OB/GYN Exam master Questions &
Answers (Grade A+)
You are caring for a 29-year-old G3P2 at 39 weeks gestation, who
has been laboring for 6 hours. She is a diet-controlled diabetic. Her
last child was 9 pounds 8 ounces. She has been completely dilated
for 2 hours, and the fetal head is at a plus 2 station, which is
unchanged. What is the next most appropriate course of action?
A Begin oxytocin
B Vacuum extraction
C High forcep extraction
D High forcep rotation
E Cesarean section -
correct answer ✅Cesarian Section
The patient is a diabetic with a history of a macrosomic infant; the
likelihood of macrosomia in this infant is significant. Instrument
delivery is not recommended if macrosomia is suspected. By
definition, she has had an arrest of descent of the fetal head and
one should be highly suspicious for macrosomia, in which case a c-
section is the preferred method of delivery.
A 75-year-old woman presents to your office complaining of intense
pruritis of the vulva and occasional bleeding. She is unsure if the
bleeding is caused by her scratching in attempts to alleviate the
itching. She has tried some OTC preparations to alleviate the itching
,OB/GYN Exam master Questions &
Answers (Grade A+)
and has not had any relief from them. She denies any vaginal
discharge or dysuria. On physical examination you notice
excoriations and some scattered lesions that look like eczema on
the vulva and they do not scrape off. Also noted was inguinal
lymphadenopathy. You decide to do a punch biopsy. The pathology
report reveals large eosinophilic cells.
Question
What is the most likely diagnosis?
Answer Choices
1 Lichen sclerosis
2 Vulvar carcinoma
3 Paget's disease
4 Melanoma
5 Candida albicans -
correct answer ✅Paget's disease
Explanation Paget's diseaseis associated with intense pruritus of
the vulva, along with lesions that resemble eczema. Pathology also
characteristically shows large eosinophilic Paget's cells (1).
Lichen sclerosis is not correct because the pathology would reveal
changes associated with chronic inflammation.
,OB/GYN Exam master Questions &
Answers (Grade A+)
Vulvar carcinoma is incorrect as it generally shows squamous cell
characteristics. (1).
Melanoma is incorrect as the lesion will generally appear
hyperpigmented (1).
Candida albicans is incorrect because the lesions that appear on the
vulva do not scrape off and she does not have any vaginal
discharge. Candida albicans is also not associated with inguinal
lymphadenopathy.
The pregnant mother of a 2-year-old patient is concerned about
exposure to environmental neurotoxins affecting her developing
fetus.
She asks you questions about whether the placenta would block
any transfer of toxins to a growing fetus. Which environmental
neurotoxin transfer to the fetal system is actually enhanced by the
placenta?
Answer Choices
1 Mercury
, OB/GYN Exam master Questions &
Answers (Grade A+)
2 Cadmium
3 Polychlorinated biphenyls
4 Insecticides
5 Environmental tobacco smoke -
correct answer ✅mercury
Explanation Methyl mercury is absorbed almost completely and
crosses the placenta easily and then becomes stored in the fetus.
Fetal blood concentrations exceed maternal concentrations by 50-
100%. High doses can result in mental retardation, spastic paralysis,
and death. Low doses are linked to deficits in neuromotor
performance, cognition, memory, and language.
The placenta effectively blocks the transfer of cadmium. Studies
have shown cadmium concentrations in umbilical cord blood to be
significantly lower than that in maternal blood and placental
cadmium concentration to be highest.
Polychlorinated biphenyls (PCP) have contaminated sport fish,
particularly bottom-feeding species from water contaminated with
PCPs. Also during the 1940s and 1950s the inside of concrete silos
on many farms in the Midwest were coated with sealants
containing PCPs that over time have peeled off and become mixed
with silage to feed beef and dairy cattle. Incinerators and other
PCP-disposal facilities or hazardous waste sites are other sources of
Answers (Grade A+)
You are caring for a 29-year-old G3P2 at 39 weeks gestation, who
has been laboring for 6 hours. She is a diet-controlled diabetic. Her
last child was 9 pounds 8 ounces. She has been completely dilated
for 2 hours, and the fetal head is at a plus 2 station, which is
unchanged. What is the next most appropriate course of action?
A Begin oxytocin
B Vacuum extraction
C High forcep extraction
D High forcep rotation
E Cesarean section -
correct answer ✅Cesarian Section
The patient is a diabetic with a history of a macrosomic infant; the
likelihood of macrosomia in this infant is significant. Instrument
delivery is not recommended if macrosomia is suspected. By
definition, she has had an arrest of descent of the fetal head and
one should be highly suspicious for macrosomia, in which case a c-
section is the preferred method of delivery.
A 75-year-old woman presents to your office complaining of intense
pruritis of the vulva and occasional bleeding. She is unsure if the
bleeding is caused by her scratching in attempts to alleviate the
itching. She has tried some OTC preparations to alleviate the itching
,OB/GYN Exam master Questions &
Answers (Grade A+)
and has not had any relief from them. She denies any vaginal
discharge or dysuria. On physical examination you notice
excoriations and some scattered lesions that look like eczema on
the vulva and they do not scrape off. Also noted was inguinal
lymphadenopathy. You decide to do a punch biopsy. The pathology
report reveals large eosinophilic cells.
Question
What is the most likely diagnosis?
Answer Choices
1 Lichen sclerosis
2 Vulvar carcinoma
3 Paget's disease
4 Melanoma
5 Candida albicans -
correct answer ✅Paget's disease
Explanation Paget's diseaseis associated with intense pruritus of
the vulva, along with lesions that resemble eczema. Pathology also
characteristically shows large eosinophilic Paget's cells (1).
Lichen sclerosis is not correct because the pathology would reveal
changes associated with chronic inflammation.
,OB/GYN Exam master Questions &
Answers (Grade A+)
Vulvar carcinoma is incorrect as it generally shows squamous cell
characteristics. (1).
Melanoma is incorrect as the lesion will generally appear
hyperpigmented (1).
Candida albicans is incorrect because the lesions that appear on the
vulva do not scrape off and she does not have any vaginal
discharge. Candida albicans is also not associated with inguinal
lymphadenopathy.
The pregnant mother of a 2-year-old patient is concerned about
exposure to environmental neurotoxins affecting her developing
fetus.
She asks you questions about whether the placenta would block
any transfer of toxins to a growing fetus. Which environmental
neurotoxin transfer to the fetal system is actually enhanced by the
placenta?
Answer Choices
1 Mercury
, OB/GYN Exam master Questions &
Answers (Grade A+)
2 Cadmium
3 Polychlorinated biphenyls
4 Insecticides
5 Environmental tobacco smoke -
correct answer ✅mercury
Explanation Methyl mercury is absorbed almost completely and
crosses the placenta easily and then becomes stored in the fetus.
Fetal blood concentrations exceed maternal concentrations by 50-
100%. High doses can result in mental retardation, spastic paralysis,
and death. Low doses are linked to deficits in neuromotor
performance, cognition, memory, and language.
The placenta effectively blocks the transfer of cadmium. Studies
have shown cadmium concentrations in umbilical cord blood to be
significantly lower than that in maternal blood and placental
cadmium concentration to be highest.
Polychlorinated biphenyls (PCP) have contaminated sport fish,
particularly bottom-feeding species from water contaminated with
PCPs. Also during the 1940s and 1950s the inside of concrete silos
on many farms in the Midwest were coated with sealants
containing PCPs that over time have peeled off and become mixed
with silage to feed beef and dairy cattle. Incinerators and other
PCP-disposal facilities or hazardous waste sites are other sources of
