OB/Gyn NBME/ UWORLD (2023/ 2024 Update) Questions and Verified Answers|100% Correct| Grade A
OB/Gyn NBME/ UWORLD (2023/ 2024 Update) Questions and Verified Answers|100% Correct| Grade A
OB/Gyn NBME/ UWORLD (2023/ 2024
Update) Questions and Verified
Answers|100% Correct| Grade A
Q: 36 AAF w/ heavy feeling in lower abdomen for 1 year. 9-10 days periods w/heavy cramps.
2 first trimester miscarraiges. Mobile globular mass w/several protuberances below the
umbilicus. Dx
Answer:
Leiomyoma uteri.
Q: 10. 32 w/ pelvic pain for past 2 days after period ended. Hx of heavy periods w/clots. Hx of
sp abortion. Irregularly enlarged uterus, dilated cervix @ 5cm w/ spherical firm and smooth mass
visible through external os w/ bleeding around it. Dx
Answer:
(prolapsing) Leiomyoma uteri. Aborting submucous myoma
Q: 4 wks after third degree laceration during labor, repaired w/ sutures and 24hr vaginal
packing to tamponade, 25 G1P1 prx w/ malrodous vaginal d/c for 2 wks w/ small red velvety
area on posterior vaginal wall w/ foul-smelling brown d/c. dx
Answer:
Rectovaginal fistula
Q: 32 @ 18wks prx w/ confsuin & incoherence. Unsteady and falls down. Recenty w/ N/V txt
w/ iVF & antiemetics in ER. Persistent vomiting & lost 7kg of preg weight. PE shows
nystagmus, epigastric pain, b/l pedal edema & b/l absent ankle reflex. Lab: low Hct, Na, K, Cl,
inc Bicarb, inc AST & ALT. dx
Answer:
Thiamine def. Wernicke encephalopathy (AMS ++ nystagmus + gait ataxia).
Q: 53 w/ heavy vaginal bleeding. Soaks pads q2hrs. menopause @ 45. Fam hx of breast ca. BP
low, obese, dark red blood in posterior vaginal vault. 3cm friable mass on ectocervix and extends
laterally a dbleeding actively. Hb is low. Thin endometrial stripe and no adenexal mass. Risk
factor
Answer:
Tobacco. Cervical cancer
Q: 32 @ 28wks prx w/painful contractions for 2 hrs q5mins. Cervix is closed. 3cm dilated w/
90% effaced bulging bag. U/S confirms vertex presentation. Betamethasone & indomethacin
administered. NBS
Answer:
Administer magnesium sulfate.
Q: 35 @ 31 wks prx w/ RUQ abdominal pain, BP 160/90, low Hb, low PLT, low Proteins,
evelated liver enzymes & bilirubin, 2+protein on urine dipstick
Answer:
Distenstion of liver capsule. HELLP syndrome-> centrilobular necrosis, hematoma formation &
thrombi in capillary portal system-> liver swelling w/ distension of the haptic capsule-> RUQ
/epigastric pain
Q: pt s/p dx of preeclampsia is given corticosteroids and magnesium sulfate. 3 hrs later she
develops dyspnea and drop in oxygen sat, BP 150/80, 112 pulse, 91% on room air, bibasilar
crackles, use of accessory muscles for breathing and 2+ pitting edema of lower extremeties.
Cause of resp sxm
Answer:
Pulmondary edema (w/HTN-> inc afterload -> inc pulm capillary pressure -> pul edema)
Q: 35 G1P0010 has been trying to conceive for 3 yrs, says shes been having morning sickness
for the past few weeks, abdominal distension, breast fullness, LMP was 2 months ago, home
preg test +ve. US shows thin endometrial stripe, and office preg test -ve. Dx
Answer:
Pseudocyesis. Somatization of stress affects HPA axis-> sxm of early preg
Q: 16 runner, excessive facial hair, irregular menstrual cycles, BMI 20, hirtuism, normal
external female geniatalia, labs: inc LH & FSH, inc 17’OH progesterone, inc testosterone, inc
DHEA-S, normal glucose & electrolytes. Dx
Answer:
Congenital adrenal hyperplasia.
Q: 29 w/ recurrent fevers 5 days after CS. Gentamicin, clindamycin given on POD #5,
ampicillin given on POD #3, T 102.2F, tenderness @ incision site w. serosanguineous drainage,
nontedner uterus. Hb 10.8g/dL. Dx
Answer:
Septic pelvic thrombophlebitis.
Q: 35 w/ breast mass. Fam hx of breast cancer. Fixed mass palpated in outer quad of R breast.
Mammogram shows speculated mass w/coarse calcifications, US shows hyperechoic mass, core
bx shows foamy macrophages and fat globules. NBS
Answer:
Reassurance and routine follow-up. Fat necrosis of the breast.
Q: 67 w/ LMP @ 53. Last pap w. HPV test -ve 2 years ago. All prior pap normal. O fam hx of
cancer. Normal cervix. Recommendation for cervical cancer screening in this patient
Answer:
No further screening (21-30: pap q3yrs. 30-65: pap q3yrs or pap + HPV test q5yrs. 65 on: d/c if –
ve 3 pap or -ve 2 pap + HPV test)
Q: 31 @ 7wks prx w/vaginal bleeding and lowe abdominal pain. Hx of chlamydia cervicitis.
Surgical hx of LEEP for CIN3. Blood clots in vagina & active bleeding from a dilated cervix.
Bimanual exam reveals a 6wk size tender uterus. US shows gestational sac in lower segment of
uterus, simple cyst in right ovary & free fluid in posterior cul-de-sac. Dx
Answer:
Inevitable abortion.
Q: 29 @ 10wks gestation prx w/ vaginal bleeding of large clots and intense lower abdominal
cramping. Bp 90/65mmHg. She is AB -ve. Large clots evacuated from the vagina during pelvic
exam, w/ actibe bleeding noted from an open cervical os. Hb is low, 9wk fetus notedon
transvaginal US w/ no fetal cardiac activity. IVF administered. NBS
Answer:
Suction curettage. Because she’s hemodynamically unstable. If she was stable; expectant
management or administer misoprostol.
Q: 28 evaluated for infertility prx w/ clear vaginal d/c for 2 days. Took PCN last week an exam
shows clear mucus at cervical os. Cause of d/c
Answer:
ovulation. Vs. Cervical mucus plug seen in preg as a barrier to asc infection; brown, red or
yellow thick mucus.
Q: 45 G5P5 prx w/ involuntary loss if urine. PE shows vaginal bulge (cystocele). Loses small
amount of urine when asked to cough. Cause
Answer:
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