A pregnant woman at 28 weeks says she fell. She has bruises of different ages on her abdomen, and her partner answers every question for her. Four days after delivery, a new mom cries easily but is still caring for her baby. A week after delivery, another mother says her baby is evil.

Each of these is a classic PANCE setup, and each one has a wrong answer that sounds reasonable.

In Episode 177, we cover trauma in pregnancy and postpartum psychiatric disorders, including:

• Why a minor fall still matters, and how long you watch the baby afterward
• Getting the imaging the mother needs, and how much radiation actually worries you
• What to do when a pregnant patient is hypotensive lying flat on her back
• The red flags for abuse, and how to ask about it
• Postpartum blues vs postpartum depression: the timeline that separates them
• Which SSRI to pick for a breastfeeding mother
• Postpartum psychosis: the strongest risk factor, and why an SSRI alone is the wrong move

The study strategy for this episode: get into the sun. About 10 minutes of bright light early in the morning, and more later in the day, sets your body clock. Better sleep is one of the biggest things you can do for your studying.

Visit physicianassistantexamreview.com/177 for the episode notes.

Coming in November: a free Master Class on getting the most out of the question bank you already have, Nov 10 and 12. Register at physicianassistantexamreview.com/masterclass.

Think different. Work different. Score different.

A new mom is bleeding heavily minutes after delivery, and her uterus feels soft and boggy above the umbilicus. Six weeks later, another mother still can't breastfeed and her period hasn't come back. Two days after a C-section, a third has a fever, a tender uterus, and foul-smelling lochia.

Each of these is a classic PANCE setup, and each one has a wrong answer that sounds reasonable.

In Episode 176, we cover postpartum complications, including:

• What counts as postpartum hemorrhage, and why blood pressure is a late sign
• The 4 T's: tone, trauma, tissue, and thrombin
• Placenta accreta vs placenta previa, and why they get mixed up
• The first steps for hemorrhage, and how to pick a second-line uterotonic by what the patient can't take
• Where tranexamic acid fits, and its time window
• Sheehan syndrome: the hormones that drop and the order you replace them
• Postpartum endometritis: the risk factors, the antibiotic of choice, and what to do when the fever won't break

The study strategy for this episode: go back to material you've already covered. Pull a few cards from an old pile, or reread one section from a month ago. A little, often, is how you interrupt the forgetting curve.

Visit physicianassistantexamreview.com/176 for the episode notes.

The December 33 Days cohort is coming soon. Join the waitlist at physicianassistantexamreview.com/33.

Think different. Work different. Score different.

A breastfeeding mom asks for contraception at her two-week postpartum visit. A patient with gestational diabetes returns six weeks after delivery. A new mother on postpartum day six has a severe headache and blood pressure of 164/112.

These cases contain the common wrong answers that sound reasonable but can cost you points on the PANCE.

In Episode 175, we cover postpartum contraception and follow-up, including:

• The three requirements for the lactational amenorrhea method
• When progestin-only contraception can be started
• The day 21 rule for estrogen-containing contraception
• When breastfeeding changes the timing
• IUD placement after delivery
• RhoGAM, MMR, varicella, and Tdap before discharge
• Follow-up after gestational diabetes and why the 2-hour glucose tolerance test beats hemoglobin A1C
• Postpartum hypertension, preeclampsia, and magnesium sulfate
• Blood pressure medications compatible with breastfeeding
• Why the recommended interpregnancy interval is 18 months

The study strategy for this episode is simple: for every topic, identify the trap before you see the answer choices. Ask yourself, "What would sound reasonable but be wrong here?"

Visit physicianassistantexamreview.com/175 for the episode notes.

The December 33 Days cohort is coming soon. Join the waitlist at physicianassistantexamreview.com/33.

Think different. Work different. Score different.