CREOG True learn Flashcards
1
Q
% of women who experience DV
A
30
2
Q
rate of uterine inversion
A
1/2000 - 1/20’000
3
Q
up to how many weeks can you use misoprostol for IOL with hx of CD
A
28w
4
Q
FIGO score of high risk GTD
A
7+
5
Q
what % of cervical cancers are caused by HPV 16 or 18
A
66%
6
Q
name 7 high risk HPV genotype
A
16 18 31 33 45 52 58
7
Q
Minimum % weight loss for obese patient to have improvement in stress incontinence
A
5%
8
Q
Treatment of high risk GTD
A
EMA-CO:
- etoposide
- MTX
- actinomycin D
- cisplatin
- oncovin (vincrisine)
9
Q
dose-limiting side effect of cisplatin
A
nephroxicity
10
Q
what is BEP?
A
rx of malignant germ cell and sex-cord stromal tumors
- belomycin
- etoposide
- cisplatin (Platinum)
11
Q
AE of etoposide
A
secondary leukemia
12
Q
AE of bleomycin
A
pulmonary toxicity
13
Q
AE of cyclophosphamide
A
hemorrhagic cystitis
14
Q
what % of APLS have iuGR
A
15%
15
Q
how many x more likely to get PEC with APLS
A
5.5x
16
Q
what % of women with recurrent pregnancy loss have APLS
A
5-20%
17
Q
what % of fetuses enter the pelvis in OP position?
A
20%
18
Q
what % of fetuses deliver in OP position
A
5-10%
19
Q
what % of fetuses enter pelvis in OA position
A
50%
20
Q
what % of fetuses enter pelvis in OT position
A
25%
21
Q
NNT of epidurals for 1 more successful ECV
A
5
22
Q
prevalence of autism
A
1/88
23
Q
incidence of brachial plexus injuries after shoulder dystocia
A
4-20%
24
Q
what % of brachial plexus injuries occur during CD
A
4%
25
what % of brachial plexus injuries lead to permanent damage
<10%
26
1g ancef for weight and BMI:
<100kg (<220lbs), <35 BMI
27
2g ancef for weight:
>100kg/220lbs, BMI >35
28
when to redose ancef (hrs, EBL)
>3hrs
| >1500 EBL
29
incidence of breast-feeding associated mastitis
1%
30
given mastitis, what % will get abscess?
10%
31
1st line for mastitis
dicloxacillin
32
1st line for mastitis is pen allergic
erythromycin
33
what is in cryoprecipitate?
- FFP
- Factor VIII
- Factor XIII
- fibrinogen
- VWF
34
risk of transmission and perinatal death with primary syphilis
50%/50%
35
risk of transmission and perinatal death with secondary syphilis
50%/50%
36
risk of transmission and perinatal death with early latent syphilis
40%/20%
37
risk of transmission and perinatal death with late latent syphilis
10% transmission
38
MOA of oxybutinin
competitive Ach inhibitor at M receptors --> decreased detrussor contractions
39
world prevalence of PCOS
6-10%
40
% of infertility patients that have PCOS
25-30%
41
what % of women who are anovulatory have PCOS (as per roterdam cirteria)
90%
| 50% as per NIH criteria
42
types of invasive genetic testing and what GA to do them
CVS: 10-14w
Amnioscentesis: >14w
43
incidence of heterotopic pregnancy
1 in 30'000
44
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%
```
45
lifetime risk of breast cancer in women
1 in 8
46
E6 of HPV targets:
p53
47
E7 of HPV targets:
Rb
48
what is the most common mullerian abnormality and what is the rate of miscarriage with this abnormality
```
septate uterus (85-90%)
65% miscarriage rate
```
49
creatinine level in vagina above which you can say there is aurogenital fistula
17
50
optimal placement of lateral trochars
2cm medial and 2cm cephalic from ASIS
51
most commonly injured vessels during laparoscopic port placement
inferior epigastric arteries
52
what common thalassemia can hgb electrophoresis NOT pick up
