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CREOG Study > CREOG Institutional Prep Exam Review > Flashcards

CREOG Institutional Prep Exam Review Flashcards

1
Q

Give 3 definitions for GTN by FIGO criteria

A

1) weekly hCG levels plateau over a 3 week period (+/- 10 % of the previous result)
2) hCG levels inc more than 10% across 3 values over a 2 week duration
3) persistence of detectable serum hCG levels for more than 6 months after evacuation

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2
Q

What are 5 Lynch - syndrome related genes

A

Mell 1 , Mesh 2 & 6 , PMS 2, EPCAM

(MLH 1, MSH 2 , MSH 6, PMS 2, EPCAM)

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3
Q

What is the most common symptom in patient with lactotroph microadenoma

A

Amenorrhea

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4
Q

Most common complication of pelvic radiation

A

GI toxicity

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5
Q

What is the most common congenital infection ?

when is the risk of severe infxn the highest?

When is the most common occurrence of vertical transmission?

A

CMV

1st trimester risk for severe infxn is highest

Vertical transmission is highest in third trimester

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6
Q

Maximum lidocaine dosing without epinephrine vs with

A

Without - 5 mg/kg

With Epi - 7 mg/kg

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7
Q

Define MTP

A

10 units in 24 hrs

4 units within 1 hour ( with more anticipated)

Replacement of a complete blood volume

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8
Q

Risks associated with massive transfusion

A

Hyperkalemia ( from tissue damage or hemolysis)

Hypocalcemia ( due to citrate toxicity)

Metabolic acidosis ( production of lactic acid and decreased removal of citrate)

Hypothermia ( which reduces platelet and enzymatic activity)

TRALI and transfusion associated infections

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9
Q

Diabetes with nephropathy ( >500 mg/day of proteinuria) is what White classification?

A

Class F ( for fucked up kidneys)

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10
Q

Class D diabetes is defined as

A

Diagnosed when they were dumb young (<10 yrs old) and duration > 20 years

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11
Q

Class B diabetes is defined as

A

Diagnosis in their BIG AGE (onset after age 20, duration < 10 years)

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12
Q

Class C diabetes is defined as

A

Occurring during the CONFUSING ages of 10 - 19 yrs with duration between 10 - 19 years

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13
Q

How is acetycholinesterase related in fetal development?

A

It is an enzyme present in the amniotic fluid of fetuses with an open neural tube defect

( when combined with ultrasound findings and AFP, it is diagnostic of open neural tube defect

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14
Q

What clinical scenarios can one find acetylcholinesterase present

A

Open neural tube defects
Ventral abdominal wall defects
IUFD

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15
Q

When do we screen for neural tube defects with MSAFP

What organs secrete MSAFP

A

15 - 18 weeks

Yolk sac and the liver

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16
Q

MSAFP levels greater than _____ MoM are concerning for a NTD

A

2.5

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17
Q

When can I deliver a patient with pregestational diabetes as early as 36 - 38+6

A

Poor glucose control
Hx of still birth
Vasculopathy
Nephropathy

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18
Q

The endometrial lining is _____ before ovulation and ____ after ovulation

A

Proliferation before ovulation

Secretory after ovulation

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19
Q

Cryoprecipitate contains ______________

A

VFF8-13

Vonwillebrand
Fibrinogen
Factors 8 & 13

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20
Q

FFP contains

A

All soluble plasma proteins and clotting factors

  • increases level of any factor by nearly 30%*
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21
Q

Lifetime risk of ovarian cancer in general population is

A

1/70 ( 1.4%)

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22
Q

What are three blood disorders that indicate the need for anticoagulant in in pregnancy

A

Homozygous factor V Leiden
Homozygous prothrombin G20210A mutation
Antithrombin deficiency

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23
Q

A brand name for Low molecular weight heparin is

A

Lovenox

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24
Q

What can u give to reverse unfractionated heparin in a pregnant women who didn’t get to stop her lovenox and transition to unfractionated heparin before delivery?

A

Protamine sulfate

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25
Q

Epidural is associated with what two components of labor?

A

Shorter first stage when compared to systemic opioids

Also longer second stage of labor by only a few minutes

26
Q

Gestational thrombocytopenia is most common at what point in pregnancy ?

When do platelet counts resolve?

A

Most common in 2nd and 3rd trimester

Return to normal within 1-2 months after delivery

27
Q

Prevalence of ectopic pregnancy among women in ED with 1st tri bleeding

A

5 - 18% (~15%)

28
Q

For women with hx of 2 or more ectopics, recurrence risk is ____

A

25%

29
Q

Most common sign of uterine rupture

A

Fetal heart rate anomalies

30
Q

Risk of uterine rupture with one prior scar

A

0.5 - 0.9%

31
Q

What is the work up for a baby with ambiguous genitalia

A

Karyotype to evaluate sex chromosomes ( fetuses with CAH will usually by 46 XX)

Electrolytes

17 - hydroxyprogesterone levels

32
Q

What is the dosage and management for a patient who needs stress dose steroids while in labor?

