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pregnancy

Practice targeted AMC-style multiple-choice questions on pregnancy.

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Ovarian Cyst
Image by James Heilman, MD CC BY-SA 3.0 · Source

A 32-year-old woman presents to the ED with acute lower abdominal pain and nausea. She reports her last menstrual period was 6 weeks ago, and home pregnancy test was negative yesterday. Vitals are stable. A CT scan of the abdomen and pelvis is performed, the relevant image is shown. What is the MOST appropriate next step in management?

A. Oral contraceptive pills
B. Follow-up ultrasound in 6-8 weeks
C. Laparoscopic cystectomy
D. Serum CA-125 level
E. Immediate laparotomy
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A 28-year-old woman, 18 weeks pregnant, presents to her GP two days after her 5-year-old son developed varicella. She is unsure of her immunity status and is asymptomatic. Which of the following is the most appropriate initial management step?

A. Observe closely for symptoms and treat with acyclovir if rash develops.
B. Reassure her that the risk is low given she is asymptomatic.
C. Administer varicella vaccine.
D. Obtain urgent varicella serology and administer VZIG if non-immune.
E. Administer varicella-zoster immunoglobulin (VZIG) as soon as possible.
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A 32-year-old woman, currently 28 weeks pregnant, presents to the antenatal clinic for a routine check-up. She has a history of gestational diabetes mellitus (GDM) diagnosed at 24 weeks of gestation. Her current treatment includes dietary modifications and regular blood glucose monitoring. Her recent fasting blood glucose levels have been consistently between 5.5 and 6.0 mmol/L, and her postprandial levels are between 7.5 and 8.0 mmol/L. She reports feeling well and has no symptoms of hypoglycemia. Her obstetric history includes one previous pregnancy complicated by GDM, which was managed with insulin. Her current pregnancy is otherwise uncomplicated. What is the most appropriate next step in the management of her gestational diabetes?

A. Increase dietary carbohydrate intake
B. Start metformin therapy
C. Schedule an early induction of labor
D. Initiate insulin therapy
E. Continue current management and monitor closely
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A 37-year-old lady presents with a sudden right-sided facial droop, with no ear symptoms or dysphagia. She is 16 weeks pregnant. What is the likely diagnosis?

A. Multiple Sclerosis
B. Schwannoma
C. Stroke
D. Ramsay Hunt syndrome
E. Bell's palsy
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A 32-year-old woman, G1P1, presents to her general practitioner at 34 weeks gestation complaining of a new, intensely itchy rash. The rash started on her abdomen around the umbilicus and has now spread to her thighs and buttocks. On examination, there are erythematous papules and plaques, some with vesicles, located within the striae distensae of her abdomen. She denies any personal or family history of eczema or other skin conditions. She is otherwise well, with normal blood pressure and no proteinuria. Fetal movements are normal. Which of the following is the most appropriate initial management?

A. Oral corticosteroids
B. Topical corticosteroids and emollients
C. Referral to a dermatologist for biopsy
D. Induction of labour
E. Oral antihistamines alone
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Ovarian Cyst
Image by James Heilman, MD CC BY-SA 3.0 · Source

A 28-year-old female presents to the ED with acute onset right lower quadrant pain. She reports nausea and vomiting. Her last menstrual period was 6 weeks ago, and she denies any vaginal bleeding. She is hemodynamically stable. A CT scan of the abdomen and pelvis is performed, with a relevant image shown. What is the MOST appropriate next step in the management of this patient?

A. Emergency hysterectomy
B. Laparoscopic cystectomy
C. Administration of broad-spectrum antibiotics
D. Initiate anticoagulation therapy
E. Expectant management with analgesia
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Ovarian Cyst
Image by James Heilman, MD CC BY-SA 3.0 · Source

A 28-year-old female presents to the ED with acute onset right lower quadrant pain. She reports nausea and vomiting. Her last menstrual period was 6 weeks ago, and she denies any vaginal bleeding. She is hemodynamically stable. A CT scan of the abdomen and pelvis is performed, with a relevant image shown. What is the MOST appropriate next step in the management of this patient?

A. Laparoscopic cystectomy
B. Immediate laparotomy
C. Expectant management with analgesia
D. Oral contraceptive pills
E. Serum CA-125 level
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A 14-year-old girl living alone presents with a positive urine pregnancy test. She states she was raped 6 months ago and wishes to terminate the pregnancy. What is the next appropriate step?

A. Refer her to a gynaecologist.
B. Inform police.
C. Send her to the women's home.
D. Terminate the pregnancy.
E. Inform child protection services.
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Ovarian Cyst
Image by James Heilman, MD CC BY-SA 3.0 · Source

A 28-year-old female presents with sudden onset severe right lower quadrant pain, associated with nausea and one episode of vomiting. Her last menstrual period was 6 weeks ago. On examination, she is afebrile, heart rate 88, blood pressure 120/70. Abdominal examination reveals tenderness in the right iliac fossa. A CT scan of the abdomen and pelvis is performed, with a relevant axial image shown. Considering the clinical presentation and the findings demonstrated in the image, what is the MOST appropriate immediate next step in the management of this patient?

A. Perform a diagnostic laparoscopy to confirm appendicitis
B. Order a pelvic ultrasound for further characterisation
C. Arrange for outpatient follow-up with gynaecology
D. Laparoscopic surgical exploration
E. Administer broad-spectrum antibiotics
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A 30-year-old woman attends her first antenatal visit at 28 weeks gestation. She has no significant medical history and received her last tetanus booster 10 years ago. She is otherwise well. According to Australian guidelines, which vaccination is most specifically recommended for administration during this gestational period?

A. Hepatitis B vaccine
B. Influenza vaccine
C. Measles-mumps-rubella (MMR) vaccine
D. Varicella vaccine
E. Diphtheria-tetanus-acellular pertussis (dTpa)
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A 14-year-old girl who has been living alone presents with a positive urine pregnancy test. She states she was raped 6 months ago and wishes to terminate the pregnancy. What is the next appropriate step?

A. Refer her to a gynecologist.
B. Terminate the pregnancy.
C. Send her to a women's home.
D. Inform the police.
E. Inform child protection services.
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