OB-Gyn Shelf Exam

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Books Preferred for Ob-Gyn Shelf Exam

  • Blueprints

    Votes: 24 70.6%
  • NMS

    Votes: 2 5.9%
  • First Aid

    Votes: 2 5.9%
  • PreTest

    Votes: 4 11.8%
  • Boards and Wards

    Votes: 0 0.0%
  • Appleton and Lange

    Votes: 2 5.9%

  • Total voters
    34
  • Poll closed .
I don't like that they don't tell you what the cervix is...I would go with cervical trauma or preterm labor. On the exam, I guess I'd go with preterm labor since there are contractions (don't know if she's feeling them or if it's on the monitor) and the bleeding is increasing.[/QUOTE]

Exactly!! If they would just say that there was cervical change, that would make preterm labor the perfect answer!

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for the first one I got it right. My rationale was that it the cervix and station are completely unchanged, and the vertex was occiput anterior the whole time, it was less likely to be a shoulder. The baby's head just kept hitting the pelvis and going nowhere each time.

I think the second one is C. The spotting, normal BP, no pain ("first noticed spotting . . . 12 hours ago") sounded like the question was hinting that this was not an acute bleed. And the U/S showed a fundal placenta at 20 weeks.

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I took this last week. It wasn't that bad overall. I felt like the best time and money I spent were on the NBME's: both 1 and 2. I saw a few very similar, almost repeat, questions, and many, many repeat concepts -- very similar to the way in which they were presented in the NBME's. The uWISE questions were great, too, but honestly, they were time consuming and I didn't do them all. Case Files was also a great resource. Blueprints -- lots of detail, but I read it so early in the rotation that I can't even gauge how helpful it was. It seemed like a balance between OB and GYN. A few weird perinatology things: some I had seen, one or two were WTF questions. It was definitely a fair test. I agree with one of the previous posters who said it was between NBME's 1 and 2 in level of difficulty.
 
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Shelf score: 98th percentile. What I did:

Blueprints - read through 85% of this before I started working on questions
Case Files - x1 (plus a quick review the night before the exam of earmarked cases I thought were especially high yield)
Kaplan questions - x2
Uworld questions - x2
Uwise questions - x1

The highest yield for me was going through a massive number of questions. I did every single one of the Uwise questions. I got so used to reading some of the question stems that I could anticipate the answer before I even looked at the answer choices. Blueprints was good as a prep for the actual rotation for various pimping questions and what-not, but I found it was sometimes too detailed for the shelf. Case Files was a really great source, and I would encourage everyone to go through that at least once.
 
Nice job, VisionaryTic. Which of the resources you used did you feel was the most valuable? Thanks.

UWorld, First Aid for Ob/Gyn.

Blueprints was overkill for me. I used it on sections I was weaker on.
 
LOL, i guess it is a bit of the SDN effect, but also at our school, your overall grade has to be a 90 or above in Ob/gyn to get honors. So I guess I was hoping I would get at least 90 to take the pressure off some of my evals from being spectacular.

But I recognize its a solid score.

Oh, well then yeah, be annoyed. Damn that's pretty intense. I wasn't close to 90 on any of my shelf exams.
 
Only Ob/gyn requires a 90 overall grade. In the other clerkships, they just look at the top 15% of kids overall grades and give them honors. In ob, if no one gets over 90, no one gets honors.

Your OB department is dick. Sounds about right considering who becomes an OB/GYN.
 
I hated the OB/Gyn shelf. My program based our grades on 3 factors: shelf exam, oral exam, and clinical evaluations, each roughly 1/3 of our grade. My oral and clinical scores were both in the 90s, which I THOUGHT implied some knowledge of the exam materials... right? Nope. Low 70s, worst shelf score in the year to date.

Then again my studying habits are pretty terrible. I only used Qbank and scattered UWorld questions. Then again that's been my study habits for every shelf so far and I've been doing pretty well. I think it's kind of like Surgery - you're expecting a certain sphere of questions, but they throw in so much medicine you might as well be taking IM again.
 
Only Ob/gyn requires a 90 overall grade. In the other clerkships, they just look at the top 15% of kids overall grades and give them honors. In ob, if no one gets over 90, no one gets honors.


