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COMLEX 3 > OB/Gyn > Flashcards

OB/Gyn Flashcards

1
Q

Which contraceptive has greatest risk of DVT/PE?

A

patch

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2
Q

pregnant –> positive for syphilis –> PCN allergy –> tx?

A

desensitize in ICU –> treat w PCN

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3
Q

DEXA scan –> at what age?

A

65yo

60yo if smoker

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4
Q

menopause –> what happens to FSH and anti-Mullerian hormone (increase/decrease)?

A
  • increase FSH

- decrease AMH

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5
Q

how confirm rupture of membranes?

A
  • vaginal pooling
  • nitrazine test
  • fern test
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6
Q

what is fetal fibronectin used for?

A

marker to assess likelihood of preterm labor bw 22-34wk pregnancy

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7
Q

fetal heart tone –> late decel –> indicates what?

A

uteroplacental insufficiency

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8
Q

fetal heart tone –> early decel –> indicates what?

A

fetal head compression –> increase vagal tone

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9
Q

fetal heart tone –> variable decel –> indicates what?

A

umbilical cord compression

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10
Q

pregnant –> DVT –> tx?

A

SQ LMWH

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11
Q

PID –> inpt tx –> abx?

A
  • cefoxitin + doxy

- clinda + gent

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12
Q

PID –> outpt tx –> abx?

A

ceftriaxone + doxy + metro

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13
Q

secondary amenorrhea –> preg test negative –> next step?

A

check FSH, TSH, prolactin

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14
Q

Down synd –> quad screen results

A
  • AFP decreased
  • estriol decreased
  • Bhcg increased
  • inhibin increased
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15
Q

quad screen:

  • AFP decreased
  • estriol decreased
  • Bhcg decreased
  • inhibin decreased

what condition?

A

Trisomy 18

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16
Q

quad screen:

  • AFP increased
  • estriol normal
  • Bhcg normal
  • inhibin normal

what condition?

A

open neural tube defect

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17
Q

quad screen:

  • AFP normal
  • estriol normal
  • Bhcg normal
  • inhibin normal

what condition?

A
  • normal fetus

- trisomy 13

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18
Q

quad screen:

  • AFP normal
  • estriol decreased
  • Bhcg normal
  • inhibin normal

what condition?

A

X-linked ichthyoses (steroid sulfatase deficiency)

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19
Q

chorionic villous sampling –> at what gestation can be performed?

A

9-11wk gestation

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20
Q

at what gestation can amniocentesis be performed?

A

15-20wk gestation

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21
Q

chorionic villous sampling prior to 9wk gestation increases fetal risk of what?

A

limb abnormalities

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22
Q

DEXA scan –> Tscore of what diagnoses osteoporosis?

A

< -2.5

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23
Q

DEXA scan –> Tscore of what diagnoses osteopenia?

A

-1 to -2.5

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24
Q

gestation diabetes –> when screen for it?

A

24-28wk gestation (2nd trimester)

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25
Q

pap –> atypical glandular cells –> next step

A

colposcopy w endocervical curettage

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26
Q

1st trimester –> genetic screen components

A
  • UA nuchal translucency
  • PAPP-A
  • hCG
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27
Q

2nd trimester –> genetic screen components

A

triple screen:

  • hCG
  • AFP
  • estriol

quad screen: inhibin-A

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28
Q

AFP –> elevated in what conditions (4)

A
  • neural tube defect
  • abdominal wall defect (gastroschisis, omphalocele)
  • mult gestation
  • error in gestational age
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29
Q

how dx gestational DM?

A

1hr gtt >140

```
then 3hr gtt:
- fasting >90
- 1hr >180
- 2hr >155
- 3hr >140
any 2
~~~

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30
Q

gestation DM –> tx

A

insulin (based on post-prandial sugars) <180

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31
Q

20-28wk gestation –> what conditions are screened for (3)

A
  • gestational DM
  • Rh Ag status
  • maternal anemia
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32
Q

28wk gestation –> under what conditions give rhogam?

A
  • mom is negative for Rh Ag and Rh Ab

- dad is Rh Ag+ or unknown

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33
Q

gestational DM –> goal fasting glucose

A

<95

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34
Q

3rd trimester –> painless vaginal bleeding –> what condition?

