ABOG Obstetric Complications & Emergency Management 2

Question 1

According to ACOG criteria, which finding is required to diagnose preeclampsia in a patient WITHOUT proteinuria at 34 weeks gestation?

Accepted Answer

New-onset thrombocytopenia (platelets <100,000/μL)

Answer

Bilateral lower extremity edema

Answer

Weight gain >2 lbs/week

Answer

Mild headache with BP 140/90

Question 2

A patient at 32 weeks is found to have hemolysis on peripheral smear, AST 320 U/L, and platelets of 78,000/μL. Which condition does this represent?

Accepted Answer

HELLP syndrome

Answer

Acute fatty liver of pregnancy

Answer

Immune thrombocytopenic purpura

Answer

Thrombotic thrombocytopenic purpura

Question 3

A patient at 36 weeks presents with painful, constant uterine contractions, vaginal bleeding, and a rigid board-like abdomen. Fetal heart tones show late decelerations. What is the most likely diagnosis?

Accepted Answer

Placental abruption

Answer

Placenta previa

Answer

Uterine rupture

Answer

Vasa previa

Question 4

A patient on magnesium sulfate infusion develops loss of deep tendon reflexes and respiratory rate of 10 breaths/min. What is the correct immediate management?

Accepted Answer

Stop magnesium infusion and administer calcium gluconate IV

Answer

Reduce magnesium infusion rate by 50%

Answer

Administer naloxone IV

Answer

Intubate and continue magnesium at current rate

Question 5

Vasa previa is most definitively diagnosed by which modality, and what is the recommended delivery route?

Accepted Answer

Transvaginal ultrasound with color Doppler; planned cesarean at 34–36 weeks

Answer

MRI pelvis; vaginal delivery with continuous fetal monitoring

Answer

Transabdominal ultrasound; induction of labor at 37 weeks

Answer

Amniocentesis with Apt test; cesarean only if fetal distress occurs

Question 6

Immediately after delivery, a patient develops sudden uterine inversion with the fundus protruding through the cervix. What is the FIRST step in management?

Accepted Answer

Manual replacement of the uterus before placental removal

Answer

Remove the placenta then manually replace the uterus

Answer

Administer oxytocin to contract the uterus before replacement

Answer

Proceed directly to laparotomy for surgical replacement

Question 7

A patient with severe preeclampsia develops DIC with fibrinogen of 80 mg/dL and active bleeding. Which blood product most directly corrects the fibrinogen deficiency?

Accepted Answer

Cryoprecipitate

Answer

Fresh frozen plasma

Answer

Platelets

Answer

Packed red blood cells