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OBGYN Board review > Boards Review > Flashcards

Boards Review Flashcards

1
Q

Choroid plexus cyst

A

Associated with T18 but usually incidental

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2
Q

Gastroschisis

A

Right of midline, not assoc with genetic abnormalities

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3
Q

Omphalocele

A

Midline, associated with genetic abnormalities

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4
Q

Myelomeningocele

A

Check genetics after birth, Though usually are isolated

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5
Q

First Trimester screening

A

One: HCG
Two: PAPP-A
Three: nuchal translucency

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6
Q

Nuchal translucency

A

Measured between weeks 11 and 14, should be less than 3 mm

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7
Q

dandy walker

A

characterized by hypoplasia of the cerebellar vermis and a retrocerebellar cyst

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8
Q

Hydros

A

Classic: skin edema and abdominal ascites. Hydrops fetalis is defined as a fluid collection in two or more fetal cavities. Characteristic findings include: ascites, pericardial effusion, pleural effusion, skin edema, and polyhydramnios

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9
Q

Relative infant dose of opioids

A

Lipophilic nature of the drug
Degree to which the drug binds to protein
pKa and milk pH
Drug’s molecular weight
Amount of breast milk consumed
Timing of medication administration relative to breastfeeding episodes

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10
Q

Incidence of shoulder dystocia

A

1.4%. With diabetes is 9.4 to 24%. If diabetes and greater than 4500 g, approaches 50% risk.

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11
Q

Markers for Down syndrome

A

Soft markers for Down syndrome on ultrasonography include echogenic cardiac foci, echogenic bowel, a short humerus and/or femur, and absent nasal bone.

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12
Q

Maternal hypothyroidism

A

IUFD, IUGR, spontaneous abortion, and medically indicated preterm delivery

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13
Q

Cholestasis of pregnancy

A

eficiency of long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD)

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14
Q

Dexamethasone in HELLP syndrome

A

Raise platelets for regional anesthesia

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15
Q

Neural tube defect

A

Increased risk in Latina women, decreased risk in African American women

Increased with diabetes and obesity

Increased with Valproic Acid
Carbamazepine
Methotrexate

In the first 28 days: fever, amniotic bands, Sauna/hot tub

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16
Q

Maternal graves disease

A

Low birth weight, medically indicated preterm delivery, fetal hypothyroidism, fetal hyperthyroidism

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17
Q

Most common cause of first trimester maternal death

A

Ectopic pregnancy

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18
Q

Placenta accreta

A

Increased lacunae, irregularly shaped Lacunae, Placenta previa, increased vascularity to bladder

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19
Q

Low molecular weight heparin in pregnancy versus unfractionated heparin

A

Low-molecular weight heparin has a longer half-life, a more predictable therapeutic response, less bone mineral density loss, and a lower risk of heparin-induced thrombocytopenia.

Benefit of unfractionated: does not cross the placenta

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20
Q

300 µg of RhoGAM

A

which covers 30 mL of fetal blood or 15 mL of fetal red blood cells after a fetomaternal hemorrhage.

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21
Q

Group Prenatal care

A

Decreased rate of preterm birth in African-American women

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22
Q

Bromocriptine

A

Suppresses milk production

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23
Q

Clozapine

A

Life-threatening agranulocytosis in infants

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24
Q

ACE inhibitor

A

Not safe in pregnancy, fine in

breast-feeding

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25
Q

Decreased blood pressure from epidural?

A

Related to sympathetic nerve blockade

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26
Q

methimazole

A

Aplasia Cutis in the first trimester, Fine from second trimester onward

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27
Q

propylthiouracil

A

Caries risk of hepatoxicity, Should be avoided after first trimester, inhibits conversion of T4 to T3

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28
Q

Preterm delivery is associated with:

A

Delayed post natal growth

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29
Q

Combined use of vacuum and forceps

A

higher rates of subdural or cerebral hemorrhage, anal sphincter tear, subarachnoid hemorrhage, facial nerve injury, and brachial plexus injury

No increased risk of urinary incontinence compared with when used alone

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30
Q

Neural tube defect

A

If one parent affected, risk for fetus is 4.5%. If one parent and one sibling affected, risk for fetus is 12%

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31
Q

Hypercoagulability in pregnancy

A

increase in factor VIII, factor X, and fibrinogen

No change in factor V

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32
Q

Ultrasound indicated cerclage

A

Cervical length less than 25 mm in patient with history of preterm delivery prior to 34 weeks, Must currently be between 16 and 24 weeks pregnant

