Gynecology Flashcards
1
Q
Painless genital ulcer with skin rash
A
2ry Syphilis
2
Q
Post operative fever cause’s
A
2-3 days = atelectasis or pneumonia/ 3-5 days = UTI / 5-7= DVT / >7 = wound infection
3
Q
Vaccines allowed in pregnancy are
A
Dtap / influenza
4
Q
Cottage like discharge = ….
A
Candida
5
Q
Hyphea In urine microscopy?
A
Candida
6
Q
Ptn with odorless, white-grey vaginal discharge adherent to the vaginal wall, under microscope there are spores, diagnosis
A
Candida
7
Q
Budding yeast cells, pseudohyphea in vaginal discharge = …..treated by ………
A
Candida / Fluconazole
8
Q
………..is ass. With miscarriage
A
Rubella
9
Q
Painful genital ulcer + conjunctivitis + rash =
A
Gonorrhea
10
Q
Mother with hepatitis B delivered a baby 12 hours ago, what to give the baby
A
HBV vaccine with IG
11
Q
Ptn with fishy smell, itchy discharge, treatment?
A
Oral metronidazole is the best for bacterial vaginosis
12
Q
Bacterial vaginosis sample under microscope =
A
Granular epithelial cells
13
Q
Pic of clue cells, diagnosis
A
Bacterial vaginosis
14
Q
Female with vaginal discharge under microscope shows motile flagella, what to give the husband?
A
Metronidazole ( because of trichomonas infection )
15
Q
Female with cheesy discharge, what to give the husband?
A
Nothing
16
Q
Pregnant lady complain of foul smelling discharge, treatment
A
Metronidazole
17
Q
Pregnant lady her water broke but she had history of herpes, what to do
A
Speculum exam
18
Q
Ptn with dysparenuria and postcoital spotting, where is the source
A
Cervix-uterus
19
Q
At what age you should start cervical Cancer screening?
A
21
20
Q
Pregnant woman at 26week with large genital warts, how to treat
A
Cryotherapy
21
Q
Pic of female genital warts, history of multiple sexual partners, organism
A
Condylomata lata
22
Q
Organism to cause warts =
A
HPV 6-11
23
Q
Pap smear screening every…..years
A
3 years
24
Q
Pap smear shows ASCUS , WHATS NEXT?
A
Colposcopy
25
Treatment of mastitis
Amoxicillin
26
Campylobacter jejuni treatment?
Azithromycin
27
Treatment of C .difficile?
Oral vancomycin
28
Ptn with familia Mediterranean fever, which drug to avoid ?
Amoxicillin
29
Pregnant at 35 weeks complaining of headache, abdominal pain ? Management
Give magnesium sulfate and admit for delivery
30
Pregnant with hyperthyroidism on carbimazole 15mg , but still not controlled?
Increase dose to 20
31
Pregnant with hyperthyroidism, what to give?
Propylthiouracil
32
True or false , smoking affects the efficacy of hydroxychloroquine
True
33
……..is a uterotonic medicine that is CONTRAINDICATED in ptn with asthma
Carboprost F2 alpha
34
Which medication can help to prevent hypercalciuria that causes stones
Thiazide
35
20 weeks pregnant ptn with history of preterm delivery , her cervix is 30mm what to do?
Give progesterone
36
Mom just eat polished rice, expected deficiency?
Vit B1
37
Ptn presents with sever asthma on salbutamol what to add
ICS
38
Ptn with irregular cycles anovulatory cycle, how to treat
Progesterone
39
Pregnant with UTI symptoms what to give
Nitrofurantoin, but if she’s in 3rd trimester give her cephalaxin
40
Ptn was given IV mgS04 , what can you give to reverse the action
Calcium gluconate
41
How to treat pregnant ptn with hyperthyroidism?
Depends on the trimester ( if first = propylthiouracil) if 2nd =carbimazole
42
Bleeding diagnosed with ovulatory dysfunction, treatment
OCP
43
Types of estrogen : pregnancy =………., childbearing age …….., postmenupause …..
Pregnancy = Esteriol ( E3 ) / childbearing = Estradiol ( E2 ) / post menopause = Estrone ( E1 )
44
What’s the most important immunoglobulin on breast milk
IgA
45
HIV mother asking if she can lactate
No she’s can’t
46
How can a mother with TB lactate?
Via expressed milk
47
HIV pregnant woman is asking if her baby will be infected?
If the mother is taking her HIV medication, the Chance of passing HIV is less than 1%
48
Lactating mother has UTI, which antibiotics considered safe to use?
Nitrofurantoin, ciprofloxacin, levofloxacin, ofloxacin, trimethoprime-sulfamethoxazole ( tpm, SMX )
49
Can mother with hepatitis B lactate
Yes
50
Female has difficulty breast feeding because there’s no milk, diagnosis
Sheehan syndrome
51
Lactating female with breast swelling, mass, hotness, or redness around areola, mass , tender, LN enlargement. diagnosis & treatment
Abscess / needle aspiration or incision and drainage +/- antibiotics
52
How often mammogram should be done for women 55 and above?
