High-yield MCQs for Ob/Gyn board exams

📚 Quick Study Guide

• 🤰🏻 Pregnancy Diagnosis: Presumptive (subjective), Probable (objective), and Positive (fetal heart tones, fetal movement felt by examiner, visualization of fetus).
• 🩸 Postpartum Hemorrhage (PPH): Defined as blood loss >500 mL after vaginal birth or >1000 mL after cesarean. Common causes: Tone (uterine atony), Trauma, Tissue (retained placenta), Thrombin (coagulopathy).
• 📈 Gestational Diabetes Mellitus (GDM): Screen between 24-28 weeks gestation. Diagnose with a 2-step or 1-step approach using glucose tolerance tests.
• 💊 Preeclampsia: Hypertension and proteinuria after 20 weeks gestation. Severe features include: BP ≥160/110 mmHg, thrombocytopenia, impaired liver function, renal insufficiency, pulmonary edema, or visual/cerebral disturbances.
• 👶🏻 Fetal Monitoring: Assess fetal heart rate (FHR) patterns. Normal FHR is 110-160 bpm. Evaluate for accelerations, decelerations, and variability.
• 🦠 Common Infections: Group B Streptococcus (GBS) screening at 35-37 weeks. Treat with intrapartum antibiotics if positive.
• 🗓️ Stages of Labor: Stage 1 (latent, active, transition), Stage 2 (pushing), Stage 3 (placental delivery), Stage 4 (postpartum).

🧪 Practice Quiz

1. A 28-year-old primigravida at 30 weeks gestation presents with blood pressure of 150/90 mmHg and 3+ protein on urine dipstick. Which of the following is the MOST likely diagnosis?
   1. A. Gestational hypertension
   2. B. Chronic hypertension
   3. C. Preeclampsia
   4. D. Eclampsia
2. Which of the following is the MOST common cause of postpartum hemorrhage?
   1. A. Retained placental fragments
   2. B. Uterine atony
   3. C. Cervical laceration
   4. D. Coagulation disorder
3. A pregnant woman at 26 weeks gestation undergoes a 1-hour glucose challenge test, and the result is 150 mg/dL. What is the NEXT step in management?
   1. A. No further testing needed
   2. B. 3-hour glucose tolerance test
   3. C. Start insulin therapy
   4. D. Prescribe oral hypoglycemic agents
4. Which of the following fetal heart rate patterns is MOST concerning?
   1. A. Accelerations
   2. B. Early decelerations
   3. C. Variable decelerations
   4. D. Moderate variability
5. A woman in labor is fully dilated and effaced but has been pushing for 3 hours with no fetal descent. What is the MOST likely diagnosis?
   1. A. Protraction disorder
   2. B. Arrest of descent
   3. C. Precipitous labor
   4. D. Normal labor progression
6. A pregnant woman at 36 weeks gestation tests positive for Group B Streptococcus (GBS). What is the appropriate management?
   1. A. Treat with oral antibiotics immediately
   2. B. Treat with intrapartum antibiotics
   3. C. Perform a cesarean section
   4. D. No treatment is needed
7. Which of the following is a contraindication to vaginal birth after cesarean (VBAC)?
   1. A. Prior low transverse cesarean incision
   2. B. Prior classical cesarean incision
   3. C. Two prior low transverse cesarean incisions
   4. D. Fetal macrosomia