CREOG True learn Flashcards
% of women who experience DV
30
rate of uterine inversion
1/2000 - 1/20’000
up to how many weeks can you use misoprostol for IOL with hx of CD
28w
FIGO score of high risk GTD
7+
what % of cervical cancers are caused by HPV 16 or 18
66%
name 7 high risk HPV genotype
16 18 31 33 45 52 58
Minimum % weight loss for obese patient to have improvement in stress incontinence
5%
Treatment of high risk GTD
EMA-CO:
- etoposide
- MTX
- actinomycin D
- cisplatin
- oncovin (vincrisine)
dose-limiting side effect of cisplatin
nephroxicity
what is BEP?
rx of malignant germ cell and sex-cord stromal tumors
- belomycin
- etoposide
- cisplatin (Platinum)
AE of etoposide
secondary leukemia
AE of bleomycin
pulmonary toxicity
AE of cyclophosphamide
hemorrhagic cystitis
what % of APLS have iuGR
15%
how many x more likely to get PEC with APLS
5.5x
what % of women with recurrent pregnancy loss have APLS
5-20%
what % of fetuses enter the pelvis in OP position?
20%
what % of fetuses deliver in OP position
5-10%
what % of fetuses enter pelvis in OA position
50%
what % of fetuses enter pelvis in OT position
25%
NNT of epidurals for 1 more successful ECV
5
prevalence of autism
1/88
incidence of brachial plexus injuries after shoulder dystocia
4-20%
what % of brachial plexus injuries occur during CD
4%
what % of brachial plexus injuries lead to permanent damage
<10%
1g ancef for weight and BMI:
<100kg (<220lbs), <35 BMI
2g ancef for weight:
> 100kg/220lbs, BMI >35
when to redose ancef (hrs, EBL)
> 3hrs
>1500 EBL
incidence of breast-feeding associated mastitis
1%
given mastitis, what % will get abscess?
10%
1st line for mastitis
dicloxacillin
1st line for mastitis is pen allergic
erythromycin
what is in cryoprecipitate?
- FFP
- Factor VIII
- Factor XIII
- fibrinogen
- VWF
risk of transmission and perinatal death with primary syphilis
50%/50%
risk of transmission and perinatal death with secondary syphilis
50%/50%
risk of transmission and perinatal death with early latent syphilis
40%/20%
risk of transmission and perinatal death with late latent syphilis
10% transmission
MOA of oxybutinin
competitive Ach inhibitor at M receptors –> decreased detrussor contractions
world prevalence of PCOS
6-10%
% of infertility patients that have PCOS
25-30%
what % of women who are anovulatory have PCOS (as per roterdam cirteria)
90%
50% as per NIH criteria
types of invasive genetic testing and what GA to do them
CVS: 10-14w
Amnioscentesis: >14w
incidence of heterotopic pregnancy
1 in 30’000
types of submucosal fibroids and success rates for hysteroscopic removal
Type 0 (all in cavity) = 96-97% Type 1 (<50% in myometrium) = 86-90% Type 2 (>50% in myometrium) = 61-83%
lifetime risk of breast cancer in women
1 in 8
E6 of HPV targets:
p53
E7 of HPV targets:
Rb
what is the most common mullerian abnormality and what is the rate of miscarriage with this abnormality
septate uterus (85-90%) 65% miscarriage rate
creatinine level in vagina above which you can say there is aurogenital fistula
17
optimal placement of lateral trochars
2cm medial and 2cm cephalic from ASIS
most commonly injured vessels during laparoscopic port placement
inferior epigastric arteries
what common thalassemia can hgb electrophoresis NOT pick up
a-thal
what % of pregnancies with elevated AFP actually have NTD
2%
what % of pregnancies with NTD have elevated AFP
80-90%
4 criteria to diagnose HIE
- umbilical artery acidemia
- multisystem organ failure
- APGAR <5 at 5 and 10 mins
- spastic quadriplegia or dyskinetic cerebral palsy
risk of shoulder dystocia with previous dystocia
10% (up to 16%)
incidence of shoulder dystocia
3%
under what EF is TOP recommended
<40%
under what circumstances do women need antibiotic for HSG and what is the abx
hx of PID (or any STDs) or dilated tubes
Doxy pre-procedure and 100 BID q5d after
emergency contraception that can be used in the 72- 120hrs period
Ulipristal and copper IUD
dosing of HPV vaccine per age
<15yo: 2 doses, 0 and 6-12m
>15yo: 3 doses, 0, 1-2, and 6m
mirena failure rate at 1 yr
0.2%
copper IUD failure rate @ 1 yr
0.8%
Nexplanon failure rate @ 1 yr
0.05%
female sterilization failure rate @ 1 yr
0.5%
male sterilization failure rate @ 1 yr
0.1% (1.5% typical use)
below what plt count to treat ITP
30k
min plt for Cesarean
50k
min plt count for epidural
80k
partial mole IHC staining marker
p57kip2
normal umbilical artery findings
pH 7.28 ± 0.05
PCO2 49.2 ± 8.4 mm Hg
PO2 18.0 ± 6.2 mm Hg
HCO3 22.3 ± 2.5 mEq/L
MTP options of RBC:FFP:plt
1: 1:1
4: 4:1
6: 4:1
hgb goal in sickle cell in pregnancy
hgb >10
hbS < 40%
max amount of lidocaine
4mg/kg
max amount of lidocaine + epi
7mg/kg
what weeks can you collect cell free DNA?
