100+ Free ABPS Family Medicine Obstetrics Practice Questions

Prenatal Care & Routine Antenatal Management

Initial prenatal panel (CBC, ABO/Rh + antibody screen, RPR, HIV, HBsAg, HCV, rubella, varicella, urine culture), folic acid 400-800 mcg, ACOG/USPSTF screening (gestational diabetes 24-28 weeks two-step, GBS at 36 0/7 - 37 6/7 weeks, anemia, IPV, perinatal depression EPDS), vaccinations per ACIP 2026 (Tdap 27-36 weeks every pregnancy, IIV any trimester, RSV Abrysvo 32-36 weeks during Sept-Jan, COVID-19 mRNA), aneuploidy screening (cfDNA/NIPT, first-trimester combined, quad), pan-ethnic carrier screening (CF, SMA, hemoglobinopathies), IOM weight gain, caffeine <200 mg/day, cannabis counseling, dating by CRL +/- 5-7 days, low-dose aspirin 81 mg from 12-16 weeks for preeclampsia prevention.

Antenatal Complications (HTN, GDM, Preeclampsia, HELLP)

Chronic HTN management (avoid ACEi/ARB/atenolol; use labetalol/nifedipine/methyldopa), gestational HTN, preeclampsia with/without severe features (BP >=160/110, plt <100k, LFTs 2x, Cr >1.1, pulmonary edema, cerebral/visual symptoms), severe-range HTN acute treatment within 30-60 min (IV labetalol, IV hydralazine, oral immediate-release nifedipine), HELLP syndrome, magnesium sulfate seizure prophylaxis (4-6 g IV load, 1-2 g/hr; monitor toxicity, calcium gluconate antidote), gestational diabetes Carpenter-Coustan diagnosis, GDM treatment (MNT first; insulin first-line per ACOG, metformin alternative), thyroid disease (trimester-specific TSH), iron deficiency anemia (Hgb <11 1st/3rd trimester, <10.5 2nd), spontaneous abortion classification.

Labor Management & Operative Vaginal Delivery

Zhang/Consortium labor curves, active phase arrest at >=6 cm with ROM and no change x4h adequate or x6h inadequate contractions, second-stage timing (3-4 h nullipara, 2-3 h multipara), Bishop score >=6-8 favorable, cervical ripening (Foley balloon, misoprostol, dinoprostone), oxytocin low-dose vs high-dose protocols, Montevideo units >=200 = adequate, ARRIVE trial 39-week elective induction reduces cesarean, amniotomy, ECV at 36-37 weeks for breech, Term Breech Trial planned cesarean preferred, shoulder dystocia HELPERR (NEVER fundal pressure), perineal laceration grades 1-4 (OASIS), vacuum/forceps indications and contraindications (vacuum <34 weeks contraindicated, max 3 pop-offs/20 min), subgaleal hemorrhage recognition, uterine rupture during TOLAC.

Intrapartum Fetal Monitoring

NICHD 2008 three-tier categories (I normal, II indeterminate, III abnormal — sinusoidal or absent variability with recurrent late/variable/bradycardia), normal FHR baseline 110-160, accelerations (15x15x2 in 20 at >=32 weeks; 10x10 before 32), early decels (head compression, benign), late decels (uteroplacental insufficiency), variable decels (cord compression), prolonged decels, intrauterine resuscitation (left lateral, IV bolus, stop oxytocin, amnioinfusion for variables, terbutaline for tachysystole), cord prolapse emergency (elevate presenting part, knee-chest, fill bladder, immediate cesarean), nonstress test reactive criteria, contraction stress test.

Cesarean Delivery & VBAC/TOLAC

ACOG/SMFM Safe Prevention of Primary Cesarean (labor dystocia ~34% leading indication), preoperative chlorhexidine-alcohol skin prep, cefazolin 2 g IV (3 g if BMI >=30) within 60 min before incision, azithromycin 500 mg IV add-on for laboring/ROM cesareans (CSOAP trial), neuraxial preferred (spinal > epidural > general), TOLAC counseling (60-80% VBAC success), uterine rupture risk ~0.5-0.9% one prior LTC (avoid prostaglandins for induction in TOLAC), absolute contraindications (prior classical/T incision), placenta previa management (resolve by 28-32 weeks; cesarean 36 0/7 - 37 6/7 if persistent), placenta accreta spectrum (deliver 34-35 6/7 at expert center), VTE prophylaxis (SCDs all; LMWH high-risk), uterine inversion, cesarean hysterectomy.

