Hacker moore s essentials of obstetrics and gynecology 6th edition by hacker gambone

Hacker & Moore's Essentials of Obstetrics andG
x x x x x x x



ynecology 6th Edition by Hacker, Gambone
x x x x x




"classic"xformxisxmostxseverexandxpresentsxasxaxnewbornxinfantxgirlxwithxambiguousxgenital
iaxandxadrenalxinsufficiencyx(withxorxwithoutxlife-
threateningxsaltxwasting).x"Nonclassic"xisxaxlate-
onsetxformxthatxpresentsxwithxandrogenxexcessxorxcouldxbexasymptomatic.xCannotxconve
rtx17-xhydroxyprogesteronextox11-
deoxycortisolx→x↓xcortisolxsynthesisx→x↑xadrenalxstimulationx→
↑xACTHxandxandrogens.
FirstxAidxUSMLExStepx2xCKx-x10thxEd,xP366


80.xPatientxdidxbilateralxoophorectomyxandxsalpingectomy.xWhatxisxthextypexofxhormonexre
placementxtherapy?
A. LevonprogesteronexIUD
B. OCP
C. Progesteronexpatchx-x:xA.
ThexA,xherexisxProgesteronexonlyx(Levonprogesterone)x/xMirenaxIf
xthexquestionxwasxmissingxaxcluexaboutxHysterectomy




1-putxthexpatientxintoxlateralxrecumbent,x2-xreducexoxytocinxinfusion,x3-
xincreasexfluids.xCategoryx3xmanagementxstartsxbyxthexsamexmanagementxasxcategoryx2
xfirst,xthenxgoxseriesxofxstepsxdiscussedxinxhacker.

Source:xhackerxandxMoorexpx133

142. Axprimigravidaxatx32weeksxGAxwithxBPxofx150/90mmhg.Therexisxassociatedxedemaxof
xhandsxandxlegs.Whatxtoxdo?

A. DiureticsxB.
B. TabsxLabetalol
C. Continuedxevaluationx-xisxC
Explanation:xfurtherxevaluationxisxneededxasxthexpositionxofxthexmotherxmightxaffectxbloodx
pressure,xandxforxmeasuringxbpxpositionxeitherxsittingxorxlateralxdecubitus.
Swellingxofxhandxandxlegsxisxaxnormalxphysiologyxinxpregnancyxfurtherxevaluationxisxneede
dxforxpreeclampsiaxdiagnosisxandxtreatment.xAsxforxgestationalxHTNxclosexmonitoringxonl
y.
Source:xhackerxandxMoorexp185

143. Placentaximplantedxdeepxintoxuterinexwall.xDiagnosis?
A. Placentaxaccretax(superfici'lxmyometrium)
B. Placentaxincretax(deepxmyometrium)
C. Placentaxpercretax(serosa)xA,xisxBx
Source:xhackerxandxMoorexp139

,144. Post-
deliveryx6xweeks.xExclusivexbreastxfeeding.xDoesn'txwantxkidsxforxatxleastx2xyears.xWhic
hxcontraceptivexmethod?
A. Depoxproveraxinjection
B. Transdermalxpatch
C. Vaginalxring
D. OralxcombinedxcontraceptivexA,xisxA
Explanation:xchoicexAxisxanxinjectionxthatxisxgivenxeveryx12-
14wxwhichxwillxbexmorexconvenient,xthusxmorexcompliancexandxisxsafexwithxbreastfeeding.
xBxisxchangedxeveryxweek,xCxisxchangedxeveryxmonth.

Source:xhackerxandxMoorexp331,xuptodate


145. Pregnantxatxthexthirdxtrimesterxshexisxcrohn'sxpatientxonx'azathioprinex+xbiologicalxa
gentxaskxaboutxherxchildxvaccines?
A. givexall
B. delayxtillx3xmonth
C. delayxtillx6monthxA,xisxnotxknown
Explanation:xIxfoundxaxresearchxsayingxthatxbiologicalxagentsxarexsafexforxchild,xbutxIxcan'tx
bexsurexaboutxazathioprinexasxhackerxandxMoorexonlyxmentionedxthatxtherexisxincreasedxri
skxofxpretermxandxfetalxanomalies.xIxwouldxsuggestxAxasxanxA,xcuzxIxfoundxaxresearchxthatxs
aidxitxisxsafexandxchildrenxhadxnoxproblemsxwithxthexvaccines.
Source:xhackerxandxMoore,xhttps://academic.oup.com/ecco-jcc/article/5/2/95/475727


146. CTGxshowxdecreasexvariabilityx'andxhexisxonxmgxsulphatexcausexis?
A.xmgxsulphatextoxicityxA,xisxA
Explanation:xMagnesiumxfreelyxcrossesxthexplacenta

16xyearxoldxgirlxwithxirregularxmenstrualxcycle.xShexwasxuncomfortablexandxagitated.xWhatx
isxherxproblem?
A. Mood
B. Behavioral
C. Anxietyx-x:xC?




