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USMLE Rapid Review > OB/GYN > Flashcards

OB/GYN Flashcards

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USMLE® Step 1 flashcards
1
Q

classic US and gross appearance of complete hydatiform mole

A

snowstorm on US and cluster of grapes appearance on gross exam

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2
Q

chromosomal pattern on complete mole

A

46 XX

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3
Q

molar pregnancy containing fetal tissue

A

partial mole

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4
Q

symptoms of placental abruption

A

continuous, painful vaginal bleeding

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5
Q

symptoms of placenta previa

A

self-limiting, painless vaginal bleeding

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6
Q

when should a vaginal exam be performed w/ suspected placenta previa

A

never

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7
Q

abx w/ teratogenic effects

A

tetracycline, fluoroquinolones, aminoglycosides, sulfonamides

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8
Q

meds given to accelerate fetal lung maturity

A

betamethasone or dexamethasone x 48 hrs

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9
Q

most common cause of postpartum hemorrhage

A

uterine atony

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10
Q

tx for postpartum hemorrhage

A

uterine massage; if that fails, oxytocin

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11
Q

typical abx for GBS prophylaxis

A

IV PCN or ampicillin

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12
Q

pt fails to lactate after an emergency c-section w/ marked blood loss

A

sheehan’s sydnrome (postpartum pituitary necrosis)

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13
Q

first test to perform when a woman presents w/ amenorrhea

A

b-hCG (the most common cause of amenorrhea is pregnancy)

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14
Q

cause of amenorrhea w/ normal prolactin, no response to estrogen-progesterone challenge, and hx of D&C

A

asherman’s syndrome

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15
Q

therapy for polycystic ovarian syndrome

A

weight loss and OCPs (consider metformin if insulin resistant)

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16
Q

meds used to induce ovulation

A

clomiphene citrate

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17
Q

diagnostic step required in a postmenopausal woman who presents w/ vaginal bleeding

A

endometrial biopsy

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18
Q

medical options for endometriosis

A

OCPs, danazol, GnRH agonists

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19
Q

laparoscopic findings in endometriosis

A

powder burns, “chocolate cysts”

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20
Q

most common location of ectopic prego

A

ampulla of the oviduct

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21
Q

most common cause of bloody nipple discharge

A

intraductal papilloma

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22
Q

contraceptive methods that protect against PID

A

OCPs and barrier methods

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23
Q

unopposed estrogen is contraindicated in which cancers

A

endometrial or estrogen receptor + breast cancer

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24
Q

pt w/ recent PID and RUQ pain

A

consider fitz-hugh-curtis syndrome

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25
Q

breast malignancy presenting as itching, burning, and erosion of the nipple

A

paget’s dz (underlying adenocarcinoma)

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26
Q

annual screening for women w/ strong family hx of ovarian cancer

A

CA-125 and transvaginal US

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27
Q

50 yo woman who leaks urine when laughing or coughing. Dx? Tx?

A

stress incontinence. kegel exercises, estrogen, pessaries, surgery

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28
Q

30 yo woman has unpredictable urine loss. Dx? Tx?

A

urge incontinence. tx w/ anticholinergics (oxybutynin) or beta-adrenergics (metaproterenol)

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29
Q

lab values suggestive of menopause

A

increased serum FSH

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30
Q

most common cause of female infertility

A

endometriosis

31
Q

breast cancer type that increases the future risk of invasive carcinoma in both breasts

A

lobular carcinoma in situ

32
Q

primary causes of third trimester bleeding

A

placental abruption and placenta previa

33
Q

type of incontinence - loss of urine only w/ increased intra-abdominal pressure (ie coughing, laughing, exercise)

A

stress incontinence

34
Q

type of incontinence - sudden urgency to go to the bathroom (key in the door sign)

A

urge incontinence

35
Q

type of incontinence - constant dribbling +/- urgency, w/ inability to completely empty bladder

A

overflow incontinence

36
Q

thin, off-white discharge w/ fishy odor, no inflammation, pH >4.5, clue cells (epithelial cells w/ bacteria attached to surface), positive whiff test (amine odor w/ KOH). Dx? Tx?

A

bacterial vaginosis (gardnella). tx w/ metronidazole

37
Q

thin, yellow-green, malodorous, frothy discharge, vaginal inflammation/pruritus, pH > 4.5, motile, flaagellated protozoa. Dx? Tx?

A

trichomoniasis. tx w/ metronidazole. tx partner as well

38
Q

thick, cottage cheese discharge, vaginal inflammation/pruritus, pH normal (3.8-4.2), budding yeast and pseudohyphae. Dx? Tx?

A

candida vaginitis. tx w/ fluconazole

39
Q

pt presents w/ crampy, lower-abdominal pain during menses and a normal PE. Dx? Tx?

A

primary dysmenorrhea. tx w/ NSAIDs and hormonal contraception

40
Q

tx for UTI in prego?

A

nitrofurantoin, amoxicillin or amox-clavulanate, or fosfomycin (avoid fluroquinolones and TMP/SMX)

41
Q

pt presents w/ rapid onset of respiratory failure, severe hypotension, and DIC during or immediately following labor. Dx? Tx?

A

amniotic fluid emobolism. tx is supportive w/ poor prognosis

42
Q

tamoxifen increases the risk of what cancer?

