonepnbe ans may alsa ee ueeetor Uncomplicated eystts nnerpragnat aus Fcroareleres ae css Ccrugsn regrancy because they rave the potential cause srtropaty mn he ureom ets (holee 6) Cindsmyeinis aclass 8 mesicatanin pregrancy Whleitwould probaly te sate fortis, oman, Ef poor cate for uray act nfacons because ths na gram gabe coverage (Choice 9) oayeycine an anereacycineactites are clas D masietions mn presnancy. Mey Ineate tn tot Savelomere ans shou narbe used ne seen hat ot pregnaney om ehisen ese than years af a, (Ghotee &) Tnetrapim surametnoxrol is 8s C medcatanin pregnancy. tmay be used dung Me Secand wmester buts natracormended fr ute dung fe fat wmrestar because Reteres wah fll 2d© cinaamycin 1. Dorycyine E_Tiimshopim-sufamstvaza sora Ln ‘This woman has asymptomatic bacteria a postive wine cure nthe absence of urinary act mpm Cine cette tat pregnant women vith septs basta ano testes wth amtbties inorder to decrease invasive iar Pact fechons, preterm delves, andiw bth righ ‘inten. "The evince fr teatmentis mast ecusefor women between 12 and TB weeks Destabn, Gut Sore autharbes odand his ecomndabar Incughas pregnancy. Fo woman inte thr ties of bregrany the recommended anigice ss amcicln, ura, anor cephiecpein. (hotee 8 ciproxacn is astine agent ne eaten of pelneghits and may ao be Use or Uncampleated eystte n nonpregnant aus Fuctoqualenes ae class C aug n pregnancy becasse thoy have the potantal cause artropaty she urea (Choice 6) cindomcinis a class B mediatonin prezvaneyWhletould roby be sf orth woman C6 pour chats for uray act nfecons because thas na gam neqabe coverage (hotee 0) Dayeycine ad aber teracycine attics ar clas D mesictos in pregnancy. They Inefere ttt develsgmere and shoud notte usednthe sorand hat of pregnancy a mchien ess than yeas of ge (holes &) Trmatnepem sutaatnosazls ie a lace © madieatanin pregvany. Emaybe used auinathe Second timester buts rotfecormended fr use dung the frst hreste becuse ieferes wah fle 38 ‘etaalam of avg athrstimestereecause tineleases Me skaters ine mentor educational abjecive: [tie srongly recommended that asymptomatic bocenurin pregnant women be ested especialy nomen at2-Jeweaks gestation, Recommended ateltcs rete aod nmotuttan, and oa cephalosporins 79% of eon answe astute (2120=< | 22-year oltwoman beng flowed by her tty physician during her rst premancy. Sheiscurerty at = 28 week! gestan, feeling wel and gang an appropiate amaut cf weight. She has nat had seal inmarcourse forthe past 1B ooks. Hor frstprenaal am was a 12 weske gostaton, at wrchime her HW, Chiara, goarhes, D-artbady.andurne cures were regave. He! bad Woes Anegatve. She (des ot nae ho befor ete ci but excited orate hia the ae thee rather. She ‘Sunsets reallor can her mmunizson sit or anumserovacemes Winn othe fel59mg ‘ensres i worartes t ths ti? 2 UNReccnaion Urine ture © C.REO) andy tet HY anibosy test Proumacocalvaccne ‘The United States Prevents Sanices Task Fore (USPSTF) stongy recommends Rh-beodtying and tezing for Rr antbodes atthe frat prenatal vt ae el a apes Rh antoogy tering 3128 reeks 0 Unsenstees women ih ivsostive or F-unknonn panne Ths partcurpaborts Rh regave and oes nat now tne faer's Rh status us, her Ph areod satus shoud be checked ahs me (Chotes A) in pregrare man whose imunizatn tatu is uninaen or unconfirmed he shysican shoul ChesktormuelaimmuntyHaeever tee NM vacene enotrecorende or reanare (omen Instead suscep mdvadals shuld be advised ta aad docu potanbaly ft ih rel (holes 8) Scrosring nd veaent or asymptomatc barter between 12 ad 1 woeksgestaton Signicarty decreases symplomat unary tact rfecons over bth weight babes, and peter Geivees, nis suonay cormensed uy he USPSTF. Ths worratray easy boen sereenedandie not Ingnn to have peseposngraacore forsturen unaware ike urnay os: noes ‘ee cal disaee, {Ghotes 0) The USPSTE sonal recommends Wat seanant women be soreenes for HV/nfeston ate frst prenatal vatbecause ear intaan af arabia medeatans can sigieany desrease dscase1H antbody test eS E Preumacezcavaccie “The United States Preverve Sanices Task Fare (USPSTF) soma ecommens Rh.baod tying and tesingfor Rn amboses atte set prenatal vt aa oe ar apes Rh anteoey tering mt 28 etke n Unsersties waren th bpostve or R-aninonn pares Ths partculrpatet ls R-regave and ‘oes not inowine tamer Rr status Dus. her Rh arteady satus SroudWer2nesked at Ws te, (Cholee A) in regnere women whose rnmunsaton sti is uninaan or unconrmes ne ysian shou ‘heskorruela mmunty However telve MMB vaccine not recommended or regnare ‘omen insted. Siscet mihadiats shoul be advised aad ndlaas potently ee WN rela (holee ) Screening andtresmet or asymptomate bacerura between 12 and 15 weeks gestaton Sonica decreasce symplamatc uinay vat ifecons, over