A

placenta previa

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35
Q

3rd trimester –> painful vaginal bleeding –> what condition?

A

placental abruption

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36
Q

placenta previa –> RF (3)

A
  • prior C/S
  • multiparity
  • uterine surgery
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37
Q

3rd trimester –> vaginal bleeding –> next step

A

fetal ultrasound

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38
Q

placental previa –> pelvic exam is contraindicated –> T/F?

A

T

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39
Q

hydatidiform mole –> tx

A

D&C

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40
Q

hydatidiform mole –> tx w D&C –> followup management

A

monitior hCG –> continued high level can indicate malignancy (commonly mets to lung)

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41
Q

late decel –> uteroplacental insuff –> decreased oxygen delivery to fetus

MCC

A

excessive uterine contraction

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42
Q

late decel –> uteroplacental insuff – due to excessive uterine contraction

common cause of excessive uterine contraction

A

oxytocin administration

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43
Q

pap smear –> atypical cells of undetermined significance (ASCUS) –> next step

A

HPV screen

or repeat pap in 6-12mo

44
Q

pap smear –> atypical cells of undetermined significance (ASCUS) –> HPV screen positive –> next step

A

colposcopy

45
Q

pap smear –> stop at what age?

46
Q

pap –> abnormal cells –> next step

A

colposcopy

47
Q

abnormal pap –> colposcopy –> ecto positive, endo negative –> next step

A

local ablation:

  • LEEP
  • cryoablation
48
Q

abnormal pap –> colposcopy –> ecto negative, endo positive –> next step

49
Q

HPV vaccine –> who?

A

F: 11-26
M: 11-21

50
Q

pregnant –> BMI normal –> how much weight gain during pregnancy?

51
Q

pregnant –> BMI overweight –> how much weight gain during pregnancy?

52
Q

pregnant –> BMI underweight –> how much weight gain during pregnancy?

53
Q

pregnant –> BMI obese –> how much weight gain during pregnancy?

54
Q

pregnant –> how much daily folate supplementation?

55
Q

pregnant –> h/o son with spina bifida –> how much daily folate supplementation?

56
Q

Asherman’s synd: labs

  • FSH level: decreased/normal/increased?
  • LH level: decreased/normal/increased?
A

normal ovarian fx

FSH: normal
LH: normal

57
Q

uterine fundus –> at umbilicus

what gestational age?

58
Q

17F pregnant –> 37wk gestation –> ER c/o vag bleed, intense pelvic pain –> VSS

dx? next step?

A

1 step: assess maternal & fetal status

placental abruption

mother is stable ==> next step is begin fetal monitor

next step is NOT pelvic exam, type&screen, or ABCs

59
Q

nurse is pregnant –> cannot take care of patients with what infections (4)?

A
  • parvovirus B19
  • measles
  • varicella
  • rubella
60
Q

dysfunctional uterine bleeding –> pathophys

A

unopposed production of estradiol –> anovulatory cycles

61
Q

dysfunctional uterine bleeding –> acute bleeding –> acute tx for acute bleeding

A

high dose estrogen for 48hr

62
Q

dysfunctional uterine bleeding –> acute bleeding trted w high dose estrogen –> return to ER after 3 days with continued profuse vaginal bleeding

next step? why?

A

D&C –> rule out endometrial CA

63
Q

> 45F –> suspect anovulatory abnormal uterine bleed –> best initial diagnostic test

A

endometrial bx –> rule out cancer

64
Q

endometrial bx shows endometrial CA –> check what tumor marker to evaluate for extrauterine spread?

65
Q

CA-125 –> extremely elevated –> indicates what condition?

A

ovarian CA

66
Q

postmenopausal bleeding –> bx shows endometrial hyperplasia –> tx

A

progesterone

67
Q

postmenopausal bleeding –> bx shows endometrial adenoCA –> tx

68
Q

postmenopausal bleeding –> bx shows endometrial adenoCA –> mets –> chemotherapy regimen?

A

paclitaxel + doxorubicin + cisplatin

69
Q

postmenopausal bleeding –> endometrial bx shows complex atypia

tx: progestin or surgery?

70
Q

postmenopausal bleeding –> endometrial bx shows atypia

tx: progestin or surgery?

