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OB/GYN Flashcards

1
Q

The secretory phase of the menstrual cycle (day 14-28) is dominated by what hormone?

A

Progesterone

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2
Q

Who is more likely to acquire pre-eclampsia nulliparous or multiparous

A

Nulliparity

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3
Q

Purulent cervical discharge is consistent with what diagnosis?

A

Neisseria gonorrhoeae

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4
Q

A description of a young girl with a web neck or wide shield chest should make you think of what diagnosis?

A

Turner’s Syndrome

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5
Q

Cervical biopsy comes back as CIN1. What would you do next?

A

Repeat pap smear in 6 months and repeat colposcopy in 12 months

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6
Q

What is the most common cause of secondary amenorrhea?

A

Pregnancy

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7
Q

What three labs should you order if you are considering secondary amenorrhea?

A

beta HCG, TSH, Prolactin

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8
Q

Define premature birth

A

Delivery of uterine contents between 20-36 weeks

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9
Q

A unilateral, single, mobile, firm, nontender solid breast mass should make you think of what diagnosis?

A

Fibroadenoma

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10
Q

Define metrorrhagia

A

Bleeding between menstrual cycles

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11
Q

Postmenopausal bleeding is immediately believed to be what diagnosis?

A

Endometrial cancer until proven otherwise

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12
Q

During what portion of the menstrual cycle does PMS occur?

A

The 2nd half, and menstruation should relieve the symptoms

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13
Q

Treatment for bacterial vaginosis

A

Metronidazole x 7 days

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14
Q

What location within the pelvis is endometriosis most commonly found?

A

On an ovary

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15
Q

What is the gold standard lab test for chlamydia?

A

Nucleic acid amplification test

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16
Q

Are fibrocystic breast masses usually bilateral or unilateral?

A

Bilateral

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17
Q

How do you definitively diagnose endometriosis?

A

Exploratory laparoscopy

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18
Q

What is the most common uterine tumor?

A

Leiomyoma, also known as fibroids.

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19
Q

What ethnic background is at an increased risk of fibroids?

A

African American

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20
Q

How do you treat vaginal candida?

A

Fluconazole po 1 dose or azole cream x 1 week

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21
Q

What is the first step of treatment for endometrial cancer?

A

Total hysterectomy and bilateral salpingo-oophorectomy

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22
Q

If you see the term chocolate cyst it should make you think of what diagnosis?

A

Endometrioma

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23
Q

A surge in what hormone leads to ovulation

A

Luteinizing hormone

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24
Q

A patient presents with irregular menses, hirsutism and infertility. What is the most likely diagnosis?

A

Polycystic ovarian syndrome

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25
Q

What endocrine issue is associated with PCOS?

A

Insulin insensitivity

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26
Q

You have a patient with PCOS who would like to
get pregnant. What are two medications you may
start her on?

A

Metformin and Clomid

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27
Q

What is the medical treatment for an early ectopic

pregnancy?

A

Methotrexate

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28
Q

An ovarian cyst that contains hair and teeth should

make you think of what diagnosis?

A

Teratoma

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29
Q

What is the mean age for ovarian cancer?

A

63, Older patient with vague abdominal symptoms

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30
Q

Define the second stage of labor.

A

Fully dilated to delivery

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31
Q

A 66 year old female patient presents with bouts
of nausea, weight loss and vague abdominal pain.
What is the most likely diagnosis?

A

Ovarian cancer

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32
Q

When is it recommended to begin pap smears?

A

When a woman becomes sexually active or when she is 21 years old

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33
Q

Cervical biopsy comes back as CIN2 or CIN3. What

is your next step?

A

Excision (LEEP, Cold knife, Cryotherapy)

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34
Q

List two risk factors for cervical cancer.

A

Multiple sexual partners, smoking

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35
Q

How much time needs to pass before diagnosing

secondary amenorrhea?

A

Normal cycling = 3 months; Irregular cycling = 6 months

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36
Q

What is a cystocele?

A

A herniation of the bladder into the vagina.

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37
Q

What is the treatment for Turner’s Syndrome?

A

Cyclical estrogen and progesterone

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38
Q

What are three treatment for uterine prolapse?

A

Pessary, Kegel’s maneuvers, surgical repair

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39
Q

What is the most common organism that causes

mastitis?

A

Staph aureus

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40
Q

At approximately how many weeks pregnant is the

uterus at the level of the umbilicus?

A

20 weeks

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41
Q

What is the most common cause of postpartum

hemorrhage?

A

Uterine atony

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42
Q

Define missed abortion.

A

No vaginal bleeding, cervix is closed, products of conception are retained

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43
Q

At what age is primary amenorrhea diagnosed?

A

Age 14 if no secondary sex characteristics. Age 16 if some secondary development.

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44
Q

What is the first line treatment for mastitis?

A

Dicloxacillin = 1st line; Cephalexin or erthromycin = 2nd line

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45
Q

Should a breast feeding mother stop breast feeding

if she develops mastitis?

A

Mastitis is not a reason to stop breast feeding, but an abscess is.