Same policy for OB at my school. It's hard to foresee many, if any, people getting honors with such a cutoff. I know that I will be nowhere near this, so I've never once even hoped for honors (shooting for pass at this point), but I'm sure it's extremely frustrating for those who are interested in Ob/gyn and working for an H.
 
Not shelf-related, but anyone have tips for preparing for an obgyn oral exam? I have one in about a week--my first one and not really sure what to expect or how to prepare for an oral exam.
 
Not shelf-related, but anyone have tips for preparing for an obgyn oral exam? I have one in about a week--my first one and not really sure what to expect or how to prepare for an oral exam.

1) Make sure you scrub the patient super well down there.
2) Might want to put a dental dam on based on your patient population.
3) Work on tongue strenghtening exercises.
4) Go to town on that obgyn oral.









Er, wait, what?

Anyways serious advice - Do you know what the possible questions/topics are that you will be asked on? If so, read up on them. If not.... sounds kinda dickish.
 
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People get Uwise thru there school?! Seems to me like the majority of posters here did Uwise at least once.. so many schools offer?!

We've got UWise, but haven't had any time to do them yet....
 
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We've got UWise, but haven't had any time to do them yet....

oh man I just went to look on Uwise's website. 150 schools/programs offer them to students. Mine is not one of them!!! =( though I guess w/ 13 hrs of non stop work 5-6 days a week not much time anyway.. but still would be nice to have the option of doing it
 
Blueprints + Case Files + Uworld + uWISE.

Any opinions?
 
oh man I just went to look on Uwise's website. 150 schools/programs offer them to students. Mine is not one of them!!! =( though I guess w/ 13 hrs of non stop work 5-6 days a week not much time anyway.. but still would be nice to have the option of doing it

My school too :thumbdown: Does this mean we have no way to access it? No individual subscriptions? Bootleg versions online?
 
Blueprints + Case Files + Uworld + uWISE.

Any opinions?

Sounds great! If you were going to lose one, I'd lose Case Files. I did Blueprints + Uworld + uWISE and got honors on the shelf.
 
My school too Does this mean we have no way to access it? No individual subscriptions? Bootleg versions online?
I actually found my school on the list sort of.. they listed the name of the hospital associated with the school, not the name of the medical school. so i couldn't find it at first. just created an account but not sure if it worked.

Actually is uwise just some online questions? I thought it was like a Qbank program like uworld but is it just the 7 units + comprehensive?

Ie unit one shows
1. History*
2. Examination*
3. Pap Smear and Cultures
4. Diagnosis and Management Plan*
5. Personal Interaction and Communications Skills*
6. Legal Issues & Ethics in Ob-Gyn
7. Preventive Care and Health Management

Is that what you guys are talking about when referring to Uwise? and only 3 of those have quizzes.. the rest are useless? It's not clickable.. not sure if there is supposed to be background information on those topics or not or if they just listed those for no reason.

Edit: clicked it and got "Your membership has expired or you do not have the correct membership to view this quiz. Please refer to our Troubleshooting page for more information." even though its listed -___-
 
BTW for those whos school dont got Uwise, I was told that you can just google for uwise password.. some schools apparently announce it publically to everyone. I didn't try this but a lot of my classmates said this worked.

Anyone know if Blueprint 6th edition is much better than 5th for shelf?
 
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So if I had to choose one (+uworld/uwise), Blueprints or Case Files?

If Case Files is sufficient, i much prefer this format. Blueprints is much more thorough though and if case files is not sufficient, i will stick to blueprints. thanks!
 
So if I had to choose one (+uworld/uwise), Blueprints or Case Files?

If Case Files is sufficient, i much prefer this format. Blueprints is much more thorough though and if case files is not sufficient, i will stick to blueprints. thanks!

I used Blueprints and loved it, and earned honors on the exam. I would strongly suggest Blueprints, but that said, I hate the Case Files format. So, +1 for Blueprints, but hopefully someone who used Case Files and did well can comment also.
 
I have the 5th edition of Blueprint laying around. Should I get the new 6th edition that just came out or just save money and use the 5th?

And no one here is a fan of PreTest for Ob/Gyn? I preferred it over Case Files when I was on studying for Peds shelf.
 
