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Year 3 > Ob/Gyn > Flashcards

Ob/Gyn Flashcards

1
Q

increased menstrual bleeding, pelvic pain, increased inhibin

A

granulosa cell tumor

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2
Q

tocolytic contraindications

A

maternal hemorrhage
chorioamnionitis
Poor fetal testing

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3
Q

closed cervix, empty uterus

A

complete abortion

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4
Q

MC complication w / forceps

A

perineal laceration

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5
Q

management of CIN 1

A

do nothing until 1) still there after 2 years or 2) gets worse.
1) → ablation (cryo or laser)

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6
Q

advantage of laser VS. cryo ablation

A

maintain squamocolumnar jxn → Can do colps in future

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7
Q

cardinal mvmts of labor

A 
engagement
descent
flexion
int. rotation
extension
ext. rotation
expulsion
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8
Q

Cardinal mvmt @ 0 station

A

engagement

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9
Q

cardinal mvmt @ ischial spine

A

int. rotation

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10
Q

deceleration starts after contraction and ends after contraction

A

late decelerations

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11
Q

deceleration starts with contraction and ends with contraction

A

early decelerations

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12
Q

rapid decelerations that resolve quickly

A

variable decelerations

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13
Q

hysterosalpingography contraindication

A

active pelvic infection

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14
Q

management of prolapsed cord

A

C-section!
Trendebnburg
fill bladder (500-700 mL)
elevate fetal presentation

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15
Q

post-op fever – when is it ok?

A

first 48 hours

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16
Q

weeks to do chorionic villus sampling

A

10-13

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17
Q

weeks to do amniocentesis

A

14-18

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18
Q

order of puberty/growing things (girls)

A

thelarche
pubarche
growth spurt
menarche

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19
Q

enlarged, tender, erythematous, firm breasts

A

inflammatory breast cancer

ddx: cellulitis, mastitis, neglected breast CA

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20
Q

dx: inflammatory breast cancer

A

mammography

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21
Q

when do you do a Kleihauer-Betke test?

A

determine how much Rh Ig to give

dx placenta abruption (kinda)

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22
Q

when do you use the Apt test?

A

dx vasa previa (but not really so much)

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23
Q

tx: postpartum endometritis

A

clindamycin + gentamicin

pip-tazo if not

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24
Q

ASCUS next steps

A

HPV testing
negative –> observe
positive –> colp

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25
Q

preg physio: SVR

A

decreases

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26
Q

preg physio: CO

A

increases (HR and SV both increase)

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27
Q

preg physio: BP

A

decrease (SVR down (MAP down), CO up)

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28
Q

preg physio: creatinine

A

decreases (clearance up)

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29
Q

preg physio: insulin resistance

A

increases

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30
Q

feedings: 1 wk old

A

8 - 12/day

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31
Q

type of abortion by weeks gestation

A

medical: up to 7 (internet says 10)
7 - 14 wks: suction D&C
14+: D&E

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32
Q

tx: pregestational DM, now gestational

A

insulin (or metformin + insulin)

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33
Q

possible GDM tx

A

metformin
glyburide
insulin
(not tolbutamide)

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34
Q

FSH level = low ovarian reserve

A

> 30

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35
Q

tx for low risk of rupture ectopic preg

A

methotrexate (+ check bHCG @ day 4 and 7 – must go down by 15% or give a second dose/laproscopy)

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36
Q

why would someone be considered low risk ectopic preg

A

hemodynamically stable
beta-HCG < 5000
gestational sac < 4 mm
no fetal heart tones

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37
Q

pain in endometriosis

A

right before menses to end of menses
dyspareunia
dyschezia
uterosacral ligaments

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38
Q

dx: solid breast mass

A

core needle biopsy (even w/ negative mammography)

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39
Q

amniotic fluid pH

A

~ 7 (turns nitrazine paper blue)

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40
Q

when to test for GBS

A

35 - 37 wks

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41
Q

only thing continuous cardiotocography has been shown to improve

A

neonatal seizures (which lack long term effects)

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42
Q

causes of abnormal uterine bleeding

A 
PALM E. COIN
polyps
adenomyosis
leiomyomas (fibroids)
malignancy
endometrial
coagulopathy
ovulatory dysfxn (menopause, PCOS, weight, thyroid)
iatrogenic
not yet classified
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43
Q

enlarged globular uterus + abnormal bleeding

A

adenomyosis

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44
Q

when to give anti-Rh (D)

