OB/Gyn

Question 1

vulvar lesions that resolve with addition of trichloroacetic acid are likely due to…

Answer 1

HPV genital warts (condyloma acuminata)

Question 2

how do you manage a molar pregnancy

Answer 2

evacuate the uterus (D&C), CXR, give MTX or dactinomycin for malignant disease

Question 3

low-level homogenous internal echos in a cystic mass of a patient with dyspareunia, infertility and regular cycles is likely

Answer 3

endometriosis; don’t be fooled by the regular cycles, low-level homogenous internal echos on US suggest endometrioma

Question 4

what is the best way to prevent transmission of genital herpes

Answer 4

CONSISTENT condom use (even when lesions are not present)

Question 5

how do epidurals sometimes cause maternal hypotension

Answer 5

blocking of sympathetic nerve fibers leads to peripheral vasodilation, which decreases venous return

Question 6

a patient with persistent cough productive of scant blood following a URI, with normal CXR should be treated with what

Answer 6

supportive care; post-URI bronchitis is self-limited and not dangerous, no further workup needed

Question 7

when is fetal fibronectin used

Answer 7

to determine if a woman is going into preterm labor when the presentation is equivocal

Question 8

when is progesterone used in a pregnant woman

Answer 8

to prophylax against preterm labor in a woman with a history of preterm labor; given at 16-36 weeks

Question 9

when are non-stress tests normally initiated

Answer 9

32-34 weeks; unless there is a decrease in fetal movement to indicate earlier screening

Question 10

what complications are commonly seen in babies who are small for gestational age

Answer 10

hypoxia (and resultant polycythemia), hypothermia, hypoglycemia, meconium aspiration (due to stress), hypocalcemia

Question 11

list all the different screening methods for aneuploidy with their associated gestational age ranges

Answer 11

1st trimester combined test (PAPP, b-hCG, nuchal translucency): 9-13 weeks
2nd trimester quad: 15-20 weeks
CVS: 10-13 weeks
amniocentesis: 15-20 weeks
2nd trimester US: 18-20 weeks
cell free DNA: after 10 weeks

Question 12

define arrest of labor in the first stage

Answer 12

cervix 6cm or more, ruptured membranes and either:
-4 or more hours without change and adequate CTXs
or
-6 or more hours without change and inadequate CTXs

Question 13

what is tachysystole

Answer 13

abnormal irregular and frequent contractions that can impair bloodflow and hurt the baby (beware of putting mothers on oxytocin who already have adequate contractions for this reason)

Question 14

retraction of fetal station is alarming for

Answer 14

uterine rupture

Question 15

up until what point can you do a medical abortion rather than D&C

Answer 15

until 7 weeks

Question 16

at 10 weeks, all mothers at increased risk for aneuploidy (age, FHx) should be offered

Answer 16

cell free DNA testing (abnormal results can be confirmed via more invasive tests such as CVS or amnio)

Question 17

OCP’s lower your risk of what cancers

Answer 17

endometrial and ovarian cancer

Question 18

a woman with low-grade fever, vaginal bleeding, and chills and mild leukocytosis several hours after giving birth should be treated with what

Answer 18

reassurance: chills, low-grade fever, lochia rubra (bloody lochia), and mild leukocytosis is normal in post-partum period

Question 19

babies born to anorexic mothers are at risk for what complications?

Answer 19

prematurity, SGA, intellectual disability

Question 20

what is the first line of therapy for PCOS

Answer 20

weight loss to decrease insulin resistance and OCP’s for anti-androgenic therapy

Question 21

what are the medical options for treatment of abnormal uterine bleeding in the acute setting in a hemodynamically stable patient

Answer 21

high dose estrogen, high dose combination estrogen-progesterone, high dose progesterone, tranexamic acid (anti-fibrinolytic used in patients who can’t take hormones)

Question 22

what impact does endometriosis have on fertility

Answer 22

endometriosis increases risk of infertility via adhesions and inflammation of the ovaries

Question 23

what is the treatment for endometritis

Answer 23

clindamycin and gentamicin

Question 24

define preeclampsia

Answer 24

gestational HTN (BP >140/90 after 20 weeks) + proteinuria OR end-organ damage (creatinine, bilirubin, etc.)