2/20/13

Question 1

What is thought to be the cause of variable decelerations in the fetal heart rate?

Answer 1

umbilical cord compression, low amniotic fluid, or fetal hypoxia

Question 2

What is the first step in case of a non-reassuring fetal heart rate, such as variable decelerations?

Answer 2

maternal administration of O2 and change of position

Question 3

What is the first-line of treatment for premenopausal pts w/ endometrial hyperplasia (simple or complex) without atypia?

Answer 3

cyclic progestins and repeat biopsy in 3-6 mos

Question 4

What is the proper treatment for women with complex, atypical endometrial hyperplasia who do do not wish to have any more children?

Answer 4

hysterectomy

Question 5

What is the appropriate Tx for women w/ complex atypical endometrial hyperplasia who wish to preserve fertility or are poor surgical candidates?

Answer 5

cyclic progestins an repeat biopsy in 3-6 mos

Question 6

What are the histological types of endometrial hyperplasia and the rates of progression to uterine cancer?

Answer 6

simple: 1%, complex: 5%, simple atypical: 10%, complex atypical: 29%

Question 7

What is the “gold standard” for evaluating cervical incompetence?

Answer 7

transvaginal US

Question 8

What is the most common cause of mucopurulent cervicitis?

Answer 8

Chlamydia trachomatis

Question 9

What should you suspect in most cases of bilateral nipple discharge in a woman who has not recently had a child?

Answer 9

prolactinoma

Question 10

What are the 3 “red flags” for nipple discharge (cancer)?

Answer 10

unilateral, guiac positive, breast lump

Question 11

Kalla\man’s syndrome consists of a congenital absence of _______ secretion associated with _______.

Answer 11

GnRH; anosmia

Question 12

What are the 3 D’s of endometriosis?

Answer 12

dyspareunia, dysmenorrhea, and dyschezia

Question 13

What is the definitive diagnostic procedure for endometriosis?

Answer 13

laparoscopy

Question 14

What are the 3 main categories of managament/treatment for endometriosis?

Answer 14

hormonal, analgesic, surgical

Question 15

What are 3 hormonal treatments for endometriosis?

Answer 15

OCPs, leuprolide (GnRH agonist), and danazol (modified testosterone)

Question 16

Green, frothy, foul-smelling vaginal discharge is most likely caused by?

Answer 16

Trichomonas

Question 17

What is the Tx for vaginal trichomoniasis?

Answer 17

oral metronidazole for pt and partner

Question 18

What condition causes porcelain-white, polygonal macules and patches on the vulvae w/ an atrophic “cigarette paper” quality? (Mostly affects postmenopausal women.)

Answer 18

Lichen sclerosus et atrophicus

Question 19

What is a non-malignant but serious potential consequence of lichen sclerosus et atrophicus?

Answer 19

scarring of the labia majora and clitorus can lessen the size of the vaginal introitus

Question 20

What is the malignant possibility with lichen sclerosus et atrophicus?

Answer 20

SCC

Question 21

What procedure should be considered to rule to rule out squamous cell carcinoma in pts w/ lichen sclerosus et atrophicus?

Answer 21

punch biopsy

Question 22

What is thought to be the etiology of the chronic inflammation of the anogenital region in lichen sclerosus et atrophicus?

Answer 22

autoimmune

Question 23

What is the first-line Tx for lichen sclerosus et atrophicus?

Answer 23

topical corticosteroids