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Kaplan step 2 qbank > ob and gyn > Flashcards

ob and gyn Flashcards

* master the art of answering questions

1
Q

what is urge incontinence

A

It refers to the leakage of urine caused by involuntary bladder contraction

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2
Q

what is the first line management of urge incontinence

A

behavioral therapy:
pelvic floor exercises
bladder training (frequent voiding q1-2hrs while awake)

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3
Q

the most frequently prescribed medication for urge incontinence is ……

A

anticholinergic drugs with antimuscarinic effects e.g. oxybutyrin

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4
Q

surgery is an effective treament for urge incontinence. True/False

A

False

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5
Q

other than abstinence, what is the best method to prevent sexually transmitted disease (STD)

A

proper use of condom

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6
Q

depo-medroxyprogesterone acetate shot is associated with prolonged and/or irregular vaginal bleeding. T/F

A

True

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7
Q

what is recommended for a patient who is interested in intrauterine device (IUD) who recently got treated for STD

A

the patient should wait 3 months before an IUD use

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8
Q

what is fetal scalp sampling (FSS)?

A

FSS is a method of fetal assessment used in labor and delivery to obtain fetal blood for pH assessment which will help with the management of labor if fetal heart rate tracing isn’t reassuring

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9
Q

what is the management of the fetus with pH >7.25 upon FSS

A

manage expectantly

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10
Q

what is the management of the fetus with pH7.20-7.25 upon FSS

A

FSS should be repeated in 15 to 30mins

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11
Q

what is the management of fetus with pH<7.20

A

delivery is indicated

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12
Q

most commonly used prenatal vitamins contain………IU or …..

A

5000 IU or less

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13
Q

why is Vitamin A contraindicated during pregnancy?

A

there is increased risk of neural crest malformation with use

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14
Q

severe variable FHR decelerations are due to ……………………..

A

umbilical cord compression

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15
Q

Prolonged, severe variable decelerations may result in fetal …………

A

acidemia

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16
Q

define placenta previa

A

It is defined as a placenta located over the cervical os

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17
Q

what are the three major types of placenta previa?

A
  • central or total or complete placenta previa
  • partial
  • marginal or low-lying placenta
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18
Q

what are the three major risk factors of placental previa

A

maternal age, minority race and previous cesarean delivery

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19
Q

what complication of placenta previa increases in those with repeated cesarean deliveries and h/o placenta previa?

A

placenta accreta

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20
Q

what is the most likely management of a patient with a previa and accreta at the time of delivery?

A

hysterectomy

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21
Q

how is hyperthyroidism diagnosed in pregnant women?

A

it is made when serum results show TSH < 0.1 mU/L and high free T4

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22
Q

for pregnant women with moderate to severe symptoms of hyperthyroidism, what is the drug of choice?

A

propylthiouracil or methimazole

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23
Q

what is the most common physical symptom of premenstrual dysphoric disorder?

A

abdominal bloating

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24
Q

what is the treatment of group B streptcoccus in a pregnant woman?

A

penicillin G

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25
Q

what is the treatment of chlamydia in pregnancy?

A

a single dose of azithromycin

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26
Q

how do one ensure that the infection of chlamydia is cleared?

A

treatment of all sexual partners and test of cure 4-6 weeks after treatment

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27
Q

define fetal demise?

A

fetal demise is defined as death of a fetus after 20 weeks’ gestation and prior to delivery

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28
Q

the ACOG recommends treatment of persistent chronic hypertension when the blood pressure is

A

persistently >=160mmHg systolic or >=105mmHg diastolic

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29
Q

The NIH and AHA recommend keeping blood pressures below

A

150/100mmHg

30
Q

pregnant women who have uncomplicated mild hypertension are at risk for ……………, ………………, ………………, …………………

A

intrauterine growth restriction, placental abruption, preterm delivery and superimposed preeclampsia

31
Q

a breast feeding mother presents with a hard, red, tender, swollen area of one breast, fever and chills. what do you suspect?

A

mastitis

32
Q

mastitis is most commonly caused by ………………

A

staphylococcus aureus

33
Q

what is the treatment of mastitis?

A

beta-lactamase-resistant drug like dicloxacillin or erythromycin if patient is allergic to penicillin and continue breastfeeding

34
Q

what is the criteria for the diagnosis of preeclammpsia?

A

blood pressure > 140/90mmHg after 20 weeks’ gestation with proteinuria >300 mg/24 h or >1+ on urine dipstick

35
Q

what is the management of mild preeclampsia?

A

expectantly management

36
Q

what are the aims of fetal heart monitoring?

A

to evaluate fetal response to blood volume changes, acidemia and hypoxemia

37
Q

a fetal heart monitoring shows the baseline to be in the 140s with gradual decrease (15/min) in heart rate that coincide with uterine contraction indicates ……………

A

early deceleration

38
Q

what is the most common cause of late deceleration?

