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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.

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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?

A Cefazolin
B Clindamycin
C Gentamicin
D Vancomycin

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.


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Chorioamnionitis, Intra amniotic infection, Triple I

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After each explanation is a straightforward question with a simple, memorizable answer that reinforces the corresponding topic.

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Q: True or false: intra-amniotic infection is an indication for cesarean delivery.

Reveal Answer

A: False.

Intra-amniotic Infection (Chorioamnionitis)

  • Infection or inflammation of the amniotic fluid, placenta, fetus, fetal membranes, or decidua
  • Risk factors: preterm labor, prelabor rupture of membranes, prolonged rupture of membranes
  • GBS infection at 18 hrs
  • Rx: ampicillin + gentamicin

Rapid Review

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These bulleted reviews focus on condensed, high-yield concepts about the main topic, from patient presentation to preferred management.

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I focused on the Rosh Review Qbank before my shelf exam, and I scored the highest in my clerkship. All I have to say is...your content is amazing.


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Where can I find free shelf exam practice questions?
You can access free practice questions with a free trial for a Shelf Exam Qbank—no billing information required. The free trial includes practice questions that align with topics found on the shelf exam and include comprehensive answer explanations and beautiful teaching images.

After practicing with these questions, if you decide you're ready for hundreds of additional questions to help you confidently prep for the shelf exam, you can easily upgrade to a full Qbank subscription.
What are the OB/GYN shelf exam topics?
Here's a summary of what the exam covers (see the Content Outline for a complete topic list and breakdown):

  • General Principles (normal age-related findings, care of the well patient, pregnancy, childbirth, & the puerperium)
  • Female reproductive system & breast
  • Endocrine system
  • Other systems, including multisystem processes & disorders
  • Social sciences
  • Applying foundational science concepts
  • Diagnosis: knowledge pertaining to history, exam, diagnostic studies, & patient outcomes
  • Health maintenance, prevention, & surveillance
  • Pharmacotherapy, intervention, & management
  • Ambulatory care
  • Emergency care
How difficult is the OB/GYN shelf exam?
Because the content is unique to this clerkship alone, the OB/GYN shelf exam can be challenging! Learn the best resources and study tips from two MDs who crushed their OB/GYN shelf exam.

And for general shelf exam strategies, read How to Study for the Shelf Exams & Step 2 CK…And Impress Residencies.
How many questions is the OB/GYN shelf exam?
The exam has 110 multiple choice questions, which you have 2 hours and 45 minutes to complete.

The OB/GYN Shelf Exam Qbank has 500 questions covering all the topics you need to know, so you'll get plenty of practice!
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Whether you have a trial account or you purchased a subscription, access Rosh Review by logging in at To access the Qbank, go to the Create Exam tab to begin making and taking exams made up of questions from the Qbank. You can find any boost exams under the My ExamsBoost Exam tab. Once you've completed and submitted a few exams, you can see your statistics under the Performance Analysis tab.
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