71
Q

postmenopausal bleeding –> endometrial bx shows dysplasia

tx: progestin or surgery?

72
Q

tamoxifen –> increases risk of what CA?

A

endometrial

73
Q

pregnant –> vaginal bleeding

Passage of parts: no
Os: open
US: dead baby

dx?

A

inevitable abortion

74
Q

pregnant –> vaginal bleeding

Passage of parts: yes
Os: open
US: retained parts

dx?

A

incomplete abortion

75
Q

should be able to see fetus at what B-hCG level?

76
Q

vaginal bleeding –> UPT positive –> can’t see anything on TVUS –> B-hCG <1500

next step?

A

too early to see pregnancy on ultrasound –> repeat B-hCG quant in 48hr

77
Q

vaginal bleeding –> UPT positive –> can’t see anything on TVUS –> B-hCG <1500 –> repeat in 48hr shows B-hCG has doubled

dx?

A

intrauterine pregnancy

78
Q

vaginal bleeding –> UPT positive –> can’t see anything on TVUS –> B-hCG <1500 –> repeat in 48hr shows B-hCG has not doubled

dx?

A

ectopic pregnancy

79
Q

Sheehan’s synd (postpartum hypopituitarism) –> presentation

A
  • failure to lactate
  • amenorrhea
  • other hypopituitarism
80
Q

Sheehan’s synd (postpartum hypopituitarism) –> when does it present?

A

days to years after delivery

81
Q

prolactinemia –> tx

A

dopamine agonist:

  • pramipexole
  • ropinirole
82
Q

prolactinoma –> tx

A

dopamine agonist:

  • pramipexole
  • ropinirole

NOT surgery

83
Q

what is savage synd

A

resistant ovary synd –> ovaries resistant to gonadotropin –> ovarian failure –> 2ndary amenorrhea

84
Q

blind ended vagina

what condition?

A
  • androgen insensitivity synd (testicular feminization)

- mullerian agenesis

85
Q

androgen insensitivity synd (testicular feminization) –> pathophys

A

46XY –> X-linked recessive dz –> external genitalia –> fail to masculinize

86
Q

androgen insensitivity synd (testicular feminization) –> risk of what complication

A

intra-abdominal gonads –> risk of malignancy

87
Q

primary amenorrhea –> FSH & LH are low

what condition?

A
  • Kallman’s

- craniopharyngioma

88
Q

primary amenorrhea + anosmia –> dx?

A

Kallman’s

89
Q

Turner synd –> karyotype

90
Q

OCP can cause HTN

T/F?

91
Q

what is raloxifene

A

SERM:

  • breast cancer
  • osteoporosis
92
Q

raloxifene –> contraindication?

93
Q

hepatic adenoma –> assoc w what med?

A
  • OCP

- anabolic steroid

94
Q

pregnancy –> recommended daily increase in caloric intake

A

300 kcal/day

95
Q

breast: 2ndary mound

what Tanner stage? what age?

A

age 13-15 –> Tanner 4

96
Q

breast: enlarge

what Tanner stage? what age?

A

11.5-13yo –> Tanner 3

97
Q

endometrial bx –> endometrial adenoCA –> next step is CT imaging

T/F

A

F

next step is TAH/BSO

98
Q

late decels –> uteroplacental insuff –> tx?

A
  • L lat decubitus
  • O2
  • d/c oxytocin
99
Q

what is contraindication for administering Mg sulfate in eclampsia

A

myasthenia gravis

100
Q

differentiate: compete vs partial molar pregnancy

A

complete:
- no fetus –> only moles

partial:
- fetus/amniotic fluid/gestational sac is present

101
Q

PCOS –> tx for oligoovulation/amenorrhea?

A

clomiphene –> estrogen agonist/antagonist –> increase GnRH pulse amplitude –> increase LH/FSH –> ovulation

102
Q

pubic: adult quality –> sparse distribution

what tanner stage?

A

Tanner stage 3

103
Q

breast: breast bud

what tanner stage? what age?

A

10-11.5yo –> Tanner stage 2

104
Q

ovarian cancer that cause SBO –> what kind?

A

mucinous epithelial carcinoma

105
Q

what constitute severe preeclampsia?

A
  • > 160/100
  • 3+ proteinuria
  • progressive renal fail

COMLEX 3 (17 decks)

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