bth weigh babes, ard potrm Seieries, andis stoma ecorended ty he USPSTF. Ths wna ras eat been screened ands not Kroon ohare pradeposingrakactorfarracurent inayat factor ke uray act anaes, Sos cl esac, 2 {hoice 0) The USPSTE strongly recommends bat pregnant women be screened for HVinlecton athe frst prenatal vstbecaise ety inlan of itebaal medeaians can sigifcany decrease deease transmesion ote fetus. Ths paterthad anegatwe test ther ftv rd. gvenherask anew erposures, does retneed tobe reszreered (hotee e) ris tecommenses nat pregnant wamen te vaccinated spat wun bunt agaast peamacaccus Eéucatona sbjective Alte rs pera st od yong andr arteady testa nF. negathe ome) shoul be performed” Unsensizea R-negabve women petertaly canying an Rr-postve tes shaulshave het Rh Smubod status retested bebveen 24 and 28 weeks’ geiaton, Patera isk of lommurizaion shouldbe Suen ar hme kn at 2 weave and agon aebtme of seve ‘Comsrart USM 2 (wr ar009| 28-year ols woman resets tone obstetcinfr er et prenatal vt. She is t Beaks gestation 3s =| {eterna by nerlasrmeratical prod. che has na medal problems and tes na madeaton Sho oes not sek cigaretins and stopped dining aoha when she decdedto become pregnant. She Mas no histo ie drug use and has rever been dagnosed wth a sell vansmtied dscase. She hasbeen ‘2 monegamaisalaonshe wth et husband forthe pat one year Her ami history suerte Her Bis 23gm2. Her pysiea examinaton, nclsing}tal sign, stan normal its. Which othe faring revenbve measuesis warared ats Vt? © Achikenze veecine Hemoglobin elcroshoreis Hepat Cantood esing D.chiamysaPoR Gononhes PCR Fasting tod sugar ‘The Centers for Disease Convo (CDC) recommend ta a peanant women taut cntandstins ‘Seeve te ntuenzaseccinanan Explanation: {hotce 8) Hemoxotn elecoophoresis is only recrmendedor pater thigh ik for arsmiing a emogbomopaty bases on amy nstary, and ne one (Cholee 6) Thre ne insiesion forthe rune evauanoncthepse C stain patent ee (Choice 0) The USPSTE recommends that all regnant women age 2 and young aswel as oer regan women at eevated isk aw or mutele pares, Nistor ct sewslyransmied icons, be Sereanegforehsmydalwfecton The USPATF doesnot resmmendae testing m waren age 26 and ler average iskfor Chlamydia (holes €) The USPSTF tecommends et nets semily ace women 292 24 ans younger, new oF Ile partner, histry of senaly tansraadifetons),ncung those who are pegnart be screened fer gatas, Teabmont dcreases he isk of ramature ragture of membranes rte aber, andoe Hepat anteoa testng Fr os 1. chiamyesa PCR =| Gononhea POR Fasting ood sugar “The Centers for Disease Conta (CDC) recammend tha al pregnant wamen wthaut cantando: races te uanzavaccnaien {hoice 8 Hemoxctin electrophoresis on resrmendedor aber thi rior tarsmiing a ernalobnopaty based on amy tary, and sha fone (holes )Thate ine indican forthe rouine evaluation ef hepatic Ceti ntti (Ghotes 0) The USPSTErecorimends nat ll regnent women pe 24 and younger 3b el 9 Or Dregiatwarmen a eevted ck (aw or mutele pares, hat of seatalyranamiie fatona, at) be {ereaneetercamyaa fasion. The USPSIF does notrasammendravine tang m women a3¢ 26 ans ler average nskfor Chaya (Choice 2) The USPSTF recommends that highisks2maly active amen age 24 and younger, sew of Ite parmere,nezoy a sealy ranemtedntetone) cling tose a are psghant be ereanes fer gootthes Treatment decreases the sk of premature pire of membranes, preter aba, and ‘hmaneiones Ths woman does natal wenn te Yecommendsd a range or steenng and 6 henuse at erage nk (Chotes Fl pregnant women shou have ts fang blood sugar teeed at 240 28 Wook af estan. Hate patents (rakes obety family Mistry of dabees| can be screened eater mn pepiancy éucatonal objective: ‘The ODE rezorenends that al pregrart women without covaindcatons be vaccinated agai ifenza orate Lasupdate (12005 JORLD.LLC. Oberk ver 2009.02 F2 18yeacoi presents fr evaluatan of ane, which has been geting prasessive wars aver the past? ‘weeks. Her modcal hy is sgnileat fr syst nus eybamatosus (SLE) or ich se Fas bean taking preavsanefor a recent exacerbation. Hytarychorequne isher oy ther mediene. She doesnot Use bacco, aeohalarduge snd her mental cytes regu On pcs xamnaton, her baos pressureie 110) mmbigans er ules 2mm, Her Ehit 22 gre Ditnutes ovr metace, arms ana trunk ae mansmorpheus anematous papas. Thee tere open or closed comedores. "Tho remander fe praca examination tvemarkQe. Wich ote flowy isthe mest Way cause oe aoe? (© A Adokscent ane (© 8 Androgen stuse © © Poheystic ovaran disease © D Medication side eect © E Systemic pus eynemaoaus Poot2 st-yeacoi semualy active femal cames to yuroffice because of inary equency snd dys foro Gays. She has nade such epsodes ne pas, ach weated wth alates. Physical earnnaton ‘eveas