Women's and Maternity
Health Med Challenger
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1. Incorrect
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Which of the following statements is most accurate?
The most common cause of death in patients with eclampsia is renal failure
Symptoms of carpal tunnel syndrome will usually improve with the onset of pregnancy
The most common cause of death in eclampsia is cerebral hemorrhage
The incidence of venous thromboembolism in pregnant patients is half that of nonpregnant patients
Incorrect
In patients with eclampsia, the most common cause of death is cerebral hemorrhage. While the most
common cause of headache during pregnancy is muscle contraction headache, serious causes of headache
that may be exacerbated by pregnancy include pseudotumor cerebri, subarachnoid hemorrhage, and certain
brain tumors. Pregnant patients are at a five-fold increased risk of venous thromboembolism.While acute
kidney injury is common in patients with eclampsia, death is rare since the advent of peritoneal dialysis and
renal transplantation,
Carpal tunnel syndrome can worsen with pregnancy and subside post-partum.
References:
Mackay AP, Berg CJ, Atrash HK, Pregnancy related mortality from preeclampsia and eclampsia,
ObstetGynecol 2001; 97: 533-538
Liu Y, et al.Pregnancy outcomes in patients acute kidney injury during pregnancy: a systematic review and
meta-analysis, BMC Pregnancy Childbirth, 017; 17: 235
Jido TA, Eclampsia: maternal and fetal outcome. AFR Health Sci 2012; 12: 148-152
2. Incorrect
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A patient early in her first trimester complains of severe lower abdominal
pain. Which of the following most significantly decreases the likelihood of
ectopic pregnancy?
, Doubling of the quantitative HCG in 72 hours
An intrauterine gestational sac with a double decidual sac sign visible on transvaginal sonography
A history of prior tubal sterilization
Blood visible at the cervical os
A previous history of pelvic inflammatory disease or other STD
Incorrect
Identification of an intrauterine gestational sac with a double decidual sac sign significantly reduces the
likelihood of an ectopic pregnancy (though it does NOT rule it out!). HCG levels normally double every 1.8 to
3 days for the first 6 to 7 weeks. The ectopic pregnancy sometimes results in abnormally low HCG
production, however, normally rising HCG levels are commonly seen during early ectopic pregnancy. Slow
leakage of blood or abrupt rupture of the pregnancy may lead to vaginal bleeding or blood in the
peritoneum or pelvis. Factors predisposing to ectopic pregnancy include previous tubal infections or
surgeries, use of an IUD, smoking or older maternal age.
Reference:
Marx: Rosen’s Emergency Medicine, Concepts and Clinical Practice, 6th ed., 2006, Chpt 177: Acute
Complications of Pregnancy
3. Incorrect
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A patient at 12 weeks' gestation presents with prolonged nausea and
vomiting. A diagnosis of hyperemesis gravidarum was made on a prior
ED visit. Which of the following best supports a diagnosis of molar
pregnancy?
, Abnormal appearance of the uterus on pelvic
ultrasound Presence of normal fetal heart tones
Uterine fundal height palpable just at the pelvic
outlet Presence of serum or urine ketones
Starvation, weight loss and dehydration
Incorrect
The diagnosis of gestational trophoblastic disease (molar pregnancy) is based on the characteristic
"snowstorm" appearance of hydroptic vesicles within the uterus. Absence of fetal heart tones during the
second trimester is a common presenting sign. The uterine size is larger than expected by dates by 4
weeks or more. Severe nausea and vomiting, with resultant starvation ketosis and dehydration, are
present in both hyperemesis gravidarum and molar pregnancy.
References:
Marx: Rosen’s Emergency Medicine, Concepts and Clinical Practice, 6th ed., 2006, Chpt 177: Acute
Complications of Pregnancy
Dhanda, Sunita, Subhash Ramani, and Meenkashi Thakur. "Gestational trophoblastic disease: A
multimodality imaging approach with impact on diagnosis and management." Radiology research and
practice 2014 (2014).
DiSaia, Philip J., and William T. Creasman. Clinical gynecologic oncology. Elsevier Health Sciences, 2012.
Seckl, M. J., et al. "Gestational trophoblastic disease: ESMO Clinical Practice Guidelines for diagnosis,
treatment and follow- up." Annals of oncology 24.suppl 6 (2013): vi39-vi50.
4. Incorrect
Question Tools:
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Which of the following are abnormal physical examination findings in the
pregnant patient?
Reddish linear striae on the abdomen, breasts, and thighs
Reddish velvety epithelium extending into the ectocervix
Diastolic murmurs, and systolic murmurs of III/VI or greater
Spider nevi on the face, neck and upper chest
Incorrect
A third heart sound and systolic murmurs are common in pregnancy. All diastolic murmurs and systolic
murmurs greater than or equal to III/VI warrant further investigation. In pregnancy, normal extension of
columnar epithelium of the endocervix into
Health Med Challenger
,Search
1. Incorrect
Question Tools:
Report Question
Which of the following statements is most accurate?