Every 2 years
53
Pregnant with unilateral mobile breast mass? Next
Bilateral US
54
……….. nipple is Contraindicated for breastfeeding
Cracked nipple
55
Treatment of cysttosarcoma phyllodes
Wide local excision
56
Most risk factor for breast cancer is
Age
57
Lactating mother with inverted nipple with slit, diagnosis
Duct ectasia ( widen and hyperplasia of milk duct that becomes blocked )
58
When breastfeeding counseling should be done?
Third trimester
59
If one breast has abscess can she use the other?
Yes
60
Ptn with BIRAD 3 score on mammogram, what’s next ?
Means it’s probably benign and needs follow up in 6 months
61
Female in her 40s with high FSH and LH, she’s in risk for
Osteoporosis ( because high FSH= low estrogen )
62
Ptn on OCP for long time, developed hepatic adenoma, management
Stop OCP
63
Post menopausal woman wants hormonal replacement therapy
Refuse
64
Post menopausal woman with urine incontinence , management
First excercise
65
What’s the most common type of valvular cancer
Sq. Cell carcinoma
66
How to treat valvular cancer , carcinoma in situ?
Superficial local excision with margins
67
Treatment for atrophic vaginitis
Estrogen
68
Female doesn’t want to get pregnant for 2 years what can you offer
Depo Provera injections
69
Post menopausal woman with history of myomectomy ( fibroid removal ) is present with bleeding , endometrial biopsy shows 20mm thickness, diagnosis
Cancer ( most likely )
70
What’s the normal endometrial thickness in post menopausal woman
<5 mm
71
What the normal endometrial thickness during childbearing age
<14mm
72
PTH with history of breast cancer on tamoxifen( ttt for breast cancer ) , what are you afraid of developing
Endometrial cancer
73
Ptn on tamoxifen with post menopausal bleeding, next
Biopsy
74
Ptn with breast cancer and fibroid 8 cm and hypoechoic area, on tamoxifen, presents with vaginal bleeding, diagnosis
Endometrial cancer
75
Ptn with strawberry cervix with post coital bleeding , diagnosis , treatment
Trichomoniasis, metronidazole
76
Female with post coital bleeding, how to diagnose
Inspect vagina and cervix
77
What’s the most likely indicative bleeding for cervical source
Postcoital bleeding
78
Ptn with postcoital bleeding, speculum exam was done and revealed fumigating mass, what next
Cone biopsy
79
Ptn complain of urine leaks during intercourse and after urination, diagnosis
Urethral diverticulosis
80
Ptn with dysuria, dyspareunia with normal urine analysis , without fever?
Urethral diverticulosis
81
What are medrozyprogestone uses?
Treat amenorrhea / uterine bleeding / prevent endometrial hyperplasia
82
Case with amenorrhea for 1 year, treatment
Medroxyprogesterone
83
48 years old female has irregular menses with uterine bleeding , treatment
Medroxyprogesterone
84
Abdominal hysterectomy complicated by abdominal bleeding, what’s the cause?
Liver hemangioma
85
Post menopausal woman with endometrial hyperplasia, management
Hysterectomy
86
Ptn underwent total hysterectomy with oophorectomy, what to give her
Estrogen patch
87
Female complains of vaginal atrophy, treatment
Topical estrogen
88
Bleeding in old female is usually from…..
Uterus
89
Ground glass appearance on US =…..and what does it cause
Endometrioma / it causes infertility
90
What’s the triad of endometriosis?
Pain with menses, sex and deification
91
Post menopausal woman with bleeding, management
Endometrial biopsy
92
Endometriosis is associated with infertility, true or false
True
93
Nulliparity increase risk of endometrial cancer, true or false
True
94
Ovarian cancer treatment
Surgery and chemotherapy
95
Next step after diagnosis malignant phylloid tumor ( type of breast cancer)
Chest CT scan
96
Healthy woman with FH of breast cancer and ovarian cancer,wants to do screening test, what to choose
BARCA genetic test
97
Hypoechoic ovarian cyst = ……..cyst
Malignancy
98
Ca……is elevated in ovarian cancer but it’s not specific
Ca125
99
Pleural effusion + ascites + benign ovarian tumor indicate what syndrome
Meigs syndrome
100
Pregnant, jaundice, itching =
Pregnant cholelithiasis
101
Pregnant with asymptotic mid systolic murmur, diagnosis
Physiologic pregnancy murmur
102
What’s the most common cause of morbidity in multiple gestation?
Prematurity
103
What immunoglobulin can cross placenta
IgG
104
What’s hyperemesis gravidarum?
الوحم
105
Closed Os, empty sac on US , no passage of tissue, diagnosis , management
Anemberoinic pregnancy / follow up after 4 weeks
106
Ptn came to the ER with heavy vaginal bleeding during menses ( menhorragea ) how to stop the bleeding?