A

endometrial cancer

43
Q

first line tx of PMS

A

SSRI

44
Q

ddx of placental abruption, vs placenta previa, vs uterine rupture

A

placental abruption = sudden-onset vaginal bleeding, abdominal pain, hypertonic/tender uterus, no loss of fetal station
placenta previa = painless vaginal bleeding, low-lying placenta, no loss of fetal station
uterine rupture = sudden-onset vaginal bleeding, constant abdominal pain, cessation of uterine contractions, palpable fetal parts, fetal deterioration, loss of fetal station

(uterine rupture is differentiated from placental abruption by loss of fetal station vaginally or palpable fetal parts through the site of rupture abdominally)

45
Q

type of abortion - bleeding/may only have spotting, pain ceased, POC expelled, closed os, US shows empty uterus

A

complete abortion

46
Q

type of abortion - bleeding/mild cramping, some POC expelled, open os w/ visible tissue, US shows retained fetal tissue

A

incomplete abortion

47
Q

type of abortion - uterine bleeding, +/- pain, no POC expelled, closed os, fetal cardiac motion on US

A

threatened abortion

48
Q

type of abortion - uterine bleeding/cramps, no POC expelled, open os, +/- rupture of membranes

A

inevitable abortion

49
Q

quad screening finding in trisomy 21

A

decreased MSAFP and estriol, and increased inhibin A and b-hCG

50
Q

quad screening finding in trisomy 18

A

decreased MSAFP, estriol, inhibin A, and b-hCG

51
Q

hyperglycemia in the first trimester suggests?

A

pre-existing DM and therefore should be managed as pregestational DM

52
Q

classic triad of pre-eclampsia

A

HTN, proteinuria, and edema

53
Q

HELLP syndrome?

A

hemolysis, elevated LFTs, and low platelets

54
Q

triad of ectopic prego?

A

pain (abdominal), amenorrhea, vaginal bleeding

55
Q

regular uterine contractions + concurrent cervical change at less than 36 weeks

A

preterm labor

56
Q

indications for c-section

A

maternal factors = prior classical c-section; prior transverse c-section (relative indication); active gential herpes; cervical carcinoma; HIV infection
maternal and child factors = cephalopelvic disproportion; placenta previa/abruption; failed operative vaginal delivery; post-term prego
fetal factors = metal malposition; fetal distress; cord compression/prolapse; erythroblastosis fetalis (Rh incompatibility)

57
Q

fever > 38 w/in 36 hrs of delivery + uterine tenderness + malodorous lochia

A

postpartum endometritis

58
Q

OCPs decrease the risk of which cancers?

A

ovarian and endometrial cancers

59
Q

DDx for acute pelvic pain in women

A

appendicitis, ruptured ovarian cysts, ovarian torsion/abcess, PID, and ectopic pregnancy

60
Q

3 signs of placental separation

A
  1. gush of blood
  2. umbilical cord lengthening
  3. fundus of uterus rises and firms
61
Q

name 2 labor-inducing agents and mechanism

A
  1. vaginal prostaglandins - ripening (softening) of the cervix
  2. IV pitocin - increases the strength and frequency of contractions
62
Q

causes of post-partum hemorrhage - 4 T’s

A
  1. tissue = retained placenta
  2. trauma = instrumentation, lacerations, episiotomy
  3. tone = uterine atony (most common)
  4. thrombin = coagulation defects, DIC
63
Q

women w/ abnormal uterine bleeding should undergo ________. tx based on two findings?

A

endometrial biopsy. two findings include hyperplasia vs cancer. tx hyperplasia w/ progestin therapy. tx cancer w/ hysterectomy

64
Q

maternal serum alpha-fetoprotein screening - what causes increased? decreased?

A

increased - open NTD, ventral wall defects, multiple gestations
decreased - aneuoploides (trisomies)

65
Q

emergency contraception?

A

most effective is copper IUD (0-120 hrs after intercourse). alternative is progestin pills (0-72 hrs after intercourse)

66
Q

VEAL - CHOP

A

decels. ..
1. variable decels - cord compression (bad)
2. early decels - head compression (ok)
3. accelerations - oxygenation (ok)
4. late decels - placental insufficiency (bad)

67
Q

workup for asymptomatic women w/ pelvic mass…

A

initial workup by transvaginal US and then cancer antigen (CA-125). any elevation in CA-125 in a post-menopausal woman raises suspicion for ovarian cancer. if the US suggests a simple cyst and the CA-125 is not elevated, masses under 10 cm can be watched

68
Q

anovulation vs premature ovarian failure

A

FSH and LH are normal in anovulation vs FSH and LH are increased in premature ovarian failure

69
Q

anti-psychotic that can cause amenorrhea and galactorrhea

A

risperidone (due to dopamine effects –> hyperprolactinemia)

70
Q

systemic and topical steroid effects on skin

A

acneiform eruption characterized by monomorphus, erythematous follicular papules distributed on the face, trunk, and extremities that lack comedones

71
Q

characteristics of uterine atony? tx of uterine atony?

A

characteristics include soft, boggy, poorly contracted uterus
tx includes bimanual uterine massage, IVF, uterotonic agents (oxytocin, methylergonovine, carboprost), and blood transfusion

72
Q

postpartum pt w/ fever, uterine tenderness and foul-smelling lochia. dx? cause? tx?

A

postpartum endometritis. cause is polymicrobial infection composed of gram + and gram - organisms, aerobes, and anerobes. tx includes clindamycin and gentamicin

73
Q

woman w/ new onset hirsutism, menstrual dysfunction, negative US, normal uterus/ovaries on US, and adrenal mass noted on US. dx? specifc lab for condition?

A

androgen-producing adrenal tumor - DHEA-S is specific
(explanation –> androgens produced by women include androstenedione (AS), dehydroepiandrosterone (DHEA), testosterone (T), and DHEA-sulfate (DHEA-S) –> DHEA and T are produced by the ovaries and adrenals, whereas DHEA-S is predominantly produced by the adrenal glands only; since DHEA and DHEA-S are not true androgens (no receptor), they are converted to testosterone, therefore overproduction of these hormones can lead to clinical features of androgen excess)

USMLE Rapid Review (16 decks)

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