1|Page
PAEA OBGYN EOR Topics Exam 2025 |
Comprehensive Q&A For Certification
Success
what is the only type of spontaneous abortion where the pregnancy may still be
viable? - correct -answer-threatened- pregnancy may progress or abortion may
follow- just a wait and see issue so you send them home to rest
*it is the MC cause of 1st trimester bleeding*
in a threatened spontaneous abortion s/sx are bloody vaginal d/c, spotting to
profuse bleeding, +/- contractions, uterus size compatible w/ dates, closed
cervical os; are there POC (products of conception) expelled? what can you check
to see if pregnancy still progressing? - correct -answer--no POC expelled
-serial B-hCG to see if doubling
-remember to give RhoGAM if indicated
what is the MC cause of spontaneous abortion? - correct -answer--fetal
chromosomal abnormalities (50%)
,2|Page
-others include: maternal infxn, uterine defects, endocrine abnormalities,
malnutrition, immunologic, physical trauma, smoking, drug use, etc.
what types of medical txs for elective/induced abortion are available? - correct -
answer-1. (safe up to 9 weeks pregnant) *mifepristone* (an anti-progestin) +
*misoprostol* 2-3 days later (prostaglandin that causes uterine contractions)
2. (safe up to 7 weeks pregnant) *methotrexate* (antimetabolite) + *misoprostol*
3-7 days later
surgical elective/induced abortions can be performed up until ____ weeks
pregnant by what procedures? - correct -answer-until 24 weeks pregnant
-D&C (dilation & curettage w/ or w/o suction) @ 4-12 weeks gestation (1st
trimester)
-D&E (dilation & evacuation) >12 weeks gestation (2nd trimester)
Dx/Tx? painful dark red vaginal bleeding in the 3rd trimester, contractions, fetal
bradycardia, possible shock symptoms, tender/rigid uterus - correct -answer--dx:
placental abruption (premature separation of placenta from uterine wall)
-tx: hospitalization for hemodynamic stabilization, immediate delivery usually bc
c/s
*DIC (disseminated intravascular coagulation) occurs in 10% of pts
,3|Page
what is the MC cause of placental abruption (premature separation of placenta
from uterine wall)? - correct -answer--*HTN*
-others include: smoking, ETOH, cocaine, folate deficiency, high parity, AMA
(advanced maternal age), trauma, chorioamnionitis
where is the MC site of ectopic pregnancies? - correct -answer--98.3% in fallopian
tubes (especially ampulla)
-1.4% in abdomen
-0.15% in ovary
-0.15% on cervix
what are some risk factors for ectopic pregnancy? - correct -answer--previous
abdominal surgery (adhesions)
-PID
-previous ectopic
-tubal ligation
-endometriosis
-IUD use
-assisted reproduction
, 4|Page
what is the classic triad of sx's with ectopic pregnancy? - correct -answer-1.
unilateral pelvic/abdominal pain
2. vaginal bleeding
3. + pregnancy (noticed by test or by amenorrhea)
how is a ectopic pregnancy (that has not ruptured) diagnosed and treated? -
correct -answer--Dx by serial quant *B-hCG that do not double q 1-2 days* &
*TVUS*
-Tx: *methotrexate* (disrupts cell multiplication) w/ *B-hCG monitoring* for
*≥15% drop* OR laproscopic salpingotomy or salpingectomy + RhoGAM if Rh-
MTX can be given in single/double or multiple doses (4) w/ *Leucovorin* (med to
help protect against harmful s/e of MTX)
-single/double dosing: monitor B-hCG on days 0, 4, 7 for a ≥15% drop
-multiple dosing (4 doses): monitor B-hCG on days 0, 1, 3, 5, 7 until ≥15% drop on
2 successive draws
what are the indications/contraindications for giving MTX to tx an ectopic
pregnancy? - correct -answer--indications: hemodynamically stable, early
gestation <4 cm, B-hCG <5,000, no FHT (fetal heart tones)
-contraindications: *ruptured* ectopic, h/o TB, *B-hCG >5,000*, *+FHT*,
noncompliant pt
PAEA OBGYN EOR Topics Exam 2025 |
Comprehensive Q&A For Certification
Success
what is the only type of spontaneous abortion where the pregnancy may still be
viable? - correct -answer-threatened- pregnancy may progress or abortion may
follow- just a wait and see issue so you send them home to rest
*it is the MC cause of 1st trimester bleeding*
in a threatened spontaneous abortion s/sx are bloody vaginal d/c, spotting to
profuse bleeding, +/- contractions, uterus size compatible w/ dates, closed
cervical os; are there POC (products of conception) expelled? what can you check
to see if pregnancy still progressing? - correct -answer--no POC expelled
-serial B-hCG to see if doubling
-remember to give RhoGAM if indicated
what is the MC cause of spontaneous abortion? - correct -answer--fetal
chromosomal abnormalities (50%)
,2|Page
-others include: maternal infxn, uterine defects, endocrine abnormalities,
malnutrition, immunologic, physical trauma, smoking, drug use, etc.