Give estrogen alone not combined
107
Ptn with history of multiple D&C which went deeper than it should, now is not having menses anymore, which layer was damaged?
Basiles
108
Most common cause of recurrent abortion in first trimester
Chromosomal abnormalities, or anatomical pb as septate uterus= 1 trimester or arcuate uterus = 2nd trimester
109
When to say this is gestational hypertension?
If it occurs after 20 weeks of pregnancy
110
Eclampsia occurs after 20 weeks of pregnancy and can be caused by gestational hypertension or chronic hypertension, true or false?
True
111
Pregnant in week 22 with hypertension. Treatment / another Q pregnant (12 weeks) complaining of mild edema in the lower limbs ,mild elevation in BP , there is Trace of protein in the urine. What to give
Methyldopa
112
Which drugs can be given for sever HTN?
Labetolol, hydralazin
113
What do you need to diagnose eclampsia
2 readings of HTN + one of these : proteinuria, seizure, headache or visual pb , low platelets, liver dysfunction, other signs of kidney dysfunction, fluid in Lungs,
114
Most common complication of having HTN in pregnancy
IUGR
115
What are the test used to detect chromosomal abnormalities in fetus?
Nuchal translucency, chorionic villus sampling (CVS)
116
Pregnant with DM and now has hypoglycemia, what’s the best rout to give her glucose without causing harm to the baby?
Peripheral venous
117
Pregnant with repeated vomiting, what will you find in urine
Ketones
118
Post partum primary hemorrhage is during first…..hours
24 hours
119
Treatment of postpartum hemorrhage
Oxytocin
120
PPH not responding to oxytocin and massage what to do
B-lynch suture
121
Steps to stop PPH =
Oxytocin with massage, if didn’t stop use ergonovine, if fails either do ligation of uterine vessels or hysterectomy
122
Death from PPH is ….%
25%
123
PPH with asthma, contraindicated drug is ?
Carpoprost
124
Ptn with irregular menses, hairsuthism, high LH, normal FSH , high testosterone , how to diagnose
Glucose tolerance test and lipid profile
125
Obese Ptn with irregular menses, hairsuthism, infertility, diagnosis
Polycystic ovary syndrome
126
Simple test for Turner syndrome
FSH/LH
127
Treatment of polycystic ovary syndrome in ptn doesn’t want to get pregnant soon
Combines pills ; estrogen with progesterone
128
In polycystic ovary, what blood test done for hairsuthism evaluation?
Testosterone
129
What’s the other name of polycystic ovary
Stein levanthal syndrome
130
PCOS Ptn wants to get pregnant what to give
Clomiphene
131
How does PCOS cause endometrial hyperplasia
Because of unopposed estrogen due to lack of ovulation
132
Best treatment combo for ptn with PCOS who wants to get pregnant
Metformin + wt loss + clomiphene
133
In Ptn with PCOS what shall you test for
Glucose, Lipid profile
134
Female with normal breast and coarse pubic hair with high testosterone. Diagnosis
Androgen insensitivity syndrome/ if same symptoms but normal testosterone then it’s Mayer ruktansky syndrome
135
Ptn with dysmenorrhea, heavy menses, history of fibroid or uterine surgery, history of endometriosis, with bulky uterus on examination and MRI, diagnosis / another Q . Patient with dysmenorrhea, heavy bleeding. shows symmetrical uterine enlargement, what is the diagnosis
Adenomyosis
136
How to diagnose adenomyosis?
Mainly clinically + MRI
137
Definitive treatment for adenomyosis
Hysterectomy
138
Risk factors of adenomyosis
Endometriosis , fibroid , uterine surgery
139
What’s adenomyosis
It’s invasion of the endometrium gland into myometrium
140
Adenomyosis usually occurs at age……to….
35-50
141
What do you call a placenta planted deep into uterine wall
Placenta increta
142
Pregnant woman developed sudden dyspnea, chest X-ray shows snow storm appearance. Diagnosis
Amniotic fluid embolism ( fatal case )
143
Complications of D&C for ptn had molar pregnancy
Amniotic embolism
144
Snow storm appearance in uterus US mean’s there is ….
Complete hayditidiform mole ( molar pregnancy)
145
Pregnant with sever vomiting, veryyyy high HCG , uterus is larger than GA, what’s your diagnosis
Molar pregnancy
146
Treatment of molar pregnancy
D&C and follow up on HCG for 6m-1 year, future pregnancy preferably after 1 year
147
D&C done for case with molar pregnancy, what’s the expected early complication
Perforation
148
How to treat tubo - ovarian abscess
Antibiotics, if didn’t work or there is large abscess do drainage
149
Vulvar mass on 5 o’clock with redness, Pain and fever, diagnosis
Infection or abscess in bartholine gland
150
Case with placenta previa came with bleeding at 34weeks. Management
( expectant management = give dexamethasone ) Admit and try to keep her stable until 36 weeks then plan CS, but if heavy bleeding you might need to deliver before so prepare the baby’s lung with corticosteroids
151
What’s the most common presentation for placenta previa?