The most common cause of death in patients with eclampsia is renal failure
Symptoms of carpal tunnel syndrome will usually improve with the onset of pregnancy
The most common cause of death in eclampsia is cerebral hemorrhage
The incidence of venous thromboembolism in pregnant patients is half that of nonpregnant patients
Incorrect
In patients with eclampsia, the most common cause of death is cerebral hemorrhage. While the most
common cause of headache during pregnancy is muscle contraction headache, serious causes of headache
that may be exacerbated by pregnancy include pseudotumor cerebri, subarachnoid hemorrhage, and certain
brain tumors. Pregnant patients are at a five-fold increased risk of venous thromboembolism.While acute
kidney injury is common in patients with eclampsia, death is rare since the advent of peritoneal dialysis and
renal transplantation,
Carpal tunnel syndrome can worsen with pregnancy and subside post-partum.
References:
Mackay AP, Berg CJ, Atrash HK, Pregnancy related mortality from preeclampsia and eclampsia,
ObstetGynecol 2001; 97: 533-538
Liu Y, et al.Pregnancy outcomes in patients acute kidney injury during pregnancy: a systematic review and
meta-analysis, BMC Pregnancy Childbirth, 017; 17: 235
Jido TA, Eclampsia: maternal and fetal outcome. AFR Health Sci 2012; 12: 148-152
2. Incorrect
Question Tools:
Report Question
A patient early in her first trimester complains of severe lower abdominal
pain. Which of the following most significantly decreases the likelihood of
ectopic pregnancy?
, Doubling of the quantitative HCG in 72 hours
An intrauterine gestational sac with a double decidual sac sign visible on transvaginal sonography
A history of prior tubal sterilization
Blood visible at the cervical os
A previous history of pelvic inflammatory disease or other STD
Incorrect
Identification of an intrauterine gestational sac with a double decidual sac sign significantly reduces the
likelihood of an ectopic pregnancy (though it does NOT rule it out!). HCG levels normally double every 1.8 to
3 days for the first 6 to 7 weeks. The ectopic pregnancy sometimes results in abnormally low HCG
production, however, normally rising HCG levels are commonly seen during early ectopic pregnancy. Slow
leakage of blood or abrupt rupture of the pregnancy may lead to vaginal bleeding or blood in the
peritoneum or pelvis. Factors predisposing to ectopic pregnancy include previous tubal infections or
surgeries, use of an IUD, smoking or older maternal age.
Reference:
Marx: Rosen’s Emergency Medicine, Concepts and Clinical Practice, 6th ed., 2006, Chpt 177: Acute
Complications of Pregnancy
3. Incorrect
Question Tools:
Report Question
A patient at 12 weeks' gestation presents with prolonged nausea and
vomiting. A diagnosis of hyperemesis gravidarum was made on a prior
ED visit. Which of the following best supports a diagnosis of molar
pregnancy?
, Abnormal appearance of the uterus on pelvic
ultrasound Presence of normal fetal heart tones
Uterine fundal height palpable just at the pelvic
outlet Presence of serum or urine ketones
Starvation, weight loss and dehydration
Incorrect
The diagnosis of gestational trophoblastic disease (molar pregnancy) is based on the characteristic
"snowstorm" appearance of hydroptic vesicles within the uterus. Absence of fetal heart tones during the
second trimester is a common presenting sign. The uterine size is larger than expected by dates by 4
weeks or more. Severe nausea and vomiting, with resultant starvation ketosis and dehydration, are
present in both hyperemesis gravidarum and molar pregnancy.
References:
Marx: Rosen’s Emergency Medicine, Concepts and Clinical Practice, 6th ed., 2006, Chpt 177: Acute
Complications of Pregnancy
Dhanda, Sunita, Subhash Ramani, and Meenkashi Thakur. "Gestational trophoblastic disease: A
multimodality imaging approach with impact on diagnosis and management." Radiology research and
practice 2014 (2014).
DiSaia, Philip J., and William T. Creasman. Clinical gynecologic oncology. Elsevier Health Sciences, 2012.
Seckl, M. J., et al. "Gestational trophoblastic disease: ESMO Clinical Practice Guidelines for diagnosis,
treatment and follow- up." Annals of oncology 24.suppl 6 (2013): vi39-vi50.
4. Incorrect
Question Tools:
Report Question
Which of the following are abnormal physical examination findings in the
pregnant patient?
Reddish linear striae on the abdomen, breasts, and thighs
Reddish velvety epithelium extending into the ectocervix
Diastolic murmurs, and systolic murmurs of III/VI or greater
Spider nevi on the face, neck and upper chest
Incorrect
A third heart sound and systolic murmurs are common in pregnancy. All diastolic murmurs and systolic
murmurs greater than or equal to III/VI warrant further investigation. In pregnancy, normal extension of
columnar epithelium of the endocervix into
