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ABOG written test prep > deck 5 > Flashcards

deck 5 Flashcards

1
Q

treatment for transfusion-associated citrate toxicity?

A

Calcium chloride or gluconate

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2
Q

what is the prevelence of obesity in 20-39 year old women?

A

40%

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3
Q

why would you titrate LMWH levels in pregnancy and what is your target therapeutic level

A

altered metabolism ie from morbid obesity or renal disease

0.6-1.0 measured 4 hours after dosing.

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4
Q

recommended daily intake of iodine in pregnancy

A

220 mcg

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5
Q

criteria for dx of diabetes

A

HgbA1c > 6.5%
Fasting BS > 126
2hr after 75g glucose > 200
random > 200 w/ symptoms

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6
Q

what is the failure rate for detecting endometrial cancer in postmenopausal women using an in-office pipelle for endometrial biopsy?

what percentage of the cavity is sampled?

A

1%

5-15%

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7
Q

what is the increased risk of endometriosis with a first degree family member with the diagnosis

A

8x higher risk

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8
Q

failure rate of copper and mirena IUDs

A

copper - 0.8%
mirena - 0.2%
sterilization - 0.5%

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9
Q

absolute vs relative contraindications of cell saver

A

absolute:
- contamination with hemostatic products or bone cement (floseal, surgicel ect)
- hypotonic fluids (sterile water)
- solutions that would be toxic with IV administration (abx irrigation, hydrogen peroxide, alcohol, iodine)

Relative

  • bacterial infection in surgical wound
  • active malignancy in surgical field
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10
Q

14-methyl prostaglandin F2-alpha aka and side effects

A

carbaprost

Side effects include diarrhea, flushing, hypertension, tachycardia, nausea, or vomiting. Additionally, bronchospasm may occur, so this medication is contraindicated in patients with a history of asthma.

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11
Q

MOST COMMON complication following laparoscopic gynecologic surgery?

A

bleeding

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12
Q

rate of vertical transmission of herpes simplex virus with primary genital infection at time of vaginal delivery?

A

40-80%

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13
Q

ppx for hx of HSV infection in pregnancy

A

Beginning at 36 weeks’ gestation, either

  • acyclovir 400 mg three times daily or
  • valacyclovir 500 mg twice daily
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14
Q

odds ratio equation

A

ad/bc (cross products)

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15
Q

How is iodide transported across the placenta

A

carrier mediated process

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16
Q

Erb’s palsy involves which nerve roots

A

C5-6

waiters tip

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17
Q

Klumpke’s palsy

A

claw hand
C8-T1
may be associated with Horner’s syndrome, with ptosis, and miosis

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18
Q

treatment of thyroid storm

A
  • PTU
  • iodine 1-2hours after PTU
  • Dexamethasone or hydrocortisone (blocks peripheral conversion of T4 to T3)
  • B-blocker
  • supportive measures
  • avoid delivery during storm, fetal status should improve after maternal stabilization
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19
Q

extraintestinal manifestations of chron’s

A

Venous Thromboembolism
Renal Calculi
Osteoporosis
B12 Deficiency

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20
Q

On average, epidural analgesia prolongs the

second stage of labor by how many minutes?

A

5-10 minutes

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21
Q

The granulosa cell aromatase enzyme allows conversion of androstenedione to which hormone

A

estrone

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22
Q

In which phase of the cell cycle does protein

synthesis and RNA synthesis occure

A

G1

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23
Q

What phase of the cell cycle does DNA replication occure

A

S

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24
Q

bone formation markers

A

Osteocalcin
Bone specific alkaline phosphatase
Procollagen type I
N-terminal pro-peptide

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25
Q

when do you repeat dexa scan for a patient with osteopenia

A

5 years (could do sooner if T score < -2)

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26
Q

organism for ear infection in adult

A

H. flu

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27
Q

Why use a b-blocker in a pregnant pt with mitral stenosis

A

prevents tachycardia leading to pulmonary edema

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28
Q

After an exposure and infection with Hepatitis B,

what is the first detectable serological marker?