Bleeding Painless fresh blood
152
What’s placenta previa
When the cervix is covered with placenta
153
Painless bleeding =
Placenta previa
154
Pain + bleeding =
Abruption Placenta
155
Symptoms of placental abruption
Bleeding ( not always) , pain ( Abd, back ) , contractions ( fast ) , uterine tenderness or rigidity
156
Pregnant fell of stairs, she had bleeding then contractions started with closed cervix , diagnosis
Abruption placenta
157
Placenta Abruption first step in the management
Call multidisciplinary team
158
Management of Abruption placenta with massive bleeding
Blood transfusion
159
Ptn with suprapubic pain with cystitis symptoms, diagnosis
Honeymoon syndrome
160
What’s meigs syndrome
Triad of benign ovarian tumor + pleural effusion + ascites
161
What’s the Treatment in nullipara woman to stop sever menorrhagia
Give Conjugated estrogen
162
6 years old girl with vulva itching and bleeding, diagnosis
Foreign body
163
Ptn leak urine whit stress like laugh, cough, sneeze and also when urge to bathroom, what type of incontinence
Mixed incontinence
164
Main action of OCP?
Suppress gonadotropin release
165
Ptn with galactorrhea and irregular menses. First test to do
Prolactin / next step MRI
166
What is the best time to do tubal ligation for woman who doesn’t want to get pregnant
After mensterual cycle
167
Ptn with Turner, has amenorrhea, next test
FSH level
168
What cardiac pb ass. With Turner syndrome
Coartication of aorta
169
Probability of having second child with Turner syndrome
Is very low 1.5 % or 35 fold
170
Teenage girl with webbed neck and short stature, what’s the type of pb
Chromosomal pb
171
What’s the name of the test done to screen for Down syndrome in 2nd trimester
Quadruple test
172
HCG remain high to gestational age indicate:
Maybe Down syndrome
173
Management of ptn with menorrhgia
OCP
174
Adenexal mass was found on pelvic examination, her last period was 2 weeks ago, what is it
Follicular cyst ( that will go away spontaneously in 3 months )
175
Infertility + high prolactin =
Prolactinoma
176
A healthy woman complains of white vaginal discharge, PH is normal, wiff test and culture are negative, diagnosis
Normal physiological discharge
177
Woman with sickle cell disease what to do before she has another abortion,?
Test husband hemoglobin electrophoresis
178
Ovulation happens after ……hours after LH peak
36 hours
179
Treatment that helps in sever normal dysmenorrhea
SSRI
180
Ptn with ground glass appearance, Hypoechoic, what complication expected
Diagnosis is endometriosis, complications is Infertility
181
What’s the acid-base balance for fetus with asphyxia because of placental Abruption
Metabolic acidosis
182
Picture of CTG showing early deceleration, what does it indicate
Intrauterine contractions causing increased intracranial pressure
183
What causes decreased CTG variable deceleration?
Umbilical cord compression ( compression on vein happens first causes acceleration , while artery compression causes deceleration) also magnesium sulfate and nifedipine can cause it
184
What does late deceleration on CTG means
It means there is reduced blood flow to the placenta as in ( Abruptio placenta) and decreased blood flow to fetus causing hypoxia ( asphyxia ) and acidosis,
185
What phase of contractions does late deceleration on CTG indicate?
Peak of uterine contractions and recovers after contraction ends
186
……….deceleration is an absolute contraindication for ECV ( external cephalic version )
Variable deceleration
187
What are the contraindications for doing ECV?
Amniotic fluid too high or too low , twins, extended neck, fetal abnormalities, fetal distress or mother with heart pb, vaginal bleeding , placenta previa, abnormal uterus shape, CS is already needed
188
If uterus compress inferior vena cave it will cause….
Hypotension
189
Woman in labor was given oxytocin, her water broke 20 hours ago and now the CTG shows late deceleration, what to do
Stop oxytocin
190
Ptn in labor is having Anesthesia, fetus is now having bradycardia, what to do
Stop anesthesia
191
Hypotensive Ptn in labor with normal contractions , CTG shoes bradycardia, what’s the possible cause
Epidural anesthesia
192
DM Ptn in active labor the fetus is in distress , what to do ?
Change mother position
193
Ptn in labor in 2+ station without uterine contractions and cervix opening is 4cm what to do ?