Note: if no history of preterm birth but short cervix, use vaginal progesterone. If cervical dilation may be a candidate for rescue cerclage

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33
Q

300 µg RhoGAM

A

May neutralize 15 mL of fetal blood cells and 30 mL Of whole blood

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34
Q

Mentum anterior presentation ( chin on the maternal pelvis )

A

Usually can deliver vaginally

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35
Q

ITP

A

Prednisone is first line at 1-2 mg/kg/day

I VIG can also be used, particularly if more urgent intervention needed

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36
Q

Monochorionic twin pregnancy

A

If death of one twin, 18% risk of neurologic injury to the surviving twin, 15% risk of death to the surviving twin

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37
Q

Pancreatitis and pregnancy

A

Most common cause is gallstones

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38
Q

Uncontrolled hyperthyroidism in pregnancy

A

severe preeclampsia, maternal heart failure, preterm delivery, and low birth weight

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39
Q

Thyroid storm In pregnancy

A

Treatment should begin with propylthiouracil, which blocks the release of T3 and T4 and also blocks the conversion of T4 to the more active metabolite T3. Sodium iodide will also help block the release of T3 and T4. Glucocorticoids help block the conversion of T4 to T3. Beta-blockers can be used to control heart rate.

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40
Q

Nuchal translucency

A

3 mm is the cut off for 95th percentile and usually when testing is offered

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41
Q

Prolonged latent phase

A

defined as >20 hours in nulliparous women and >14 hours in multiparous women

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42
Q

Active third stage management:

A

1) oxytocin administration, 2) uterine massage, and 3) umbilical cord traction.

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43
Q

Glyburide is a sulfonylurea that binds to beta-islet cells of the pancreas to stimulate secretion of insulin

A

Associated with neonatal hypoglycemia

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44
Q

Neural tube defect’s

A

Five in 10,000 births

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45
Q

Congenital Varicella

A

hydrops, hyperechogenic foci in the liver and bowel, cardiac malformations, fetal growth restriction, microcephaly, and limb deformities.

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46
Q

Alloimmune thrombocytopenia

A

Neonatal alloimmune thrombocytopenia is the MOST common cause of severe thrombocytopenia among term newborns. The cause is maternal alloimmunization to paternal inherited platelet antigens. The mother’s platelet count is normal, and unlike Rh-D alloimmunization, the first pregnancy is at risk.

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47
Q

TB treatment in pregnancy

A

Beginning after first trimester for nine months

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48
Q

Thrombotic thrombocytopenic Purpera, TTP

A

characterized by thrombocytopenia, fragmentation of red blood cells, renal disease, and neurologic symptoms such as headache, seizures, altered mental status, and stroke. TTP is related to a deficiency of or antibody against ADAMTS13. This protease is lowered in normal pregnancy and thus is thought why TTP is more common in pregnancy. The gold standard treatment is plasmapheresis to remove antibodies to ADAMTS13

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49
Q

Cardinal movements of labor

A

Engagement, descent, flexion, internal rotation, extension, external rotation, expulsion

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50
Q

Magnesium therapy for pre-eclampsia

A

Immediate administration of a 6-g loading dose of magnesium sulfate intravenously followed by 2 g per hour should be initiated for cessation of a current seizure and prevention of another seizure. An alternative option if intravenous access is not available is intramuscular injection of 5 g of magnesium sulfate in each buttock (total of 10 g).

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51
Q

Best source for chromosome all studies in IUFD

A

Amniocentesis

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52
Q

Parvo virus infection during pregnancy

A

Serial ultrasonography to assess for hydrops and to measure the middle cerebral artery peak systolic velocity (to assess for fetal anemia) should be performed every 1–2 weeks for 8–12 weeks after exposure.

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53
Q

CMV

A

Primary infection rates are:
first trimester 30%
Second trimester 34%–38%
Third trimester 40%–72%

Ultrasonographic findings:
Intracranial calcification
Fetal hydrocephalus
Microcephaly
Fetal intrahepatic calcification
Fetal hepatomegaly
Evidence of intrauterine growth restriction (IUGR) 
Echogenic bowel
Intracranial calcification
Fetal hydrocephalus
Hydrops fetalis
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54
Q

H pylori

A

treatment: proton pump inhibitor given along with an antibiotic regimen, which includes amoxicillin and clarithromycin

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55
Q

Preterm birth rate

A

12%

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56
Q

Low molecular weight heparin

A

Hold for 24 hours prior to epidural for therapeutic dose, Hold for 12 hours if prophylactic dose

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57
Q

Rh Allo immunization

A

ritical value dependent on the laboratory, but usually ranges 1:8 to 1:32. In the case that paternity is certain and the father of the baby is available, paternal blood typing should be performed to avoid unnecessary fetal testing and procedures. If the father is Rh+, then red cell antigen genotyping should be performed to determine zygosity. If the father is homozygous, there should be no further work-up as the fetus must be Rh+ by serology and should be monitored closely. If the father is heterozygous, then amniocentesis should be performed for red cell genotyping.

