13

Question 1

why RUQ pain during HELLP?

Answer 1

centrilobular necrosis, hematoma formation, thrombi in portal cap system

–> liver swelling and distention

Question 2

fetal hydantoin syndrome

Answer 2

from carbamazepine and phenytoin

microcephaly, dev. delay
cleft lip/palate
excess hair
mid facial and digit hypoplasia

Question 3

renal changes in pregnancy

Answer 3

increased RBF, GFR, bm permeability

decreased serum BUN and Cr

increased renal protein excretion

Question 4

raloxifine contraindication

Answer 4

DVT

Question 5

treatment for chorioamniotis

Answer 5

broad spectrum antibiotics and deliver!

Question 6

management for false contractions

Answer 6

reassure

Question 7

why do PCOS women struggle with infertility

Answer 7

high levels of estrone from adipose down regulate LH and FSH and GnRH –> failure of follicle development

Question 8

which one has normal fetal HR tracing of the previas

Answer 8

placenta previa

vasa previal abnl!

Question 9

confirm lichen sclerosis with…

Answer 9

vulvar punch biopsy

Question 10

first line therapy for lichen sclerosis

Answer 10

high potency topical steroids

Question 11

whats next step for detecting high grade SIL?

Answer 11

colpo!

only do HPV co-testing if it’s low grade SIL or ASCUS

Question 12

menopausal genitourinary syndrome aka atrophic vaginitis symptoms

Answer 12

dryness, irritation, pruritus
vag bleeding
dyspaurenia
urinary incontinence, recurrent UTIs, urgency
pelvic pressure

Question 13

pubic symphysis diastasis

Answer 13

after traumatic vag delivery (macrosomia, forceps, twins)

suprapubic pain that radiates to back/hips
exacerbated by activity
waddling gait

supportive care, recover w/in month

Question 14

adjustments for levothyroxine during pregnancy

Answer 14

increase dose during pregnancy

Question 15

choriocarcinoma can follow

Answer 15

molar pregnancy
spontaneous abortion
normal gestation

Question 16

low back pain during pregnancy

Answer 16

normal, conservative management

Question 17

maternal complications of abruptio placenta

Answer 17

DIC

hypovolemic shock

Question 18

when to stop pap smears

Answer 18

age 65 or hysterectomy + no hx of CIN II

+ 3 consecutive negative paps
or 2 consecutive negative co-testing

Question 19

how does chemo affect repro system?

Answer 19

ovarian failure- affects proliferating cells of ovary

Question 20

common causes of prolonged 1st stage of labor

Answer 20

1. inadequate contractions (<3 in 10 min)

2. maternal obesity

Question 21

common causes of prolonged 2nd stage of labor

Answer 21

1. fetal malposition- non-occiput anterior

2. maternal obesity

Question 22

how to detect renal stones in pregnancy

Answer 22

US

Question 23

how to detect if baby is preterm at 16 weeks

Answer 23

transvaginal US to measure cervical length (short–>preterm)

Question 24

when is measuring fetal fibronectin helpful to detect preterm?

Answer 24

mid-second and third trimester

because high until 20 weeks, and then dips down until labor

Question 25

management for lactation suppression

Answer 25

supportive bra
avoid nipple stimulation
use ice packs and analgesics (NSAIDS)