Wait for 2 hours
194
Symptoms of vasa previa
Usually occurs after rupture of membrane, there might be painless dark vaginal bleeding, fetus bradycardia
195
Causes of fetal sinosoidal heart rate pattern
Fetal anemia ( iron deficiency) , asphyxia, infection, cardiac anomaly, fetal or maternal hemorrhage,drugs as narcotics ( it’s ass. With high morbidity ) it looks like even-straigh soft zigzag / wavy line
196
Common cause to decreased variability on CTG is
Magnesium sulfate
197
Mother can’t feel the baby’s movement, non-stress test was done and it’s reactive, biophysical profile is 8, what to do
Reassure and follow up after 1 week ( full score is 10, score 6 is equivocal )
198
Prolonged deceleration is when it’s more than ……minutes and it means Non-reassuring and if it’s more than ….. then it’s abnormal
More than 2 minutes/ more than 3 minutes
199
Woman with pre-eclampsia + hypotension and on oxytocin, magnesium sulphate and epidural anesthesia the fetus CTG shows prolonged deceleration, what’s the cause
Epidural anesthesia
200
Pregnant came at 10 weeks pregnancy its her 1st visit, what to check first?
CBC for anemia
201
Ptn at 31 weeks and 5 days with premature rupture of membrane, CTG with sever variable deceleration, management
Give Tocolytics and corticosteroids
202
Premature rumor membrane on 32 weeks, management
IV antibiotics and corticosteroids
203
When to give antibiotics in case of premature rupture of membrane
I’m cases before 34 weeks
204
How to confirm that the fluid is actually an amniotic fluid, tests!
Nitrazine and ferning tests
205
Rupture of membrane in woman at 38weeks GA, what’s next
Induction of labor
206
Female with prior history of premature labors, came at 22 week , cervical opening was 30mm, what to do
Give her progesterone only
207
Pregnant with premature labor at 32 weeks was giver magnesium sulfate 2 days ago, now the respiratory rate is 8 with other side effects, what to do
Stop magnesium sulfate
208
How can you differentiate thalassemia from iron deficiency anemia
From RBC count, which is low in iron deficiency anemia and normal to high in thalassemia
209
Ptn smoker, on OCP for 6 years is now having ovarian cystectomy, suddenly during the surgery she developed hypoxia, tachycardia, hypotension, what the cause
PE
210
Ptn with IUFD came with dyspnea and other symptoms, her PT and PTT was high and her plasma and fibrinogen are low, diagnosis
DIC
211
Old lady had uterine fundal mass, surgery was done what lymphatic drainage should be removed as well
Para-aortic
212
What should you give female planing to get pregnant
Folate
213
Ptn primigravida with history of DVT , what to give her
Enoxaprin
214
Ptn on OCP develops signs of DVT, what’s the cause
OCP
215
Female missed period for 2 months and has signs of right leg swelling, what’s the important question to ask
History of using OCP
216
Ptn had still birth at 38 weeks, she was normal on discharge but after 3 days she came with bleeeding from injections sites, cause
DIC , check fibrin products
217
Pregnant with fetal death develops DIC, management
Induce labor
218
Female with history of multiple abortions and pulmonary embolism or thrombo embolic events, +/- in history might mention high ptt and anticardiolipin elevated , diagnosis
Antiphospholipids syndrome
219
Pregnant came with open OS and history of passing some tissue, diagnosis
Incomplete abortion, if complete the OS would be closed
220
Case of incomplete abortion, D&C was done ,after that the ptn never had menses, what layer was damaged
Basalis layer of endometrium
221
Incomplete abortion with sever bleeding management
Fluids, D&C
222
Vaginal bleeding with closed os, diagnosis, management
Threatened abortion, bed rest
223
Inevitable abortion means
Heavy bleeding with abdominal pain with open of OS but no tissue passage yet
224
Threatened abortions means
Vaginal bleeding with closed OS and NO tissue passage
225
When to give antibiotics in case of CS
In preoperative preparations
226
Pregnant at 32 ( maybe ) hypertinsive ,she was given magnesium sulfate but she had seizure whats next?
Immediate CS
227
2nd stage of Labor , face presentation what to do
CS
228
34 weeks present with contractions every minutes , cervix is dilated 3 cm , with intact membrane, transverse fetus with good HR, she had vagina bleeding , on US placenta is attached to the posterior fundus , what to do
CS
229
Occipito-………is done with vaginal delivery while occipito……..need CS
Occipito-anterior = vaginal delivery / posterior = CS
230
Primigravida in station 2 labor for 3 hours , was given epidural, what’s next
Observe ad wait
231
Female in labor, everything was normal suddenly the contractions stopped and develops fetal distress , what to do
Change mother’s postision
232
Ptn with IUFD ( death ) with DIC, the cervix is 6cm dialted, what do do
Try to do vaginal delivery with help of oxytocin
233
Case of labor with cervix efacement 50% and 2 cm dilated, mother snd fetus are stable, how to confirm
Re-check through pelvic exam every 2 hours
234
Ptn term for delivery and cervix is dilated whats next
Oxytocin
235
Fetal heart drops to 80 and contractions last only 2 minutes, what next ? Another Q pregnant at 38 weeks with polyhydraminus, presents with ROM and abd. pain, fetal bradycardia, diagnosis?