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58
Q

History indicated cerclage

A

history of ≥ 1 pregnancy loss in the 2nd trimester related to painless cervical dilation without placental abruption or labor

prior cerclage due to painless cervical dilation in the 2nd trimester

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59
Q

Hypothyroidism In pregnancy

A

Increase levothyroxine by 25%

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60
Q

Herpes

A

Double-stranded DNA

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61
Q

Changes in clotting factors during pregnancy

A

Procoagulants such as fibrinogen, factor VII, factor VIII, factor X, von Willebrand factor, plasminogen activator inhibitor-1, and plasminogen activator inhibitor-2 are increased, whereas the anticoagulant protein S is decreased.

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62
Q

Antiphospholipid syndrome Criteria for testing

A

1) Vascular thrombosis
2) Pregnancy morbidity
a) One or more deaths of a normal fetus
after 10 weeks
b) One or more premature births of a normal
neonate before 34 weeks due to severe preeclampsia,
eclampsia, or placental insufficiency
c) Three or more unexplained consecutive spontaneous
pregnancy losses before 10 weeks

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63
Q

Antiphospholipid syndrome Treatment in pregnancy

A

Low molecular weight heparin and aspirin

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64
Q

Warfarin in pregnancy

A

abnormalities of the bone and cartilage, which result in hypoplasia of mid-facial bones and the nasal bridge and stippling of vertebral and femoral epiphyses. Warfarin embryopathy occurs most commonly when the drug is taken between 6 and 12 weeks of gestation

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65
Q

Retinoic acid

A

spontaneous abortion and with microtia and anotia

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66
Q

Thalidomide

A

Limb abnormalities

67
Q

Lithium

A

Ebstein anomaly, which is a downward displacement of the tricuspid valve.

68
Q

mature cystic teratoma

A

Most common neoplasm in pregnancy

69
Q

Antithrombin III

A

Most thrombophilic

Risk in pregnancy is 11 to 40%

Factor VIs the most common, risk in pregnancy for a homozygote is about 25% and heterozygote is 7%

70
Q

Post maturity syndrome

A

decreased subcutaneous fat, lack of vernix and lanugo, and meconium staining of the amniotic fluid, skin, and membranes

Risk is 10 to 20% in post term pregnancies

71
Q

Twin to twin transfusion syndrome stages

A

Quintero stage 1 twin-to-twin transfusion. Stage 2 is diagnosed when criteria for stage 1 are met and the bladder of the donor twin is not visualized. Stage 3 is diagnosed when criteria for the previous stages are met and Doppler studies (i.e., umbilical artery, ductus venosus, and/or umbilical vein) are abnormal for either twin. Stage 4 signifies hydrops fetalis is present in one or both of the fetuses, and stage 5 is diagnosed when one or both of the twins have died

72
Q

Vacuum assisted vaginal delivery

A

Contra indicated prior to 34 weeks

73
Q

Anti Lewis antibodies

A

type M immunoglobulins (IgM) that do not readily cross the placenta. As a result, this antibody is not associated with erythroblastosis fetalis

74
Q

Amstel criteria

A

The first is a thin, gray-white vaginal wall discharge. The second is a vaginal pH greater than 4.5. The third is a positive whiff amine test, which is a fishy odor noted when a drop of 10% potassium hydroxide is added to a sample of vaginal discharge. The fourth is clue cells (>20% of the vaginal epithelial cells) noted in microscopy of the vaginal smear

75
Q

Neural tube defect

A

If prior child with neural tube defect, 70% risk reduction with appropriate folic acid supplementation

76
Q

Post placental IUD insertion

A

10 to 25% risk of expulsion

77
Q

Rate of preterm birth

A

12%

78
Q

Fetal red blood cells

A

Form at 42 days

79
Q

Congenital vericella

A

echogenic foci in the fetal liver, limb anomalies, intrauterine growth restriction, microcephaly, and ventriculomegaly

