blueprints questions

Question 1

nL endometrial strip in pre-menopause

Answer 1

12 mm

Question 2

what are risk factors for hyperplasia?

Answer 2

DM2
obesity
HTN
PCOS
oligomenorrhea

Question 3

what is the lowest titer to begin serial amniocentesis to check for RBC hemolysis?

Answer 3

1:16

Question 4

what pathology commonly presents after evacuation of a molar pregnancy?

Answer 4

metastatic persistent gestational trophoblastic disease (choriocarcinoma > invasive molar pregnancy)

Question 5

how often do you check titers once RH sensitization is discovered?

Answer 5

every 4 wks
fetal testing b/w 16-20 wks
d/c if fetal Rh testing is negative

Question 6

what are 2 indications to proceed with immediate delivery in the setting of severe pre-eclampsia?

Answer 6

• severe symptoms (headache, RUQ pain)

- HEELP syndrome

Question 7

What is most likely to improve chances of conception in an endometriosis pt?

Answer 7

Surgical removal of implants leading to fibrosis

Question 8

What are risks assoc. w/ persistent + hep B antigen?

Answer 8

Vertical transmission at birth

Question 9

How to manage HepB+ mom?

Answer 9

Placental barrier to antenatal transmission
Neonate given hep B vaccine + HBIG at birth
c/s doesn’t incr. risk

Question 10

what is treatment for BV in pregnancy?

Answer 10

Metronidazole

Question 11

What are indications for SBE antibiotic prophylaxis during pregnancy?

Answer 11

Ampicillin for mechanical/prosthetic valves / unreapried cyanotic lesions + infxn that may cause bactermia (chorio/pyelo)

Question 12

What is the risk assoc. w/ breast feeding & Hep B/HepC+ moms?

Answer 12

No higher than baseline (highest risk, 4% assoc. w/ vaginal delivery)

Question 13

What must be supplemented in breast milk?

Answer 13

Vit D (400 IU)

Question 14

What is assoc. w/ a bicornuate uterus?

Answer 14

malpresentation, 2nd trim loss, preterm labor / delivery

Question 15

What is assoc. w/ a uterine septum (fertility)?

Answer 15

Infertility (avascular septum = poor implantation site)

Question 16

how to manage breast mass in women > 30 yo?

Answer 16

core-needle biopsy

Question 17

when to use needle/wire-guided excision?

Answer 17

seen on imaging, but not palpable

Question 18

how to manage solid breast mass in women < 30 yo?

Answer 18

FNA

Question 19

what is risk of ectopic after 1 ectopic pregnancy? after >1 ectopic

Answer 19

1 = 10%

2 >25%

Question 20

how to diagnose h. ducreyi?

Answer 20

r/o syphilis / HSV

Question 21

how to treat chancroid?

Answer 21

many options; treat partners also
ceftriaxone 250 IM once
azithromycin 1 g PO
cipro 500 mg BID x 3d
erythromycin 500 mg QUID

Question 22

what is fitzhugh-curtis syndrome?

Answer 22

perihepatitis from ascending PID

Question 23

how does fitzhugh-curtis sydrome present?

Answer 23

RUQ / pleuritic pain + PID

Question 24

how is fitzhugh-curtis syndrome diagnosed?

Answer 24

gold standard = violin-string adhesions b/w anterior liver capsule + anterior abdominal wall/diaphragm

Question 25

How is VIN stratified?

Answer 25

Usual vs. differentiated
Usual = HPV + full-thickness atypia
Differentiated – related to inflammatory dermatosis (lichen sclerosis vs. planus)

Question 26

What meds can contribute to male infertility?

Answer 26

Cimetidine
Sulfasalazine
Spironolactone

Question 27

How to manage a eclamptic woman on Mg who seizes again?

Answer 27

Rebolus w/ Mg (assumption: seizure = low serum Mg

Question 28

With idiopathic infertility, what is the likelihood of conception in 3-5 yrs?

Answer 28

60% - expectant management acceptable

Most therapies have no higher success rates than no treatment

Question 29

What is target range for fasting blood glucose / 1 hr post-prandial values?

Answer 29

< 90 mg/L
1-hr < 140
2 hrs < 120

Question 30

When to initiate insulin?

Answer 30

25-35% of glucose elevated à give meds

Question 31

What additional screening is needed for +Paget’s disease of the vulva?

Answer 31

Screening for invasive adenocarcinoma (not a known invasive squamous cell carcinoma)

Question 32

What is recommended treatment for Paget’s disease?

Answer 32

Excision, though ablation is acceptable

Question 33

How is endometrial cancer staged?

Answer 33

TAH, BSO, pelvic/para-aortic lymphadenectomy (if invasion > 1/3 myometrial thickness)

Question 34

LCIS (lobular carcinoma) is what type of lesion?

Answer 34

Pre-malignant à indicates subsequent risk for: intraductal, invasive ductal, lobular carcinoma
Subsequent cancers may be on either side
Found incidentally (not seen on mammo / not palpable)

Question 35

Most common benign cause for bloody nipple discharge?

Answer 35

Intraductal papilloma

Question 36

When are pts counseled to schedule 36-37 wk c/s for concern about risk of uterine rupture?

Answer 36

hx of:

• myomectomy requiring cavity entry
• previous classical c/s
• major uterine surgery (corneal wedge resection for ectopic pregnancy)

Question 37

How does leuprolide work for endometriosis?

Answer 37

GnRH agonist –> provides tonic GnRH stimulation –> medical menopause

Question 38

Treatments for CIN 2,3

Answer 38

LEEP

Question 39

when to LEEP (if not CIN 2/3)

Answer 39

CIN1 persist > 2 yrs

HGSIL PAP w/ discrepancy from biopsy of 2 grades

Question 40

Excision vs. ablation for treatment of abnL colpo?

Answer 40

Ablation acceptable for Cin1
Excise if:
-unsatisfactory colpo, ECC+

Question 41

What is risk of ASCUS+HPV progression to CIn2/3?

Answer 41

10% –> should do further testing if ASCUS + HPV status known

Question 42

LSIL + Pregnancy?

Answer 42

likely colpo, but not going to LEEP someone