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By Robert Casanova, Visit Amazon's Veeral S. Sheth Page, search results, Learn about Author Central, Veeral S. Sheth, , Stanley Zaslau

Succeed at the NBME shelf examination and your obstetrics and gynecology rotation with Shelf-Life OB/GYN, a new pocket-sized query ebook filled with 500 fine quality questions and solutions that align with present NBME content material outlines.

  • Increase your knowing with every one query you resolution as you cross over the specific rationales that contain causes for not just the proper resolution selection, yet all distractors.
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  • Prepare for forums with confidence—the book’s 500 questions and solutions align without delay with present NBME content material outlines.
  • Increase your visible realizing of key content material with the 4 colour layout and nearly a hundred scientific photos, corresponding to medical images, x-rays, CTs, and EEG strips.
  • Extend your studying past the e-book with the web query financial institution that includes all of the booklet questions in electronic layout   for examine at the go.

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Women with a previous pregnancy complicated by any trisomy, in which the fetus survived at least to the second trimester, are at risk for having a recurrence of the same or different trisomy. The risk of trisomy recur­ rence is 1 . 2 times the maternal age risk. This risk depends on several fac­ tors, including the maternal age during the index pregnancy, type of trisomy, and pregnancy outcome. Certain sex-chromosome abnormalities may also carry an increased risk of recurrence. Turner syndrome (XO) and XYY karyotypes carry a nominal recurrence risk; fetal XXX or XXY has an increased recurrence risk.

Physical examination shows a gravid uterus with a fundal height of 36 em. The baby is found to be ver­ tex by Leopold maneuvers. Speculum examination shows an anterior, soft, thinning cervix with some serous discharge. Microscopic examination of the vaginal discharge shows few bacteria, 0 to 5 white blood cells (WBCs)/hpf (high power field), 0 to 5 RBCs/hp£ No ferning was noted. Manual cervical examination indicates that she is dilated 3 em, 75% effaced, and at 0 station. What is the next step in the management of this patient?

17 - ----1 • I '-': F 1--16 19 -- --4 20 G . -21 22 X y Fig u re 3-4 (A) (B) (C) (D) (E) a-fetoprotein (AFP) , intact hCG, estradiol, inhibin A Intact hCG, estradiol, inhibin A AFP, estradiol, inhibin A AFP, intact hCG, inhibin A AFP, intact hCG, estradiol The answer is E : AFP, i ntact hCG, estrad i o l . Inhibin A is not used in the calculation of risk for trisomy 1 8 . Typically, the values of AFP, intact hCG, and estradiol are all reduced when the fetus is at increased risk for trisomy 1 8 (see Figure 3 -4) .

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