A 30-year-old woman presents to the clinic with a painful swelling in her right breast for the past five days. She reports associated redness and warmth in the area, along with intermittent fevers and chills. She is currently breastfeeding her 3-month-old infant and states that the symptoms started after noticing a sore nipple. She denies any history of prior breast infections or trauma.    The patient explains that she initially experienced mild tenderness in the right breast, which progressed to localized swelling and increased pain. She attempted warm compresses and frequent breastfeeding, but the symptoms worsened. She also noticed a decrease in milk output from the affected breast. Her medical history is unremarkable, and she takes no regular medications. She is a non-smoker.    On examination, the patient appears uncomfortable but not acutely ill. The right breast shows an area of erythema, warmth, and induration in the upper outer quadrant. A fluctuant mass approximately 4 cm in diameter is palpable, with tenderness on palpation. There is no nipple discharge or overlying skin breakdown. Axillary lymph nodes are mildly enlarged and tender. The left breast is normal, with no signs of infection or tenderness. Ultrasound of the right breast reveals a well-defined, hypoechoic fluid collection consistent with an abscess. What is the most likely causative organism?

Joanna, a 23-year-old college student, presents to the clinic for her first prenatal visit. During the visit, she mentions occasional recreational drug use and expresses concern about the health effects of cannabis. She says she uses cannabis socially on weekends and perceives it as harmless because it’s legal in her state. She denies using other substances like cocaine, heroin, or prescription drugs. Her physical examination is unremarkable, and she appears healthy. During the discussion, she asks: “Is cannabis really the most commonly used drug, or are there other substances more popular?” Which of the following is the most commonly used illicit substance in the United States?

A 32-year-old G2P1 woman at 38 weeks gestation presents to the emergency department with shortness of breath, severe fatigue, and chest tightness. She reports sudden-onset symptoms following a prolonged labor induction for which she received tocolytics. Her past medical history includes preeclampsia during her first pregnancy. She also reports recent vaginal bleeding after a suspected placental abruption. On examination, the patient appears distressed, with a respiratory rate of 30 breaths/min, oxygen saturation of 85% on room air, and crackles heard bilaterally on auscultation. Chest X-ray reveals bilateral infiltrates consistent with pulmonary edema. Laboratory results are significant for proteinuria, thrombocytopenia, and elevated liver enzymes. Which of the following is a cause of acute respiratory distress syndrome (ARDS) unique to pregnancy?

A 36-year-old G3 P1 pregnant woman at 34 weeks gestation presents with sudden-onset vaginal bleeding, severe abdominal pain, and uterine tenderness. Her history is significant for preeclampsia in her first pregnancy and chronic hypertension. She smokes one pack of cigarettes a day and uses cocaine occasionally. On examination, the uterus is firm and rigid on examination, and fetal heart rate monitoring shows distress. You suspect placental abruption in this patient. Which of the following is a risk factor for this disorder in this patient?

A 30-year-old woman presents to the emergency department complaining of severe lower abdominal pain, vaginal bleeding, and nausea. She reports her last menstrual period was 6 weeks ago and she has experienced mild cramping and spotting. A pelvic examination reveals tenderness in the adnexa. A pregnancy test is positive. A transvaginal ultrasound is performed, which shows a non-viable intrauterine pregnancy and a complex adnexal mass, suggestive of an ectopic pregnancy. What is the most common site for an ectopic pregnancy?

A 29-year-old woman, G2P1, presents to the labor and delivery unit at 39 weeks of gestation in active labor. She reports spontaneous rupture of membranes approximately 12 hours ago and has had mild intermittent contractions over the past 6 hours. Key History: Positive GBS screening at 36 weeks gestation. Stable maternal vitals, reassuring fetal heart rate. Cervical exam: 4 cm dilation, 80% effacement, -1 station. The obstetric team decides to initiate intrapartum GBS antibiotic prophylaxis due to her positive GBS status and prolonged rupture of membranes. What is the first-line antibiotic for intrapartum GBS prophylaxis?