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46
Q

A physical exam revealing a retroverted uterus or
uterosacral ligament nodularity should make you
think of what diagnosis?

A

Endometriosis

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47
Q

At how many weeks of pregnancy can an

amniocentesis be done?

A

15-20 weeks

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48
Q

List four risk factors for breast cancer?

A

BRCA1 or 2 positive, unopposed estrogen, nulliparity, early menarche, late menopause

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49
Q

What is the average age of menopause?

A

51

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50
Q

Cottage cheese discharge should make you think of what diagnosis?

A

Vaginal candidiasis

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51
Q

The follicular phase of menstruation is dominated by what hormone?

A

Estrogen

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52
Q

About how much weight should a woman gain

during pregnancy?

A

20-35 lbs.

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53
Q

Thin, sticky, malodorous vaginal discharge should

make you think of what diagnosis?

A

Bacterial vaginosis

54
Q

Vaginal infection with motile flagellated protozoa

should make you think of what diagnosis?

A

Trichomonas

55
Q

List two medications commonly used for

hypertension in pregnancy.

A

Methyldopa and labetalol

56
Q

What is the classic triad of pre-eclampsia?

A

HTN, edema, and proteinuria

57
Q

Why is ovarian cancer so hard to diagnose?

A

There are no good markers and the symptoms are very vague

58
Q

What are two important things you need to tell you

patients before putting them on metronidazole?

A

Stay out of the sun and avoid alcohol

59
Q

Define inevitable abortion

A

Vaginal bleeding, cervix is open, products of conception are retained

60
Q

How is the first day of the menstrual cycle defined?

A

The first day of menstrual bleeding

61
Q

What is the karyotype for patient with Turner’s

syndrome?

A

(45,X) They are missing one sex chromosome

62
Q

Give the time frame for preterm labor.

A

20-37 weeks

63
Q

A patient presents with mucopurulent discharge
and cervical motion tenderness. What is the most
likely diagnosis?

A

Chlamydia - cervicitis

64
Q

Which four human papillomaviruses are linked to

cervical cancer?

A

HPV 16.18.31, and 33

65
Q

Clue cells should make you think of what

diagnosis?

A

Bacterial vaginosis

66
Q

What is the hallmark physical exam finding for

placenta previa?

A

Trick Question! NEVER do a physical exam on someone with presumed placenta previa

67
Q

What medium do you need to grow out Neisseria

gonorrhoeae?

A

Thayer martin

68
Q

What age range is the HPV vaccination

recommended for?

A

9-26 years old

69
Q

A patient with primary amenorrhea and a low FSH

should make you think of what diagnosis?

A

Hypothalamic pituitary insufficiency

70
Q

What characteristic of pelvic inflammatory disease
will help to differentiate it in a question stem from
ectopic pregnancy, appendicitis, ovarian torsion and
ovarian cyst?

A

It will be bilateral pain, but most other common abdominal complaints have unilateral pain.

71
Q

List 2 factors for ovarian cancer.

A

BRCA 1, Family history, nulliparity, late menopause, Caucasian, Asian.

72
Q

Define abortion.

A

Delivery of uterine contents before 20 weeks.

73
Q

Does mastitis tend to be unilateral or bilateral?

A

Unilateral and only one quadrant

74
Q

Define full term.

A

Delivery at 37-42 weeks

75
Q

When does quickening occur?

A

Nulliparous 18-20 weeks, multiparous 14-20 weeks

76
Q

List three risk factors for placental abruption.

A

HTN, smoking, AMA, cocaine use, PROM

77
Q

What is the treatment for ovarian cancer?

A

Total hysterectomy and bilateral salpingo-oophorectomy. Chemo + radiation.

78
Q

A patient believes she is pregnant. You notice that
her cervix appears a little blue. What is the name
of this sign?

A

Chadwick’s sign

79
Q

At approximately how many weeks pregnant is the

uterus at the level of the symphysis pubis?

A

12 weeks

80
Q

A snowstorm appearance on ultrasound should

make you think of what diagnosis?

A

Hydatidiform mole

81
Q

What medication can be used to control bleeding

due to uterine atony?

A

Oxytocin (pitocin)

82
Q

What is the term for when the placenta has

implanted directly over the cervical os?

A

Placenta previa

83
Q

At how many weeks of pregnancy can chorionic

villus sampling be done?

A

10-13 weeks

84
Q

Why is folic acid given as a prenatal vitamin?

A

To prevent neural tube defects

85
Q

What is the most common endometrial cancer?

A

75% are adenocarcinomas

86
Q

A strawberry cervix with copious yellow/green
discharge should make you think of what
diagnosis?

A

Trichomonas

87
Q

What organism causes us to warn pregnant
patients to stay away from deli meats and soft
cheeses?

A

Listeria

88
Q

The baby was delivered several minutes ago.
Suddenly there is a increase in blood flow from the
vagina and the cord noticeably lengthens. What is
the most likely cause of these signs?

A

Placental separation

89
Q

What are two medications used to induce labor?