supropbic tendemess ander ualyis postive forint, leuronte esterase mary WESC, anda ‘moserate amount ofwaciera. Which the alana isthe most caman reason fo Bishgha nedence of nna wact facts nfemales mann ales? (© A. Closer promi of he weil mats othe anus in eas (© B Frequeréuse of spermicie ad daphregsinfeales © © Sharer utr eng infemaes (© Higher posevoidune resitual infest © Hormana fuchiatoneFerales Poot2 18yeacolid iis bought ta yaurofice by her mathe for evaision of primary amsnonhea. Her alder ‘Seer a ar frstperad at age 13. Wal signs are vt naral ims. Physical sarmnaten shows Shsense of breast development nd external gentaia at Tamme stage | Examination shows na ther [bnarmaltez ven ate flonan athe me speeaprate net tap n management? © A Estrogen levels © 8 Soumtsiewts © © SenmFSHleels © 0 Kenexypiog (© E.GoRH stimuitn tet © F Reassuance Block aioePeer 2 2b yeacoli imc woman tS weeks gestation cames tothe physician because cf swelig ia her hands and anos She haemo toadache, aul dtubancoe or spgacte pan. she hs no previous tmedcaiproiems She doesnt use etacco aicoha orlict drugs Her rewous renal eheceup at 8+ reels gestaton was nama’ Her medal feces show na preesing hypertension of pret Her Bose pressures ISH mmHg, and ater 16 ransesoateral ret aepeatreacng 14708 mig. Physical eaminaian shows 2 ping edama in bath egs and hands. Deop tendon rflngs are Format Fundsscape: etamaton shane: no aenormaltes Fata neat ones ae aude by Dope. Laboratory sudes show He tang Het £0 Pateets 0g 000% (restore mpi tem sof Lats shows 1+ prune, hich sna. Which ofthe flowing the mast aly agnosie? © A Mispreclonps © 8 Severe preectmpsia © C Chant hypertension © 0 Transient hypatensian of pregnancy © © Eslemeas © F.Ctroric hypertension with supstinposed preeclampsia Pooteee tema of2 Wich othe faloning i te most appropri intal madcaton ta eather hypertension and protsruria? © A Lsinopa © 8 Memsopa © © Furwserise © D.Niroprussie © E Verapari Poottom: 6 of 44 2 1Ryeacold female comes ta he physician's office for arautneprysical examination. She has a Complats andhas no pus medcal peters. She hat beehhewng sox inc the ape of 4 and has had seus parers sp far Vial signs we sible and physica examinations uverarhale Pap srear is Deformed anne report care tak a sabtacoy fo evduato’ and shows mi yeaa (ow ade Invaentnall sin). Whine te flaning isthe mas aprrpre not step n management? (© A Repeat Pap sarin 2 weeks (© 8 Repeat Pap smear in 2 mantis © © RefecHvtestng (© D.Celposcony (© Endometrial euetage PootCee 2 27-yeacoli pimigra woman at 28 weeks gestation cames tothe physician oie because she has cat fet any etal movements fr te past 8 hows. Ha reprancy hus far hasbeen uncompicated. Pres Utrasaun atthe 2h seek fgets shored an nfaenne gestion consort wth dees ard howe I armies ‘She hazna etry of aura. Shehes na aye aeraus ness, Ree yearn Fveas a abnarmalbes. She does nat us tobacco, alcael or drugs. Fetal heatones arent near) Dole. Vial sigs are noma rem of2 ich cFne along i te mast appropri nest stn management? (© A nuton of lar © 8 Nonstess test © C.Serialbetenc (© 0 mentor coagutten pate © E-Restimeutraanoaram PootCee tema of2 ‘Real ime ultaconograty shave na ftal movements and o fetal heart mon. Amateral coagulation role shows no orale, nducton of ito permed ad the dead etusis evacuated. Looking at Fer anenatal cha yau nace ha he mathar had mssod? marty apart Which the elowng isthemast appropratestatemere ahs ome? © A "Dont wo, there sno nreased sk orang ast Br nna pregnancies (© B "Weneest mantra sera bet. NOG lever nex 3 mons” © C.Wenneed to maior seri Fnogen|evels fer restourweckst (© 0 “hwadsrecommend an atpsy of fetus a placenta" [E "Rieuld nat have happened you ad good renal care” PootCree 2 22yeacold woman reserts with complains of vaghal discharge and severe war pus. Sheis henge heathy. Psi examination raveas ai, maadorov vagina decharge and matked what ana “Zag entema The poof he vapral discharges 85. Merascoicexarnabon al the dschargeis most Il ta reveal ich one aa (© A Poeusetyphae (© B Flagelted mote organisms © 0.Guecels © D Mubnuclasted gant cls © E Numerous eosinopie Pootrere A St.yeacold woman cames nthe physician’ fice fr evaluation of vaginal dynes, baring 2nd Gyspasun. She abo ras dysura srdinceased unary Wequency. Te symptom have boon prssntfor Severs manins hahavemtensidrecenty. She hashed avetne-courer nares aie eet Her lactmenstual pecs was seven years ago. 