OB/GYN Flashcards
On examination of a pregnant patient the physician assistant notes a bluish or purplish discoloration of the vagina and cervix. This is called
Hegar’s sign.
Cullen’s sign
McDonald’s sign
Chadwick’s sign
Chadwick’s sign is a bluish or purplish discoloration of the vagina and cervix.
Ovulation can be confirmed with mid-luteal phase measurement of which of the following?
Prolactin
Progesterone
Luteinizing hormone
Thyroid stimulating hormone
Ovulation can best be confirmed by measuring serum progesterone levels in the mid-luteal phase
LH, FSH, and prolactin are used to confirm ovulation in patients with irregular menstrual cycles.
What causes discharge that is profuse, frothy, greenish, and foul smelling. pH of the vagina is 6.0.
Vulvovaginal candidiasis
Bacterial vaginosis
Trichomoniasis
Atrophic vaginitis
Trichomoniasis presents with vulvar pruritus and a profuse, frothy, greenish, foul-smelling vaginal discharge with a pH usually exceeding 5.0.
- Vulvovaginal candidiasis presents with a thick, curd-like discharge and vulvar pruritus.
- Bacterial vaginosis presents with malodorous, gray-white discharge. The pH is typically 5.0-5.5.
A 30-week pregnant patient presents with sudden onset of profuse, painless vaginal bleeding. Which of the following is the most likely diagnosis?
Uterine rupture
Placenta previa
Disseminated intravascular coagulation
Abruptio placentae
Placenta previa presents with sudden, painless, profuse bleeding in the third trimester
- Abruptio placentae presents with abdominal pain and vaginal bleeding.
- Uterine rupture presents with vaginal bleeding or hematuria with suprapubic pain and tenderness.
- Disseminated intravascular coagulation presents with systemic signs of bleeding and thrombosis and typically presents at the time of delivery.
A 25 year-old female presents with constant premenstrual pelvic pain. She also notes dysmenorrhea and dyspareunia. Which of the following is the most likely diagnosis?
Endometriosis
Ovarian cysts
Endometrial polyps
Uterine leiomyoma
Endometriosis presents with premenstrual pelvic pain, dysmenorrhea, and dyspareunia
- Leiomyomas of the uterus may present with abnormal uterine bleeding, but typically do not present with any symptoms.
- Endometrial polyps present with menorrhagia and intermenstrual and premenstrual bleeding, pain is not typical.
- Ovarian cysts present with adnexal mass and acute pain upon rupture.
Which of the following prenatal vitamins has been shown to decrease the risk of neural tube defects?
Riboflavin
Niacin
Thiamine
Folic acid
Folic acid given daily has been shown to effectively reduce the risk of neural tube defects. It should be started 1-3 months prior to pregnancy.
A 35 year-old female presents with a solitary breast mass. Fine needle aspiration reveals bloody fluid with no malignant cells. What is the next best step in the care of this patient?
Monthly follow-up
Excisional biopsy
Hormone therapy
Repeat fine needle aspiration
Excisional biopsy is the next step in cases of bloody fluid, residual mass or thickening.
-Monthly follow-up is indicated in cases where the mass disappears with aspiration or the fluid is clear.
Excisional biopsy
-Repeat fine needle aspiration is indicated in solid masses which are benign or in which cytologic findings are inconclusive.
What is the primary treatment for an infected Bartholin's duct cyst? A Acyclovir B Azithromycin C Warm compresses D Incision and drainage
Incision and drainage is the treatment of choice for a Bartholin duct cyst
A 36-week pregnant patient presents to the ED with hypertension. Physical examination reveals 2+/4+ edema in the lower extremities with hyperreflexia and clonus bilaterally. A urinalysis reveals 3+ protein. Which of the following is the best treatment option for this patient?
A Magnesium sulfate B Nifedipine (Procardia) C Diazepam (Valium) D Captopril (Capoten)
Magnesium sulfate
A patient presents with infertility due to chronic anovulation. Laboratory testing reveals a normal follicle stimulating hormone, estradiol, and prolactin levels. The patient’s progestin challenge test was positive. Which of the following is the drug of choice for the treatment of infertility in this patient?
A Dehydroepiandrosterone sulfate
B Clomiphene citrate
C Bromocriptine
D Human menopausal gonadotropin
B Clomiphene citrate
Clomiphene citrate is the first drug of choice in patients with infertility due to anovulation with normal hormone levels.
Progesterone influence on the breast tissue prior to menstruation causes
A proliferation of the mammary ducts.
B growth of the lobules and alveoli.
C proliferation of Cooper’s ligaments.
D increase in the number of glands of Montgomery.
B growth of the lobules and alveoli.
Growth of the lobules and alveoli is under the influence of progesterone. Prior to menses, the breast swelling that women notice is a result of the progesterone which is secreted from the corpus luteum. During menses, the swelling subsides.
A 40 year-old female presents with a 1.5 cm well-circumscribed mass noted on mammography in the right upper, outer quadrant. Which of the following procedures is most appropriate and should be done next?
A Fine needle aspiration
B BRCA 1 and BRCA 2 genetic testing
C Serum CA-125
D Radiation therapy
Fine needle aspiration is fairly accurate, easily performed, and has minimal morbidity
Although BRCA 1 and BRCA 2 genetic tests are used in the risk assessment for possible breast and ovarian cancer, it would not replace the need to perform a more definitive evaluation of an identified breast mass.
Serum CA-125 is a tumor marker for ovarian, not breast, cancer.
What is the initial treatment of choice for hyperthyroidism in a 10-week pregnant patient? A No treatment is necessary B Propylthiouracil (PTU) C Radioiodine treatment D Subtotal thyroidectomy
B Propylthiouracil (PTU)
Although thyroid function tests are altered in pregnancy true hyperthyroidism can occur and should be treated.
Treatment of the patient with Pediculosis pubis consists of which of the following?
A Permethrin (Nix) cream B Clotrimazole (Gyne-Lotrimin) C Podofilox (Condylox) solution D Selenium sulfide (Selsun) suspension
A Permethrin (Nix) cream
Patient education for a 23 year-old using oral contraceptives should include which of the following?
A Rifampin may decrease the effectiveness of the oral contraceptives.
B Acetaminophen may decrease the effectiveness of the oral contraceptives.
C Oral contraceptives may provide some protection from coronary artery disease.
D Changing to the “minipill” (progestin only) will inhibit ovulation more consistently than
A Rifampin may decrease the effectiveness of the oral contraceptives.
Progestin only oral contraceptives are less effective at inhibiting ovulation than the combination oral contraceptive.
