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Obstetrics and Gynecology · USMLE Step 2 CK

USMLE Step 2 CK OB/GYN: Normal Pregnancy and Prenatal Screening

Prenatal visit schedules, trimester-specific screening tests, and normal pregnancy physiology tested on USMLE Step 2 CK.

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How often are prenatal visits scheduled from weeks 4 to 28 of gestation?
Every 4 weeks
How often are prenatal visits scheduled from weeks 28 to 36 of gestation?
Every 2 weeks
How often are prenatal visits scheduled from weeks 36 to 40 (until delivery)?
Every week
What is the formula for Naegele's rule when estimating the due date (EDD)?
Take the first day of the last menstrual period, subtract 3 months, then add 7 days (and 1 year)
In early pregnancy, what is the most accurate method for estimating gestational age?
First trimester ultrasound (crown-rump length)
What three components make up first trimester combined screening for aneuploidy (11-14 weeks)?
Nuchal translucency ultrasound, PAPP-A, and beta-hCG
What noninvasive prenatal screening test can be performed starting around 10 weeks using a maternal blood sample?
Cell-free fetal DNA testing (NIPT)
What four analytes make up the second trimester quad screen?
AFP, hCG, estriol, and inhibin A
During what gestational age window is the quad screen performed?
15 to 20 weeks (ideally 16 to 18 weeks)
An elevated maternal serum AFP is associated with which fetal conditions?
Neural tube defects, abdominal wall defects (gastroschisis or omphalocele), and multiple gestation
A low maternal serum AFP is classically associated with which chromosomal condition?
Down syndrome (trisomy 21)
At what gestational age is chorionic villus sampling (CVS) performed?
10 to 13 weeks
At what gestational age is genetic amniocentesis typically performed?
15 to 20 weeks
At what gestational age is the fetal anatomy survey ultrasound performed?
18 to 20 weeks
At what gestational age is the 1-hour glucose challenge test (GCT) routinely performed?
24 to 28 weeks

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