'Se nes hyvecrahlanide a Myperensch ana prorat ‘ehjgernaestrsima, Physics sarinaton shone saree pute Marana esse sstey snare oF the var shin. Pale, dr and smc vaginal pinolumisroted. Ure cpsick sara. Which fhe faloning te mest aspaprite net sto n anagem ‘@ © Cprtoiainar ane week (© 8 Newondazce far one week © C.Discentnu hykocherathaeie (© 0 Vaginal estogen replacement © E Highptencycorcestesis cream Pooteee) | a8. yearold woman, gravida |, para, comes fr aroutne prenatal Wat, According ther try, she is a ‘erncekegeeaton. Hat aml histori ipfcaeter Dawn synstome on har matasl ade She dose not Use beso, seaholor dupe. Val sms ae normal andphysal exanaton unremarlental laboratry sues aha adecieasea maternal eum apa tcgrotan [SAPP] heh a Be alow ‘the most appropiate net sep n management? © Aamncertss (© 8 Chonan wus samping © © Uratanogam © D Crdocentsis © E Uinary estat eves Pootard Block err ‘A atyeacold woman resets a your office with 2st palpated beast arp. She dseoveredthe mass 2 Gays agowle ang 2 shower ad noted iat fis mid tnd. Her menedual periods ae regu, curing (rer 25 days Her ast renstul pe (WP) vos Seek ago He past medal history ts sighfcat ‘She has ra arly nator of breast cance’ Prysealexamaton feveas a ump he superar ae! Susirant tne ngrterezt wena papas rmphacenapaty Which othe aling a he most eesonace fos sep the manapemert of hs pen (© A Asker to retum shay ae the mens paiod © B Crdarmarraehy © © Prossesntn ne needle aepeion biopsy © D-Supgestecisional biopsy © E Reassue thatthe mass is benign anna folonup is necessary aioeere 2 Teyeacold woman resets with complaints of severe war itching forthe pastsicmanhs. Shes red (vere cours topic bears whew ret. Phystcal examination reveals numerous vat rcoratons. Thewuvar shins thin, yard white eaor Telia minora ae cut to vise tem 4 of2 Wich othe faloning i te most apropiste nxt stn management (© A.Vaghal Pap smear © B.Vivarpunch psy © ©. Radical wivectomy (© D stogen cresm © E Wetmaumsmesr Pooteee tema of2 ‘Adagnotic of chen sleeve ic mods. Vic ofthe folloning ete most aproprie net stapin rmaragerert © A Radealecony © B Tope catcosterad © C-Topial exogen © D chyanerapy © E Topica cotimazale Pooteee 2 sbyeacoldG2 1 woman a 8 weeks gestation peserts tthe hasptalcamplaning of regular and pal asin contractor that sated toute eat. Pe\iesramiraton raved long merrane, ond Met Corsis 50% faced ad ised to 3m. Her pegrancy nas compte ty rstrmesterhemarhape oF Uninaan cause Het past meseal sty © uremaratle Stet pacing etalneart ments san ‘eral tacometr ante patert youncte separate 1S best decreases nthe tel hea rata not Concking wth tsrnsconractoneeachlaeinptor 2 seconds, When of th fawn isthe most ‘sptronte net step nthe rangement of he patent? ‘© A Onyn amination and change in maternal poston (© B Arial rupture af membranes © C-Armintusn © 0 Fatalscap pt testi © E Emergent cesarean secon Pooteee 2 1Syeacolid iis being evaued fr primary amenenhea. She's ethers heathy andhasnapreious ‘meazaiproleme. Vial ene ae vin noma Imes. Physical exsrinaton reveals nama breast evelopment arma pubic and ally har, and Unsvapra, te uerus and adheca could nt be ‘appreciates. Pei utasanosaphy recat? ovares anda wets seen. The kanypele ae 2. Which afte falonngis te most ke dagness? © A.Muleran aginene (© B Androgen seri © C S.phareducase dafcincy (© D mparorats hymen © & Tomer sytrome Pooteee |B. yer os oman dived heathy baby by van ivy a SE wees gestation She ha = proonged semsure rupture o ra memtranee, and mi forse evoleaten wae reaured Gunna {eivery. On the second postpartum day she complanedoffever ad chil. She coral treastleed because herpes aetander Her temperatures 305 [101 3F), lea pessute 128 meng and pluses min Beara amnsban enone tencer eros andiauzmeling nena. Hernles =e raced btrithoutsureundngenthema or vant. Physical examin stare se ‘Sarmattes stem sof Wich ofthe along i the reste diagnsis? ‘© A Namal pesparim (© B Puerperal masts ©. Endometis © 0 Deepyenaisttrambess, © € Asoraton peuranis Pooteee tema of 3 Wich che faloning pathogens is mast Ihalyresponste or this patents curentcondian? © A. Chlamda wactamats © 8 Group Steptacaceus © © Nebsera gonortea © D Staphyccoccus aureus © E Pabmeratiainecton 5s Qn rmercnrescetet niet an enter Pooteee tema of 3 ich ete long is the mst apposite nal harap otis pain? (© A Vancomyen and getaicin (© 8 Cindamycin and merandszole (© © Vancamyein a clindamycin © D .andamyein and gentamicin (© Cefticone and szahromycin Poottom: 20 of 44 2 snyeacold woman, gravida para at 7 weeks aestaton is bout tothe emergency department because of acute onetmeresusrne cerractons and Vag teeans. Sha hasbeen old oss for preeelampais sree her 2nd west ef gesinton. Her emperaie 7.0 (98) tlood pressures {Wereemmg puss 'a arm and expratana ae faim Physical examiston sows ute tandamess and nyperacoty ard moderate vapnal ieang. Pele examina shone an efaced and Sem ais Conde. Utrasonogapy shows 3 func placerta and fetus inthe cephal poston. Fatalhowt racing Shows mn wah goos ung tm ana beat