A

~ 28 wks

w/ vaginal bleeding

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45
Q

dx: endometriosis

A

pain, dysmenorrhea, menorrhagia refratory to tx w/ nsaids + OCPs
after U/S –> laparoscopy

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46
Q

first line tx for depression in preg

A 
psychotherapy
then 
1) sertraline (not paroxetine)
2) venlafaxine/bupropion 
3) nortriptyline
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47
Q

why dyschezia in endometriosis

A

implanted tissue on rectal serosa –> dyschezia, constipation or cyclic heamtochezia

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48
Q

postpartum: fever, uterine tenderness, purulent lochia

A

postpartum endometritis

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49
Q

prophylactic ABx for cesarean section

A

cefazolin (or cefoxitin)

50
Q

tx for Turners @ puberty

A

conjugated estrogens

51
Q

tx for hyperprolactinemia

A

bromocriptine (or cabergoline)

52
Q

tx for PCOS wanting kids

A

clomiphene citrate

w/ or w/o metformin

53
Q

tx for precocious puberty

A

leuprolide

goserelin

54
Q

how much folic acid for someone w/ previous spina bifida

A

4000 micrograms/day

55
Q

tx for CIN 2+

A

LEEP
laser conization
cold-knife conization

56
Q

MC complication after cesarean

A

postoperative ileus

57
Q

preggo w/ hep B tx

A

tenofovir

telbivudine

58
Q

hormone levels in PCOS

A

increased DHEA/T

LH:FSH = 3:1

59
Q

tx PCOS

A

OCPs, metformin

60
Q

amenorrhea + anosmia

A

Kallman’s (problem in hypothalamus)

61
Q

when to c section HSV pts

A

lesions present or prodromal sx (burning/tingling)

62
Q

ABx for PROM

A

ampicillin + gentamicin

use clinda w/ penicillin allergy

63
Q

tx for lichen sclerosis

A 
topical steroid (clobetasol)
biopsy first, apparently
64
Q

dx endometriosis

A

laparoscopy (not EMB)

65
Q

f/u after granulosa cell tumors

A

uterine sampling for endo hyperplasia/cancer

66
Q

mgmt: visible cervical lesion

A

biopsy

67
Q

body measurement that shows IUGR

A

abdominal circumference

68
Q

fluid for hypovolemic shock (hemorrhage)

A

packed RBCs, FFP, platelets (1:1:1)

if none –> lactated ringers or normal saline

69
Q

changes to surgical protocol w/ shellfish allergies?

A

no iodine prep –> use alternative (chloroprep)

70
Q

fetal acceleration =

A

up 15 bpm for 15 s

71
Q

fetal deceleration =

A

drop 15 bpm for 15 s

72
Q

warfarin in pregnancy

A

nope
switch to heparin
(if have antiphospholipid ab synd give ASA too)

73
Q

risk of anemic preggo

A

PTL

74
Q

how anemic can preggo be?

A

Hb < 6 increases risk of PTL

75
Q

infertility tx: low motility sperm

A 
intrauterine insemination (1st)
in vitro insemination (2nd)
76
Q

LSIL in 21 - 24 yo

A

Pap next year

77
Q

LSIL in > 25

A

colposcopy

if >30 and HPV is neg, you can wait a year

78
Q

what is EMB for?

A

endometrial hyperplasia/cancer

79
Q

urge incontinence path

A

detrusor muscle instability

80
Q

urge incontinence tx

A 
muscarinic antagonists (anticholinergics)
2nd: TCAs but not great
81
Q

IUD relative contraindications

A

STI in past 3 months
weird uterus
hx of ectopic preg

82
Q

toxic shock syndrome organisms

A

group A strep
staph aureus
clostridium sordellii

83
Q

postpartum, high fever, hTN, diffuse desquamating rash, 2 organ systems involved

A

toxic shock syndrome (endometritis)

84
Q

tx for hot flashes

A
  1. HRT (E+P) if they have a uterus
  2. E (w/o uterus)
  3. SSRI (w/ hx of thromboembolic events)
85
Q

tx for PMS/PMDD

A

SSRI

86
Q

metrorrhagia/menorrhagia in 40 - 50

A

endometrial polyps

87
Q

trisomy 13

A

Patau: facial cleft, rockerbottom feet, digital malforms, holoprosencephaly , cystic hygroma