Just use the 5th edition, look up what the screening guidelines for cervical cancer are online (but look at recommendations from a year or two ago, not the current ones).
 
blueprints for obgyn is so long, anyone used FA for OBGYN shelf? Quicker read?

Also anyone try just using Kaplan lectures /notes for obgyn for shelf?
 
blueprints for obgyn is so long, anyone used FA for OBGYN shelf? Quicker read?

Also anyone try just using Kaplan lectures /notes for obgyn for shelf?

Yes. and Yes.

No.
 
how did you do on your shelf with FA? You recommend it?
 
Did you guys take notes on Blueprints or did you just read it multiple times?
 
Did you guys take notes on Blueprints or did you just read it multiple times?

I just read it through once and then repeated passages that I was weaker in on the qbanks as I went along.
 
This was my favorite rotation but my worst shelf exam. I still can't put 2 and 2 together. Maybe it's because I went in too confident. But hey, I passed and I can't complain I s'pose.

Me: blueprints and uworld = <80 raw score


blueprints x2
(I suggest you use an UPDATED blueprints. I can't recall which edition I had but it was an older one -plus, they often substitute the brand names for the generic in the text -which is useful for the wards/clinic but not for the test)

Uworld x3 - excellent review source

I also used Beckman for additional stuff I didn't cover elsewhere but I didn't go in depth.

My school had a subsx to UWISE (the OB/GYN qbank). I heard later that is an excellent source so if you have it, use it -I wish that I did.

good luck
 
how much detail about cervical cancer screening is expected for this test?

And should we be going by the updated guidelines or the old ones?
 
Question for those who took the shelf, is Case Files and Uworld enough to pass in your opinion?

I am also planning on buying the Blueprints but I don't know how much I'll be able to get done on this rotation.

Thanks again
 
how much detail about cervical cancer screening is expected for this test?

And should we be going by the updated guidelines or the old ones?

Use the new guidelines.

Regarding cervical cancer screenings: you definitely need to know when to do them and how to manage results. (Uworld has a couple of great cheat-sheet flow charts for management on HSIL/LSIL, etc. Those are sufficient and map it out really nicely.)

Don't need to know any staging stuff or anything like that. (at least I didn't have any)
 
Question for those who took the shelf, is Case Files and Uworld enough to pass in your opinion?

I am also planning on buying the Blueprints but I don't know how much I'll be able to get done on this rotation.

Thanks again

At my school the general consensus was that CF/UWorld was sufficient. Honestly, I hate CF and never do well on shelves that I only used Case Files. Regarding uWorld, honestly I felt it could be misleading / false sense of security inducing. (for example I had a question about organism involved in BV... on uworld the answer is merely the cop-out answer "polymicrobial"... but on the real thing that wasn't an option and you actually had to pick the actual bug in greatest frequency in the answer choices... and I had no clue. I had multiple scenarios like this. I'm not saying uWorld is bad, just don't expect your test to be like it.)

If you have time, honestly I would highly highly highly recommend the uWise questions instead of UWorld. If I'm remember correctly, there's around 200(?) obgyn uworld questions, where as there's 500 uWise. So if you have access to them, I personally think it's better spend your UWorld time on the uWise. (that's a mouthfull)
 
You can get them here nsas.nbme.org/home It's $20 for each block of 50 q's.

For anyone who's taken the shelf, how were the questions like? Did you think they were more or less nitpicky than uWise or NBME 1 or 2 q's? Thanks!
 
1)C. I know estrogen and progesterone together aren't nearly as bad as just estrogen alone, but I think stimulating them will increase incidence of breast cancer. Great-aunt isn't a first degree relative.

2)D. Candida vaginitis is a problem for people with uncontrolled DM.

3) D. Precocious puberty is a long process to define. I would re-look at how to differentiate between precocious puberty and normal growth.

4) D. New onset breast mass in someone of 'cancer age', especially if on HRT, = FNA

5) A. No urgency/frequency/pyuria. She's feeling pain with urination because she just had surgery. Her fever is due to the breast engorgement. Endometritis would likely have tender uterus, mastitis would be if she was breast feeding, wound cellulitis if it was her C/S incision that was tender.

It's been a while since I've been on OB/GYN, so I may not be correct on all of these, just my thoughts.
 
1)C. I know estrogen and progesterone together aren't nearly as bad as just estrogen alone, but I think stimulating them will increase incidence of breast cancer. Great-aunt isn't a first degree relative.