beatanacy. Aner ital esusotanon fe eesany & Sopped. Which ofthe floning isthe mae appropiie net step nmanagemant? © A Vapna deve wi augmentation of bo, necessary © B Emergency cesarean secon © C Pert ncolyis and schedule cesarean secon thn 48 hours © 0 Forceps delivery © E Conserve management athome Pooteee wean executive donates fv mon dala or te prevertin of iauterne akath restictian nthe lca Coury. Spending hs raney an which of ollvungpragrams woud provera grees numba af neve oft ron resncton (FG) te positon (© Aleonois ananynaus| ‘© 8 Smotingcessatan © C-Walnurionpeverton © D.Hypatersion conta © E infection conta Pootfers) err ‘A 2byeacolGIPO, maman at 35 weeks getaton comes athe hospital because of eouar were Cortracons and pareape of cea fudpervagra. She has ra cher symptoms. Her pregnancy fs farhas Sean uncompleated Her temperature 532.€(100F) lod pressures 2008 mei. plse fen lana espaion are Tin. Speculum sarwaton shaes a oses cer ad ear fuls poling the “ingna fmieThe parte fiadie 75 Peta heart anton anova arate o sion and tan Cortractons occuring every 3-4 minut, Intl aberaary tudes show Hemotin 10291, Plate 136 000mm Leukocyte court ‘400mm Newsophis 85% Lymphocytes 1 rem sof ich ore along is he mest ie doanesis? © A Abrupt pacer © 8 Invaamnatc rection © C Urry act infection (© 0 Teramonas veginse © E Normal ator Block aioeeee tema of2 Wich othe faloning i th most appropri nxt stn management © A Adronietertaayes © 8 Betamenasone (© © Cesarean section © D tnmadiats induction © E Expectantmanagement Poottom: 24 of 44 2 sbyeacoltAfican American waman wih ype-t dabetes and hypertension comes othe plysicia sof ster otanin 2 postve recut rm ahome pregnancy test. She tales nsuin ard era, She es nt Use bacco, alcohol or het dugs. Her temperature 37 2 (380%) Bod pressures 1280 mm Hg fubeis Tami ang esas are ln Physical eniacon ic unvematabie. Her NV Temas land creatnne & 14 mic. Arepeat BHCG tes perormed inte fice cans pregancy. Which af he faloning is te mest appropri next stopin manager (© A Stop eal and start uosemide (© 8 Cortine endape and add mations (© C Stop enaapt and sta ie (© D Stop eral and stat lsatan © E Continue curent neapy Pooteee 1.28 yeacoldG1PO female presets fr her fest prenatal st at M4 weeks gestation. Apap smaaris done at that ame anda figh rade squamous zaepitelallesons (HSL) soon at ytbogy.Atast fr HEY {declones the presen of sran win hghancagens sk. sesfotoncaposeapy ie done and shows no Stef stnormates. ats ime ened bent ‘© A Loop eectosurgcal excision process (LEEP) (© B Repeat pap smear [2 months (© © Termnaton of reananey (© 0 Repeat copascopy ater delvery © E Endocenica cuetone Pootesd Block err | 28 yearald woman comes ta the physician for rutin plysc al exainaon ane a Pap sme, She has had mute sexual panos an uses barr methods for caacepion. Sha was Wester chara Cernts four montis age. Shehas no ote medica protles. Pee examina is uverarlabe and 2 Papamear vcs paren, A eck terns reaut cama on sabtacay or svat’ and ars si ou de rept lsen) hen he lege mon ere Me SP raragere (© A Repeat Pap srearin Deeks (© 8 Repeat Papsmex in 12 mnths © C Reflochevtestng © 0 Cone biopsy © E Copascany aioetom: 27 of 44 1 25yeacolirliraid woman coms tothe physician because of canstant phic and iw saralback pin for emeralmonte The pant usualy wereepromancnualy. She tad ve tha cue arama redcatons but dite rele! She hos been na moragarous elaoonshp wh Re boyfend forthe past {eas She nas no ever er normal vagal dssraige. Her lempratre ls a7 2 (989) and Uae Dreseurete 1278 mma. Physic! samnnston sve tender posener vagal fame and pa pen ern ‘oto, Compl load count sno. Pele utasonogram ener. rem of2 ich che falonng is most appropriate aghast testin her management? ‘© A.Endametal biopsy © 8 Lapwoscony © CCA ovals © 0 Hysteosapngegam © E Sara tans © F CT scan ofthe pte Pooteee tema of2 “Tis parts atric of develeping of wich of he flog? © A Endomatial carcrama © 8 Breastcancer © hrerty © D Abrupt placer © E Pretarm tar Pooteee Block 1 25 yeacoli pimiarous maman comes ta yaur afc 12 weeks ater vain evry of shea female baby. She nas notha'amensuulperod since celery. Shes rursing, and i sig barr metas for Cortrecepbon Exorinaion saws no abnormal, shiek othe foloning she mast ely mechan fo Inceaneres amenarmea (© A itary oft on FSH andLH by placental astogens (© B Inhbtary fecton GaRt by proarn © © Suppression of erdometial mrlfrabon by axtoon © 0 Suppression of aulaton by human placental actagen © E Physio postpartum endametial a ophy aioetom: 30 of 44 2 abyer ald GOP0 woman presets tothe emergency ram ith camplins of vagal bleeding and ake loner quscrartpan, Het lat menstua penad wae ssproumatly€ weeks apo. She is seul acbve and Uses condoms