A

Cervidil (prostoglandin gel applied to the cervix) which encourages cervical ripening and oxytocin which encourages uterine contractions.

90
Q

As part of the antepartum testing a baby has a

positive stress test. What does that mean?

A

They have had two heart rate accelerations in 20 minute period of 15 beats above baseline for at least 15 seconds. This is a good thing

91
Q

Is FSH high or low in Turner’s syndrome?

A

High, there are no ovaries to respond to FSH and so there is no negative feedback.

92
Q

What is the most common type of ovarian cyst?

A

Functional cyst - no treatment necessary.

93
Q

Define threatened abortion.

A

Vaginal bleeding, closed cervix, products of are conception retained

94
Q

List 4 risk factors for endometrial cancer.

A

Chronic unopposed estrogen,
nulliparity, early menarche, late
menopause, Tamoxifen, DM, obesity,
HTN, breast CA, ovarian CA

95
Q

What would you expect to see on a KOH prep if the

patient had vaginal candidiasis?

A

Pseudohyphae

96
Q

What is the #1 cause of septic arthritis in sexully

active young adults?

A

Neisseria gonorrhoeae

97
Q

How many days after conception is a serum beta

HCG positive?

A

8

98
Q

If the pap smear results come back anything other

than negative or ASCUS what is your next step?

A

Colposcopy and biopsy

99
Q

List three risk factors for an ectopic pregnancy.

A

Previous ectopic, scarred tubes

(hx of PID or salpingitis), IUD.

100
Q

Grape like vesicles or a sack of grapes on
ultrasound should make you think of what
diagnosis?

A

Hydatidiform mole

101
Q

What medication is used to increase surfactant
levels and help with lung maturity if you are
worried about preterm labor?

A

Betamethasone

102
Q

What are two tocolytic medications you should be

aware of?

A

Magnesium sulfate and calcium channel blockers

103
Q

A woman presents to the ED concerned she is in
preterm labor. What treatment should you begin
before even getting any imaging or lab results?

A

Give IV fluids

104
Q

A pap smear comes back as atypical squamous
uncertain significance (ASCUS). What is your next
step?

A

Repeat pap smear in 4-6 months.

105
Q

What are three ways you can check for ruptured

membranes?

A

Ferning pattern on a slide, visualized leakage from the cervix, pooling in the vagina.

106
Q

What is the normal range of fetal heart rate?

A

120-160 bpm

107
Q

Define menorrhagia.

A

Heavy prolonged menstraul flow.

108
Q

What Rh combination for mom and dad might
cause the mother to create antiboides against the
babies red blood cells?

A

Mom Rh negative and dad Rh

positive.

109
Q

At what point during pregnancy is Rhogam given if

it is needed?

A

28 weeks

110
Q

Define complete abortion.

A

Vaginal bleeding, cervix open, products of conception have passed.

111
Q

Gestational diabetes puts mom and baby at

increased risk of for what three things?

A

Pre-eclampsia, macrosomia, slowing in fetal lung development

112
Q

Which is associated with painful third trimester bleeding placental abruption or placenta previa?

A

Placental abruption

113
Q

What are three causes for postpartum hemorrhage?

A

Uterine atony, genital laceration, retained placenta

114
Q

Define the third stage of labor.

A

Delivery of baby to delivery of placenta.

115
Q

What medication(s) are used to treat a postpartum metritis?

A

Clindamycin and gentamicin together.

116
Q

What organism is the most common sexually transmitted infection?

A

Chlamydia

117
Q

Interference with work or school is part of which
diagnosis premenstrual syndrome or premenstrual
dysphoric disorder?

A

Premenstrual dysphoric disorder

118
Q

Which reproductive cancer carries the highest rates

of death in women?

A

Ovarian cancer

119
Q

What is the most common infection following a

C-section?

A

Metritis

120
Q

How do you treat a Trichomonas infection?

A

Metronidazole

121
Q

Define incomplete abortion

A

Vaginal bleeding, cervix is open, products of conception partially passed.

122
Q

What is the most common site of an ectopic pregnancy?

A

Within the fallopian tube

123
Q

Early on in pregnancy serial beta HCG should double over what time period?

A

Every 48-72 hours

124
Q

Define procidentia.

A

Uterine prolapse beyond the the

introitus.

125
Q

What is the more popular term for Stein-Leventhal

syndrome?

A

Polycystic ovarian syndrome

126
Q

What is the formula for calculating estimated date

of confinement or due date?

A

First day of last menstrual period + 7 days - 3 months.

127
Q

What are the five components of the biophysical

profile as part of antepartum testing?

A

A non stress test, fetal breathing,
two gross body movements, fetal
tone, amniotic fluid index.

128
Q

Define the first stage of labor.

A

Onset of contractions to full dilation

of the cervix.

129
Q

Rope like breast mass should make you think of

what diagnosis?

A

Fibrocystic breast mass

130
Q

What is the causative organism of syphilis?

A

Treponema pallium

131
Q

What is primary syphilis characterized by?

A

Chancre

132
Q

How long of treatment is usually needed for a UTI?

A

3 days

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