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Step 2 CK > OB/gyn > Flashcards

OB/gyn Flashcards

0
Q

Admin of pgf2 (method)

A

IM

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1
Q

Appropriate weight gain for preg.
If normal weight
Obese

A

Normal 25-35

Obese 11-20

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2
Q

Labor warnings fetal movement

A

10 per 2 hours

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3
Q

Variable decelerations mcc

A

Cord compression

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4
Q

Early decelerations mcc

A

Head compressions

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5
Q

Late decelerations mcc

A

Placental insufficiency (hypoxia = concerning)

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6
Q

Trichomonas discharge gross

A

Yellow and frothy

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7
Q

Montevideo units and cutoff

A

Sum up internal changes in 10 minutes. 200 required for adequate labor.

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8
Q

Definition embryo

A

To 8 weeks

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9
Q

Pre viable

A

Before 24 weeks

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10
Q

Post term

A

42 weeks

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11
Q

Goodell sign

A

Softening of cervix

1st sign of preg equals 4 weeks

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12
Q

Time of teleangiectasias and palmar erythema

A

1st trimester

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13
Q

Chloasma and time

A

Hyper pigmentation 2nd trimester

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14
Q

Linea nigra

A

Line of hyper pigmentation. 2nd trimester

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15
Q

Time when US can confirm gestational age

A

11 to 14 weeks

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16
Q

Quickening time period

A

16 to 20

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17
Q

Time period for triple or quad

A

15 to 20

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18
Q

Time for gbs and chlamydia screen

A

36

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19
Q

Time period for cervical checks in 3rd trimester

A

37 weeks

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20
Q

Abortion def

A

Demise before 20 weeks

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21
Q

Test necessary to dx type of abortion

A

US

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22
Q

Complete vs incomplete abortion

A

Complete means no products of conception left

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23
Q

Products of conception with intrauterine bleeding(2)

Cervix dilated or not

A

Cervix dilated is inevitable

No dilation is threatened

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24
Q

Death of fetus with all products of conception in uterus

A

Missed abortion

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25
Q

Abortion with infection of uterus

A

Septic abortion

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26
Q

First 2 clues to multip

A

Increased msafp and Bhcg

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27
Q

Fetal weight cutoff for underweight at delivery

A

2500 mg

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29
Q

2 most common tocolytics in order

A

Mg sulfate - neuroprotection

CCBs

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30
Q

dosing of folic acid

nonrisk and risk (2)

A

nonrisk =.4

risk = 4

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31
Q

appropriate weight gain for obese women in pregnancy

A

11-20 lbs

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32
Q

apgar (5)

Include amt of p

A 
appearance
pulse =>100 for 2 points 
grimace
activity
respiration
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33
Q

acrocyanosis

A

blue at extremities only

apgar score =1

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34
Q

tx fir placenta previa with bleeding or drop in hematocrit

A

strict pelvic rest

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35
Q

placental abruptions which are

serious
minimal complications

A 
concealed = serious
external = minimal complications
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36
Q

cause of death in erythroblastosis fetalis (hemolytic disease of newborn)

A

+CO = CHF

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37
Q

test for Ab

A

indirect coombs

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38
Q

management if patient sensitized with > 1:16

A

Transcranial Doppler, if positive:

serial amniocentesis to assess bili level

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39
Q

tx (2) high bili level in sensitized mom

A

percutaneous umbilical blood sample

perform intrauterine transfusion

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40
Q

tx for HELLP

A

same for preeclampsia;
term = deliver
preterm = betamethasone for lungs, mg sulfate for seizures
if severe, hydralazine for BP

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41
Q

DM tests during pregnancy

32 weeks+
36 weeks+
37 weeks
38-39 weeks

A

32 weeks + = weekly NST
36 weeks + = NST + BPP
37 weeks = L/S ratio for lungs (if mature, deliver)
38-39 weeks = induce delivery.

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42
Q

2 timings and types of IUGR

A

symmetric. first 20 weeks

asymmetric. smaller head. second 20 weeks

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43
Q

First 2 causes of IUGR

A

smoking

maternal infections = #2 (immunize!)

