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.

Fifteen PANCE-style questions, mixed systems, the way the exam mixes them. Pause after each one, say your answer out loud, then check yourself. Keep count.

This is Rapid Rounds, a short set of practice questions between the regular episodes of the Physician Assistant Exam Review Podcast. About 16 minutes.

What's in this one:

• A firefighter with a pulse ox of 99% who isn't fine
• The toddler who won't use the arm after being pulled up by the wrist
• Chest pain that gets better leaning forward
• Resistant hypertension with a potassium of 2.9
• Back pain, saddle anesthesia, and urinary retention
• A platelet count that drops by half on day 5 of heparin
• Blisters that shear off with a little pressure
• The worst headache of her life and a negative head CT
• Restlessness three days after starting risperidone
• A sodium of 125 on an SSRI
• Abdominal pain out of proportion to the exam in a patient with AFib
• Milky nipple discharge and a prolactin of 95
• A rusty nail in an unvaccinated patient
• Sudden painless vision loss with hemorrhages in all four quadrants
• A new apical murmur a few days after an inferior MI

Every question comes out of the new edition of The Final Step.

It's PA Week, and I'm giving away a seat in 33 Days, a Stop Guessing Session with me, and the new Final Step before anyone can buy it. Enter by Friday night: https://physicianassistantexamreview.com/giveaway

Full episode notes: https://physicianassistantexamreview.com/rapid-rounds-01/

Think different. Work different. Score different.