03-08 U-world

Question 1

eval for postmenopausal bleeding

Answer 1

TVUS or endometrial bx (endo thickness of 4+mm on TVUS still needs bx)

Question 2

rapid onset breast erythema + dimpling

Answer 2

inflammatory breast carcinoma

Question 3

RUQ pain in HELLP syndrome

Answer 3

liver swelling/distension of hepatic capsule

Question 4

pts w/ PCOS have inc risk of ___ cancer

Answer 4

endometrial - due to estrogens unopposed by progesterone

Question 5

adnexal mass w/ lack of doppler flow

Answer 5

ovarian torsion - prompt laparoscopy indicated

Question 6

RUQ pain, hypoglycemia, leukocytosis, hyperbili, inc LFTs (only2-3x nml), thrombocytopenia

Answer 6

acute fatty liver of pregnancy (due to abnml maternal-fetal fatty acid metabolism) -> manage w/ immediate delivery

Question 7

malodorous off-white vaginal discharge

Answer 7

BV: pH >4.5, clue cells, tx w/ metronidazole or clinda

Question 8

carboprost tromethamine (hemabate) contraindications

Answer 8

asthma (PG F2a analog)

Question 9

methylergonovine (methergine) contraindications

Answer 9

HTN (b/c potent vasoconstrictor)

Question 10

mammary paget dz assoc w/ ___

Answer 10

adenocarcinoma

Question 11

unilateral bloody nipple discharge

Answer 11

breast papilloma

Question 12

condylomata lata vs acuminata

Answer 12

lata = syphilis (smooth)
acuminata = genital warts (verrucous)

Question 13

next steps for pts w/ dec fetal movement

Answer 13

NST -> BPP if NST is nonreactive

Question 14

tx for CT w/ negative GC

Answer 14

azithromycin

Question 15

tx for GC w/ neg CT

Answer 15

ceftriaxone + azithromycin

Question 16

active phase arrest definition

Answer 16

no cervical change for >4 hrs despite adequate contractions -> move to C/S

Question 17

dysmenorrhea + deep dyspareunia

Answer 17

endometriosis

Question 18

fertility tx for pt w/ PCOS

Answer 18

weight loss -> letrozole (aromatase inhibitor) vs clomiphene citrate (SERM)

Question 19

management of uterine tachysystole

Answer 19

dc the oxytocin

Question 20

abd pain, vaginal bleeding + loss of fetal station

Answer 20

uterine rupture

Question 21

tx for pregnant pt w/ oophorectomy prior to 10 wks

Answer 21

supplement progesterone

Question 22

tx for placenta previa

Answer 22

c-section at 36-37 weeks

Question 23

magnesium excretion

Answer 23

renal

Question 24

vulvovaginal atrophy vs lichen sclerosus

Answer 24

lichen sclerosus can involve the perianal region

Question 25

BP med for severe maternal HTN, w/ bradycardia

Answer 25

IV hydral or nifedipine PO

Question 26

pathophys of neonatal thyrotoxicosis

Answer 26

transplacental passage of maternal TSH-R Abs -> bind to baby + cause XS thyroid hormone release

tx w/ methimazole + B-blocker

Question 27

hyperandrogenism after puberty + elevated 17-OHP

Answer 27

nonclassical CAH (partial def in 21-hydroxylase)

Question 28

unilocular adnexal mass w/ homogenous low level echoes

Answer 28

chocolate cyst