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OBGYN APGO UWise Exam Questionswith 100% Correct Answers | Verified |
Latest Update
Ani18-year-
oldiG1P0iwomaniisiseeniinitheicliniciforiairoutineiprenatalivisitiati28iwee
ksigestation.iHeriprenatalicourseihasibeeniunremarkable.iSheihasinotibe
enitakingiprenatalivitamins.iHeripre-
pregnancyiweightiwasi120ipounds.iInitialihemoglobiniatitheifirstivisitiati
eightiweeksigestationiwasi12.3ig/dL.iCurrentiweightiisi138ipounds.iAfter
iperformingiaiscreeningicompleteibloodicounti(CBC),itheiresultsiareinota
bleiforiaiwhiteibloodicounti9,700/mL,ihemoglobini10.6ig/dL,imeanicorp
uscularivolumei88.2ifLi(80.8i-
i96.4)iandiplateletsi215,000/mcL.iTheipatientideniesivaginaliorirectalible
eding.iWhichiofitheifollowingiisitheibestiexplanationiforithisipatient'sian
emia?
A.iFolateideficiency
i
B.iRelativeihemodilutioniofipregnancy
i
C.iIronideficiency
i
D.iBetaithalassemiaitrait
i
E.iAlphaithalassemiaitraiti-iCorrectiAnswer-
i
B.iRelativeihemodilutioniofipregnancy
Thereiisinormallyiai36%iincreaseiinimaternalibloodivolume;itheimaximu
miisireachediaroundi34iweeks.iTheiplasmaivolumeiincreasesi47%iandith
,eiRBCimassiincreasesionlyi17%.iThisirelativeidilutionalieffectilowersithei
hemoglobin,ibuticausesinoichangeiinitheiMCV.iFolateideficiencyiresultsii
niaimacrocyticianemia.iIronideficiencyiandithalassemiasiareiassociatedi
withimicrocyticianemia.
Ai34-year-
oldiG3P1iwomaniati26iweeksigestationireportsi"difficultyicatchingiherib
reath,"iespeciallyiafteriexertioniforitheilastitwoimonths.iSheiisiainon-
smoker.iSheidoesinotihaveianyihistoryiofipulmonaryioricardiacidisease.iS
heideniesifever,isputum,icoughiorianyirecentiillnesses.iOniphysicaliexam
ination,iherivitalisignsiare:ibloodipressurei108/64,ipulsei88,irespiratoryir
atei15,iandisheiisiafebrile.iPulseioximeteriisi98%ioniroomiair.iLungsiareicl
earitoiauscultation.iHeartiisiregularirateiandirhythmiwithiII/VIisystolicim
urmuriheardiatitheiupperileftisternaliborder.iSheihasinoiloweriextremityi
edema.iAicompleteibloodicountirevealsiaihemoglobiniofi10.0ig/dL.iWhat
iisitheimostilikelyiexplanationiforithisiwoman'sisymptoms?
A.iPulmonaryiembolism
i
B.iMitralivalveistenosis
i
C.iPhysiologicidyspneaiofipregnancy
i
D.iPeripartumicardiomyopathy
i
E.iAnemiai-iCorrectiAnswer-C.iPhysiologicidyspneaiofipregnancy
i
Physicaliexaminationifindingsiareinoticonsistentiwithipulmonaryiembol
i
usi(e.gitachycardia,itachypnea,ihypoxia,ichestipain,isignsiofiaiDVT)iorimit
ralistenosisi(diastolicimurmur,isignsiofiheartifailure).iPhysiologicidyspne
aiofipregnancyiisipresentiiniupitoi75%iofiwomenibyitheithirditrimester.iP
eripartumicardiomyopathyiisianiidiopathicicardiomyopathyithatipresen
,tsiwithiheartifailureisecondaryitoileftiventricularisystolicifunctionitowar
dsitheiendiofipregnancyioriinitheiseveralimonthsifollowingidelivery.iSym
ptomsiincludeifatigue,ishortnessiofibreath,ipalpitations,iandiedema.iTh
eihistoryiandiphysicalidoinotisuggestiaipathologiciprocess,inoridoesiherih
emoglobinilevel.
Ai24-year-
oldiG4P2iwomaniati34iweeksigestationicomplainsiofiaicoughiandiwhitish
isputumiforitheilastithreeidays.iSheireportsithatieveryoneiinitheifamilyih
asibeenisick.iSheireportsiaihighifeverilastinightiupitoi102°Fi(38.9°C).iSheid
eniesichestipain.iSheismokesiaihalf-
packioficigarettesiperiday.iSheihasiaihistoryiofiasthmaiwithinoipreviousii
ntubations.iSheiusesianialbuteroliinhaler,ialthoughisheihasinotiusediitith
isiweek.iVitalisignsiare:itemperaturei98.6°Fi(37°C);irespiratoryiratei16;ip
ulsei94;ibloodipressurei114/78;ipeakiexpiratoryiflowiratei430iL/mini(bas
elineidocumentediinitheioutpatienticharti=i425iL/min).iOniphysicaliexa
mination,ipharyngealimucosaiisierythematousiandiinjected.iLungsiareicl
earitoiauscultation.iWhiteibloodicellicounti8,700;iarterialibloodigasesioni
roomiairi(normalirangesiiniparentheses):ipHi7.44i(7.36i-
i7.44);iPO2i103immiHgi(>100),iPCO2i26immiHgi(28i-
i32),iHCO3i19immiHgi(22i-i26).iChestix-rayiisinori-iCorrectiAnswer-
B.iCompensatedirespiratoryialkalosisi
Theiincreasediminuteiventilationiduringipregnancyicausesiaicompensat
edirespiratoryialkalosis.iHypoventilationiresultsiiniincreasediPCO2iandit
heiPO2iwouldibeidecreasediifisheiwasihypoxic.iAimetaboliciacidosisiwou
ldihaveiaidecreasedipHiandiailowiHCO3.iTheipatient'sisymptomsiareimos
ticonsistentiwithiaiviraliupperirespiratoryiinfection.
, Ai28-year-
oldiG1P0iinternalimedicineiresidentiati34iweeksigestationiwantsitoidisc
ussitheivaluesioniheripulmonaryifunctionitestsiperformeditwoidaysiagoi
becauseisheiwasifeelingislightlyishortiofibreath.iSheiisiainon-
smoker,iandihasinoipersonaliorifamilyihistoryioficardiaciorirespiratoryidi
sease.iVitalisignsiare:irespiratoryiratei16;ipulsei90,ibloodipressurei112/7
0;ioxygenisaturationiisi99%ioniroomiair.iOniphysicaliexamination:ilungsi
areiclear;iabdomeninon-
tender;ifundaliheightiisi34icm.iTheiresultsiofitheipulmonaryifunctionitest
siare:
InspiratoryiCapacityi(IC)iincreased
Tidalivolumei(TV)iincreased
Minuteiventilationiincreased
Functionalireserveicapacityi(FRC)idecreased
Expiratoryireserveicapacityi(ERC)idecreased
Residualivolumei(RV)idecreased
i
Whatiisitheinextibestistepiinitheievaluationiofithisipatient?
A.iRoutineiantenatalicare
i
B.iChestix-ray
i
C.iArterialibloodigas
i
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