2)D. Candida vaginitis is a problem for people with uncontrolled DM.

3) D. Precocious puberty is a long process to define. I would re-look at how to differentiate between precocious puberty and normal growth.

4) D. New onset breast mass in someone of 'cancer age', especially if on HRT, = FNA

5) A. No urgency/frequency/pyuria. She's feeling pain with urination because she just had surgery. Her fever is due to the breast engorgement. Endometritis would likely have tender uterus, mastitis would be if she was breast feeding, wound cellulitis if it was her C/S incision that was tender.

It's been a while since I've been on OB/GYN, so I may not be correct on all of these, just my thoughts.


Thanks for your help! Really appreciate it
 
Loved my OBGYN rotation, but so many horror stories about the residency I'm not sure I can put myself through that.

98th percentile- First Aid, Case Files, Pretest x 1 w/ notes for wrong answers, UWorld, both NBME practice exams
 
1st degree relative with positive Hx is concerning. "great aunt" is some obscure relative that 9 out o 10 people don't even know where to place on a tree. Hormone therapy is always a risk factor.

Probably a contact dermatitis to something in the creams. Vaginal candidiasis doesn't cause a papular rash. The rash on the thighs is consistent with contact dermatitis. The DM would be another decent choice if not for the rash simply because as a rule they have issues clearing infections.

I suck at the tanner stages.... but I would hvae gone with D here (assuming now that the ">" aren't typos but the correct answers?). Puberty for girls typicaly happens around age 11 give or take a couple years (I think). all in all, it puts her at the correct age for pubert. She is large for her age so the delayed growth spurt is out. I am not aware of an increased risk of PCOS and the risk of menarche with breast cancer has to do with total lifetime estrogen exposure so a normal onset of puberty isn't a concern here.

Cancers tend to be non-tender and immobile. This one is cyst-like and mobile which increases likelihood that it is benign. Regardless, we don't really know what to do with it until we have a piece of it. FNA is a great option for something you can easily palpate. Don't even need to give a local.

I'm not 100% on this one. The woman has too many RBCs in the urine (again, I think... need to review those NLs). Mastitis is not uncommon in breastfeeding women, but tends to be unilateral (I think...) and endometritis would be a complication of a C/S but I would guess it would be much more tender. I guess I am going to say D.

not saying I'm right, but this is how I would have answered this. Granted I just started OB yesterday.

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DM is one of the main reasons people don't heal. Unless obesity is an answer, that's worse. ;)

Another question: The timeline and presentation does not follow with mastitis. Mastitis is often a couple weeks or so postpartum. Mastitis is also unilateral and often only one section of that single breast. Breast engorgement is very very common, can cause a temp, etc. Timeline is perfect, as it often happens when the milk comes in (around day 3). The RBCs in the urine are likely from lochia, we see blood in urine all the time postpartum, and it's very hard to get a clean catch once a foley is out (should have been out PostOp day 1). There are practically no WBCs, which, from the info given, makes a UTI unlikely.

Also...not to be a buzzkill or anything, but I'm pretty sure we aren't supposed to be posting these questions here, but no one has said anything yet, so I figure, whatever.

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Hi guys, just took NBME2 and was wondering if anyone could explain some of these to me. Thanks in advance!


I forget all the defining characteristics between Andron insensitivity, etc. etc. but if it's not B, then it clearly has to be C.

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LEEP of the cervical transformation zone (which is very close to the cervical os) = consider cervical incompetence.

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Good fetal movement with no contraction = check a nonstress test to make sure baby is reactive. Mom's BP is 100/55 which is fine. Seems like PPROM(?) with some vaginal bleeding, maybe due to the cigs.

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A ruptured cyst wouldn't be an expanding mass. An abscess would expand with time.

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I'm not really sure what this is.,A pleural rub is a sign of pneumonia or PE. Had to google this. Fibrin split products are used to diagnose DIC, not PE. So I'd say it's PE

See above.

Specter - On the last question - Pt is not breast feeding, so mastitis would be very unlikely. I maintain that it is breast engorgement. A couple RBCs (1/2) in urine is not a big concern.


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Specter has the correct answers for all but the following 2.

