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Step 3 Final > Aaron: OB > Flashcards

Aaron: OB Flashcards

1
Q

Polymicrobial, infection post C-section, what is the best abx course?

A

Clindamycin plus gentamicin

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2
Q

What is a prominent post birth infection risk?

A

C-section

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3
Q

Car accident
Uterine Tenderness
High amplitude contractions
What should I think about?

A

Abruptio Placenta

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4
Q

If a child does not have ADHD symptom relief after methylphenidate medications after two months, what should happen?

A

Switch to a different medication

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5
Q

Before starting methylphenidate, what are two things that must be done?

A

Cardiac history and physical exam, baseline weight

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6
Q

With a history of pre-eclampsia, what should be started between 12-14 weeks?

A

Aspirin, prophylatically

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7
Q

Woman under the age of 19, assuming no underlying risk factors are at an increased risk of what?

A

Pre-term birth

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8
Q

During pregnancy, what hormone level can be increased due to elevated estrogen?

A

TBG and T4 and T3

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9
Q

Advanced maternal age, over the 35 years old, what is a test that should be offered to all women?

A

Cell-free DNA fetal testing

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10
Q

Can you breast feed on methadone?

A

yes you can

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11
Q

If you take valproate during pregnancy, can you breast feed afterwards?

A

yes you can

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12
Q

Methotrexate is contraindicated in patients with what two diseases?

A

Renal Disease or Hepatic Disease, meds cannot be cleared quickly enough

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13
Q

Are GBS cultures done during labor?

When are GBS cultures done?

A

No

36-38 weeks

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14
Q

GBS unknown plus preterm delivery (<37 weeks), ruptured membranes for > 18 hours, intrapartum fever (intraamniotic infection), what should be given?

A

Antibiotics

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15
Q

Constant urinary dribbling, decreased perineum sensation (diabetic history), what is the most common cause?

A

Overflow Incontinence

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16
Q

Placenta Previa is painless vaginal bleeding after how many weeks?

A

20 weeks

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17
Q

Indomethacin is a uterine tocolytic that can be used when? How much time can it buy you?

A

< 32 weeks

48 hours

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18
Q

Woman that has had a mechanical valve replaced, what is the anticoagulation scheme for pregnancy?

A

First Trimester has LMWH use
Second and Third trimester use Warfarin
Just before birth, use LMWH

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19
Q

Unfractionated Heparin is cleared how?

Low Molecular Weight Heparin is cleared how?

A

Hepatically and Renally

LMWH is renally cleared, cannot use in bad renal patients

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20
Q

Baby with a cleft lip, what are the three things that are needed to make a surgical repair?

A

Reconstruction at 10 weeks, weight 10lbs, and 10 g of hemoglobin

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21
Q

Mammograms start at 50-74 and are how often?

A

Every 2 years

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22
Q

Mammograms start early if breast cancer has what in the family?

A

Breast Cancer occurs in 2 first degree family members

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23
Q

If a patient has bariatric surgery, how long should they wait to become pregnany?

A

1 year

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24
Q

What two antibiotics are contraindicated in 1st semester pregnancy?

A

Nitrofuratonin
TMP-SMX

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25
Q

What is the non-delusional belief that a woman is pregnant but she is not pregnant?

A

Pseudocyesis

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26
Q

What is an autoimmune inflammatory disease that can occur during pregnancy that is an antibody reaction to the basement membrane?

What is the best treatment?

A

pemphigoid gestations

Steroids

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27
Q

If a woman has intrahepatic cholestasis of pregnancy, what is the lab value going to show?

A

Increase in bile acids

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28
Q

Are there any screening tests that are required for Tamoxifen when being used?

A

No, only evaluate if symptoms start

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29
Q

Constant urine leaking and decreased perineal sensation is code for what?

A

Overflow Incontinence

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30
Q

Patient has an elevated AFP, unsure about fetal abnormalities, what is the next test that should be ordered?

A

Fetal Ultrasound

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31
Q

If a patient has PPROM, what condition is concerning regarding the baby?

A

Umbilical Cord Prolapse

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32
Q

At 28 weeks, what is the a standard blood test that pregnant woman should have, assuming nothing obviously wrong?

A

CBC

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33
Q

Overflow incontinence has what anatomical problem underlying the patient?

A

Impaired Detrusor contractility

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34
Q

Urge Incontinence has what anatomical problem underlying the patient?

A

Sudden, overwhelming urge to urinate

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35
Q

Stress Incontinence has what anatomical problem underlying the patient?