Assessments for cord prolapse ( fetal bradycardia = cord prolaps )
236
Cases of episiotomy: if small, blue but not painful =…….but if large, painful…….
If small = RICE ( rest, ice, compression, elevation ) if large = surgical
237
Female complain of vaginal fulness especially when standing for long periods, whe she urinate she has to push with her hands, diagnosis
Cystocele
238
Female after uterus prolapse surgery is now having urine leaks from her vagina, or another case is passing fletus fro, her vagina, diagnosis
Vesicovaginal festula / recto-vaginal fistula
239
Urine leaks from vagina during urination ONLY , means ……..while if leaks continue……
Uretherovaginal / vesicovaginal
240
Whats the important thing to check before using instruments in delivery
Cephalo-pelvic proportion
241
What can casue 4th degree perineal laceration during vaginal delivery
Restrained legs with the use of forceps and other metal equipment
242
Favorable twin presentation in labor is
Cephalic- cephalic
243
When fetus is in breech position with flexed hips and knees, what is called
Complete breech
244
Ptn with bicorunate uterus, fetal heart is heard at the level of umbilicus, what’s the fetus presentation
Breech
245
Female present with sever unilateral lower abdominal pain with nausea and vomiting, US show mass ( also felt on examination) whats the diagnosis?
Ovarian torsion
246
Female with maybe ( multiple sexual partners history ), came with abdominal pain and suprubic tenderness , fever , discharge,
Salpingitis ( fallopian tube infection )
247
Female asymptomatic, has fibroid 5*6 cm ,management , treat
Follow up every 6 months /
248
Female didn’t complete her family, has subserous fibroid, management
Hysteroscopic myomectomy
249
Ptn with bleeding and fibroid, she wants to have kids, management
Laparoscopic myomectomy
250
Fibroid that increase in size in post-menopause , consider…….endometrial hyperplasia maybe present
Lyiomyosarcoma
251
Fibroid inceasing in size + endometrial hyperplasia =
Leomyosarcoma ( myosarcoma )
252
Female with ectopic pregnancy 1-3cm , bhcg 2600 , treatment
Methotrexate
253
In ectopic pregnancy the defect is in ……
Implantation
254
What determines treatment if ectopic pregnancy wether to do medical or surgery?
Vital stability
255
Path had salpingiostomy, now present with high BHCG, treatment
Methotrexate
256
Vague abdominal pain with amenorrhea for 2 months , history of perforated appendicitis 14 years ago , came with HCG 1800 ,treatment
Methotrexate
257
Ectopic pregnancy with BHCG 2500, A week later its 6000 , despite medical treatment whats next
Salpingiostomy ( removal if fetus only with preserving the tubes )
258
Best question to ask ptn with ectopic pregnancy / another Q ; 3. What to ensure before discussing a medical management in a pt with ectopic pregnancy
Accessibility to hotspital, if she lives far away then its better to admit her
259
Married lady came to ER with right lower abdominal pain, drowsy, sluggish bowel sound, diagnosis
Ruptured ovarian cyst ( sicne the didn’t mention pregnancy test )
260
Ptn had salpingiostomy , how to follow up with BHCG measurement
Measure weekly until it’s undetectable
261
What’s the most common risk factor for ectopic pregnancy
Pelvic inflammatory disease
262
Most important contraindication for intrauterine device
Pelvic inflammatory disease
263
Ptn with ectopic pregnancy with BHCG 3500 refused surgery, next
Treat medically but let her sign consent
264
Surgical treatment for ectopic pregnancy in stable case is……while if unstable is ……
Stable : lapdoscopy , unstable laparotomy
265
Treatment of cervical polyps
Excision in clinic
266
Ptn complains of amenorrhea several moths after doing D&C, diagnosis
Asherman syndrome ( scar tissue is formed after D&C )
267
UTI treatment in pregnancy : 1st & 2nd trimester = ……. 3rd trimester =…..nad pyelonephritis…..
Treatment in 1,2 trimester is Nitrofurantoin, amoxicillin / while in 3rd trimester = amoxicillin, cephalexin /
Pylonephritis = IV ceftriaxone
268
Pregnant with UTI but asymptomatic, is treatment needed?
It Is needed because if not treated she migh has an abortion
269
Female with UTI , US shows multiple cysts in the kidney parynchema, diagnosis
Polycystic kidney
270
Female with abdominal pain with mensteruation , US shows multiple cysts with variations in size, diagnosis
Fibrocyst
271
Pregnant wirh recurrent UTI, next investigation
Cystoscopy and RFT
272
Ptn lactiting with UTI, whatto give
Nitrofurantoin
273
Ptn 3rd day post-operative has gram negative bacteremia, how it reached
The blood
Through UTI
274
Early identification of disease is considered. ………screening
2ry screening
275
Female suffered from low mood for just 2 weeks after delivery, diagnosis
Delivery blues
276
Smoking in pregnancy side effect
IUGR
277
Nuchal translucency scan is done for?
