A 37-year-old woman, G3P0, presents to the obstetrics clinic at 14 weeks of gestation for routine follow-up. She has a history of two second-trimester pregnancy losses at 18 and 20 weeks. No previous infections or labor complications were reported. However, her second pregnancy is complicated by gestational diabetes. She had a loop electrosurgical excision procedure done when she was 30 years old. The patient denies any cramping, vaginal bleeding, or fluid leakage. Today her vital signs are: temperature is 99 °F (37.2 °C), heart rate is 108 beats/min, blood pressure is 177/105 mm Hg, respirations are 19 breaths/min, oxygen saturation is 94% on room air, and BMI is 32. Which of the following is a common risk factor for cervical incompetence?
A 30-year-old woman, G3P0, presents to the obstetrics clinic at 14 weeks of gestation for routine follow-up. She has a history of two second-trimester pregnancy losses at 18 and 20 weeks. No previous infections or labor complications were reported. The patient denies any cramping, vaginal bleeding, or fluid leakage. Which of the following findings is most suggestive of cervical incompetence during pregnancy?
A 45-year-old woman comes to your office for a follow-up examination. She recently had a pelvic surgery and sustained damage to her inferior rectal nerve. Which of the following clinical conditions is most likely associated with damage to the inferior rectal nerve?
A 39-year-old female at 28 weeks pregnancy comes to the endocrinology office complaining of increased body or facial hair, including a beard or mustache, oily skin or acne on the face, male-pattern baldness, deepening of the voice, enlarged clitoris, increased sex drive for the last four weeks. She denies any abdominal pain. Ultrasound of the ovaries revealed an enlarged right ovary measuring 6 cm x 5 cm x 3.5 cm. A biopsy was taken and the specimen was submitted for histopathological examination in 10% formalin. Microscopically, sections from right ovarian mass revealed a lesion composed of diffuse masses of cells arranged in sheets, nests, and cords. The cells were polygonal in shape and had an abundant amount of finely granular eosinophilic cytoplasm. Nuclei were small, round, vesicular with prominent nucleoli. Occasional mitotic figures, areas of necrosis, and focal areas of hemorrhage were noted. Reinke crystals were not found in the sections studied. Reticulin staining fibers enclosing groups of cells, rather than individual cells. Hormonal studies reveal elevated testosterone, dihydrotestosterone, and androstenedione. Which of the following is the next step in the management of this patient?
A 30-year-old pregnant woman presented with flu-like symptoms including fever, muscle aches, and swollen lymph nodes. She also reported a recent cat exposure. A blood test confirmed the presence of Toxoplasma gondii IgG antibodies, indicating a past infection. However, a significant rise in IgM antibodies suggested a recent acute infection. Which of the following is the main mode of transmission for toxoplasma gondii?
A 34-year-old woman presents to the clinic with complaints of persistent headaches, muscle aches, and fatigue for the past two weeks. Serology came positive for Toxoplasma gondii IgM antibodies. Which of the following features from the history establish the diagnosis of toxoplasmosis in this patient?
A 26-year-old woman, at 24 weeks of gestation, presents to her obstetrician with mild fatigue and low-grade fever for the past week. She denies respiratory symptoms but reports occasional headaches and lymph node swelling in her neck. She has no significant medical history and is not on any medications. She has a pet cat at home. Physical examination reveals palpable, non-tender cervical lymphadenopathy. She is concerned about the risk of congenital toxoplasmosis to her fetus. What is the preferred treatment for a pregnant woman diagnosed with acute toxoplasmosis to prevent vertical transmission?
A 27-year-old woman, at 24 weeks of gestation, presents to her obstetrician with mild fatigue and low-grade fever for the past week. She denies respiratory symptoms but reports occasional headaches and lymph node swelling in her neck. She has no significant medical history and is not on any medications. She has a pet cat at home. Physical examination reveals palpable, non-tender cervical lymphadenopathy. She is concerned about the risk of congenital toxoplasmosis to her fetus. Which triad of symptoms is most characteristic of congenital toxoplasmosis?
A 29-year-old woman, at 24 weeks of gestation, presents to her obstetrician with mild fatigue and low-grade fever for the past week. She denies respiratory symptoms but reports occasional headaches and lymph node swelling in her neck. She has no significant medical history and is not on any medications. She has a pet cat at home. Physical examination reveals palpable, non-tender cervical lymphadenopathy. The rest of the physical examination, including fetal assessment, is unremarkable. Her serology is significant for positive IgG antibodies for Toxoplasma gondii, indicating past infection. What is the most common route of transmission of Toxoplasma gondii in pregnant women?
A 26-year-old woman, gravida 1 para 0, presents to her obstetrician at 12 weeks of gestation for routine prenatal care. She has no significant medical history and reports feeling well, with no symptoms of fatigue, jaundice, or abdominal pain. Her family history is notable for hepatitis B in her mother. As part of routine prenatal testing, the patient’s hepatitis B surface antigen (HBsAg) is found to be positive. Further tests reveal the following: HBeAg: Positive HBV DNA Levels: 1,000,000 IU/mL Liver Function Tests: Normal (ALT and AST within normal limits). Why is maternal Hepatitis B viral DNA load important in pregnancy?
