OB Flashcards
How long should pts wait to get pregnant after Tx for melanoma?
At least 3-5yrs
90% of recurrences occur within 5yrs
Most appropriate next step to attempt to resolve shoulder dystocia after McRoberts/suprapubic pressure
Delivery of the posterior arm
Endometrial Cancer Risk Factors Mnemonic
ENDOMET (Elderly, Nulliparity, Diabetes, Obesity (BMI 30+), Menstrual irregularity, Estrogen monotherapy, hyperTension)
HPV induces dysplasia by promoting the degradation of p53 via the expression of what?
E6 and E7 genes
E6 & E7 gene expression is a key element in the pathogenesis of malignant disease
Test used to Dx SUI?
Cough stress test
How many days after fertilization is embryo transfer assoc. w highest implantation and live birth rates?
5 (blastocyst stage)
Tx for central precocious puberty?
Gn-releasing hormone agonist
Tx of McCune-Albright?
Letrozole ( an aromatase inhibitor)
Presents w painful lesions, vesicles on erythematous base, primary infection may also cause systemic Sxs and tender lymphadenopathy
HSV
Prior to what GA is the use or cytotec for IOL acceptable for pts w prior c-section?
28wks
This aromatase inhibitor prevents the cnvsn of androgens to estrogens/ is typically used In Postmenopausal women w ER & PR + cancers
Anastrozole
This monoclonal Ab binds to the HER2/neu oncogene receptor & prevents cell proliferation
Trasztuzumab
(which can cause severe cardiotoxicity)
How many kilocalories per day are recc in 2nd trimester of pts w nml BMI?
340 additional kilocalories per day
No additional cals in 1st trimester, 450 in 3rd
Transilluminating for accessory port placement heps avoid injury to what?
Superficial epigastric aa.
Inferior epig aa. Tend to course beneth these but are too deep to be seen by transiluminating
What CA125 level should you refer a pt to Gyn Onc in the pre-menopausal period?
> 200
A pt at 8wks GA complains of rash, malaise, myalgias, the pt is tests + for CMV IgG and IgM, next step in diagnosis?
Avidity testing
A high-avidity IgG suggests old infection, low acidity suggests recent infection
Most imp hormone measured to confirm menopausal status? Levels above what are considered menopausal?
FSH
40
Pts typically present w a painful genital ulcer 1-2cm in size w clearly demarcated edges, may also have inguinal lymphadenopathy
Chancroid - rare infection caused be Haemophilus ducreyi, a gram Neg ROD
(Rare in US, May be seen in sex workers)
Preferred initial Tx for Chancroid (2 good options)
Azithro or Ceftriaxone
Consider empiric Tx for syphilis
What is polypropylene?
Aka Prolene- a synthetic, monofilament, nonabsorbable suture
What is polyglactin 910 ?
Vicryl!
When is cervical cancer an indication for cesarean delivery? (In those who chose to cont the preg)
Stage 1B1 or greater, And stage 1A1/1A2 with POS margins on cone performed during preg
Contraindications for COCPs in women with DM?
Evidence of microvascular disease (retino-,nephro-, or neuro- pathy) or Duration of DM >20 yrs
MC chemo regimen for granulosa cell tumors?
Bleomycin, Etoposide, and cisplatin (Platinum) ie BEP protocol
An embryo with a crown-rump length greater than or equal to what is considered nonviable in the absence of cardiac activity
7 mm
At what CA125 level should you refer a post-menopausal pt to Gyn Onc?
Greater than 35
International units/mL
4 reasons to refer a premenopausal pt w a newly Dxed pelvic mass to Gyn Onc?
- CA125 greater than 200
- Ascites
- evidence of Mets (by exam or imaging)
- FH of breast or ovarian Ca in a 1st degree relative
Perioperative use of garlic, ginkgo and ginseng have all been associated with?
(Ginseng can also cause what perioperatively?)
Increased risk of bleeding ;
Hypoglycemia
MC side effects of AIs?
Menopausal Sxs, joint and muscle pain
Competitively inhibits 5a-reductase-> inhibits cnvsn of T to DHT-> decreased DHT levels used for androgenic alopecia/ BPP/ off label for hirsutism
Finasteride
What parameters on fetal umbilical artery blood gas are consistent w a peripartum or intrapartum fetal hypoxic event?
PH <7.15, base deficit of >/=12 or both
At what gestational age should crown rump length no longer be used to data pregnancy but biometry should be used
At 14.0wks and beyond (=CRL of 84mm)
Pts w hypogonadotropic hypogonadism will respond best to what type of ovulation induction?
Urinary human menopausal gonadotropins (which contain LH and FSH)
Infant born w cataracts, patent ductus and hearing loss, what is the most likely inutero infection?
Rubella
