A 36-year-old primigravid woman at 26 weeks' gestation comes to the physician complaining of absent fetal movements for the last 2 days. Pregnancy was confirmed by ultrasonography 14 weeks earlier. She has no vaginal bleeding or discharge. She has a history of type 1 diabetes mellitus controlled with insulin. Vital signs are all within the normal limits. Pelvic examination shows a soft, 2-cm long cervix in the midline with a cervical os measuring 3 cm and a uterus consistent in size with 24 weeks' gestation. Transvaginal ultrasonography shows a fetus with no cardiac activity. Which of the following is the most appropriate next step in management?
APlan for oxytocin administration
BPerform weekly pelvic ultrasound
CPerform dilation and curettage
DPerform cesarean delivery
EAdminister magnesium sulfate
Group of 100 medical students took an end of the year exam. The mean score on the exam was 70%, with a standard deviation of 25%. The professor states that a student's score must be within the 95% confidence interval of the mean to pass the exam. Which of the following is the minimum score a student can have to pass the exam?
A45%
B63.75%
C67.5%
D20%
E65%
A 32-year-old nulligravid woman comes to the physician because of 2 weeks of postcoital pain and blood-tinged vaginal discharge. She has been sexually active with one male partner for the past 3 months. They do not use condoms. Her only medication is a combined oral contraceptive that she has been taking for the past 2 years. She states that she takes the medication fairly consistently, but may forget a pill 2–3 days per month. One year ago, her Pap smear was normal. She has not received the HPV vaccine. The cervix is tender to motion on bimanual exam. There is bleeding when the cervix is touched with a cotton swab during speculum exam. Which of the following is the most likely diagnosis?
AUterine leiomyomas
BCervix trauma
CChlamydia infection
DEarly uterine pregnancy
EBreakthrough bleeding
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