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44
Q

definition macrosomia

A

> 4500 g

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45
Q

AFI normal

A

8-18

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46
Q

AFI normal

A

8-18

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47
Q

5 components of BPP

A 
TB-MAN
tone
breathing (30 in 30 minutes)
movement (3 in 30 minutes)
AFI
NST (2 accelerations in 20 minutes)
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48
Q

definition accelerations

A

more than 15

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49
Q

definition variable decel

A

decrease in HR with no relation to contractions

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50
Q

significance variable decel

A

umbilical cord compression

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51
Q

late decels significance

A

fetal hypoxia (very concerning; often uteroplacental insufficiency)

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52
Q

lightening

A

fetal descent into pelvic brim (before labor)

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53
Q

2 signs of placental separation besides blood, cord lengthening

A

uterus fundus rising

uterus becoming firm

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54
Q

contraindication for PGE2 for cervical ripening

A

asthma

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55
Q

definition of protraction of cervix of prime

arrest

A

if no more than 1.2 cm in hour

arrest = no cervical change for 2 hours

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56
Q

prolonged latent stage cutoffs of prime and multipara

A 
prime = 20 hours
multi = 14 hours
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57
Q

tx (2) for prolonged latent stage

A

rest and hydration

58
Q

frank vs complete breech

A 
frank = hips flexed with extended knees
complete = hips and knees flexed.
59
Q

time period where you can do cephalic version

A

after 36 weeks

60
Q

PROM vs PPROM

A 
prom = before labor
PPROM = before labor and before term
61
Q

tx PPROM

A

abx

62
Q

2 indicators of fetal lung maturity (1 is a gestational age)

A

positive phosphatidylglycerol or 34 weeks gestational age

63
Q

evidence of chorioamniotis on amniocentesis

A

glucose less than 20

64
Q

moderate variability def

A

6-25

65
Q

admin of PGF2a

A

IM or uterine injection

66
Q

tx for unresponsive uterine atony

A

B lynch suture

67
Q

placental enzyme deficiency that can lead to postterm

A

sulfatase

68
Q

S/D ratio abnormality in umbilical arteries in IUGR

A

increase in the S/D ratio reflects increased vascular resistance.

69
Q

metrorrhagia

A

intermenstrual bleeding

70
Q

oligomenorrhea

A

mentrual cycle >35 days

71
Q

lichen sclerosis vs lichen planus

A 
sclerosis = cancer risk if postmenopausal
planus = violet, flat papules

tx both with topical steroids.

72
Q

marsupialization

A

I&D where you keep lesion (bartholin gland, for ex) with sutures.

73
Q

vaginal discharge with a fishy odor

A

vaginosis

74
Q

profuse, green, frothy vaginal discharge

A

trichomonas

75
Q

clue cells on KOH

dz and pathogen

A

bacterial vaginosis

gardnerella

76
Q

tx trichomonas

A

metronidazole for patient AND partner

77
Q

vulvar soreness and pruritis

red lesion with superficial white coating

A

paget dz

78
Q

paget dz of vulva dx and tx

A 
dx = bx
tx= vulvectomy
79
Q

squamous cell carcinoma stage 0 vs I vs II of vagina

A

O= in situ

1=2 cm vulva o perineum

80
Q

SCC of vagina stage III vs IV vs IVa

A 
III = urethra or anus.  unilateral nodes
IV = bladder, rectum or bilateral nodes
IVa = distant metastasis
81
Q

2 med tx for severe endometriosis (vs OCPs for mild)

A 
danazole = androgen
leuprolide = GnRH agonist constant admin
82
Q

LH: FSH ratio in PCOS

A

greater than 3:1

83
Q

GSI vs ISD

A

both types of stress continence
GSI = bladder instability (genuine stress incontinence)
ISD = sphincter probs (idiopathic sphincter deficiency, less common)

84
Q

cause of urge incontinence

A

detrusor instability

85
Q

2 tx for urge incontinence in a post menopausal female (categories)

A

vaginal estrogens

anticholinergics

86
Q

fixed, drain pipe urethra and incontinence

name and tx

A

intrinsic sphincteric deficiency ( a more rare form of stress continence).
urethral bulking procedure

87
Q

q tip test with angle greater than 30

A

hypermobile urethra

stress urinary incontinence

88
Q

nerve cutaneous sensation to the groin and the skin overlying the pubis

A

iliohypogastric

89
Q

nerve cutaneous sensation to the groin, symphysis, labium and upper inner thigh

A

ilioinguinal

90
Q

inability to adduct thigh = what nerve

A

obturator

91
Q

type of pregnancy assoc. w/placental sulfatase deficiency, fetal adrenal hypoplasia

A

postterm

92
Q

obese woman should gain how many pounds in pregnancy?

A

11-20

93
Q

dx tool for appendicitis during pregnancy

A

graded compression ultrasonography

94
Q

Normal age range for menarche

A

9-17

95
Q

Mullerian agenesis

Associated prob

A

Renal anomalies.

