OB/Gyn

Question 1

What is the uspstf recommendation for pap/hpv testing in women 21-29years

Answer 1

Solitary pap every 3years

Question 2

What is the uspstf recommendation for pap/hpv testing in women 30-65years

Answer 2

Pap/Hpv co-testing every 5 years
If a hpv test can not be done for any reason, the pt must revert to solitary Pap smears every 3years

Question 3

First line tx in endometriosis
2nd line?

Answer 3

Combined ocps
GnRH agonists (a/e - osteopenia, hot flashes, vaginal dryness ie symptoms of low estrogen)

Question 4

A well-defined, pedunculated, homogenous lesion that is isoechoic to the endometrium

Answer 4

Endometrial polyp

Question 5

Estrogen induces transcription of what clotting factors? All of which can promote clot formation.

Answer 5

Factors (II, VII, VIII, X, XII) and fibrinogen, and decreases antithrombin and protein S levels,

Question 6

Contraindications for a copper IUD

Answer 6

Suspected pregnancy, menorrhagia, or dysmenorrhea

Question 7

lower abdominal pain, nausea, cervical motion tenderness, and an adnexal mass on pelvic ultrasound

Answer 7

PID complication: Tuboovarian abscess (TOA)

Question 8

Both of these conditions are associated with nausea, right lower quadrant pain, guarding, and a mass on ultrasound

Answer 8

appendicitis and TOA

Question 9

The success rate of methotrexate therapy for ectopic pregnancy is higher for patients with?

Answer 9

An adnexal mass < 3.5 cm on transvaginal ultrasound and a β-hCG ≤ 5000 mIU/mL

Question 10

First line tx for PID

Answer 10

Intravenous cefoxitin (NOT Oral)

Question 11

What is the diagnosis for a well-demarcated, hypoechoic solid mass with smooth and clear margins in a post-menopausal woman experiencing abnormal uterine bleeding, endometrial hyperplasia (i.e symptoms of estrogen excess).

Answer 11

Ovarian thecoma

Question 12

____ presents as a simple ovarian cyst with diffusely thick walls that have increased vascularity (“ring of fire” sign) and sometimes intracystic hemorrhage

Answer 12

A corpus luteum cyst
Often diagnosed incidentally on physical examination and pelvic ultrasonography.
Combined OCPs inhibit the development of corpus luteum cysts by suppressing ovulation

Question 13

An ultrasound of the breast as the definitive diagnostic imaging of the breast is recommended in?

Answer 13

Women < 30y/o

Question 14

What is the definitive diagnostic imaging in women > 30 y/o

Answer 14

B/L mammography

Question 15

Contraindications to HRT include

Answer 15

a personal history of coronary heart disease,
venous thromboembolism,
stroke, and e
strogen-sensitive cancer (e.g., endometrial or breast cancer).

Question 16

Warfarin intake during pregnancy is associated with

Answer 16

intrauterine growth restriction, bone deformities (e.g., nasal hypoplasia), ophthalmic abnormalities, and cerebral hemorrhage

Question 17

Isotretinoin intake during pregnancy is associated with __

Answer 17

congenital malformations, such as cardiac abnormalities and facial cleft

Question 18

Carbamazepine intake during pregnancy can cause

Answer 18

maternal folate deficiency, which is associated with intrauterine growth restriction, microcephaly, fingernail hypoplasia, and neural tube defects (e.g., spina bifida)

Question 19

Most common fetal cause for spontaneous abortions, particularly in the 1st and early 2nd trimester?

Answer 19

chromosomal abnormalities

Question 20

Painless vaginal bleeding in the third trimester

Answer 20

Placenta previa

Question 21

In a pregnant patient (<20 weeks) with vaginal bleeding and absent fetal cardiac activity (both of which are consistent with an inevitable abortion) and a history of recurrent joint pain, anemia, thrombocytopenia, increased PTT (range: 25-40), and elevated creatinine (range 0.6 - 1.2). What is the most likely explanation for these physical examination findings?

Answer 21

This suggests placental thrombosis due to systemic lupus erythematosus (SLE) with antiphospholipid syndrome (APS)

This patient’s examination findings are most likely caused by APS secondary to SLE. Patients with APS form procoagulant antibodies (anticardiolipin, anti-β2-glycoprotein 1, and lupus anticoagulant antibodies) that can lead to placental thrombosis and consequent miscarriage. To establish the diagnosis of APS, serology for antiphospholipid antibodies should be performed.

Question 22

List the recommended interventions in sexual assault with penetration and when you should administer them.

Answer 22

Many patients who have experienced sexual assault do not return for a follow-up visit, all recommended interventions should be given at their initial presentation.

Empiric antibiotic therapy with ceftriaxone, doxycycline, and metronidazole is indicated for sexually transmitted infection prophylaxis against gonorrhea, chlamydia, and trichomonas in all adults (trichomoniasis prophylaxis only in women) who have experienced a sexual assault.

Other recommended interventions at the initial presentation include emergency contraception, HIV postexposure prophylaxis (a three-drug regimen of tenofovir, emtricitabine, and an integrase inhibitor (e.g., raltegravir, dolutegravir), and hepatitis B postexposure prophylaxis

Question 23

All pregnant women should receive __ vaccines between 28 - 36 weeks?

Answer 23

TDap
Flu (depending on the time of year i.e. Oct-May)
RSV

Question 24

Karyotype for Mullerian agenesis

Answer 24

(X,X)

Question 25

Tx for mullerian agenesis

Answer 25

Elevate the vagina

Question 26

preferred initial test in suspected complement pathway deficiency

Answer 26

CH50 Assay

Question 27

What is the pathophysiology of AD Hyper-IgE syndrome

Answer 27

STAT3 mutation leading to decreased TH17 production and defective neutrophils chemotaxis

Question 28

Dx of AD Hyper-IgE syndrome

Answer 28

Increased IgE
Eosiniphilia
Decreased IFN-gamma

Question 29

Tx of AD Hyper-IgE syndrome

Answer 29

IVIG, Abx