Welcome, my name is Devine. This is episode 537 of the Devine

Intervention Podcast. In today's podcast we're going to be continuing the series

on the free 120 for Step 2, CK. I am going to be going through

questions 101 to 110. Again if you've missed any other part of the, I'll encourage you to go back and go through it. I think you're going to find it to be very helpful. Let's get right to it.

Question 101, a 25-year-old prerogative woman at 28 weeks gestation comes to the office for a routine

prenatal visit. At 18 weeks gestation she had vaginal bleeding that results spontaneously.

At that time her blood group was

determined to be all-hour-h negative and she received a R-D immune globulin.

She reports good fetal movement. Blood pressure is 120 over 70. Fatal heart rate is 160. Fondal height is 30. The fetus is in a vertex position.

Hemoglobin concentration is 11 grams per decilator and hematocrity is 34%.

Serum antibody assay is positive.

The anti-d tighter is too weak to measure.

Results of serologic testing for syphilis and HIV antibody testing are negative.

Which are the following is the most appropriate next step in management?

Option A says to repeat serum anti-d antibody tighter.

Option B says ultrasonography of the pelvis.

Option C says administration of

row D immune globulin, option D says amyocentesis and option E says induction of

labor. So if you look at this question this lady appears to be in her third

trimester and you know during her pregnancy she had spontaneous vaginal bleeding and

being Irish negative which makes sense. They gave her Rodi immunoglobulin.

Remember people that are Irish negative, we love to give them Rogan at two times during pregnancy. We like to give it at 28 weeks and

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