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Shelf - FM > OB/Gyn (40) > Flashcards

OB/Gyn (40) Flashcards

1
Q

pain drug of choice in pregnancy

A

acetaminophen

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2
Q

Avoid bismuth salicylate and NSAIDs, aspirin during what semesters?

What category?

A

all (premature closure of FA)

all are category D

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3
Q

Warfarin, isotretinoin, FU, MTX - what pregnancy class

A

X - absolute CI

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4
Q

Tx of her2-neu positive breast cancer

A

trastuzumab (herceptin)

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5
Q

PCOS, hyperandrogenism, ovulatory dysfunction - tx with what SERM that inhibits hypothalamic E receptors, blocking E’s (-) f/b on GnRH pulse generator –> release of FSH and LH from ant pit

A

clomiphene

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6
Q

At 28wks gestation, what should be tested for and administered?

A

test gestational diabetes

Tdap and prophylactic dose of RhoD IgG if mom is Rh(-)

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7
Q

what should all pregnant women receive, in any semester?

A

inactivated influenza vaccine

***NEVER give active/live, MMR, zoster, varicenna

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8
Q

when should GBstrep test be done?

DoC?

A

36wk

penicillin or cefazolin

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9
Q

PCOS increases risk of what cancer

A

endometrial cancer dt unopposed estrogen

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10
Q

Dx and risk factor - new onset abd pain persisting bw contractions, vaginal bleeding, fetal HR changes(decrease)

A

urterin erupture

hx of cesarean delivery TOLAC - trial of labor after cesarean)

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11
Q

what happens to AFP during pregnancy?

A

rises in fetal plasma until 10-13

rises in maternal

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12
Q

Pap smear when used for cervical cancer screening should be performed every __ years in women __-__yo.

A

Pap smear when used for cervical cancer screening should be performed every THREE years in women 21-65 yo.

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13
Q

When can HPV testing be started? And what is the time interval if used with a pap smear?

A

after age of 30, every 5 years.

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14
Q

What is recommended for pregnant patients over 21y during initial OB appointment.

A

cervical cancer screen with Pap

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15
Q

If mom is Rh- and baby Rh+, when should RhoDIgG be given?

A

28 weeks (lasts for 12 weeks) and then 72hrs postpartum

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16
Q

Young F less than 30y w/ painless, well circumscribed, smooth, rubbery, mobile mass usually in UOQ unilaterally.

A

fibroadenoma

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17
Q

Young F with a bilateral breast pain in UOQs starting 1wk prior to menstruation and disappearing after. Dt hormoal factors associated with menstruation.Can have sweling and yellow greenish dischage.

US - thin walled/clusters

A

fibrocystic disease

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18
Q

Unexplained hyperthyroidism in a F, but negative TS Ig and normal radioiodine uptake) with a pelvic mass.

A

struma ovarii - mature (B9) thyroid follicle teratoma of ovary

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19
Q

Define a reactive nonstress test.

A

Two fetal heart accelerations within 20 minutes with or without fetal movement detecetd by patient.

This is good!

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20
Q

what is an acceleration in a NST?

A

fetal HR inc by at least 15bpm for duration of 15-120 sec.

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21
Q

very common cause of 3rd trimester vaginal bleeding (varies in intensity) afteer vaginal intercourse of pelvic exam. No pain or trauma. Mostly when no prenatal care.

A

placenta previa

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22
Q

placenta accreta associated wtih what type of prior delivery

A

hx of c section

placental villi attach to uterine myometrium no endometrium

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23
Q

Evaluate mastitis and breast abscess in lactating women how?

then what?

A

evaluate the mass with US and use to guide direct needle aspiration for drainage.

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24
Q

pelvic itching, pain, dyspareunia with malodorous green/yellow frothy discharge.

A

trichomonas

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25
Q

cottage cheese discharge odorless with KOH, NORMAL vaginal pH. vulvar pruritis

A

vaginal candidiadis

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26
Q

KOH, fishy odor, grey-white vaginal discharge cells covered in bacteria

A

bacterial vaginosis

“clue cells”

27
Q

First two lines of treatment for endometriosis

A
  1. NSAIDs

2. Combination oral contraceptives

28
Q

When should chlamydia screening begin?

A

all sexually active women and pregnant women age

29
Q

Bp screening begins?

A

18 and older

30
Q

Cervical cancer screening

A

Pap every 3 years 21-65

Pap+HPV every 5 years 30-65

31
Q

70yo F with nipple inversiona nd discharge that appears white w/ creamy consistency. Blood tinged. Smoking and increased age are risk factors. Ductoscopy = dilated ducts filled iwth secretions and fibrotic debris.