88
Q

trisomy 18

A

Edward: overlapping digits, NTDs, rockerbottom feet, diaphragmatic hernia, choroid plexus cysts

89
Q

breast lump > 30

A

usually fibroadenoma

90
Q

causes of postabortal hemorrhage

A

common: uterine atony, cervical lac
rare: uterine perf, retained tissue, infection, coagulopathy

91
Q

trisomy 21 quad

A

AFP down
Estriol down
hCG up
inhibin up

92
Q

trisomy 18 quad

A

AFP down
Estriol down
hCG down

93
Q

mgmt: PROM

A

after 34 wks –> induce labor
before 34 wks, not in labor –> expectant management
before 34 wks, in labor –> tocolytics, antenatal corticosteroids

94
Q

what can you see on hysteroscopy

A 
endo polyps
adhesions
foreign bodies
endocervical lesions
uterine septum
95
Q

risks of IUGR

A

cerebral palsy

96
Q

HA, fever and flushing after syphilis tx

A

Jarisch-Herxheimer rxn

tx w/ acetaminophen + IV fluids

97
Q

cervical insufficiency vs PTL

A

in CS, dilation is painless

in PTL there are painful contractions

98
Q

recurrent preg loss definition

A

3+ spontaneous abortions w/ same partner

99
Q

mgmt of recurrent preg loss

A 
maternal anatomu exam
immuno workup (anticardiolipin abs and lupus anticoag)
mat/pat karyotype analysis
100
Q

cervical ripening agents

A

misoprostol
dinoprostol
(contraindicated w/ hx c section)

101
Q

mgmt: postmenopausal bleeding

A

EMB > TVUS

102
Q

tx asrhma during preg

A

albuterol PRN

add daily budesonide if needed

103
Q

wtf is the Kleihauer-Betke test

A

tests for fetomaternal hemorrhage (detects/measures fetal blood cells in maternal circulation)

104
Q

stillbirth postmortem testing

A 
CBC
UDS
RPR (or past)
blood Ab screen
glucose/glycosylated glucose (or past GTT)
Kleihauer-Betke/flow cytometry
105
Q

HIV viral load that –> c-section

A

> 1000 copies/mL

106
Q

ABx for GBS (+) mom

A

penicillin G @ onset of labor

107
Q

vaccines for HIV (+) preggers

A

pneumococcal
flu (inactivated)
TDaP
Hep A/B

108
Q

other name for human placental lactogen (HPL)

A

chorionic somatomammotropin

109
Q

monozygotic twins: chorio/amnio/split time

A

MC: monochorionic, diamniotic, split btwn 4 - 8 days

110
Q

recommended weight gain for under/normal/over/obese preggers

A

28 - 40 lbs (under)
25 - 35 lbs (normal)
15 - 25 (over)
11 - 20 (obese)

111
Q

CA a/w DES exposure

A

clear cell adenocarcinoma of vagina/cervix

112
Q

cheapest birth control

A

IUD (if use for at least 2 yrs)

113
Q

mgmt: postpartum hemorrhage, boggy uterus

A

bimanual uterine massage
oxytocin
uterotonics:
1. misoprostol (PGE1 analogue)
2. carboprost (PGF2-alpha analogue) – not w/ asthma
3. methylergonovine (ergot) – not w/ HTN
if all else fails –> surgery, even TAH if encessary

114
Q

Rh alloimmunization test

A

indirect Coombs

115
Q

cause of bleeding 2 weeks post spontaneous abortion

A

no infection clues –> retained products of conception

infection –> septic abortion, endometritis

116
Q

imaging for bulging vagina/cyclic pain w/o bleeding

A

pelvic MRI > TVUS

117
Q

measurement limiting head engagement

A

obstetrical conjugate - shortest AP diameter in females – shortest distance from sacral promontory to pubic symphysis

118
Q

intrapartum varicella infection consequences

A

scarring rash (cicatricial)
limb hypoplasia
chorioretinitis

119
Q

normal post-void value

A

50 mL

>200 –> retention

120
Q

mgmt: postmenopausal w/ terrible hot flashes

A

combination E+P (if have uterus)

E only if uterus-less

Year 3 (5 decks)

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