OB/GYN

Question 1

urinary frequency, nocturia, frequent passage of small amounts of urine, high post-void residual volumes

causes and tx

Answer 1

neurogenic bladder causing overflow incontinence

non Rx: suprapubic pressure, double voids, timed voids, scheduled indwelling catheters

rx: cholinergic agents like bethanachol (bethany can’t pee)

Question 2

most common cause of incontinence, causes and tx

Answer 2

urge incontinence: incredible urge to pee, can’t hold it

caused by detrusor instability, muscarinic agonists, pelvic floor exercises might be helpful

Question 3

tx of stress incontinence

Answer 3

pelvic floor exercises - incontinence with increased pressure like laugh/cough/sneeze

Question 4

syphilis Tx in pregnant patients

Answer 4

penicillin G IV, if allergic then try pcn desensitization, erythromycin is effective in tx but it won’t cross the placenta

Question 5

complications, management and prevention of HepC during pregnancy

Answer 5

complications: gestational diabetes, cholestasis of pregnancy, preterm delivery
management: ribavirin is teratogenic, no need for barrier protection in serodeiscordant, monogamous couples, HepA&B vaccination
Prevention: transmission associated with viral load, C/S not protective, avoid scalp electrodes, breastfeeding encourage unless there’s maternal blood present

Question 6

soft boggy poorly contracted uterus after labor is ___________; what are some risk factors for this and what is tx

Answer 6

uterine atony, compresion of the uterus results in expulsion of blood clots and blood from the vagina; risk factors are multiple gestation, polyhydramnios, macrosomia, and uterine fatigue

tx: oxytocin infusion and then packing if its still unresponsive to that

Question 7

brawny edematous cutaneous plaque with peau d/orange and how to diagnose

Answer 7

inflammatory breast carcinoma; most patients also have axillary lymphadenopathy and 1/4 end up having metastasis and spontaneous nipple discharge; hard to distinguish it from breast abcess so need biopsy for histology

Question 8

Tx of variable decels of FHR

Answer 8

result of umbilical cord compression; intermittent variables are well tolerated, but recurrent variable ones (>50% of contractions) are concerning for fetal academia –> administer O2 and change maternal position, discontinue uterotonic drugs –> amnioinfusion –> C/S

Question 9

acute onset of hypoxia, crackles and dyspnea during pregnancy is most likely ________

Answer 9

pulmonary edema, a sever complication of HELLP

Question 10

placenta previa management

Answer 10

if stable and less than 38 weeks manage at conservative; if greater than that schedule C/S

Question 11

bloody discharge from nipple in perimenopausal woman

Answer 11

intraductal papilloma