A

Hydrocortisone 25 mg IV q 6 hours

At time of delivery, give 100 mg IV, then taper the dose to her baseline regimen over 3 days

33
Q

What 3 groups of patients don’t need stress dose steroids in labor?

A

A - ANY dose of steroids for <3 weeks
M - MORNING dose <5 mg/day for any length of time
E - <10 mg of prednisone EVERY other day

34
Q

Progesterone inhibits what stage of lactogenesis

A

Stage I —> so it inhibits alpha lactalbumin which is the main stimulator of lactose synthase

35
Q

What is the AFE triad for diagnosis ?

A

Breathing compromise + hemodynamic instability + DIC

36
Q

If one twin in a monochorionic gestation dies after 14 weeks there is a ____ chance that the surviving twin also dies

A

15% risk of death

And almost 20 % risk of neurological injury to surviving twin

( compare to dichorionic twin where Neuro injury risk is 1% and risk of death is 3%)

37
Q

When to deliver placenta accreta?

A

34 - 35+6 weeks via C- hyst

38
Q

Risk factors for PPROM

A

Smoking

2nd tri bleeding

3rd tri bleeding

Previous PPROM

Short cervix

Low SES

Low BMI

39
Q

Preterm birth rate in US (2019)

A

~10 %

40
Q

Typical surgical site infxn occurs how many days after abdo surgery

A

4- 7 days

( Think 47 days and nights of struggle with that baby before a damn infection pops up!)

41
Q

About ____ % of women with PCOS have T2 diabetes

A

10 %

42
Q

Define periviability

A

20 + 0 - 25+ 6

43
Q

Suspected intramniotic infection criteria are

A

Maternal fever AND

elevated WBC count
OR
Purple not cervical drainage
OR
Fetal tachycardia

44
Q

What labs should be ordered to work up primary amenorrhea ?

A

UPT ( obviously rule out pregnancy )

(Testosterone, FSH, Estradiol , LH, TSH, prolactin) and 17-OHP

(Test FELT Pro) and 17-OH P

45
Q

Normal testoterone levels in women

A

40 - 60 ng/dL

46
Q

Normal follicular phase FSH

A

3 - 11 mIU/mL

47
Q

Normal follicular phase LH

A

1 - 11 mIU/ml

48
Q

What percent of survivors of neonatal herpes will have long term neuro issues

A

20% (including impairment within first 12 months of life

49
Q

Layers of bladder from inner to outer

A

Mucosa ( transitional then lumina propia)
Submucosa
Detrusor muscle
Adventitious

50
Q

By how much does breastfeeding increase material caloric requirements?

A

500 kcal/ day

51
Q

The corpus luteum makes what kind of progesterone ?

A

17 alpha hydroxy progesterone

52
Q

The distal (lower) one third of the vagina drains to _______

A

Inguinal / femoral nodes then to pelvic nodes

53
Q

The upper 2/3rds of the vagina drains to what nodes?

A

Pelvic then para aortic

54
Q

Most common cause of intracranial hemorrhage AT TERM ?

AT PRETERM?

A

Term - obstetric trauma

PRETERM - hypoxia and ischemia

55
Q

UTI incidence in sexually active young women

A

0.5 - 0.7 per person-year

56
Q

What is the most commonly identified mutation in women who develop VTE during pregnancy

A

Heterozygous Factor V Leiden

57
Q

Heterozygous factor V Leiden accounts for ___ % of VTE in pregnancy

A

40%

58
Q

Women with heterozygous factor V Leiden deficiency and no hx of VTE have what % risk of developing VTE in pregnancy

A

< 2%

(0.5 - 1.2%)

59
Q

How do you test for factor V Leiden mutation

A

Protein C resistance assay ( 2nd gen)

** this can be reliable in pregnancy and acute thrombosis but is NOT RELIABLE IF THE PATIENT IS ANTOCOAGULATED**

60
Q

What is the leading cause of death in pregnant women and women in the postpartum period

A

Cardiovascular disease (15.3%)

61
Q

Serum progesterone level of ________ is a objectively indicative that ovulation occurred

A

> 3 ng/mL

62
Q

Methimazole is associate with ___ in the ___ trimester

PTU is associated with _____

A

Methimazole - MESSES up your nails ( aplasia cutis) in the first trimester
PTU - pitiful liver ( hepatotoxicity)

PTU - PRIMARY hyperthyroidism med in 1st trimester, THEN Methimazole to MAINTAIN

CREOG Study (8 decks)

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