Use for the new 2020–21 computer-based examination. Authored & peer-reviewed by faculty, clinicians, and program directors.
Each question is written to resemble the format and topics on the exam, meaning you won’t see any negatively phrased questions, no “all of the following except,” no “A and B”…you know what we mean. Most importantly, all questions include selective distractors (incorrect answer choices), which will help you think critically.
A 29-year-old woman presents to the labor floor with painful contractions at term. She has no known drug allergies. She is found to have spontaneously ruptured her membranes but is not in active labor. She is admitted for induction and develops fever intrapartum with fetal and maternal tachycardia. You treat her with antibiotics and monitor her labor curve. She eventually meets the criteria for arrest of dilation and is on call to the operating room for primary cesarean section. Which of the following antibiotics should you add to her regimen?
Intra-amniotic infection can affect all intrauterine contents, such as amniotic fluid, placenta, fetus, and decidua. It is polymicrobial and is typically an ascending infection caused by vaginal flora. Instrumentation such as intrauterine catheters and fetal scalp electrodes and frequent vaginal examinations increase the risk of infection. Appropriate diagnosis and treatment should be initiated due to the increased neonatal risk of intra-amniotic infection, such as neonatal pneumonia, meningitis, sepsis, and death. The diagnosis of intra-amniotic infection is primarily clinical, as a definitive diagnosis is most commonly obtained after delivery. Maternal fever is commonly present, and other major clinical criteria include maternal leukocytosis, purulent cervical drainage, and fetal tachycardia. In women without known drug allergies, the recommended antibiotic regimen comprises ampicillin and gentamicin. Alternatives can be considered in the setting of mild or severe penicillin allergy. When the route of delivery changes to cesarean, the addition of clindamycin is recommended to improve anaerobic coverage.
Cefazolin (A) is not warranted, since the treatment for intra-amniotic infection already covers skin flora and is sufficient for prophylaxis. Gentamicin (C) is already part of the regimen for treatment of intra-amniotic infection. Vancomycin (D) is recommended in women with severe penicillin allergy and group B streptococci colonization.
Understanding why an answer choice is incorrect is just as important as knowing why one is correct. That’s why every Rosh Review question includes detailed explanations for the correct and incorrect answer choices. These comprehensive summaries link the most important components of a topic—from risk factors to diagnostics and treatment—giving you the context to build relationships between them.
Custom illustrations and tables help further clarify the core concepts. When information is presented visually, you can focus on meaning, easily reorganize and group similar ideas, and make better use of your memory.
Your personal analytics allow you to see your progress at all times, so you can create an efficient and effective learning strategy and stay on pace with your plan.
Deep insights to determine your strengths and weaknesses so you can spend your time on the subjects that matter.
Discover how your answer choices align with those selected by learners across the country.
Using data generated by previous users, your Qbank gives a prediction of how likely you are to pass your exam.
After each explanation is a straightforward question with a simple, memorizable answer that reinforces the corresponding topic.
Intra-amniotic Infection (Chorioamnionitis)
These bulleted reviews focus on condensed, high-yield concepts about the main topic, from patient presentation to preferred management.