> 9-10w
when does neural tube close?
4w post-conception (6w post-LMP)
first line medicine for fibromyalgia
TCAs (amytryptiline)
how old is APA?
40-50
normal level of free testosterone
25-40nG/dL
Normal DHEA-S
non detectabel - 470 (workup if > 500)
what is sapropterin
synthetic BH4, adjunctive rx to moms with PKU to further decrease toxic phenylalanine levels
when do give TDAP in pregnancy
27-36w
incidence of postpartum depression
10-20%
IUD perforation rate
1/1000
IUD expulsion rate
2-10% (24% if immediately PP)
what is FRAX
Fraction Risk Assessment Tool. Used if DEXA reveals osteopenia to determine need for medications
When to Rx for osteopenia based on FRAX score
major osteoporotic fracture risk >20% in 10-yrs
Hip fracture risk >3% in 10 years
At what aortic root dilation should you do cesarean
> 40-45mm dilation
when do start DM screening if BMI <25
45yo
when to start DM screening if BMI >25
if other RF present: sedentery, 1st degree relative, high ethnic/racial group, hc G-DM, HTN, dyslipidemia, PCO, vascular disease
how often to screen for DM once started
q3 years
MCC of acute pancreatitis (2)
alcohol
gallstones
together 2/3 of cases
what is best fluid type for recussitation
colloid ( LR, NS, dextran, glycogen, starches)
Stages of Gestational Trophoblastic Neoplasia
Stage I: confined to the uterus
- Stage II: GTN extends outside of the uterus but is limited to genital structures (adnexa, vagina, broad ligament) - Stage III: GTN extends to the lungs, with or without genital tract involvement - Stage IV: GTN extends to distant sites, including liver and brain
At what age should you start biopsying bartholin gland cysts to rule out malignancy
40yo
Incidence of HIV transmission penis to oral
0-4/10’000
incidence of HIV transmission receptive anal
138/ 10’000
incidence of HIV receptive penile to vaginal
8/ 10’000
Prevalence of gestational thrombocytopenia
7-12% of pregnancies
herbal treatment for hot flashes
Black Cohosh
What is a positive contraction stress test
Late decels with 50% of ctx (need min 3/10mins)
Lifetime risk of cervical cancer
1/75
What percentage of smokers quit during pregnancy
53%
What percentage of smokers who quit during pregnancy resume smoking by 6 months PP
40%
when to start assessing presentation for possible ECV?
36w
sensitivity of pipelle endometrial biopsy for detection cancer vs. hyperplasia
99% cancer
81% hyperplasia
what % of the endometrium is sampled during a pipelle biopsy
5-15%
time to onset of pitocin; time to steady state
5 mins; 40 mins
baseline % of spontaneous abortions in the general population
7-20%
% of spontaneous abortions in pre-gestational diabetics
26.8%
baseline risk of PTD
3.5%
risk of PTD after excisional procedure
6.6% (~double the baseline risk of 3.5%)
Metabolic syndrome criteria
3/5 of:
Elevated waist circumference (≥102 cm or ≥ 40 in. in men, ≥ 85 cm or ≥ 35 inches in women)
Elevated triglyceride levels (≥ 150 mg/dL)
Reduced HDL levels (<40 mg/dL in women)
Elevated blood pressure (≥ 130 mm Hg systolic or ≥85 mm Hg diastolic)
Elevated fasting glucose levels (≥ 100 mg/dL)
what is the risk of recurrence of OASIS
3%
what is the most thrombogenic of the thrombophilias
Antithrombin deficiency
when is the greatest risk of VTE during pregnancy?
<20w
incidence of pre-partum depression (pregnant - 12m PP)
1/7
incidence of PROM in term pregnancies
8%
%of term PROM that will deliver by 5hrs; 28hrs of rupture?
