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Clin Med > GYN Final Dz Overview > Flashcards

GYN Final Dz Overview Flashcards

1
Q

Macrosomia?

A

Baby > 8 lbs and 13 oz or 4500 g.
Mom has hx of DM and macrocosmic baby.
Unchanged/arrest of descent.
C-section indicated.

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2
Q

Uterina Atony?

A

Bleeding and soft boggy uterus.
Given Oxytocin during labor and multiple gestations.
Bimanual uterine massage –> IV Oxytocin –> Methylergonovine.

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3
Q

Gestational Trophoblastic Dz/Choriocarcinoma?

A

Painless bleeding during pregnancy.
Large uterus and elevated hCG.
D+C and hysterectomy while monitoring hCG.

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4
Q

Polycystic ovary syndrome (PCOS)?

A

Androgen excess, anovulation, and small ovarian cysts.
Bleeding b/w periods, irregular, acne, hair growth on body.
DM 2.
Hormonal contraception if still symptomatic Spironolactone.
LH:FSH ratio of 2:1 or greater.

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5
Q

Endometriosis?

A

Pelvic pain, dysmenorrhea, dyspareunia.
Nodularities and CMT.
Laparoscopy.
Oopherectomy, COCs/NSAIDs.

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6
Q

US for lump on breast?

A

< 30 y/o.

Determine if solid or cystic.

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7
Q

Fibroids?

A

Abnormal bleeding, pressure/fullness, dysmenorrhea, urinary frequency, fatigue.
Enlarged mobile irregular contour on biannual palpation.
Lumpy bumpy cobblestone sensation.
Pelvis US.
GnRH agonist- Leuprorelin, COCs, myomectomy.

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8
Q

PID/tubo-ovarian abscess?

A

Acute abdomen w/ high risk sex and fever.
Elevated WBC and negative hCG.
Uterine tenderness (unable to perform speculum exam), CMT or adnexal masses.
FEVER.
Ceftriaxone 250mg IM once and
Doxycycline 100mg PO bid x 14 d.

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9
Q

RH- mom and possible Rh + baby?

A

Hemolytic disease of the newborn.

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10
Q

Ovarian Cancer?

A

“Heartburn”.
Fatigue, bloating, early satiety, constipation, diarrhea, ascites.
Solid irregular fixed lesion in LLQ.
Transvaginal US.
Total abdominal hysterectomy (cervix & uterus) and bilateral salpingo-oophorectomy.

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11
Q

Abruptio placentae?

A

Hx of smoking.
Premature partial or complete separation of the normally implanted placenta.
Painful (severe) cramps/abdominal pain and vaginal bleeding.
Deliver baby.

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12
Q

Acute cervicitis caused by Trich?

A

Purulent, malodorous, thin, greenish-yellow, frothy discharge w/ vaginal irritation and strawberry cervix.
pH > 4.5 and motile trichomonads.
Metronidazole.

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13
Q

Bartholin gland cyst?

A

Located at Introitus.
Painful to sit on.
I&D.

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14
Q

Invasive duct carcinoma?

A

Firm, irregular non tender mass with rock hard consistency.
Redness and dimpling of skin w/ nipple retraction.
Bloody nipple discharge.
Fibroglandular tissue with possible microcalcifications or immobile hypoechoic mass.
Biopsy.

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15
Q

Norethindrone?

A

Progestin. Inhibiting release of luteinizing hormone (LH) secretion from the anterior pituitary.

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16
Q

Ectopic pregnancy?

A

Amenorrhea, adnexal mass, elevated hCG.
Hx of PID.
Cramping abd pain.

17
Q

Pre-eclampsia

A

Headache, visual disturbances, abdominal pain, vomiting, face swelling.

18
Q

Mastitis?

A

Breast pain/tenderness w/ malaise and fevers.
Breast Feeding
S. Auerus.
Breast erythema and swelling.

19
Q

Largest risk factor for endometrial cancer?

A

Estrogen exposure.

20
Q

Umbilical cord prolapse?

A

Severe variable decelerations or bradycardia occur after membrane rupture.
Low birth weight, malpresentation, long umbilical cord.
Preoperative intrauterine resuscitation.

21
Q

PROM/PPROM?

A

37 or >: PROM
< 37: PPROM
Check for cervical dilation.
PROM: Admit and start fetal monitoring & await spontaneous labor (90% will go into labor within 24 hours)
Monitor for infection (chorioamnionitis or endometritis).
If labor or infection does not occur prior to 18 hours, induce labor.

PPROM:
Admit and start fetal monitoring.
If 34 weeks or less, give Betamethasone to enhance fetal lung maturity**
Tocolytics can be given to delay delivery up to 48 hours to allow the steroids to work (as long as not already 4 cm or more dilated, no sign of infection and no fetal distress.
Ampicillin & Azithromycin often given to prevent infection
Prompt delivery (Oxytocin) is required with any signs of maternal or fetal infection or distress.