12

,22xYO,xfemale,xcomplainingxofxbreastxpainxbeforexmenstruationx -

24xyearsxoldxmarried,xneverxhadxpapxtest?
A.xDoxitxnowx-x:xA.




40

29xyearsxoldxfemalexhadxaxnegativexpapxsmear.xWhatxtoxdo?
A. Repeatxwithxcytology
B. Doxitxafterx3xyearsx-x:xB.
Inxasymptomatic,ximmunocompetentxwomen,xcervicalxcancerxscreeningxwithxPapxsmearxs
tartsxatxagex21,xregardlessxofxsexualxactivity.xInxwomenxyoungerxthanx30xyearsxold,xscreen
ingxwithxPapxalonexisxdonexeveryx3xyears.xAfterxagex30,xeitherxdoxPapxsmearxalonexeveryx3
xyearsxorxdoxPapxsmearxwithxHPVxco-

testingxeveryx5xyearsxforxasxlongxasxbothxtestsxarexnegative.
MasterxthexBoardsxUSMLExStepx2xCKx-x5thxEd,xP972


41

41xyearxDysfunctionalxUBxbestxinitialx‼?
A. D&Cxforxbiopsy
B. Endometrialxablation
Dysfunctionalxuterinexbleedingxmeansxyouxexcludedxorganicxcauses.xPapxsmearxtoxrulexo
utxcervicalxcancer.xUltrasonographyxtoxlookxforxuterinexmasses,xpolycysticxovaries,xandxthi
cknessxofxthexendometrium.
■ Performxendometrialxbiopsy:
■ Ifxthexendometriumxisx≥x4xmmxinxaxpostmenopausalxwoman,xorxifxthexpatientxisx>x45xye
arsxofxage.
■ Ifxthexpatientxisx>x35xyearsxofxagexwithxriskxfactorsxforxendometrialxhyperplasiax(eg,xob
esity,xdiabetes)
FirstxAidxUSMLExStepx2xCKx-x10thxEd,xP364


17x-

A. admitxforxobserve
B. followxupx4wks
C. admitxforxevacuationxThex-xis:xN/A

, Explanation:xWomenxwithxanxincomplete,xinevitable,xorxmissedxabortionxcanxbexmanagedx
withxsurgicalxuterinexaspirationxorxmedicationxuterinexevacuationxorxwithxexpectantxmanag
ement.xAllxthreexapproachesxhavexsimilarxefficacy,xandxthexchoicexofxtreatmentxmethodxde
pendsxmainlyxuponxpatientxpreference.
Note:xsurgicalxevacuationxisxrequiredxforxwomenxwithxheavyxbleedingxorxintrauterinexsepsi
sxinxwhomxdelayingxtherapyxcouldxbexharmful.xItxisxalsoxrequiredxforxwomenxwithxcontraindi
cationsxtoxmisoprostolx.
Source:https://www.uptodate.com/contents/spontaneous-abortion-
xmanagement?search=Missed%20Abortion&source=search_result&selectedTitle=1~32& x

usagxe_type=default&display_rank=1&id=spontaneous-abortion-
xmanagement&languageCode=en




289. Pregnantxasymptomaticxwithxurinexanalysisxshowingxbacteriuriaxdiagnosis?
A.xAsymptomaticxbacteriuriaxThexA,xis:xA
Explanation:xForxasymptomaticxwomen,xbacteriuriaxisxformallyxdefinedxasxtwoxconse
cutivexvoidedxurinexspecimensxwithxisolationxofxthexsamexbacterialxstrainxinxquantitati
vexcountsxof
≥105xcolony-
formingxunitsx(cfu)/mLxorxaxsinglexcatheterizedxurinexspecimenxwithxonexbacterial




speciesxisolatedxinxaxquantitativexcountxofx≥102xcfu/mLx[2].xInxclinicalxpractice,xhowever,xon
lyxonexvoidedxurinexspecimenxisxtypicallyxobtained,xandxdiagnosisx(andxtreatmentxinitiation
)xisxmadexinxwomenxwithx≥105xcfu/mLxwithoutxobtainingxaxconfirmatoryxrepeatxculture.
Source:https://www.uptodate.com/contents/urinary-tract-infections-and-asymptomatic-
xbacteriuria-in-

xpregnancy?search=Asymptomatic%20bacteriuria&source=search_result&selectedTitle=

x2~6x9&usage_type=default&display_rank=2#H253489103




290. Pregnantxwithxasymptomaticxbacteriuriax,xallergicxtoxpenicillinxandxsulfaxdrugs?
A.xNitrofurontoinxThexA,xis:xA
Explanation:xAsymptomaticxbacteriuriaxisxtreatedxwithxanxantibioticxtailoredxtoxthexsus

Abruptioxplacentaxmanagement:
A.xMultidisciplinaryxteamx-x:xA.


20

agex>65,xonlyxwithxhistoryxofxsignificantxCIN,xAfterxtotalxhysterectomyxcytologyxnotxne
eded.