OB/GYN

Question 1

What is seen on lab work for a pt with hypothalamus amenorrhea

Tx?

Answer 1

low FSH and LH

Clomiphene (stimulate gonadotropin secretion)

Question 2

What is seen on lab work for a pt with pituitary dysfunction?

Answer 2

low FSH and LH, high prolactin

caused by adenoma –> resect the tumor

Question 3

What is seen on lab work for a pt with ovarian d/o?

Answer 3

high FSH and LH, low estradiol

Question 4

how do you dx ovarian d.o?

Answer 4

progesterone challenge test (give 10 mg medroxyprogesterone x10 days)

Question 5

Pt has bleeding after 10 mg medroxyprogesterone x10 days. what does this mean?

Answer 5

there is an ovary problem. plenty of estrogen, but pt is anvoulatory

Question 6

Pt does not have bleeding after 10 mg medroxyprogesterone x10 days. what does this mean?

Answer 6

the pt is hypoestrogenic (from hypothalamus-pituitary failure) or uterine problem (asherman’s, uterine outflow problem)

Question 7

what is the most sensitive test to check for menopause?

Answer 7

high serum FSH

labs will show high FSH, LH with low estrogen

Question 8

what medication can reduce the size of a leiomyoma?

Answer 8

leuprolide (GnRH agonist that causes inhibition when given continuously)

Question 9

abx given for endometritis after c-section and after vaginal delivery

Answer 9

C. section: clindamycin + Gentamicin

Vaginal: Ampicillin + gentamicin

Question 10

what do you give a pt with endometrial hyperplasia w/o atypia?

Answer 10

progestin (follow-up)

Question 11

what do you do for a pt with endometrial hyperplasia w/ atypia?

Answer 11

hysterectomy

progestin is not a surgical candidate or wants to presever fertility

Question 12

what tumor marker is used to detect ovarian carcinoma

Answer 12

CA-125

Question 13

PCOS is due to ____ resistance

Answer 13

insulin (high insulin, high LH, high ovarian androgen production)

Question 14

what lab values will you see with PCOS

Answer 14

high testosterone

LH:FSH of >3:1

Question 15

pt is >25 y.o with ASCUS pap result, what is the next step?

Answer 15

1. do HPV testing (if - then repeat in 3 yrs, if + then colposcopy w/ bx)
2. repeat pap in 1 yr Iif - then resume as normal, if + perform colposcopy)

Question 16

pt is 21-24 y.o with ASCUS pap result, what is the next step?

Answer 16

repeat in 1 year or do HPV testing

Question 17

pt is <21 y.o with ASCUS pap result, what is the next step?

Answer 17

repeat pap in 1 year

Question 18

painful genital ulcer with painful inguinal lymphadenopathy?

Answer 18

Chancroid (haemophilus Ducreyi)

Question 19

tx for Chancroid (haemophilus Ducreyi)

Answer 19

azithromycin

ceftriaxone, cipro

Question 20

danazol can improve what breast complaint?

Answer 20

fibrocystic breast dz

Question 21

what is naegels rule?

Answer 21

LMP + 7 days minus 3 months

Question 22

a-FP = low
B-hcg = high 
estradiol = low

Answer 22

down syndrome

Question 23

a-FP = high
B-hcg = n/a
estradiol = n/a

Answer 23

open neural tube defect

Question 24

a-FP = low
B-hcg = low
estradiol = low

Answer 24

trisomy 18

Question 25

preeclampsia isHTN + protein during pregnancy after ___ wks

Answer 25

20

Question 26

3rd TM painless bleeding. uterus is soft and nontender

Answer 26

placenta previa

Question 27

3rd TM bleeding with abd pain and rigid uterus

Answer 27

abruptio placentae

Question 28

what does APGAR stand for?

Answer 28

``` A = appearance (baby is pink all over) P = Pulse ( >100) G = Grimace (pulls away, sneeze, cough) A = activity (flexes arms and legs, resists extension) R = respiration (stong, crying) ```

Question 29

what are some meds that stop uterine contractions?

Answer 29

indomethacin nifedipine Mg sulfate terbutaline (can cause maternal pulm edema)