occasional Her temperature 372 (38.3F),bbod pressures 12074 mm Hg, uses Simin andrespeatane a 14min Erammaton shoo mid ightlanar guaran tansemess but ‘abound ar uarng. Tete gra actve Vagha teeang and he cervcalosisclasea. Her néalhemegstin IeTiO gal. Shere Rh poste and 3 quarts BACG 1000 mim A vagal ulracoun ie Cone a3 ro rraerne or exrauterne pregnancy canbe seen. Vit the folowng snes test te ‘managers (© Coneantforapersscony © 8 Methane admission © C Pepe BHCC ind8 hows (© D Acmstabon of ant.0 mune bun (© Conserter latton ana curatage Pootors Block err 2 22yeacoli migra woman comes fo her nial prenatal visit 28 weeks gestatan. She has no Cconplars ecept mignausea. She ut iabacco and acopoluse ater she eared he was pregrant. Veal sgn ae win normal lms. Physical examina sows ra abnoralies The soreeing ‘GDRL tat retuns postive a: does te canmatoryFT Aes tat The pabertnas aMoty of alerge reactants penciin. Wah of flluing the best reamere for fs patent? © ADoqeyaine © B Enftromycn © C Tebaeycine © 0 Cipretxain © E Peniciindesensizatin © F Noweatment aioeeee 2 1Byeacoiruliraid woman coms tothe physicin's fic for aroun annual check-ip. She Compas ofwaght gan about 1 bs ver te lst year. She fess isis esti ral cotacoptve pilose. She hos na prewous medealratiems She nadher ft sewalintercourse athe age of 19 She hha ben seaily sce nce pater forte ast? mani. She and ne pare’ use condoms inconsistent, ut use oral conraceptve pls equator cantacepton Vil signs are rama. Her body Ima nxt 25kgind. Physeal amination snows no Sinmahise Which the flowing ithe moet Sperone advice tos pant? © A Discontinue oral canracepive pi nd peta aap smear now (© ® Recommend corsnuing rel comracept ils adap amesr nah (© © Reassure that he weight pain is at rete a ora contaceptie pls (© 0 Recommend satin tom contraceptive pile to medronyprogesterane Pooteee 2 1Byeacoi pimigra woman at St weeks gestation cames athe physician because ose headache not upper auacrant can and vival iturbances. Duin heros veto weds 290 ene 935 frum to have an levied ond presse and 1 pretonuna, She vim pdsetofloneup closely and sent home ented entero prazsure day ia 17s1c0 mn and pubel2 abn. Priel exennain hows 2+ pring edema nbc egs and nghe upper quactettendemess. Feta nea tnes sauce by Dope. Umnaeis shows 3» proshura. Sem aspatate ainovaneferace (AST) 8 UL and ine ‘mnaanteage (ALT) © DUL. Serum ereane howe 4 mL rem sof Wien othe alonng isthe mast ie cause ofher ht ver wacrart pin? ‘© A Common be out otaructon © B Cyst duct obsoucton © C Wainepatns © D Pept ucer disease (© Rupe of hepatic adenama © F Distaton fer eapeule Poottom: 34 of 44 tema of2 ‘Ths patents adm ta the hospital an subsequerty developed generalized tonic sures wile beng evaluates. Inmesiate ravenous magresu sufaeis ste. Magrestm suse fs gven bis patertor ich ofthe fotoning purposes? © A Tolonartloed pressure © 8 Toimprove ner fnctin © © Ta decrease prtenunie © 0 Toprevertutnersemures (© E Tocontolurent secures Poottom: 35 of 44 2.28. yeacoli pimigrad woman comes tothe physician or afolonup penat vs. According to prenatal ‘corte ultrasound at 18 waaksgoetaton shaved an mautrne geetabon concise wn det ar ‘Showed no aromas. She snow atl weeks gesabon. Examination shows afuncal hei ensistert nn datas and ne erie rat tavtae Fata eat Yann is eassurng. She wees 0 corerue he pregnancy far ta mare weeks rater an undergaingnachan. She shaudbe eesely montredfarnnich fie fleaing? © A Pofnyrarmios (© 8 Oligenyramnios © C Atma placer © 0 Piecetaprwa © E Preecamsia safe Poot apal-e)tom: 36 of 44 ‘A a-yeacoli femal presets o your the evataton of acne. Further uestonng reveals hat she also has ad regur periods fer loge. She fs sng and not ssa awe. On varanaion ner Bs ST gid an sneha eenesothrstism Further evaliston reveals norense serum rec tetoteone ang HFSH va o'22. Coss iran es feveals Wo har ebad gucaseo 165 mg. Apa fam resening oral corsacepve lls, wich che flowing is hscatedin is pane? © A Clomiphene aitate (© 8 Metformin © C sua © D.Giiede (© E Noohermesiemon needed Pooteee | t-yeacold woman 2 26 asks gestation admits fordelvary. She has severe presclaesia Har oad pressure 10010 mig, puss Onin and espratons ae Temi. Physica examination shows 3+ piting edema cl the ngs antrsk deep tndanrefes. Funcoscopc saminabon stews ro nnarmaltes, Latatataysttes show elevated LN tum erie an sum ‘ransomnases. Unralyts sha 4+ pretarura rrvencus yaaiazne and magnesium sufate was ited on admission. Aer ibiza, intravenous cayocn and atl ptre of membranes (ARON) as adnsteresTrindustn ot sua. “Two how's ere Uooa pressure 8 16030 mma, uses ‘hin andrespeatons ar nn. Repeat sianinatin sho pores anda corny faced carvic that em dated. Which of he floning is the moet appropite