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USMLE STEP 2, for real tho > Kim teaches small group > Flashcards

Kim teaches small group Flashcards

1
Q

Molar pregnancy age distribution

A

the extremes

Old and young

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2
Q

labs for DIC

A

fibrinogen
Increased D-dimer
Thrombocytopenia
PT-PTT INR

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3
Q

Symptoms of prego mole

A
  • Hyperemesis
  • Irregular heavy bleeding
  • Toxemia
  • thyroid storm
  • large uterus
  • absent fetal heart
  • tone/movement
  • passage of tissue
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4
Q

HYDATDIFORM MOLE treatment

A

suction D/C to evacuate abnormal tissue

IV oxytocin will prevent hemorrhage and expel products

Put them on OCPs

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5
Q

HYDATDIFORM MOLE HCG checks

A

weekly until under 2 for three measurements
Then once a month for 6 months

need to be on birth control (differentiate why there is Hcg)

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6
Q

HYDATDIFORM MOLE is asc. with what cancer

A

Choriocarcinoma

monitored via HCG

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7
Q

Choriocarcinoma

A

Malignant tumor composed of trophoblasts and syncytlotrophoblasts; mimics
placental tissue, but villi are absent

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8
Q

Endodermal sinus tumor

A

Malignant tumor that mimics the yolk sac; most common germ cell tumor in
children

Serum AFP is often elevated.

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9
Q

Risk of recurrent molar prego

A

1-2%

after 2 moles, recurrent 10%

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10
Q

BRCAl mutation carriers have an increased risk for ____________ of the
ovary and fallopian tube

A

serous carcinoma

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11
Q

two most common subtypes of the most common ovarian tumor _________ are _________

A

SURFACE EPITHELIAL TUMORS are the most common

subtypes: serous and mucinous

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12
Q

SURFACE EPITHELIAL TUMORS are made of what

A

Derived from coelomic epithelium that lines the ovary

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13
Q

Symptoms of cervical cancer

A

post coidal bleeding

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14
Q

What happens when you get a pap + for adenocarcinoma of cervix

A

You need to get a biopsy of cervix

BUT it could also be from endometrium or ovary

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15
Q

Uterus polyp vs fibroid

A

Polyp is endometrial origin- soft

Fibroid is myometrium- hard

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16
Q

Postmenopausal endometrium strip size

A

Normal 4 mm or less

4 mm or larger is not good

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17
Q

What is a partial hysterectomy

A

partial will leave behind the cervix

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18
Q

__________ intake can increase the pain associated with fibrocystic breast changes

A

Caffeine

19
Q

A normal mammogram does not rule out breast cancer, especially in the presence of ?

A

bloody discharge.

20
Q

Most postpartum mastitis is caused by

A
  • staphylococcus aureus, so a penicillin-type drug is the first line of treatment
  • Dicloxacillin (penicillin resistant staphylococci)
  • Erythromycin may be used in penicillin allergic patients.
21
Q

Prostaglandins are used for cervical ripening and are contraindicated in patients with history of _________

A

previous Cesarean section

22
Q

What prostaglandin is for prego

A

prostaglandin E2

23
Q

A biophysical profile is not of any value in ?

A

labor.

24
Q

___________ may be used for repetitive variable decelerations

A

Amnioinfusion

25
Q

Early decelerations are physiologic caused by ?

A

fetal head compression during uterine contractions, resulting in vagal stimulation and slowing of the heart rate

characteristic mirror image of the contraction

26
Q

A late deceleration is a symmetric fall in the fetal heart rate, beginning at ?

A

start at/ after the peak of the uterine contraction and returning to baseline only after the contraction has ended.

27
Q

Late decelerations are associated with?

A

uteroplacental insufficiency.

28
Q

Variable decelerations show an ?

A

“V-Shape”

acute fall in the FHR, with a rapid down slope and a variable recovery phase.
may not bear a constant relationship to uterine contractions.

29
Q

Variable decelerations are typically associated with ?

A

cord compression, especially in the setting of low amniotic fluid volume.

30
Q

Fetal Bradycardia?

A

under 110

31
Q

Fetal Tachycardia?

A

Over 160

32
Q

Absent variability fetal HR

A

no changes in HR

hypoxia or other problems

33
Q

Mild variability fetal HR

A

less than 5 changes in HR

hypoxia or other problems

34
Q

Moderate variability fetal HR

A

2-25 changes in HR

Reassuring =)

35
Q

Marked variability fetal HR

A

over 26 changes in HR

36
Q

VEAL CHOP

A

Variable decelerations…..Cord compression
Early decelerations………Head compression
Accelerations…………….OK, may need Oxygen
Late decelerations……….Placental Insufficiency

37
Q

Variable decelerations…..

A

Cord compression

Variable decels → reposition mother to knee-chest position to get baby’s head off the cord OR use two fingers to lift the baby’s head off the cord until further interventions required

amnioinfusion may be used to treat patients with variable decelerations

38
Q

Early decelerations………

A

Head compression

sign that baby is descending into the pelvis, monitor as needed

39
Q

Accelerations…………….

A

OK, may need Oxygen

reassuring (normal) sign; last for 15+ seconds and peaks 15+ beats/min

40
Q

Late decelerations……….

A

Placental Insufficiency

worrisome sign; reposition mother, administer IV fluids and anticipate discontinuing/decreasing Oxytocin or administering a tocolytic to decrease

41
Q

Sinusoidal fetal HR

A

last 20 minutes–> immediate delivery

Looks like a sign wave

42
Q

Late decelerations when_____________ are an ominous sign

A

viewed as repetitive and/or with decreased variability

43
Q

Initial measures to evaluate and treat fetal hypoperfusion include

A
  • maternal position to left lateral position–> ↑ perfusion to the uterus
  • maternal O2
  • treatment of maternal hypotension
  • discontinue oxytocin
  • consider intrauterine resuscitation with tocolytics
  • intravenous fluids
  • fetal acid-base assessment with fetal scalp capillary blood gas or pH measurement.

USMLE STEP 2, for real tho (16 decks)

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