96
Q

Gartner’s cyst

A

Mesonephric cyst of upper vagina

97
Q

Nabothian vs mesonephric cysts

A

Cysts of cervix. Nabothian is superficial.

98
Q

Hyperthecosis

A

Severe PCOS

99
Q

time period where vacuum aspiration is OK for elective abortion

A

embryos only! (< 8 weeks)

100
Q

method of obtaining PRL level

A

fasting

101
Q

score for osteopenia

A

T score between -1 and -2.5

102
Q

making dx of urge incontinence on cystometrogram

A

uninhibited contraction of the bladder with filling

103
Q

3 factors necessary to develop 2ndary sexual characteristics

A

adequate body weight, sleep and optic exposure to sunlight

104
Q

Colpocleisis

A

surgical closure of vagina- used to tx prolapse

105
Q

3 vitamin deficiencies assoc. w/PMS

A

ABE has 6 dates of PMS

A, E and B6

106
Q

tx for anti-phospholipid antibody syndrome (2)

A

aspirin plus heparin

107
Q

complete mole

karyotype?
fetal parts?
risk od post-molar GTD?

A

diploid (XX or XY) - empty egg
no fetus
+risk of post-molar GTD

108
Q

definition of microinvasive cervical cancer

A

invasion <3 mm below basement

109
Q

relationship between OCPs and ovarian cancer

A

OCPs are protective

110
Q

ectropion of cervix

A

outward turning edge of cervix

111
Q

lyonization of genes

A

X inactivation

112
Q

tx for cholestasis of pregnancy (2)

A

ursodeoxycholic acid

naltrexone

113
Q

use of clomiphene challenge test

A

to test for ovarian reserve in old patient

114
Q

way to suppress lactation if patient does not want to breast feed (3, 2 would be a reasonable answer)

A

breast binders
ice packs
analgesics

115
Q

bloody show during labor. etiology of blood

A

friable cervix

116
Q

BV risk in pregnancy

A

PPROM

117
Q

polymenorhea

A

cycle length <21 days

normal flow

118
Q

malignant trophoblastic gestational dz
vs
choriocarcinoma

A

choriocarcinoma has metastasis

119
Q

time of division of mono-di twins

A

4-8 days

120
Q

primary amenorrhea (2)

A

no menses by:
age 16
OR
4 years post-thelarche

121
Q

secondary amenorrhea (2)

A

no menses in previous menstrual patient:
missed 3 cycles
OR
none for 6 mos.

122
Q

reactive NST

A

2 accelerations greater than 15 bpm/over 15 seconds within 20 minute window

123
Q

normal variability of FHT

A

6-25

124
Q

acceleration

A

+15 bpm over 15 seconds

125
Q

failure to progress during active labor

A

no change in 2 hours

126
Q

4 causes of postpartum hemorrhage

A

Tone (uterine atony leading to continued bleeding)
Trauma (perineal or cervical lacerations, uterine inversion)
Tissue (retained or invasive placental tissue in the uterus)
Thrombin (a bleeding disorder-much less common that the other three causes)

127
Q

general rule of thumb for neonatal weight gain once milk is in

A

1 oz gain/day

128
Q

nonstress test pass

A

2 or more accels in 20-40 minutes

129
Q

risk of trastuzumab (herceptin)

A

cardiotoxicity

130
Q

most common complication of postterm

A

oligohydramnios

131
Q

B-HCG is + how long after mab

A

4-6 weeks

132
Q

etiology of symmetric (head and body) vs asymmetric IUGR

A

symmetric tends to be fetal origin

asymmetric tends to be maternal vascular dz

133
Q

if dilation is 6 or greater arrest is considered (2)

A

no change for 4 hours despite adequate contractions

no change for 6 hours with inadequate contractions

134
Q

when in gestation can you dx gestational htn or preeclampsia?

A

after 20 weeks

135
Q

corticosteroids necessary at what gestation

A

less than 34 weeks

136
Q

cutoff for Hg for anemia in pregnancy

A

11

137
Q

normal contraction stress test (equivalent of BPP)

A

no variable or late decels

138
Q

tx (2) of postpartum endometritis

A

IV clinda and gent

139
Q

tx for bacterial vaginosis

A

metronidazole

140
Q

reason for Mg admin during preterm labor

A

neuroprotection (prevents CP)

141
Q

approach to recurrent late decels

A

indication for C/S

Step 2 CK (12 decks)

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