OB GYN NBME #2

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MudPhud20XX

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15 yo girl came to the ER b/c of nausea, vomiting, lower abdominal pain for 4 days. last menstrual period was 9 days ago. she is sexually active and does not use contraception. temp 39.7C, puls 105, bp 110/75, exam shows bilateral lower abdominal tenderness and peritoneal signs. pelvic exam shows copious yellow cervical discharge and exquisite uterine tenderness. which of the following is the most appropriate next step in management?

A. admission to the hospital for IV antibiotic therapy
B. admission to the hospital for laparoscopy
C. admission to the hospital for laparotomy
D. CT of the pelvis
E. discharge w/ analgesic therapy
F. discharge w/ oral antibiotic therapy only
G. discharge w/ oral and IM antibiotic therapy
H. limited stay observation and evaluation
I. MRI of the pelvis
J. uterine evacuation in the emergency dept
K. uterine evacuation in the OR
--> So I am debating among A, B, C. I am leaning toward B, any thoughts?

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28 yo gravida 2, para 1, comes to the physician for her 1st prenatal visit. her last menstrual period was 10 wks ago. her 1st child, a 4540 g male newborn, was born by cesarean delivery because of an arrest of descent. during this pregnancy, she is at increased risk for which?

A. abruptio placentae
B. gestational diabetes
C. polyhydramnios
D. preeclampsia
E. premature rupture of the membrane
 
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