Digital cervical examination. This can provoke catastrophic hemorrhage. Management is C-section.
AUB-O (Ovulatory dysfunction) – but in a 45-year-old, must rule out structural causes. Actually, this describes menorrhagia (heavy menstrual bleeding) with regular cycles. PALM-COEIN: AUB-O if anovulatory; AUB-L (leiomyoma) if fibroids present. Workup: endometrial biopsy, pelvic ultrasound. obstetrics and gynaecology questions and answers pdf
Section 1: Obstetrics (Antepartum) Q1: A 28-year-old G2P1 at 28 weeks gestation presents with new-onset hypertension (BP 150/95) and proteinuria (300 mg/24h). What is the diagnosis, and what is the definitive treatment? Digital cervical examination
Letrozole (aromatase inhibitor) – now preferred over clomiphene due to higher live birth rates and lower multiple pregnancy risk. Dose 2.5-7.5 mg days 3-7 of cycle. Section 7: Urogynecology Q20: What is the difference between a cystocele, rectocele, and enterocele? AUB-O (Ovulatory dysfunction) – but in a 45-year-old,
A 10-question screening tool for postpartum depression. Used at the postpartum visit (or earlier if symptoms). Score ≥10 suggests possible depression; ≥13 indicates high likelihood. It is not diagnostic but prompts further evaluation. Section 4: Gynecology – Abnormal Bleeding & Fibroids Q12: A 45-year-old with heavy, regular periods every 24 days lasting 10 days. No intermenstrual bleeding. Exam: normal. What is the PALM-COEIN classification for this condition?
Preeclampsia without severe features. Definitive treatment is delivery (after stabilization and corticosteroid administration for fetal lung maturity if <34 weeks). Magnesium sulfate is given for seizure prophylaxis.
Threatened preterm labor. First-line tocolytic is nifedipine (calcium channel blocker). Also administer antenatal corticosteroids (betamethasone) to accelerate fetal lung maturity. Section 2: Intrapartum Q5: Describe the components of the Bishop score and its purpose.