Detecting Down syndrome ,in fetus by measung the back of the neck ( neck fold thickness ) in fetus it also used to detect heart problems
278
Whats the highest yield examination in prenatal?
Pelvis examination
279
Otn in active labor with full effacement and cervix 7cm with FHR 120, station 3+ , cord prolaps out of the vagina, management
CS
280
Risk factors for endometrial cancer
Early menarche and late menopause
281
60 years old post menopause female present with pea like small mass on vulva that is itchy and ass. with bleeding after itching, diagnosis
Sq, cell carcinoma ( lesion is tender mostly abscess, if bartholine cyst usually asymptotic)
282
Pregnant at 33 week present with BP 150/100 , proteinuria 3+ , headache, management
Since its preterm admission + magnesium sulfate + lower BP + steroids , then discus delivery options
But if she full term give her the same with oxytocin and deliver
283
Ptn in labor after 10 years of infertility, the fetus in -2 , cervix is 4 cm , effacement in 50% , the presenting part was soft and globular ( breech ) , management
CS
284
Note; whats is tocolytics are used for?
Is used to ihibit labor in preterm to allow the fetus grow more before delivery but it’s contraindicated to give if the cervix is 4cm or more
285
Female ptn with stress incontinence , resambles what
Cystocele
286
Normal postpartum bleeding with vaginal delivery is …… while with CS is …..
Vaginal <500ml , CS < 1000ml
287
whats the best indicator of normal fetal growth
US ( crown-rump length ) used from 6th week till the 14th week
288
What type of consent needed to do endometrial biopsy
Verbal consent
289
Female with painful mass bulge inferior-lateral to pubic tubrcle
Femoral hernia
290
Chocolate cyst ( ovarian cyst ) size 6*7cm , management
Laparoscopic resection ( lap cystectomy )
291
65 years old lady came with IUB with endometral mass, management
Total abdominal hysterectomy
292
Case of concealed abrobtio at 34weeks , whats next
Cardiototography
293
Case of pre-eclamsia symptoms ( HTN, proteinuria ) preset at 32-34 weeks, management? Another Q ptn with preeclampsia ( sever headache , visual blurring ) at 34 week, what to do
Admit to hospital / give magnesium sulfate and induce delivery at 34 week
294
Unbooked pregnant came with bleeding , abd pain, BP 170/100 , she took time to arrive because she lives far, CTG was done amd reassuring, next
Asmit to hospital
295
Pregnant at 39 week present with proteinuria, BP 140/90 , management
Labor induction
296
Speculum exam of cervix shows mass, what type of biopsy is done
Directed biopsy
297
Melanoma on vulva is ……..melanocytes
Malignant melanocytes
298
Female ptn with DVT what to give?
Celaxane
299
Pregnant at 34 week with history on previous CS, on plevic exam : cervix is 3cm dilated, on US placenta was anterior and lying low, why ECV is contraindicated in this case?
US findings
300
Ptn in menopause asking about the cause of hot flushes
Peripheral vasodilation because of high FSH, LH
301
Ptn with amenorrhea for 12 weeks but fundus hight is 16th week , on US fetal is small to age, diagnosis
Hyditiform
302
Pregnant with lower limb edema , BP 150/70 , what to give
Labetolol
303
Primigravida in active labor for 4 hours with cervix dialted 5cm ,contractions every 3 minutes, after 5 hours still within the same condition , management
Re-evaluate in 2 hours
304
14 years old with irregular menses and normal PE, management
Reassure
305
Primigravida 42 weeks, cervix is closed, prostaglandin gel is given , fetal HR was 160 before and after is 80, with closed cervix and contractions last 2 min, next
CS
306
30 years old female with 8 months amenorrhea, high FSH, LH , otherwise normal labs, diagnosis
She’s in risk for endometrial cancer( case of PCOS )
307
Ptn with asthma and mitral stenosis, which indicate using instruments during 2nd stage of labor
Mitral stenosis
308
Pregnant in 8 week, never been vaccinated or exposed to chicken box. What to do as prevention
Avoid exposure
309
Pregnant with seizure, treatment
Magnesium sulfate
310
Pregnant with HTN and proteinuria at 34 week, management
1- give magnesium sulfate , 2- correct general condition, 3- then deliver
311
Pregnant at 38 week, present with headache, normal CBC, normal LFT, high albumin/ createnine ratio, BP is 150/90 , diagnosis
Pre-eclamsia
312
Ptn breastfeeding develops right upper quadrant breast pain with erythema and swelling , on PE : tenderness , no LN involvement, management
Fluxacin
313
Early deceleration is physiological and indicates contractions, it happens due to increase in intracranial pressure and vagal tone , true or false
True
314
Is endometriosis ass. with ovarian cancer
Yes
315
What’s adenomyosis
occurs when the tissue that normally lines the uterus (endometrial tissue) grows into the muscular wall of the uterus.