what types of medical txs for elective/induced abortion are available? - correct -
answer-1. (safe up to 9 weeks pregnant) *mifepristone* (an anti-progestin) +
*misoprostol* 2-3 days later (prostaglandin that causes uterine contractions)
2. (safe up to 7 weeks pregnant) *methotrexate* (antimetabolite) + *misoprostol*
3-7 days later
surgical elective/induced abortions can be performed up until ____ weeks
pregnant by what procedures? - correct -answer-until 24 weeks pregnant
-D&C (dilation & curettage w/ or w/o suction) @ 4-12 weeks gestation (1st
trimester)
-D&E (dilation & evacuation) >12 weeks gestation (2nd trimester)
Dx/Tx? painful dark red vaginal bleeding in the 3rd trimester, contractions, fetal
bradycardia, possible shock symptoms, tender/rigid uterus - correct -answer--dx:
placental abruption (premature separation of placenta from uterine wall)
-tx: hospitalization for hemodynamic stabilization, immediate delivery usually bc
c/s
*DIC (disseminated intravascular coagulation) occurs in 10% of pts
,3|Page
what is the MC cause of placental abruption (premature separation of placenta
from uterine wall)? - correct -answer--*HTN*
-others include: smoking, ETOH, cocaine, folate deficiency, high parity, AMA
(advanced maternal age), trauma, chorioamnionitis
where is the MC site of ectopic pregnancies? - correct -answer--98.3% in fallopian
tubes (especially ampulla)
-1.4% in abdomen
-0.15% in ovary
-0.15% on cervix
what are some risk factors for ectopic pregnancy? - correct -answer--previous
abdominal surgery (adhesions)
-PID
-previous ectopic
-tubal ligation
-endometriosis
-IUD use
-assisted reproduction
, 4|Page
what is the classic triad of sx's with ectopic pregnancy? - correct -answer-1.
unilateral pelvic/abdominal pain
2. vaginal bleeding
3. + pregnancy (noticed by test or by amenorrhea)
how is a ectopic pregnancy (that has not ruptured) diagnosed and treated? -
correct -answer--Dx by serial quant *B-hCG that do not double q 1-2 days* &
*TVUS*
-Tx: *methotrexate* (disrupts cell multiplication) w/ *B-hCG monitoring* for
*≥15% drop* OR laproscopic salpingotomy or salpingectomy + RhoGAM if Rh-
MTX can be given in single/double or multiple doses (4) w/ *Leucovorin* (med to
help protect against harmful s/e of MTX)
-single/double dosing: monitor B-hCG on days 0, 4, 7 for a ≥15% drop
-multiple dosing (4 doses): monitor B-hCG on days 0, 1, 3, 5, 7 until ≥15% drop on
2 successive draws
what are the indications/contraindications for giving MTX to tx an ectopic
pregnancy? - correct -answer--indications: hemodynamically stable, early
gestation <4 cm, B-hCG <5,000, no FHT (fetal heart tones)
-contraindications: *ruptured* ectopic, h/o TB, *B-hCG >5,000*, *+FHT*,
noncompliant pt