80
Q

Primary HSV outbreak during labor

A

60% chance of vertical transmission

81
Q

Algorithm for IV hydralazine

A

5 mg or 10 mg, then repeat blood pressure check in 20 minutes if still severe then
10 mg, then repeat blood pressure check in 20 minutes if still severe then
20 mg of IV labetalol, then recheck blood pressure in 10 minutes if still severe then
40 mg of IV labetalol, then recheck blood pressure in 10 minutes if still severe, then consult maternal-fetal medicine or critical care

82
Q

17 OHP

A

First to test for adult onset congenital adrenal hyperplasia. Should be done fasting and during the follicular phase

83
Q

Marfan syndrome

A

Autosomal Dominant

84
Q

Adult onset congenital Adrenal hyperplasia

A

Autosomal recessive

85
Q

Increase in pregnancy

A

Fibrinogen D dimer sed rate, alk phos, aldosterone cortisol triglycerides LDL HDL insulin WBC, factors 178 910, vWB, plasminogen activator one and two

No anticoagulants go up in pregnancy

86
Q

Decrease in pregnancy

A

13, 11-

Protein S

87
Q

Same in pregnancy

A

2, 5, 9

Protein C and antithrombin III

88
Q

Orlistat

A

Could be deficient in vitamins ADE or K

89
Q

Endometriosis

A

Risk for clear-cell carcinoma

90
Q

Methotrexate

A

Inhibits dihydrofolate reductase

91
Q

Salmonella

A

Chicken eggs, bloody diarrhea

92
Q

Rotavirus

A

Child day care

93
Q

Norovirus

A

Cruise ship watery diarrhea

94
Q

Beta agonists

A

Risk of pulmonary edema, tachycardia, inc BP

95
Q

Metabolic syndrome

A 
AC 88 cm or greater
BG greater than 100
TG 150
HDL less than 50
BP 130/85
96
Q

Stages of arousal

A

Desire, arousal, orgasm, resolution

Lubrication is transudative from vaginal epithelium

97
Q

Androgen insensitivity syndrome

A

X linked recessive disorder
No pubic hair, yes breasts
Inguinal hernias

98
Q

Mullarian agenesis

A

Scoliosis hearing issues kidney issues, Normal FSH, normal Karyotype, Multi factorial cause, have breasts and pubic hair

99
Q

Pneumonia

A

Usually strep pneumonia— use Azithromycin.

Most deadly pneumonia and pregnancy is Varicella.

100
Q

Anorexia

A

Low FSH, high leptin

101
Q

Symptomatic urethral prolapse in a child

A

Estrogen cream, don’t treat unless symptomatic

102
Q

Transgender females

A

Estrogen for breasts,

Spironolactone to decrease hair

103
Q

Cowden syndrome

A

PTEN

associated with hamartomas breast cancer colorectal cancer endometrial cancer, Kidney cancer, melanoma

104
Q

Ductile ectasia

A

Breast discharge, can be yellow or green

105
Q

Intraductal papilloma

A

Bloody discharge

106
Q

FRAX

A

Age, sex, BMI, previous fragility fracture, History of hip fracture, smoking status, Corticosteroid use greater than 5 mg per day, alcoholic intake greater than three drinks per day,Secondary causes of asked your process such as rheumatoid arthritis

107
Q

Crohn’s disease

A

Mouth to anus fistulas

108
Q

Ulcerative colitis

A

Bloody diarrhea

109
Q

Von Willebrand’s disease

A

Type one: Autosomal Dominant, type two and type III: autosomal recessive, Most common is type one, most difficult is type three

110
Q

Causes of primary amenorrhea

A

Most common is TUrner’s, second most common is Mullarian agenesis

111
Q

Unicornate uterus

A

Arrested development of the Mullarian ducts, Increased incidence of infertility endometriosis and dysmenorrhea ,50% of pregnancies last in the first two trimesters

112
Q

Uterine didelphys

A

Failed fusion of paired Mullarian ducts, Two endometrial cavity is each with a cervix,