A

Decreased Urethral Sphincter Tone and Urethral Hypermobility

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36
Q

Urge incontinence will say what in the question STEM?

A

Sudden, Overwhelming urge to urinate

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37
Q

Untreated appendicitis can lead to what complication?

A

pylephlebitis or infective portal vein thrombosis

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38
Q

Preterm babies at risk of early delivery before week 32 weeks, what should be given?

Preterm babies at risk of early delivery before week 34 weeks what should be given?

A

Magnesium, indomethacin, steroids

Corticosteroids and Nifedipine (fetal lung development), no benefit for babies at week 34-37 week

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39
Q

If pregnant, have an exophytic mass (looks like cervical cancer), HIV+ viral load is super high, do I biopsy/investigate cervical cancer lesion?

A

yes, investigate, because the patient is immunocompromised

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40
Q

A woman has anti-phospholipid syndrome, a clot during pregnancy, heavy menstrual periods, chronic anticoagulation, and she would like to talk about contraception options. What is the best recommendation?

A

IUD with progesterone only

Cu IUDs cannot be prescribed with a heavy bleeding history

41
Q

Estrogen cause what to happen to the TBG?

A

Increased synthesis

42
Q

High TSH levels can be due to high BHCG levels, this can cause hyperthyroid symptoms. What is the name of this disease?

A

Gestational Transient Thyrotoxicosis

43
Q

Breastfeeding mom has metronidazole given for Trichomonas, what should she do with her breast milk?

A

Breast Milk should be discarded for 24 hours, then resume, MTZ is a one-time dose

44
Q

Hemodynamically stable patients, what drug should be given?

A

Methotrexate

45
Q

Mifepristone and misoprostol are used to help do what?

A

Prime the uterus for aborition

46
Q

Sickle Cell Patients are a high risk of Pre-eclampsia, what is a necessary test at the patient’s initial visit?

A

24 hour urine collection, looks at protein baseline

47
Q

Do RH positive women need a Kleihauer-Betke test to evaluate for hemolytic disease of the new born?

A

No

48
Q

Subchorionic hematomas are treated how?

Increased risk of what?

A

Expectant Management

Spontaneous Abortion

49
Q

Pregnant woman gets bacterial vaginosis, what is the drug of choice?

Will it affect the baby?

A

Clindamycin

No baby impact

50
Q

Patients that have acute cervicitis, IUD. ABX need to be given, does the IUD need to come out or cultures taken?

A

Given prophylactic abx and keep IUD in place

51
Q

What gestational age is the oral glucose tolerance test done?

A

24-28 weeks

52
Q

How is a urethral Diverticulum diagnosed?

A

MRI of the pelvis

53
Q

Urethral Diverticulum can be described as what?

A

Tender fullness in the anterior vaginal wall, hx of multiple UTIs

54
Q

What is the absolute smoking contraindications to OCPs?

A

Smoking more than 15 cigarettes a day and/or migraines
Can still do OCPs if a few cigarettes a day, I know

55
Q

High risk of pre-eclampsia, had before, what should patients do at 12-16 weeks?

A

Start Aspirin

56
Q

Probability of a test that is positive over general population, what test should be evaluated?

A

Likelihood ratio

57
Q

Ethical Principal: ensures that methods used to achieve a worthwhile goal are necessary, appropriate, and not excessive, is what?

A

Proportionality

58
Q

Neonatal Chlamydia can cause conjunctivitis and pneumonia, but what other condition can it cause?

A

Preterm prelabor rupture of membranes

59
Q

If pregnant patient has genital warts, what is the best pregnancy route?

A

Vaginal and Expectant management, no C-section benefit

60
Q

1st line abx treatment in a complicated UTI (acute cystitis) is what?

A

Fosfomycin

61
Q

Vulvodynia is what?

Tx?

A

3 months or more of very sensitive vulva tenderness, sharp, raw burning pain with Q-tip contact

Cognitive Behavioral Therapy, Pelvic Floor PT, Behavior Modification

62
Q

In a 1st trimester woman, a patient has a slightly decreased TSH and increased T4, is this normal?

A

Yes, 2/2 estrogen during pregnancy

63
Q

Postmenopausal patients, tamoxifen use, and pelvic radiation cause an increase for what?

A

Uterine Sarcoma, remove Uterus

64
Q

After a woman has a cerclage placed, is she allowed to exercise?

A

No she cannot exercise

65
Q

Normal Amniotic fluid index is between what two numbers?

A

5 to 24 cm

66
Q

Gestational Diabetes will cause oligohydramnios or polyhydramniosis?