a-thal
53
what % of pregnancies with elevated AFP actually have NTD
2%
54
what % of pregnancies with NTD have elevated AFP
80-90%
55
4 criteria to diagnose HIE
- umbilical artery acidemia
- multisystem organ failure
- APGAR <5 at 5 and 10 mins
- spastic quadriplegia or dyskinetic cerebral palsy
56
risk of shoulder dystocia with previous dystocia
10% (up to 16%)
57
incidence of shoulder dystocia
3%
58
under what EF is TOP recommended
<40%
59
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
60
emergency contraception that can be used in the 72- 120hrs period
Ulipristal and copper IUD
61
dosing of HPV vaccine per age
<15yo: 2 doses, 0 and 6-12m
| >15yo: 3 doses, 0, 1-2, and 6m
62
mirena failure rate at 1 yr
0.2%
63
copper IUD failure rate @ 1 yr
0.8%
64
Nexplanon failure rate @ 1 yr
0.05%
65
female sterilization failure rate @ 1 yr
0.5%
66
male sterilization failure rate @ 1 yr
0.1% (1.5% typical use)
67
below what plt count to treat ITP
30k
68
min plt for Cesarean
50k
69
min plt count for epidural
80k
70
partial mole IHC staining marker
p57kip2
71
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
72
MTP options of RBC:FFP:plt
1: 1:1
4: 4:1
6: 4:1
73
hgb goal in sickle cell in pregnancy
hgb >10
| hbS < 40%
74
max amount of lidocaine
4mg/kg
75
max amount of lidocaine + epi
7mg/kg
76
what weeks can you collect cell free DNA?
>9-10w
77
when does neural tube close?
4w post-conception (6w post-LMP)
78
first line medicine for fibromyalgia
TCAs (amytryptiline)
79
how old is APA?
40-50
80
normal level of free testosterone
25-40nG/dL
81
Normal DHEA-S
non detectabel - 470 (workup if > 500)
82
what is sapropterin
synthetic BH4, adjunctive rx to moms with PKU to further decrease toxic phenylalanine levels
83
when do give TDAP in pregnancy
27-36w
84
incidence of postpartum depression
10-20%
85
IUD perforation rate
1/1000
86
IUD expulsion rate
2-10% (24% if immediately PP)
87
what is FRAX
Fraction Risk Assessment Tool. Used if DEXA reveals osteopenia to determine need for medications
88
When to Rx for osteopenia based on FRAX score
major osteoporotic fracture risk >20% in 10-yrs
| Hip fracture risk >3% in 10 years
89
At what aortic root dilation should you do cesarean
>40-45mm dilation
90
when do start DM screening if BMI <25
45yo
91
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
92
how often to screen for DM once started
q3 years
93
MCC of acute pancreatitis (2)
alcohol
gallstones
together 2/3 of cases
94
what is best fluid type for recussitation
colloid ( LR, NS, dextran, glycogen, starches)
95
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
96
At what age should you start biopsying bartholin gland cysts to rule out malignancy
40yo
97
Incidence of HIV transmission penis to oral
0-4/10'000
98
incidence of HIV transmission receptive anal
138/ 10'000
99
incidence of HIV receptive penile to vaginal
8/ 10'000
100
Prevalence of gestational thrombocytopenia
7-12% of pregnancies
101
herbal treatment for hot flashes
Black Cohosh
102
What is a positive contraction stress test
Late decels with 50% of ctx (need min 3/10mins)
103
Lifetime risk of cervical cancer
1/75
104
What percentage of smokers quit during pregnancy
53%
105
What percentage of smokers who quit during pregnancy resume smoking by 6 months PP
40%
106
when to start assessing presentation for possible ECV?