no tp in manager? ‘© A. Stop arti and de an emergancy caverianeecton (© B Stoo magnesium aft and ge eau guconats © ©. Stpytazne and montarsrum cyaride evel © 0 Stapinsaveraus axtacin and nniat the patent (© Conenue cure reatmert ans procees wth severy Poottom: 38 of 44 ‘An 18-year-old woman presente tothe physician's fice camplaning of vaginal purus and sshaige, She has nausea, vamng, ot abéominal pan. Sh has had 2 sowal parners te past smarts an takes ‘ral cartacepive pis ‘She has na ober medealprbiems and takes no ater medeabons. Shas no Ieoan ug aegis. Her temperature 37 2 (89 8) ana ood presutee 12072 mm Hg, Pe. ‘rarinatanreveas mucepunient cenicl éschargeanaatle cereal mucosa. The remande othe Byccal cna surematase ram can ote Secharge evel numerue poymorphoncat Frmnacyes reg wen arom neyatveaplosocs Whats te mast seprogrit nxt Step nmanagement? (© A Panel and dosing © 8 Onedose of inramuscuarcetiaane (© ©. Ceftinane and acttramyjen © 0 Cetmavane and mesondszole © € Ampielin ans gentamin Poottom: 39 of 44 ‘A 22. yeacold woman, gravid para at 8 weeks cestatonisadmitiedtn the hasptalfor delvry. She has ad regu andparfu use corracans occung every Smunuesfor he past (ROWS. Her pregraney hes teen uncompicaied ‘She had anormal agri geveryfor hers pregrany a equres Ln epataany, A recertuvasound 3 weeks gestaunshoneaaaus na cphale preset wth esimatd fetal wagh of 3400 9(7 Se). Examinanan shows the cevais sof, S0% face ard 2cm Gated She's gen epdra anesthesia par hr request ight hers, pr conc has netsignF-ay ‘hanged, ané une contactors are accung every 8 minutes. rich ofthe foloning ise mastiben ‘suas of har curant canton? © A Ceptalopame sproparion © 8 Eat anesthesia © CCenieadytunctan © 0 Pernestscar © © Fasetatar Poottom: 40 of 44 A.D. yeacold ada? para 1 Afcan American woman at 12 weshs gestation amas fae first ental “vat. Excoptfreary maming misheada:nes ang nausea she nas no aher symptoms. Phyl traryraton shows mid bteral aie edema Boos pressuesmeasured vce 15 mites apart ards ‘sree nag an coh accasions. ond Oran or lataratry ests and he pant sant ame wh a ‘Soup appartment 2 aay ner he etame Say ater an repeat ons pressure he sare, Laberaiary sides shoe Unasis Protein negative Blo peaatie Ghose ‘rave Ketones agate Leuacyte esterase eae Nistes regatie wee hot Rec het (Chemisty pane Serin soa so mea ‘Sen patassim 2emegL ‘charse ‘aoimeat. Barvonate zimeot Blog ureanivogen (BUN) male ‘Senn ceainne ome tem sof 2 Lvascragram revels irate gestation constant ith dates no normals etd hich of the foloning fe mest iol agnosie? (© A Prescameia © 8 Chrarc hypertension © maar presnancy © D Transient hypertension of pregnancy © E Norma pregnancyeee tema of2 “Tis womanie at gests ik f developing which ofthe elonng? © A Fotalmacrosoria © B Placenta pova © © Abrupt placenta (© D Uterine sony © © Pastarm pregnancy eo elbole oe alae oelu Poot aLalBe|eee 1.28 yeacoli pimigrad woman lB weeks gestation resets athe emergency om because o gonefalaad weakness andlghhcadearess. or ts past 4 wooks Shs as etben alto keap ating Sow and ove the past eek her nausea and voriang have morsened. ‘She has nofeve, bsomnnal pat ‘donne, neazacheysurapoyra err or est reserance, She doesnot ue toace, aca ret Suge Pertempertreie #7 2¢ [air etmontate vii re fens: AP 13868 mmig and pulse ‘8imin eine and 11070 mmHg and | Sin stanchg. Physeal exaraton shave 3y mucue rmemeranes The femander at ne exonnaon& unemaratle Laborsy suds Show Hematoet 0% laste 200 00am Serum sodium iareqt, ‘Serun patassiam 2ameat ‘chianse a5 meq Baroonate Smeg hog u28 moyen (BUN) soma Serum resin tome Bod glucose soma, rem of2 rich cFne along i te mast appropri nest stn management? (© A Upper Glendascapy © B Pate utresonogram © ©.CT scm ome ness (© D.iahtupper quadrarutrasanogram © € Quaratvs bat HCG levels Pooteee tema of2 Ins! Sagnocti tds donot reveal obvousatrormaltes, The patti started on intravenous norma Saine and potassium chord. Further wor obtaned nd shoes Usnasis Ftc rene Blot regatve Geese reaatve tones poste Esterse Fegatve es regatve Bactera rene wae ate ver sts “etal itn 14 moa Drectirtin iomea Aline shosthatase rout ‘sparateamavanstersse | ZEUL ‘anne smnranstersee 100 UL, amiase soul tase rau Wich cFnefaloning isthe mest icy diagnosis? © A. Wralhepae © B Disetc hetnaciasis © © Hato mote © D Hiyperthrsidism © £ byperemente grevsanm Pooteee 1 17yeacoldferal ces to youreffce far abice. She says that she ix planing ta have sail imareouree wn hx toyfnend forte etme. However he enoried soo contacting a urna rack Infecion because she has here hat here 2hgh nadence of UTIs mseualeacte emales, Wich of {hetotaving tna mon appropri ave to ge hie patent a Gecreaue her chance of orang 2 unary wactifecton? (© A