5hrs = 50% 28hrs = 95%
prothombin gene mutation and type of mutations
G21210A; point mutation
placement of vacuum
Center of cup 3cm from posterior fontanelle
pregnancy rate of copper IUD when used for emergency contraceptions
1/1000
Child Pugh classification and risk of death form non-hepatic surgery
A: 10%
B: 17%
C:63%
what are CAPs
Contraction Associated Protein:
- connexin-43
- (A)oytocin
- prostaglandin F2
HDFN: gene, prevalence, when does it occur, rx
gene: HPA-1a
Prevalence: 2% of preg. wiht no HPA-1a but prevalence only 1/1000 because needs fetal-maternal hemorrhage (which only happens in 5-10% of pregs)
When: first baby
Rx: IVIG +/- prednisone at 12 or 20w
success rate of EAU for fibroids
~100%
Prevalence and management of vasa previa
1/2500
Steroids 28-32w, hospitalize 30-34w, deliver 34-37w
when to deliver HIV positive, VL >1000
38w by c-section
how many weeks after varicella vaccine to conceive
4w
risk of male breast CA with BRCA 1
1%
when to stop HPV screen if normal paps
65
hx of 2x cotest in 10 yrs OR 3x reflex in 10 yrs
for what previous abnormal paps do you stop screening at 20 yrs after normal results/treatment
CIN2, CIN3, adenocarcinoma
carbamazapine teratogenicity
nail hypoplasia, facial dysmorphisms
lamotrigine teratogenicity
none! use for bipolar in pregnancy
parotexine teratogenicity
heart defects (SSRI)
valproate teratogenicity
NTD; fetal growth restriction, facial dysmorphology, and limb and heart defects
what disease linked fto primary ovarian insufficiency
Fragile X - FMR1
how many calories do you need to burn to lose weight when obese?
2000cal/week
risk of cancer per BIRADS score
0 - NA 1 - 1% 2 - 1% 3 - <2% 4a - 10% 4c - 50-90% 5 - >95%
what is the periviable period
20+0 - 25+6
how many calories do you need to burn to lose weight when obese?
2000cal/week
what % of women treated with properly fitting pessary are symptom free at 4m and 1- 2yrs?
4m = 70-90% 1-2y = 53-80%
which uterine anomaly has the best pregnancy prognosis
didelphys
patient presents with breast pain only, what are the chances she has cancer?
0.5-3%
UAE RELATIVE contraindications
Coagulopathy (bleeding complications)
Renal impairment (renal effects of contrast)
Desire for future fertility (pregnancy complications)
Uterine size greater than 20-24 weeks (difficult to embolize)
Prior salpingectomy or salpingo-oophorectomy (altered arterial anatomy)
Prior pelvic radiation (altered arterial anatomy)
Concurrent GnRH agonist use (hinders embolization)
Pedunculated: subserosal or submucous leiomyoma (necrosis causes detachment)
Large hydrosalpinx (increased infection risk)
Severe contrast allergy (allergic reaction risk)
which uterine anomaly has the best pregnancy prognosis
didelphys
ECV at 36w reduces risk of 1’ CD by what %?
50%
UAE RELATIVE contraindications
Coagulopathy (bleeding complications)
Renal impairment (renal effects of contrast)
Desire for future fertility (pregnancy complications)
Uterine size greater than 20-24 weeks (difficult to embolize)
Prior salpingectomy or salpingo-oophorectomy (altered arterial anatomy)
Prior pelvic radiation (altered arterial anatomy)
Concurrent GnRH agonist use (hinders embolization)
Pedunculated: subserosal or submucous leiomyoma (necrosis causes detachment)
Large hydrosalpinx (increased infection risk)
Severe contrast allergy (allergic reaction risk)
what is the only thrombophilia you cant test for in pregnancy?
Protein S deficiency
what type of vaccine is HPV vaccine
viral capsid protein
Sonogram findings of EPL:
crown-rump length of ≥ 7 mm and no heartbeat
mean sac diameter of ≥ 25 mm and no embryo
absence of embryo with heartbeat ≥ 2 weeks after a scan that showed a gestational sac without a yolk sac or ≥ 11 days after a scan that showed a gestational sac with a yolk sac.
what is the only thrombophilia you cant test for in pregnancy?
Protein S deficiency
what % of women do not attend a post-partum visit
40%
Sonogram findings of EPL:
crown-rump length of ≥ 7 mm and no heartbeat
mean sac diameter of ≥ 25 mm and no embryo
absence of embryo with heartbeat ≥ 2 weeks after a scan that showed a gestational sac without a yolk sac or ≥ 11 days after a scan that showed a gestational sac with a yolk sac.
When to repeat DEXA
15 years: women who are older than 65-years-old with a T-score greater than -1.5.
5 years: women with a T-score between -1.5 to -1.99.
1-year: women with a T-score between –2.0 and –2.49
what % of women do not attend a post-partum visit
40%
Medical treatment of mastalgia
Danazol 200qd or 100 bid
Only medicine
After decreased coffee, salt and fat; nsaids
AE of danazole
Hirsutism, acne, hair loss, weight gain, sore throat, voice deepening, menstrual irregularities, clitoral enlargement
% of patient with PTL that deliver full term
50%
pregnancy rates 1-2 yrs after myomectomy with no other infertility issues
40-60%
risk of clear cell carcinoma from endometriosis
0.7-1%