A

Polyhydramniosis

67
Q

A pregnant woman with nausea and vomiting can be discharged. What are the best medications to give her?

A

Oral Vitamin B6 and H1 antihistamine

68
Q

No glaring past medical history, when should mammograms start?

Are breast self exams helpful when decreasing mortality?

A

Age 50

Not helpful with decreasing mortality

69
Q

A nulliparious woman can push for how long with or without an epidural before a C-section can be discussed?

A

3 hours before C-section
4 hours before C-section with Epidural

70
Q

If a patient is sexually assaulted, what is the best contraception opition?

A

Ulipristal therapy

71
Q

Kidney Failure
AMS
Fever
Abdominal Pain/Nausea
Petechial Rash

What is this?

A

TTP

72
Q

Acute Fatty liver of pregnancy and HELLP syndrome show up in what trimester and what else?

A

3rd trimester and elevated liver enzymes

73
Q

A stable methadone use patient can or cannot breastfeed after a baby’s birth?

A

Can breastfeed, assuming she is stable

74
Q

Amenorrhea before age 40, elevated FSH and low estrogen, what is the next best step?

A

Karotype Analysis

75
Q

What medication types can decrease the patient’s OCP efficacy?

A

Anti-seizure medications

76
Q

Positive Pregnancy test, vaginal bleeding, pelvic pain/pressure, and birth 4 months ago, and an enlarged uterus, what could this be?

A

Gestational Trophoblastic Neoplasia/choriocarcinoma, can be malignant, should remove ASAP

77
Q

A clinic can “fire” a patient as long as notice is given of how long?

A

30 day notice

78
Q

What weeks is the anti-RH(D) immunization given if a person requires the transfusion?

A

1st prenatal visit, 28 weeks, and postbirth (within 72 hours)

79
Q

External Cephalic Version can be done during what timeframe?

A

Greater than 37 weeks

80
Q

What syndrome is a contraindication to pregnancy?

A

Eisenmenger Syndrome

81
Q

Rh(d) + mom and Rh(D) negative Dad, will they have problems?

A

No, mom with Rh(D) + does not have problems

82
Q

Motile, Flagellated organisms are what disease?

What is the treatment?

A

Trichomonas

Oral Metronidazole for both patient and partner

83
Q

Is the flu vaccine recommended during pregnancy?

A

Yes

84
Q

Internal Cephalic Version does what?

A

The maneuver moves a baby from breech position to a breech position, i.e. the head is moved towards the stomach and feet toward the vagina

85
Q

What does Letrozole do?

A

Inhibits aromatase and decreases estrogen production from androgen conversation, then it stimulates ovulation

86
Q

Melasma during pregnancy can be treated how?

A

Sunscreen and sun exposure avoidance

87
Q

DTAP should be given during what part of the pregnancy?

A

27-36 weeks

88
Q

Pelvic Inflammatory disease, what is the most likely risk factor?

A

Multiple Sexual Partners

89
Q

Unexplained nipple discharge from breast, what test should be ordered next?

A

Mammogram plus ultrasound

90
Q

Patient has a pale vagina and type 1 DM history, what is the most likely diagnosis?

A

Vitiligo

91
Q

Group B strept treatment, what is the best tx when the patient is allergic to penicillin?

A

Cefazolin

92
Q

Over what number is fetal tachycardia?

A

160 bpm plus

93
Q

If a patient has platelets between 100 to 150k is that normal despite almost having double the value earlier? Previous pregnancy visit

A

Yes, this is normal

94
Q

If a patient has elevated prolactin levels over 200, what should be done next?

A

Order a Brain MRI, medications only increase around 100

95
Q

What is a common psych medication that can decrease the seizure threshold?

A

Clozapine

96
Q

If a patient takes Lithium, 2 years, no relapses, and wants to change, what should be done?

A

Keep same dose, same routine

97
Q

Preeclampsia
Abruptio Placentae
Uteroplacental Insufficiency
Renal Anomalies
NSAIDs
These will do what to aminotic fluid index?

A

Oligohydramnios

98
Q

Esophageal/duodenal atresia
Anencephaly
Multiple Gestation
Congenital Infection
Diabetes Mellitus
These will do what to aminotic fluid index?

A

Polyhydramnios, increased preterm pre-labor rupture of membranes

99
Q

Placenta Previa will have light or heavy bleeding?

Vasa Previa will have light or heavy bleeding?

Which one will a patient present with hemodynamic instability?

A

Both are light

Placenta Previa will present with a mother hemodynamically unstable

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