United States Medical Licensing Examination (USMLE) Women's and Children's Health Syllabus

Women's and Children's Health syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Women's and Children's Health in United States Medical Licensing Examination (USMLE), not a summary of it.

1. 1

   Obstetrics

   4 topics

   • Prenatal care and screening
     • Routine visits and lab schedule
     • Genetic and aneuploidy screening
   • Normal labor and delivery
   • High-risk pregnancy
     • Preeclampsia and gestational diabetes
     • Preterm labor and PROM
   • Obstetric emergencies and postpartum care
2. 2

   Gynecology

   5 topics

   • Menstrual and ovulatory disorders
   • Contraception and family planning
   • Pelvic infections and STIs
   • Gynecologic neoplasia and screening
   • Menopause and pelvic floor disorders
3. 3

   Neonatology and Newborn Care

   4 topics

   • Newborn assessment and resuscitation
   • Neonatal jaundice and infection
   • Prematurity and respiratory distress
   • Congenital anomalies screening
4. 4

   Pediatrics

   5 topics

   • Growth, development, and milestones
   • Immunizations and preventive care
   • Common pediatric infections
   • Pediatric chronic and genetic disease
   • Adolescent medicine and child safety

Women's and Children's Health flashcards for United States Medical Licensing Examination (USMLE)

18 of 59 cards from the Women's and Children's Health deck — real questions with worked answers.

1. At what gestational age range is routine screening for gestational diabetes performed, and what is the standard two-step approach?

   24-28 weeks. Step 1: 50 g 1-hour glucose challenge (abnormal if >=130-140 mg/dL). Step 2 (if abnormal): 100 g 3-hour oral glucose tolerance test; diagnosis requires >=2 elevated values.

2. Which maternal serum analytes are measured in the second-trimester quadruple screen, and what pattern suggests Down syndrome (trisomy 21)?

   AFP, hCG, estriol, and inhibin A. Trisomy 21 pattern: low AFP, low estriol, high hCG, high inhibin A.

3. What is the recommended daily folic acid supplementation to prevent neural tube defects in low-risk vs high-risk pregnancies?

   0.4 mg (400 mcg) daily for low-risk women; 4 mg daily for women with a prior NTD-affected pregnancy, ideally starting 1 month before conception.

4. When is Rh(D) immune globulin (RhoGAM) routinely given to an Rh-negative pregnant woman, and what is the standard antepartum dose?

   At 28 weeks gestation and within 72 hours of delivery if the infant is Rh-positive; also after any sensitizing event (bleeding, trauma, amniocentesis). Standard dose is 300 mcg.

5. Define the three stages of labor.

   Stage 1: onset of regular contractions to full cervical dilation (10 cm), divided into latent and active phases. Stage 2: full dilation to delivery of the infant. Stage 3: delivery of the infant to delivery of the placenta.

6. What are the seven cardinal movements of labor in order?

   Engagement, descent, flexion, internal rotation, extension, external rotation (restitution), and expulsion.

7. What defines arrest of labor in the active phase of the first stage?

   Cervical dilation >=6 cm with ruptured membranes and no cervical change for >=4 hours with adequate contractions, or >=6 hours with inadequate contractions.

8. What are the three signs of placental separation in the third stage of labor?

   A gush of blood, lengthening of the umbilical cord, and the uterus becoming firm and globular (rising in the abdomen).

9. How are early, variable, and late fetal heart rate decelerations distinguished and what does each indicate?

   Early: mirror contractions, caused by head compression (benign). Variable: abrupt, variable timing, caused by cord compression. Late: nadir after the contraction peak, caused by uteroplacental insufficiency (concerning).

10. What blood pressure and proteinuria criteria define preeclampsia?

    BP >=140/90 mmHg on two occasions >=4 hours apart after 20 weeks gestation PLUS proteinuria (>=300 mg/24h or protein/creatinine >=0.3), or end-organ dysfunction if no proteinuria.

11. What laboratory findings define HELLP syndrome?

    Hemolysis (schistocytes, elevated LDH, low haptoglobin), Elevated Liver enzymes (AST/ALT), and Low Platelets (<100,000).

12. What is the first-line drug for seizure prophylaxis and treatment in preeclampsia/eclampsia, and what is the antidote for toxicity?

    Magnesium sulfate. Calcium gluconate is the antidote for magnesium toxicity (signs: loss of deep tendon reflexes, respiratory depression).

13. Differentiate placenta previa from placental abruption by their classic bleeding presentation.

    Previa: painless vaginal bleeding (placenta covers the cervical os); avoid digital exam. Abruption: painful vaginal bleeding with a tender, firm uterus (premature placental separation).

14. What is the most common cause of postpartum hemorrhage and its first-line management?

    Uterine atony (most common cause). First-line management: bimanual uterine massage and uterotonics (oxytocin first-line; then methylergonovine, carboprost, or misoprostol).

15. What are the '4 Ts' causes of postpartum hemorrhage?

    Tone (uterine atony), Trauma (lacerations/rupture), Tissue (retained placenta), and Thrombin (coagulopathy).

16. What is shoulder dystocia and what is the first maneuver used to relieve it?

    Impaction of the fetal anterior shoulder behind the maternal pubic symphysis after delivery of the head. First maneuver: McRoberts maneuver (hyperflexion of maternal hips) plus suprapubic pressure.

17. Define the FIGO/PALM-COEIN categories used to classify abnormal uterine bleeding.

    PALM (structural): Polyp, Adenomyosis, Leiomyoma, Malignancy/hyperplasia. COEIN (nonstructural): Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic, Not otherwise classified.

18. What are the diagnostic criteria for polycystic ovary syndrome (Rotterdam criteria)?

    At least 2 of 3: oligo/anovulation, clinical or biochemical hyperandrogenism, and polycystic ovaries on ultrasound (after excluding other causes).

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