2017 Walls 10/11

Question 1

4 criteria for HIE

Answer 1

1. Apgar < 5 at 5 and 10 min
2. Fetal UA acidemia
3. multisystem organ failure
4. dev of spastic quadriplegia or dyskinectic CP

MRI 24 hours after birth is very sensitive for HIE changes

Question 2

Estrogen effects during pregnancy

Answer 2

• maintains uterine lining
• cervical gland hypertrophy
• leukorrhea
• breast growth and milk duct development

Question 3

lab findings in DIC for

fibrinogen, platelets, d-dimer, PT/aPTT

Answer 3

low fibrinogen
thrombocytopenia
elevated d-dimer
elevated PT/aPTT

Question 4

% of fetus with increased NT that will have an aneuploidy

what is the measurement

Answer 4

50%

> 3mm

(of the other 50% 1/2 will have major defects including heart, diaphragmatic hernia or skeletal dysplasia or other genetic syndromes. < 20 % will have a healthy live born infant)

Question 5

most common symptom of a lactotroph microadenoma

Answer 5

amenorrhea

Question 6

omphalocele

Answer 6

extruded viscera in the midline, covered by peritoneum and amnion

Question 7

gastroschisis

Answer 7

full thickness defect in the abdominal wall secondary to incomplete closure of the lateral folds during the 6th week of gestation. right of the umbilicus

Question 8

tx of CT in patients allergic to doxy? in pregnancy?

Answer 8

azithro 1g single dose
levofloxacin 500 mg PO x7 days

Pregnancy

• prefered azithro 1 g
• amox 500 mg TID x7 days is alt

Question 9

turbutaline side effect

Answer 9

cardiogenic pulmonary edema

Question 10

mesna

Answer 10

a drug used to prevent hemorrhagic cystitis during chemotherapy with Ifex

Question 11

tx of nec fasciitis

Answer 11

treat with PCN and clindamycin

Question 12

what day of the menstrual cycle does implantation occur

Answer 12

20-24

Question 13

tx for CAP

Answer 13

azithromycin

Question 14

most sensitive test for vWD

Answer 14

vW-ristocetin cofactor assay

isolated prolonged PTT not specific will correct with mixing studies

Question 15

Male hypogonadrophic hypogonadism semen analysis finding and treatment

Answer 15

oligospermia

tx with continuous clomid

Question 16

tx for GC in pregnant women who is allergic to cephalosporins? not preg?

Answer 16

preferred: desensitization
alt: a single 240 mg IM dose of gentamicin plus a single 2 g oral dose of azithromycin
ID consult

not preg: a single 240 mg IM dose of gentamicin plus a single 2 g oral dose of azithromycin

Question 17

b thal vs alpha thal hgb electrophoresis

Answer 17

B- thal: HgA2 > 3.5%

alpha thal - can be normal

Question 18

absolute contraindications to methotrexate

Answer 18

• breast feeding
• active pulm disease
• PUD
• hepatitis
• severe anemia

Question 19

after Ulipristal acetate how long before restarting OCP

Answer 19

5 days and use backup for 14 days

Question 20

McRoberts facilitates delivery by

Answer 20

changing the outlet into a more vertical axis

Question 21

High dose radiation imaging studies

Answer 21

Pelvic CT and PET scan both are 10-50 mGy fetal exposure

Question 22

Benefits of delayed cord clamping

Answer 22

improved fetal blood count
decreased need for transfusion
lower rates of intraventricular hemorrhage
improved iron stores

Question 23

most common cause of cuff cellulitis

Answer 23

BV

Question 24

what is the most common cause of a duodenal ulcer and treatment

Answer 24

H. pylori

tx: triple
amox, clarithromycin, flagyl

dx with urea breath test

Question 25

when do you start routine pneumococcal vaccination

Answer 25

65

Question 26

most cost effective test for evaluation of hyperandrogenism

Answer 26

total testosterone

Question 27

test for suspected outflow obstruction

Answer 27

MRI (check for other anomalies) assess thickness and depth of septum, and if cervix is present

Question 28

chemo drug that causes skin necrosis and ulceration if extravasation occurs

Answer 28

doxyrubicin

Question 29

1st line treatment of rhinosinusitis

Answer 29

nasal oxymetazoline (afrin)

Question 30

hsc fluid associated with pulm edema

Answer 30

normal saline

Question 31

blue vaginal lesions after a delivery

Answer 31

GTN | - MRI to look for mets

Question 32

normal vag pH

Answer 32

3.8-4.5 higher is BV, atrophy, trich lower yeast

Question 33

donvan bodies dx and tx

Answer 33

granuloma inguinale tx: azithromycin or tetracycline found in tropics, non painful papules, indurated

Question 34

% of cervical cancer dx after age 65 in US

Answer 34

20%

Question 35

risk factors for wound dehiscence

Answer 35

malignancy, sepsis, Chronic lung disease (coughing), Age

Question 36

contraindications to robotic surgery

Answer 36

acute glaucoma, retinal detachment, increased intracranial pressure, ventriculoperitoneal shunts

Question 37

how does testosterone levels change during perimenopause

Answer 37

it does not change significantly from 5 years before to 7 years after menopause

Question 38

most likely neurological injury from a lateral trocar placement

Answer 38

ilioinguinal nerve - sensory deficit on mons and upper thigh

Question 39

best way to evaluate an enterocele

Answer 39

standing

Question 40

what does the HPV6 oncoprotein bind to

Answer 40

P53 and inactivates it leading to immortilization of the cell

Question 41

what does the HPV7 oncoprotein bind to

Answer 41

Rb and phosphorylates it