67yo has 9mo history of persistent vulvar itching despite OTC Zinc oxide, vitamin E, hydrocortisone cream, and miconazole. She has DM, herpercholesterol. Erythematous swollen vulva, papules and pustules on medial aspect of thighs, and several excoriations. KOH prep of pustules show pseudohyphae and budding yeast. Why is the patient failing to respond to treatment?
A. contact dermatitis
B> Hypercholesterol
C. Self induced excoriations
D. DM
E. vulvar malignancy
Answer is NOT C

The answer is D. DM is one of the main reasons people don't heal. Unless obesity is an answer, that's worse. ;)


3 days after c/s a 27yo has temperature 101.8 and mild pain with urination. No urinary urgency or frequency. She is bottle feeding. Incision is clean and intact. Breasts are tense, erythmatous, and tender. Uterus is firm, nontender and consistent in size with 20wk.
Leukocyte: 6500
Urine: RBC: 10-15/hpf and WBC: 1-2/hpf
Most likely diagnosis?
A. breast engorgement
B. Cystitis
C. ENdometritis
D. Mastitis
E. wound cellulitis
Answer is not B. Is is A? If so why? How can you rule out cystitis? Is it because of the normal WBC in the urine? Is mild pain with urination normal post c/s?


The answer is A. The timeline and presentation does not follow with mastitis. Mastitis is often a couple weeks or so postpartum. Mastitis is also unilateral and often only one section of that single breast. Breast engorgement is very very common, can cause a temp, etc. Timeline is perfect, as it often happens when the milk comes in (around day 3). The RBCs in the urine are likely from lochia, we see blood in urine all the time postpartum, and it's very hard to get a clean catch once a foley is out (should have been out PostOp day 1). There are practically no WBCs, which, from the info given, makes a UTI unlikely.

Also...not to be a buzzkill or anything, but I'm pretty sure we aren't supposed to be posting these questions here, but no one has said anything yet, so I figure, whatever.
Im just not comfortable with the papular rash on the thighs. That isn't really classic candida. Extending to the thighs soudns like dermatitis to me. I'll defer to yo on the mastitis thing.

See above.

Specter - On the last question - Pt is not breast feeding, so mastitis would be very unlikely. I maintain that it is breast engorgement. A couple RBCs (1/2) in urine is not a big concern.

don't have to be breastfeeding, just lactating and she is definitely lactating. Although the other poster said the timeline is a bit early.
 
These are NBME questions from the practice test. I got them right, therefore I know they are right. ;) Also, I have an 8 month old and have had both breast engorgement and mastitis, neither of which is fun. :) These questions are made to be very tricky.
 
You must 100% always rule out pregnancy in a reproductive age female. It is the #1 cause of amenorrhea. The menopausal symptoms are meant to throw you off of HCG, but 4 months without menses is not menopause (you need 12 months solid for that). Could be perimenopause and you could technically get pregnant during that, and even during the first part of menopause (my husband was conceived 14 months after my mother-in-law had stopped menses, oops).

Average age of menopause in the US is like 51.2 or something around there.

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You must 100% always rule out pregnancy in a reproductive age female. It is the #1 cause of amenorrhea. The menopausal symptoms are meant to throw you off of HCG, but 4 months without menses is not menopause (you need 12 months solid for that). Could be perimenopause and you could technically get pregnant during that, and even during the first part of menopause (my husband was conceived 14 months after my mother-in-law had stopped menses, oops).

Average age of menopause in the US is like 51.2 or something around there.

Thanks eablackwell. By any chance do you know the answer to any of the nbme form 2 questiosn I posted above (that you got correct and are 100% sure is the right answer)?

Also, any idea why they are getting SERUM hCG vs the usual urine?? Thanks!
 
Thanks eablackwell. By any chance do you know the answer to any of the nbme form 2 questiosn I posted above (that you got correct and are 100% sure is the right answer)?

Also, any idea why they are getting SERUM hCG vs the usual urine?? Thanks!

Yes, one is PE and the other is torsion, 100% sure. :)

Answering your question- 1) Urine pregnancy test isn't an option ;) In practice you would definitely do an in-house urinalysis, but there is actually a small percentage of females that don't get positive pregnancy tests via urine. If you're pregnant, something WILL show up in serum...unless implantation hasn't happened yet. :)
 
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