316
40 -year-old P5 +3 presented complaining of abnormal uterine bleeding her Menstrual period is regular, associated with blood clots and pain that is not relieved by simple analgesic she had previous myomectomy she is a known case of what?
Adenomyosis
317
20 years pregnant Woman presented with lots of fetal movement followed by , decrease urine output and dysnpea , Ptt prolonged, fibrinogen low , platelets low
Amniotic embolism
318
Abortion case: severe vaginal bleeding , hypotensive, cervix wide open you can see the tissue in examination, management
D&C
319
A female with urinary incontinence, leak when she sneeze, cough and laugh And when urge to void, what is the type of leak
Mixed incontinence
320
Female post-partum week 6, doesn’t want to conceive in the next 2 years, what contraceptive you give?
IUD
321
Pregnant with abdominal pain and tenderness, CTG shows bradycardia, what is the, cause
Placenta abruption
322
PCOS S&S, doesn’t want to get pregnant how to control her oligomenorrhea?
Combined OCP
323
Benign ovarian tumour differes from malignant tumour in that?
Hypoechoic ( cancer )
324
Pregnant female with hypertension, what is the most common complication?
IUGR
325
Risk factor for abruptio placenta?
HTN
326
Ptn with painless vginal bleeding and CTG shows fetal bradycardia?
Placenta previa , if there was ROM then painless bleeding and bradycardia then its vasa previa
327
5. 70 yr female with lesion in urthtra (pic) that easily bleed?
Urethral caruncle ( affect postmenupause women, usually painless outgrow of posterior utheral opening , treatment is with sitz baths and estrogen maybe needed )
328
27 females presented with acute abdominal pain. She was requested for CT. Which of the following is the most important
Pregnancy test
329
mother infected with HBV what type of prevention?
Secondary
330
Most appropriate management in female with placenta previa mild bleeding at 32 gestational age, us showed partial placenta previa
Expectant management
331
Counting the expected date of delivery according for NGLS rule for female her LMP is 17 May 2019
24 February
332
6 y/o child present with vaginal discharge tinted with blood, since few days what is the cause / another Q; In case of child sexual abuse what indicates hymen penetration?
Sexual abuse, tear at 6 o’clock
333
pregnant with ectopic pregnancy, bhcg 5000, us finding 4 cm non- viable sac, she lives far away from the hospital and her husband in military mission, her neighbours brought her to the hospital, whatvis highly suggestive for choosing surgical management
Social history
334
Patient unstable present with hypotension, tachycardia and signs of ruptured ectopic pregnancy, how should she manged
Immediately take care of her with observation of multidisciplinary team
335
1. Pregnant lady 11 weeks pregnant presented with UTI, name the antibiotics that is contraindicated during pregnancy?
Trimethoprim sulfamethoxazole ( better to a avoid it in 1st trimester because it causes folate deficiency)
336
young female (21-24-year-old) with history of amenorrhea for 6 weeks and us found mass (suspicious finding) patient complain of shortness of breath what is the appropriate next step
Chest CT or X-ray with chemotherapy ( maybe case of choriocarcinoma although it’s known to cause vaginal bleeding )
337
Patient had a salpingostomy, she is following up with the hcg every week, they noticed the hcg plateaued for 3 weeks on 3442, what’s next
Methotrexate
338
Patient with sever depression on paroxetine, she is thinking of getting pregnant, what to do
Stop paroxetine
339
Missed abortion pic (13 weeks) (2q same scenario) Dx and ttt
Follow up for 4 weeks
340
pregnant on 23 weeks with signs of cholecystitis what to do
Cholecystectomy
341
Pregnant with symptoms of pancreatitis and generalize abdominal tenderness + hx of cholelithiasis dx
Acute pancreatitis
342
patient came to the clinic complaining of a mass on a vagina she has a history of repeated unprotected intercourse with multiple partners, upon examination. she has a wart in the vagina, the causative agent is?
Treponema pallidum /
| if there was Condyloma acuminate > HPV is more accurate
343
Pregnant, 37 weeks or less hx of one pervious CS Now Has twin.. Twin A breech and Twin B cephalic, ROM one hour ago Dr decided CS What is the indication of CS for this Pt
Fetal presentation
344
41-Year-old pregnant GA 36 weeks presented with abdominal pain, no bleeding. On examination there’s tender tense uterus, there is NO gx of trauma within 48 course, didn’t mention CTG or hx of fibroid
Placenta abruption
345
426. 38 weeks gestation woman presented with light-headedness, dizziness and fainting “and maybe palpitations not sure”, when sleeping on bed, what is most appropriate management?
A. ECG and ECHO
B. blood transfusion
C. advice the patient not to sleep on her back
Answer is: C
346
Clear case of HTN in 15 weeks of pregnancy?
Chronic HTN
