14

Question 1

when is MVA most effective

Answer 1

less than 8 weeks

Question 2

why would postmenopausal woman get hot flashes again after THBSO?

Answer 2

because menopausal ovaries still make androgens (not estrogen), and circulating androgens get converted to estrogen

Question 3

what test would you get if older woman has problems getting pregnant?

Answer 3

anti mullerian hormone to indicate ovarian reserve

Question 4

friable cervix, think…

Answer 4

cervicitis (chlaymdia and gonorrhea)

Question 5

what type of mass can lead to ovarian torsion

Answer 5

any mass but especially teratomas

Question 6

what type of murmur is normal in pregnancy

Answer 6

systolic ejection murmur

Question 7

major risk factors for osteoporosis

Answer 7

advanced age, postmenopausal, low body weight

modifiable–alcohol, sedentary, smoke

prior history of fragility fracture!!

Question 8

septic pelvic thrombophlebitis

Answer 8

postoperative or postpartum infected thrombosis of deep pelvic or ovarian veins

persistent fever

tx: broad spectrum antibiotics plus anticoagulants

Question 9

why does epidural anesthesia give side effect of hypotension?

Answer 9

sympathetic blockade –> vasodilation –> decreased VR and venous pooling

Question 10

postpartum urinary retention

Answer 10

due to bladder atony from prolonged labor or perineal injury or regional anesthesia

unable to void >6 hrs post delivery, dribbling

temporary and reversible

Question 11

most accurate way of getting gestational age

Answer 11

first trimester US with crown-rump measurement

Question 12

contraindications to breastfeeding

Answer 12

HIV
active TB
herpes breast infections
active varicella
chemo/radiation
substance abuse (even mary jane)

Question 13

what is impaired in posterior shoulder dislocation

Answer 13

external rotation

Question 14

when asymptomatic patients have incidental finding of endometriosis, whats best management?

Answer 14

observe

Question 15

decreasing bHCG indicates…

Answer 15

fetal demise

Question 16

if dead fetus is in breech, whats best way to deliveR?

Answer 16

still vaginal

Question 17

adverse effects of oxytocin

Answer 17

tachysystole
hypotension
hyponatremia –> seizure

Question 18

causes of hyperandrogegism in pregnancy

Answer 18

• luteoma
• theca luteum cyst
• krukenberg tumor

Question 19

first step in treating uterine inversion

Answer 19

1. manual replacement of uterus

Question 20

how to prevent HIV transmission to fetus during pregnancy

Answer 20

• test mom for HIV VL until undetectable then every 3 mo
• test CD4 count every 3 mo
• avoid amniocentesis, artificial ROM, fetal scalp electrode
• **continue HAART

Question 21

whats best way to deliver fetus with HIV mom

Answer 21

if VL<1000 –> HAART + vaginal delivery

if VL>1000–> zidovudine + c-sect

Question 22

how to prevent HIV transmission post partum

Answer 22

infant should take zidovudine for 6 weeks plus serial HIV testing

Question 23

what should you do for mom with urinary retention and overflow incontinence

Answer 23

urethral catheterization

Question 24

SLE in pregnancy

Answer 24

edema, malar rash, arthritis, hematuria, proteinuria
with hypertension (don't confuse with preeclampsia!)

Question 25

normal changes right after delivery

Answer 25

shivering
uterine contraction
red-brown discharge

Question 26

postpartum fever starts at…

Answer 26

38 C or 100.4 F

Question 27

modifiable risk factors for breast cancer

Answer 27

HRT
nulliparity
increased age at first live birth
ALCOHOL

Question 28

guidelines for arrest of active labor

Answer 28

cervix dilated >6 cm

no cervical change for >4 hrs with adequate contractions or for >6 hrs with inadequate