A

HBsAg

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29
Q

In cases of endometrial cancer, levels of which

tumor associated antigen are most elevated?

A

CA 125

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30
Q

why do pts with spinal cord injuries require early epidural

A

to prevent autonomic dysrelexia (aka autonomic hyperreflexia) found in 85% of pts with lesion at or above T6.

the large, unopposed sympathetic outflow causes sudden elevation in blood pressure, piloerection, skin pallor, and severe vasoconstriction below the neurologic level.

Goal of a T10 level

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31
Q

non surgical options for tx of EIN

A 
Medroxyprogesterone acetate
Depot medroxyprogesterone
Micronized vaginal progesterone 
megestrol acetate
Levonorgesterel IUD
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32
Q

A female fetus has 6-7 million oocytes present during the 20th week of gestation. Approximately how many oocytes are present at birth? at puberty?

A

1.5 million

300,000

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33
Q

Which POP-Q point represents the level of uterosacral

ligament attachment to the proximal posterior cervix?

A

D (not assessed s/p hyst)

34
Q

at unicornuate uterus can be associated with what other gyne pathology

A

endometriosis

35
Q

WHI risks for estrogen only HRT

A

Among women receiving estrogen only, there was an increased risk of thromboembolic events,

but not an increased risk of cardiovascular events or breast cancer

36
Q

WHI findings for combined HRT

A

slightly increased risk of breast cancer, coronary heart disease, stroke, and venous thromboembolic events

Decreased risk of fractures and colon cancer

37
Q

changes to the renin-angiotensin-aldosterone system during pregnancy

A

all are increased. which helps to maintain BP particularly in first trimester

renin is produced in the maternal kidneys and placenta

38
Q

Isotrentinoin affects on pregnancy

A

include external ear malformations, cleft palate, micrognathia, conotruncal heart defects, ventricular septal defects, aortic-arch malformations, and certain brain malformations.

39
Q

CT scan with fibromuscular dysplasia

A

rental artery stenosis

40
Q

FENa < 1

A

pre-renal

41
Q

treatment for varicella exposure in pregnancy?
illness?
pneumonia?

A

exp - VZIG if nonimmune
Illness - oral acyclovir
pneumonia - IV acyclovir

42
Q

1 risk factor for dysparunia postpartum

A

3rd-4th degree lacs

43
Q

preferred suture for cerclage

A

uncoated polyester (permanent and low inflammation)

44
Q

among women with recurrent genital herpes how many will have recurrence in pregnancy? at time of delivery?

A

75%

14%

45
Q

diagnostic test for pelvic congestion syndrome

A

pelvic venography (can dx and tx) or pelvic CT

46
Q

what risk is associated with a prosthetic heart valve and how should it be prevented

A

infectious endocarditis
single dose of abx 30-60 minutes prior to delivery
ppx abx for invasive dental procedures

47
Q

what gestational age do you begin screen for TTTS

A

16 wks

48
Q

what is the best regimen for stress dose steroids in laobr

A

hydrocortisone 25 mg IV every 6 hours.

49
Q

who does NOT require stress dose steriods

A
  • taking steroids for < 3wks
  • <5mg/day prednisone for any length of time
  • < 10 mg prednisone every other day
50
Q

risk of HIV and HepB with blood transfusion

A

1: 2 million HIV
1: 200,000 hep B

51
Q

gestational age for vacuum delivery

A

> 34 wks due to increased risk of neonatal complications, including neonatal cephalohematoma, retinal hemorrhage, and intracranial hemorrhage.

forceps acceptable < 34wks

52
Q

most reliable sign of placental seporation

A

cord lengthening

53
Q

most common type of epithelial ovarian cancer

A

serous

54
Q

most likely form of fibroid degeneration in pregnancy

A

carneous/red

55
Q

where are the inferior epigastric vessels located at the level of the ASIS

A

inferior epigastric vessels typically lie 3.7 cm from the midline at the level of the anterior superior iliac spine

56
Q

At the level of the ASIS where should trochars be placed to avoid injuries

A

Most injuries to either nerves or vessels can be avoided if placement is >6 cm from the midline at this level