Tellferiguse aspemmcial daphvagm (© 8 Talnerto use a canton wn apes © C Give herprophyiacteanibites © D Advise herto vid ater etercouse © E Soul ireercause soe actin Gee) Poot2 1e.yearol gt presents for evaluation af aan, which has been gating progressively worse averthe past’? ‘ce. Har modcal hay is egret fer syst nus eyamatosus (SLE or ich ene Fas bean fokngpredhsaneforarecen exacerbation, Hyanychlroqune Isher ony ther medi. She does net ° Use bacco, aeohalarduge sndhef mens cyte le regular On pyscal examnaton ner bioos pressureie ils mmbigans ner ules 2mm, Her Bie 22 gre Ditnutes ovrne ace, rms ana {rinks moncmarphous onhemscus paplae‘Thee ate ma epenor closed comedonse “Te amunder a te pica examination unemarabe, Which ote lowing iste mast Waly cause oe ac? B Arcogen abuse C.Pokeystc avaran doase 6D asian sie ct E sje mic gus enrematosus ‘Tis paterthae etraitinducedfolicute, or stari ane, sacendayta the prednisone he is sina for het SLE iar. Slr acne is chracteized by manomarphaus pink papules ar absence of comedoes. (Choice A) Adslescert ane characterized by apen and closed condones and iflanmatay nodes in cienng stages of evotonpimanly afecing tne face, chest and back, (Choice 8 arctogen abuses» posstle couse of oth aoe wars and stroxinaiced acne. One ofthe Iman pathaphysolage meshanama undeiing ane las ansvagen exces, Caner try serch (ene satel {Ghoice )n poijcystic ovarian syndrome (PCOS) here isan undeing excess of serum andogens. As Se) Hla conmany ascites ene vapors) Ober marge Pcbs meus ena mene u (choice ) Systemic ups enthematosusitsefis rot» common cause af nef eins. The sh Tring most asec tor SLE is an aythemataus maa auton eatonal objective:pressureis 10/70 mmtigand er pulses Tim, Her Elis 29! Distuted oer the face, arms and a {nk ae mancmarpraus eqypemacus paps "Mete ate ro cpeh a closed comedores. "The amancer Stine pysca sxamnanoneuemaraee. hich at ne farang isthe mas isl cause crher acs? ‘A Adolescent ene B Anirogen suse Poweystic ovarian dsase 6D Mediation side ect Esytemic pus eneratosus wa | | ‘This paterthas steranduces oul, osteo ane, secondary to he prednisone she is using far ner SLE fare ‘Ser ane chaacteized by ranomarphaus pink paules ar absence of camecones (hotes A) Adoiecere acne i charterizes by open and cloeed comsdonss and ilamatary nodes in ‘enna stages of evouton primary afextng te face, chest and uack (Choice 8) rcrogen abuse i a posstle couse of ath ane vipa and trctinaiced ene. One ofthe ‘man pathaphysologe meshanime uncaring sone gas anarapensxcese. Gosnerhtory steak gene s motel {Chotew )n poljcystic ovarian syndrome (PCOS) heres an undeing excess of serum andoaens. As Such, comranl associated wth acnovulgais. Ober frhngsin PCOS include ieguar mens, Snowlshon angst (hotew e) Systemic lupus enéhematasusitselis rat common cause of acnefern sins. Th skin fring rast asec for SLE Ie 2 eytnematus mal aupton Eéueatona sbjectve Systemic ni opealcortcosteois can induce an acai ergon characte by manorarphaus ‘rymemarus eur papules debited an the fece, sunk and eemties. Comedanes ae charactesicaly absent ancivered ts Lastupdated (152008 Copy er 2000.02A at ¥earoi say athe Female comes o your otcetecause of wiry Heauency and dysura or eo days. She has hadiwe such epsades ne post each weced vith ol abies. Physical examnatan ‘veal suprapbic ondemocs and her urinalysis posve fr rit, leuko esterase, mary WEC, anda ‘Moderate amount of bate. Which ofthe fells he most camman reas er tehighe inefence of Unary watfactrs n females ann rales? 'A. Coser promi ofthe weal eats othe anus females 5 Frequert use of spice and dap in temales © C.Shaterurttallenghinfemses 1 Higter postvaid ue resiuainfemaes Hormanal tutto of tees roi | \Usnary act recon (UT) are more commonly sen in females than males, nha of al adut women have aU a-some ime ntnarife The hghinedence of UIT womens army Que ob share Teng ote female urea. Afr fe peruretval sea becomes colaized by rectal fa, te bactena Sevan oth ladder ta cauos facton. Ths acitatedinfarale by achat uta, Pradisoaeng Factors fer UT's cde ateron of the normal vapral fora by rece anibeb use, sen reraurse, (daghrag cr spared us. raf her of maple Us Nate, onthe cther hand, ars ees kayo develop a UTI many becausetheyhavealonger rsa han females They asa nove adr perusal enarormert and areca sistance prota which alsa Melpta gt of Wfecan (holes A) shat distance between he arus and rte women ie aceocatd wh 2 her incidence of recurert UT's wat the female population buts ot he man ease fore ference UTI equerey (Gholee 8) Spermicise ad ioghragm use ae ik actrs for UTS infemalas shorter uethvallrghin Females, however, response fr hee her requency of UT's compared tomes {ete meats postu alone sts ernst care