Postpartum Care & Hemorrhage

reVITALize 2017 PPH definition (>=1000 mL OR signs of hypovolemia within 24h, regardless of mode), quantitative blood loss (QBL), 4 T's (Tone 70-80%, Trauma 20%, Tissue 10%, Thrombin 1%), uterotonic ladder (oxytocin > methylergonovine — avoid in HTN; carboprost — avoid in asthma; misoprostol 800-1000 mcg PR/SL), WOMAN trial TXA 1 g IV within 3 hours, AIM PPH bundle (Readiness/Recognition/Response/Reporting), Bakri/JADA balloon, B-Lynch, uterine artery embolization, hysterectomy as definitive therapy, postpartum endometritis (clindamycin + gentamicin), postpartum thyroiditis triphasic, postpartum mood (EPDS, PHQ-9; brexanolone/zuranolone for PPD), fourth-trimester comprehensive visit by 12 weeks, amniotic fluid embolism (perimortem cesarean within 4 min of arrest).

High-Risk Obstetrics & Maternal-Fetal Medicine

Preterm labor and PPROM (latency antibiotics ampicillin + erythromycin or azithromycin x 7 days, antenatal corticosteroids 24 0/7 - 33 6/7 weeks plus single ALPS course 34 0/7 - 36 6/7 if no prior, MgSO4 fetal neuroprotection <32 weeks, deliver PPROM at 34 0/7 weeks), short cervix <=25 mm vaginal progesterone (Makena withdrawn 2023), cerclage indications, fetal fibronectin high NPV, GBS intrapartum penicillin G prophylaxis, twins delivery timing (DCDA 38 0/7, MCDA 36 0/7 - 37 6/7, MCMA 32-34), HIV vertical transmission prevention (cesarean if VL >1000), genital herpes (suppressive acyclovir from 36 weeks; cesarean if active lesions), chorioamnionitis/Triple I (ampicillin + gentamicin), placental abruption, FGR Doppler-guided delivery, maternal mortality leading causes (mental health/overdose, hemorrhage, CV).

Neonatal Care & NRP Resuscitation

NRP 2020 8th edition algorithm (term/tone/breathing — yes = skin-to-skin; no = warmer, position, suction only if needed, dry, stimulate; PPV if HR <100 or apneic), initial FiO2 21% for term/late preterm, 21-30% for <35 weeks, preductal SpO2 targets, chest compressions if HR <60 after 30s effective PPV (3:1 ratio, 90+30/min, 100% O2), epinephrine 0.02 mg/kg IV/IO, Apgar (1 and 5 min), delayed cord clamping 30-60s for vigorous term/preterm, universal vitamin K 1 mg IM, erythromycin ophthalmic, hepatitis B birth dose, newborn metabolic/hearing/CCHD screens, AAP early-onset sepsis calculator, MSAF management (no routine intubation/suctioning), pathologic jaundice <24 h (hemolytic), AAP 2022 phototherapy nomograms, subgaleal hemorrhage.

Breastfeeding, Lactation & Postpartum Support

AAP/WHO exclusive breastfeeding for first 6 months, continue with complementary foods to 1+ year (WHO to 2 years), breastfeeding benefits (reduced infection, SIDS, atopy, obesity; maternal — reduced breast/ovarian cancer), lactation physiology (prolactin/oxytocin), latch and positioning, mastitis (continue feeding; dicloxacillin/cephalexin first-line, TMP-SMX or clindamycin for MRSA), engorgement, abscess management, contraindicated medications during lactation (chemotherapy, radioactive iodine, amiodarone, ergots, codeine), sertraline first-line for breastfeeding mothers with depression, LactMed resource, infant TB exposure (separation until effective therapy; expressed milk safe), HIV in resource-rich settings — only routine breastfeeding contraindication.

Ultrasound for Family Medicine Obstetrics

First-trimester crown-rump length (CRL) most accurate dating (+/- 5-7 days through 13 6/7 weeks), 18-22 week detailed anatomic survey (level II — biometry BPD/HC/AC/FL, fetal anatomy, placental location, cord, amniotic fluid), fetal growth restriction (EFW or AC <10th percentile; severe <3rd), Doppler studies (umbilical artery, MCA peak systolic velocity for anemia, ductus venosus), biophysical profile (NST + 4 US components, max 10), modified BPP (NST + AFI), polyhydramnios (AFI >24 or DVP >8), oligohydramnios (AFI <5 or DVP <2), placental location (previa, abruption, accreta), cervical length screening for preterm prevention, point-of-care US for triage and fetal presentation.

Family Planning & Postpartum Contraception

CDC US Medical Eligibility Criteria (USMEC) for postpartum contraception (CHC Category 4 in 0-21 days due to VTE, Category 1 by 30-42 days if no risk factors; progestin-only and copper IUD Category 1-2 immediately postpartum and during lactation), LARC efficacy (Nexplanon implant 0.05% failure, IUDs 0.1-0.8%, BTL <0.5% — most effective reversible methods), DMPA, combined hormonal contraception, emergency contraception (copper IUD >99% to 5 days, ulipristal acetate to 120 hours, levonorgestrel 1.5 mg to 72-120 h with reduced efficacy >75 kg), postpartum tubal ligation Pomeroy via subumbilical mini-laparotomy, salpingectomy ovarian cancer reduction, Title XIX Medicaid 30-day consent rule, lactational amenorrhea method criteria.