A

duct ectasia

32
Q

Appropriate weight gain for a normal BMI (18.5-24.9) female during pregnancy

A

25-35lbs

33
Q 
#1 DoC for vulvovaginal candidiasis
#2 DoC
A
  1. topical azole (i.e. clotrimazole)

2. orgal fluconazole if pt cannot comply

34
Q

DoC for bacterial vaginosis (garderella, ureaplasma, prevotella) and trichomoniasis

A

po metronidazole

35
Q

ferning = ?

A

chorioamnionitis

36
Q

pregnant with rise in BP >15/10 from baseline, worsening/new proteinuria, end organ damage. dx and tx

A

preeclampsia

Magnesium sulfate for seizure treatment and prophylaxis to prevent eclampsia.

37
Q

what class of drug increases baseline fetal HR and incidence of fetal tachycardia?

A

beta-adrenergic agonists (terbutaline, ritodrine, albuterol)

38
Q

tocolysis drugs and function

A

used to suppress labor - relax sm m

beta-adrenergic agonists (terbutaline, ritodrine, albuterol)

CCB (nifedipine)

NSAIDs (indomethacin)
oxytocin antagonists

Mg sulfate

39
Q

pt has HTN or preeclampsia. What should be avoided if she gets uterine atony?

pt has asthma. What should be avoided if she gets uterine atony?

A

methylergonovine

carboprost

40
Q

A woman has a surgical or surgical abortion.

a) more than two weeks followingn surgical evacuation procedure she has persistent vaginal bleeding
b) evidence of infection with foul smelling discharge and a boggy tender uterus with cervical dilation

A

a) retained products of conception

b) septic abortion

41
Q

type of spontaneous abortion with a closed cervical os (products of conception have not been expelled). No fetal HR detected

A

missed abortion

42
Q

type of spontaneous abortion with vacinal bleeding, pelvic pain, open cervical os with products of conception visible in cervical canal. MC after 12 weeks gestational age

A

incomplete abortion

43
Q

type of spontaneous abortion with vaginal pink-brown to red bleeding and pelvic pain. beginning of a spontaneous abortion with dilated cervix, open cervical os, products of conception in internal os

A

inevitable abortion

44
Q

a young female w/ unilateral breast tenderness and purulent nipple discharge. MCC? MC risk factor?

A

periductal mastitis, smoker.

45
Q

tx periductal masttits

A

amoxicillin-clavulanate

46
Q

50yo F annual checkup. always choose….

A

mammogram - the first year of screening

47
Q

Dx: 12wks post partum HTN

A

chronic HTN

48
Q

acute rise in BP from baselie, new/worsening proteinuria and/or evidence of end organ damage

A

preeclamspia superimposed on chronic HTN

49
Q

absence of proteinuria if pt is >20wks gestation

A

gestational HTN

50
Q

> 2 BPs>140/90 and 300mg and

A

mild preeclampsia

51
Q

BP and prteinuria above mild ranges with evidenc of end organ damage

A

severe eclampsia

52
Q

gran mal seizure or coma on top of preeclampsia

A

eclampsia

53
Q

date of “confinement” math. naegele’s rule

A

(28 day cycle) = x days = 7
(35 day cycle) = x days = 14
(21 day cycle) = x days = 0

add x-days to first day of LMP + 9mo

54
Q

MCC of genetic abnormality causing pregnancy loss

A

trisomy 16

55
Q

wait until after this level of b-hCG (“discriminatory zone”)

A

1500

56
Q

hypothyroid pt on levothyroxine. most appropriate management now?

A

increase levothyroxine (if nt, possible cretinism)

57
Q

Type of abortion used to describe vaginal bleeding w/in first 20wks of gestation w/o evidence of spontaneous abortion.

Sx: presents with vaginal bleeding and pelvic pain

A

threatened abortion

58
Q

white, hairy appearing lesions on lateral tongue. associated with immunocompromised

A

EBV

59
Q

An infant presents with jaundice w.in first 24 hrs of life (Br>12mg/dL in first 24hrs or 5mg/dL inc in first 24hrs). Next step?

A

direct coomb’s test to chekc for foreign antibodies attached to infant’s RBC. often due to ABO and/or Rh incompatibility

60
Q

Infant with:
-Elevated direct Br (>20% of total Br level) - do what?
-

A

U/S

61
Q

tx of aphthous ulcers

A

trimcinolone (CS)

62
Q

MCC of sideroblastic anemia (iron accumulates in mito, causing marrow to roduce the rnged sideroblasts)

A

excesive alcohol use

63
Q

Threatened abortion v. inevitable abortion

A

btoh : vagina bleeding, cramping,

64
Q

MCC of elevated AFP during wk16-18 quad screen?

MCC of decreaed AFP

A
  1. incorrect gestational dating.
  2. multiple gestational
  3. open NTD

decreased - tri21

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