A

uteroplacental innsufficiency

39
Q

a fetal heart monitoring shows the baseline to be in the 140s with gradual decrease (15/min) in heart rate with onset after a contraction has occured indiates …………

A

late deceleration

40
Q

what is the most likely cause of early decleration?

A

fetal head compression

41
Q

what is the most likely cause of variable deceleration

A

umbilical cord compression

42
Q

what are the circumstances in which pap can be repeated in 6 months?

A
  • previous abnormal pap without interval normal screening
  • previous glandular abnormality
  • insufficient previous screening
  • inability to visualize/sample the endocervical canal
  • positive high-risk HPV testing in the last 12 months
43
Q

when should pap smear begin and how often should it be done?

A

begin at 21yrs, done q3y

44
Q

one of the most important risk factors for developing uncomplicated UTI in postmenopausal women who are not taking hormone replacement therapy is …………..

A

hypoestrogenemia

45
Q

how can uncomplicated UTI be prevented in a postmenopausal woman

A

estrogen administration

46
Q

what is the treatment of endometrial cancer

A

surgical staging

47
Q

for those with endometrial cancer who are not surgical candidates, what is the management?

A

radiation therapy

48
Q

an infertility workup for a couple should start with ……………

A

semen analysis

49
Q

normal semen findings include

A
  • pH 7.2-7.8
  • volume >1.5mL
  • sperm density >15million/mL
  • total motility >40%
  • morphology >4% normal forms
50
Q

what should be done after a single abnormal semen analysis

A

there should be a repeat semen analysis 4-6 weeks after the first one

51
Q

how many semen analyses are required before male factor fertility can be diagnosed?

A

two

52
Q

what is the rate of vertical HIV transmission during pregnancy in a patient on no antiretroviral therapy?

A

25%

53
Q

what is the rate of vertical HIV transmission during pregnancy in a patient on antiretroviral therapy

A

8%

54
Q

what is the rate of vertical HIV transmission during pregnancy in a patient on antiretroviral therapy and scheduled C. delivery at 38weeks

A

2% or less

55
Q

what is the rate of vertical HIV transmission during pregnancy in a patient on antiretroviral therapy and vaginal delivery with viral load <1000copies?

A

2% or less

56
Q

What are the malformations seen in congenital rubella syndrome?

A

Microcephaly, intellectual disability, cataracts, deafness, congenital heart disease

57
Q

What is the vaccine risk for a pregnant woman given MMR?

A

Low risk

58
Q

What can be given to help prevent aspiration pneumonitis?

A

Antacid

59
Q

What is a major cause of anesthesia-related death in obstetrics?

A

Aspiration pneumonitis

60
Q

Why are pregnant patients at greater risk of aspiration?

A

This is because of delayed gastric emptying that occurs with pregnancy and labor

61
Q

What are the criteria needed for the diagnosis of polycystic ovary syndrome?

A
  • oligomenorrhea/amenorrhea
  • clinical or biochemical hyperandrogenism
  • polycystic ovaries
62
Q

bone mineral density T-score ……… is diagnostic of osteoporosis

A

-2.5

63
Q

Abdominal pain, amenorrhea and vaginal bleeding are classic symptoms of ………

A

Ectopic pregnancy

64
Q

How is ectopic pregnancy evaluated?

A
  • Transvaginal ultrasound examination

- Quantitative human chorionic gonadotropin (hCG) level

65
Q

Between 18-34 weeks, intrauterine growth restriction (IUGR) should be suspected when the fundal height is …………………..

A

> 3cm below the gestational age in weeks

66
Q

…………… is defined as an estimated fetal weight of <10th percentile confirmed by ………..

A

Intrauterine growth restriction

Obstetrical ultrasound

67
Q

Clinical diagnosis of PID requires the presence of the following signs and symptoms:

  • …………………..
  • …………………..
  • ……………………
A
  • cervical tenderness
  • adnexal tenderness
  • abdominal pain and tenderness
68
Q

Ovarian torsion is a surgical emergency. True or false

A

True

69
Q

prophylactic cerclage is placed in the _____ and removed at _________ when _____

A

early second trimester

36-38 weeks gestation when the fetal lungs is fully matured

70
Q

What is the test of choice to confirm tubo-ovarian abscess?

A

Transvaginal ultrasound

71
Q

What is the treatment of tubo-ovarian abscess?

A

Intravenous antibiotics :
Clindamycin and gentamicin in penicillin allergic patients

Cefoxitin and doxycycline

72
Q

the diagnosis of preeclampsia is confirmed by a _____________ or ___________________

A

urine protein/creatinine ratio >/0.3 or 24-hour urine collection showing

Kaplan step 2 qbank (5 decks)

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