113
Q

Bicornuate uterus

A

Incomplete lateral fusion of the Mullarian and ducts

114
Q

Uterine septum

A

Most common cause of early pregnancy loss with uterine anomaly

115
Q

Inferior epigastric

A

Comes from the external iliac artery

116
Q

Colon cancer screening

A

Begin screening 10 years younger than an immediate family member diagnosis time

117
Q

Dantrolene

A

Treats malignant hyperthermia, this is a AutoSomal dominant disease

118
Q

Causes of osteonecrosis: alcohol, steroids, trauma, Gout, sickle cell disease

A

Proximal and distal Femoral head, shoulder, Ankle, elbow

119
Q

Cushing’s and PCOS

A

Both have obesity, menstrual disorders, androgen excess, cardiovascular disease,

Cushing’s has hypercortisolism and osteoporosis

120
Q

Pregnancy and thyroid

A

1st trimester: TSH goes down
T4 and T3 go up in all trimester

Resin T3 uptake goes down

Same thing happens on OCPs

Free T3 and T4 stay the same

121
Q

Pyuria in a sterile urine culture

A

Chlamydia, mycoplasma, Ureaplasma

122
Q

Mucinous ovarian cancer

A

Resembles cervical glands, goblet cells, CEA

123
Q

Granulosa cell tumor

A

Coffee bean nuclei, inhibin, call Exner bodies, engorged breasts

124
Q

Kallman’s syndrome

A

Infantile development, ataxia, unilateral agensis, cleft palate, can’t smell

125
Q

Most common structural defect

A

Heart

126
Q

NTD

A

Most common midline defect

AFP

127
Q

Most common endo disorder of reproductive age women

A

PCOS

128
Q

Toxoplasmosis

A

Treat with Spiromycin

Fetal infection: add Pyrimethamine, sulfonamide, and folinic acid —treat x1 year after birth

129
Q

Parvo

A

Most lethal, hydrops

Rate of loss 8 to 17%

130
Q

Most common fetal infection

A

CMV

131
Q

Rubella

A

Most Teratogenic fetal infection

132
Q

VAVD

A

Worst: sub Galeal hematoma 3%

Cephalohematima- doesn’t not cross suture lines

133
Q

Post pituitary

A

ADH, oxytocin

134
Q

Mag syndrome

: Ascites hydrothorax

A

Oh Varian fibroma, Brenner tumor (transitional cell epithelium), keukenberg tumor

135
Q

Perineorrhaphy

A

Bulbocavernosus and superficial transverse Perineal

136
Q

Tamoxifen

A

VTE, endometrial cancer, vasomotor symptoms, fluid retention are all risks

137
Q

Aromatase inhibitor

A

Letrozole- increases risk for osteoporosis

138
Q

Mentum ant- SVD

A

Mentum post - CS

Brow- observe

139
Q

Vaginal Cancer

A

Usually spreads lymphatically

140
Q

Dumping syndrome

A

Related to ingestion of high glycemic carbohydrate foods

141
Q

Statins

A

Myalgias, treat with coenzyme q

142
Q

Turner

A

Cystic hygroma

143
Q

Warm compress

A

Decreased rate 3rd and 4th degree

144
Q

Maternal perineal massage

A

Prevents overall decreased lacerations

145
Q

Yasmin

A

Drospirenone— synthetic progesterone for PMDD

146
Q

Fetal macrosomia

A

4000 g

147
Q

Carcinosarcoma

A

Most common type

Of uterine sarcoma

148
Q

Femoral nerve retractor injury

A

Loss of hip flexion adduction and knee extension

149
Q

Granulosa cell tumor

A

Inhibin B

150
Q

Embryonal cell carcinoma

A

Alpha fetal protein

151
Q

Beta hCG

A

Ovarian choriocarcinoma, mixed germ cells, and Embryonal cell carcinoma

152
Q

AFP

A

Yolk sac tumor

153
Q

Lactate dehydrogenase

A

Dysgerminoma

154
Q

BRCA one

A

Risk of breast cancer 55 to 65%, risk of ovarian cancer 84%

155
Q

BRCA2

A

Risk of breast cancer 45%, risk of ovarian cancer 39%

156
Q

Post operative fever

A 
Day 1 to 2: wind
Day 3 to 5: water
Day 4 to 6: walking
Day 5 to 7: wound
Day seven or more: wonder drugs
157
Q

Electrolyte free: hypotonic equals sorbitol and glycine. Iso tonic equals mannitol

A

Can use monopolar but fluid deficit for hypotonic solutions is 1 L.

500 mL for high viscosity such as 32% dextran 70 (HYSKON)

158
Q

PDS suture

A

POLYDIOXANONE

159
Q

Monocryl

A

PLOL I GLECAPRONE 25

160
Q

Victim

A

POLYGLECTIN 910

161
Q

Prophylactic BSO

A

Age 40 or when done with child Bearing

162
Q

Risk of GTN after complete Mole

A

15%

163
Q

3% sorbitol for hysteroscopy

A

Can only allow 500 mL deficit

164
Q

Dysgerminoma

A

Most common ovarian malignancy and found in pregnancy

OBGYN Board review (1 decks)

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