2cm medial to and at or superior to the ASIS, lateral to the rectus border

57
Q

what angle should the umbilical trochar be placed

A

45 degrees (up to 60 in an obese patient)

58
Q

sensitivity of dx torsion by US

A

75-90%

59
Q

what is the most common classification of neonatal HSV infection

A

disease limited to the skin, eyes, or mouth

disseminated disease #2, CNS disease #3

60
Q

At what GA do red blood cells appear

A

7-8 weeks

61
Q

A “increased awareness to breath” in pregnancy is caused by

A

decreased PCO2 (respiratory alkalosis)

62
Q

cardiopulmonary changes in pregnancy

CO, HR, SVR, Pulm vascular resistance

A

increased cardiac output (+45%)
increased heart rate (+17%)
decreased systemic vascular resistance (-21%)
decreased pulmonary vascular resistance (-34%)

63
Q

Changes in respiratory system in pregnancy

FRC, Lung cap, residual volumen, expiratory reserve V, inspiratory capacity, tital volume

A 
decreased functional residual capacity (responsible for more shallow breathing)
decreased total lung capacity
decreased residual volume
decreased expiratory reserve volume
increased inspiratory capacity
increased tidal volume
64
Q

what are increased when both forceps and vacuums are used for a vaginal delivery compared with either method alone

A

anal sphincter injuries

intracranial injuries

65
Q

who is a candidate for a presacral neurectomy?

A

pts with refractory, midline, pelvic pain, who is young and desires future fertility and has already undergone multiple laparoscopies

resection of the sympathetic nerves over the sacral promontory to block visceral afferent signals from the pelvic organs

66
Q

among women who are high risk for neural tube defect how much can folic acid reduce the risk

A

In a high-risk population, neural tube defects can be prevented in up to 70% of cases with appropriate folic acid supplementation of 4 mg daily, beginning at least 3 months prior to pregnancy

67
Q

4 parts to pathogenesis of endometriosis

A
  • retrograde menstruation
  • increased COX-2 > overproduction of prostoglandins
  • increased aromatase > increased local estrogen
  • Progesterone resistance > amplifies estrogenic effect
68
Q

hydral pathway for severe BPs

A

give 5 or 10 mg
wait 20 minutes
if still severe give 10 mg
wait 20 minutes > switch to labetalol

69
Q

how does pregnancy affect HIV disease course

A

no change

70
Q

for AIS when do you removed testes

A

after puberty

risk of malignancy prior to 20 y/o is very low

71
Q

layers of the abdominal wall

A 
skin
campers
scarpas
anterior rectus sheath
rectus abdominis muscle
transversalis fascia
peritoneum
72
Q

anion gap calc

A

sodium - (chloride+bicarb)

73
Q

first trimester screen

A

HCG, PAPP-A, NT

74
Q

polydioxanone

A

PDS

initially same strength as vicryl but maintains 50% strength at 4 weeks and less inflammation

75
Q

affects of TXA when used for PPH

A

reduction in maternal MORTALITY

benefits occurred when received within 3 hours from delivery

76
Q

how much does a BSO reduce the risk of ovarian cancer in patients with BRAC

A

80%

77
Q

pagets disease of the breast is associated with which cancer

A

Ductal or DCIS

78
Q

other than breast and ovarian Ca BRCA1 &2 are associated with

A

1- prostate

2- pancreas, prostate, melanoma

79
Q

In patients with perianal extramammary Paget’s disease,

up to 90% of cases may also have what other type of cancer?

A

colorectal

80
Q

sacral agenesis occurs at what gestationa

A

3-7 wks

81
Q

VACTERL

A 
V - Vertebral anomalies
A - Anorectal malformations
C - Cardiovascular anomalies
T - Tracheoesophageal fistula
E - Esophageal atresia
R - Renal (Kidney) and/or radial anomalies
L - Limb defects
82
Q

most common cause of necrotising fascitis

A

Group A strep

ABOG written test prep (7 decks)

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