36w
107
sensitivity of pipelle endometrial biopsy for detection cancer vs. hyperplasia
99% cancer
| 81% hyperplasia
108
what % of the endometrium is sampled during a pipelle biopsy
5-15%
109
time to onset of pitocin; time to steady state
5 mins; 40 mins
110
baseline % of spontaneous abortions in the general population
7-20%
111
% of spontaneous abortions in pre-gestational diabetics
26.8%
112
baseline risk of PTD
3.5%
113
risk of PTD after excisional procedure
6.6% (~double the baseline risk of 3.5%)
114
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)
115
what is the risk of recurrence of OASIS
3%
116
what is the most thrombogenic of the thrombophilias
Antithrombin deficiency
117
when is the greatest risk of VTE during pregnancy?
<20w
118
incidence of pre-partum depression (pregnant - 12m PP)
1/7
119
incidence of PROM in term pregnancies
8%
120
%of term PROM that will deliver by 5hrs; 28hrs of rupture?
```
5hrs = 50%
28hrs = 95%
```
121
prothombin gene mutation and type of mutations
G21210A; point mutation
122
placement of vacuum
Center of cup 3cm from posterior fontanelle
123
pregnancy rate of copper IUD when used for emergency contraceptions
1/1000
124
Child Pugh classification and risk of death form non-hepatic surgery
A: 10%
B: 17%
C:63%
125
what are CAPs
Contraction Associated Protein:
- connexin-43
- (A)oytocin
- prostaglandin F2
126
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
127
success rate of EAU for fibroids
~100%
128
Prevalence and management of vasa previa
1/2500
| Steroids 28-32w, hospitalize 30-34w, deliver 34-37w
129
when to deliver HIV positive, VL >1000
38w by c-section
130
how many weeks after varicella vaccine to conceive
4w
131
risk of male breast CA with BRCA 1
1%
132
when to stop HPV screen if normal paps
65
| hx of 2x cotest in 10 yrs OR 3x reflex in 10 yrs
133
for what previous abnormal paps do you stop screening at 20 yrs after normal results/treatment
CIN2, CIN3, adenocarcinoma
134
carbamazapine teratogenicity
nail hypoplasia, facial dysmorphisms
135
lamotrigine teratogenicity
none! use for bipolar in pregnancy
136
parotexine teratogenicity
heart defects (SSRI)
137
valproate teratogenicity
NTD; fetal growth restriction, facial dysmorphology, and limb and heart defects
138
what disease linked fto primary ovarian insufficiency
Fragile X - FMR1
139
how many calories do you need to burn to lose weight when obese?
2000cal/week
140
risk of cancer per BIRADS score
```
0 - NA
1 - 1%
2 - 1%
3 - <2%
4a - 10%
4c - 50-90%
5 - >95%
```
141
what is the periviable period
20+0 - 25+6
142
how many calories do you need to burn to lose weight when obese?
2000cal/week
143
what % of women treated with properly fitting pessary are symptom free at 4m and 1- 2yrs?
```
4m = 70-90%
1-2y = 53-80%
```
144
which uterine anomaly has the best pregnancy prognosis
didelphys
145
patient presents with breast pain only, what are the chances she has cancer?
0.5-3%
146
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)
147
which uterine anomaly has the best pregnancy prognosis
didelphys
148
ECV at 36w reduces risk of 1' CD by what %?
50%
149
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)
150
what is the only thrombophilia you cant test for in pregnancy?
Protein S deficiency
151
what type of vaccine is HPV vaccine
viral capsid protein
152
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.
153
what is the only thrombophilia you cant test for in pregnancy?
Protein S deficiency
154
what % of women do not attend a post-partum visit
40%
155
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.
156
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
157
what % of women do not attend a post-partum visit
40%
158
Medical treatment of mastalgia
Danazol 200qd or 100 bid
Only medicine
After decreased coffee, salt and fat; nsaids
159
AE of danazole
Hirsutism, acne, hair loss, weight gain, sore throat, voice deepening, menstrual irregularities, clitoral enlargement
160
% of patient with PTL that deliver full term
50%
161
pregnancy rates 1-2 yrs after myomectomy with no other infertility issues
40-60%
162
risk of clear cell carcinoma from endometriosis
0.7-1%