22
Q

What is protective against breast cancer?

A

Breast feeding.

23
Q

Vaginal bleeding post menopause?

A

Endometrial biopsy.

24
Q

DM 2 in pregnant female?

A

Diet, exercise, and insulin therapy if blood glucose remains high despite diet control

25
Q

What statement is true regarding dysfunctional uterine bleeding?
1 It is seen in all age groups equally
2 Dilatation and curettage is the only treatment
3 The condition is most common after 40 years of age
4 The condition is not seen in adolescents
5 It is never associated with ovulatory cycles

A

3

26
Q

A 28-year-old woman in her 2nd trimester of pregnancy presents with a 3.5 cm painless mass on her left breast. She has no other associated symptoms. She has a positive family history of breast cancer. She is afebrile; pulse is 80/min, and BP is 110/72 mmHg. On examination of the breasts, you notice engorgement and hypertrophy. The mass appears solid on ultrasonography (USG).

What is the next step in evaluation of this mass?

Answer Choices
1 Magnetic Resonance Imaging (MRI)
2 Percutaneous biopsy under local anesthesia
3 Fine needle aspiration cytology (FNAC)
4 Sentinel lymph node sampling using blue dye
5 Avoid any intervention at this time

A

2

27
Q

Placenta praevia?

A

The placenta covers part of the internal cervical os.
Painless bleeding.
Transabdominal US.
Complete blood count, type and hold, administration of IV fluids. C-section.

28
Q

Her Pap smear is reported as “atypical squamous cells of undetermined significance”. What is the most appropriate next step in regards to evaluating the patient?

1 Colposcopy
2 Cone biopsy
3 Hysterectomy
4 Loop electrosurgical excision procedure (LEEP)
5 Repeat PAP in one yea
A

1

29
Q

Using Nägele’s rule, what is the patient’s estimated date of confinement (EDC) if LMP February 23?

Answer Choices
1 November 16
2 November 30
3 November 23
4 September 23
5 September 30
A

2

LMP-3 months+7 days

30
Q

Post partum endometriosis?

A

sore breasts from breast-feeding and a sore abdomen. She also admits to an odorous vaginal discharge, but she denies any associated vaginal bleeding. FEVER.

31
Q

Fetal fibronectin Positive
Dried secretions on glass slide Ferning present
Nitrazine paper Color change of yellow to blue?

A

Rupture of membranes.

32
Q

what is her greatest risk factor for developing breast cancer?

Answer Choices
1 Use of oral contraceptive pills
2 Menarche at 15 years of age
3 Menopause at age 45 years of age
4 Excessive caffeine consumption
5 Nulliparity
A

5

33
Q

Vaginal trichomoniasis has been associated with adverse pregnancy outcomes. What is an example of such an outcome?

Answer Choices
1 Hyperemesis gravidarum
2 Premature rupture of membranes
3 Preeclampsia
4 Gestational Diabetes
5 Eclampsia
A

2

34
Q

While performing a Doppler ultrasound on a woman at 30 weeks gestation, you notice that the fetal heart rate is consistently within the range of 130 - 140 beats/minute. What can you conclude about the heart rate of the fetus?

Answer Choices
1 Structural heart disease
2 Normal heart rate
3 Asphyxia
4 Bradycardia
5 Tachycardia
A

2

The fetus has a normal fetal heart rate, as it is within the range of 110 - 160 beats/minute.

35
Q

Bacterial vaginosis?

A

Thin discharge with the fishy odor on KOH prep, and clue cells on wet prep (amine odor w/ KOH).
pH > 4.5.
Metronidazole.

36
Q

What do you prescribe if you suspect gonorrhea/chlamydia?

A

azithromycin 1 g PO, and ceftriaxone 250 mg IM once

37
Q

When the fetal head is engaged?

A

the widest portion of the fetal head has successfully passed through the pelvic inlet.

38
Q

The physician would like to screen for gestational diabetes and opts to perform a 50-g oral glucose challenge test. Regarding performance and interpretation of this test, what is true?

1 A standard fasting 50-g glucose challenge test with a glucose level of ≥100 mg/dL after 1 hour is abnormal and warrants further testing

2 A standard nonfasting 50-g glucose challenge test with a glucose level of ≥135 mg/dL after 1 hour is abnormal and warrants further testing

3 A standard fasting 50-g glucose challenge test with a glucose level of ≥110 mg/dL after 1 hour is abnormal and warrants further testing

4 A standard nonfasting 50-g glucose challenge test with a glucose level of ≥110 mg/dL after 1 hour is abnormal and warrants further testing

5 A standard fasting 50-g glucose challenge test with a glucose level of ≥95 mg/dL after 1 hour is abnormal and warrants further testing

A

2

Clin Med (4 decks)

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