OB/Gyn

Question 1

Postmenopausal bleeding next step in diagnosis

Answer 1

TVUS —> if endometrium >4mm do endometrial bx

Question 2

Sertoli-Leydig tumor

Answer 2

sex chord stromal cell tumor, secretes testosterone; p/w rapid-onset virilization and signs of estrogen deficiency

Question 3

Granulosa cell tumor

Answer 3

sex chord stromal cell tumor that secretes estrogen, presents as complex adnexal mass

Question 4

Primary dysmenorrhea caused by

Answer 4

increased endometrial prostaglandin production

Question 5

Primary ovarian insufficiency dx

Answer 5

amenorrhea <40 yrs, hypoestrogeneic sx, elevated FSH, low estrogen, no withdrawal bleeding with progesterone challenge

caused by ovarian follicle depletion

Question 6

Primary ovarian insufficiency is associated with

Answer 6

Turner syndrome, Fragile X carrier, autoimmune oopheritis, anticancer drugs or pelvic radiation, galactosemia

Question 7

Lichen sclerosis increases risk for

Answer 7

vulvar cancer; chronic inflammation is risk factor for malignant transformation

Question 8

Late decelerations

Answer 8

signify uteroplacental insufficiency –> can lead to fetal hypoxia and acidemia

can be result of uterine tachysystole- less time for recovery = decreased blood flow; tx is d/c uterotonic agents

Question 9

5-a-reductase deficiency

Answer 9

46XY genotype, internal male genitalia, external female genitalia (blind vagina), impaired testosterone–>DHT conversion, normal male testosterone and estrogen levels

Question 10

5-a-reductase deficiency presentation

Answer 10

phenotypically female with virilization beginning w/ puberty, male pattern hair and acne, increased muscle mass, clitoromegaly, no breast development, bilat adnexal masses = undescended testes

Question 11

Gestational hypertension features

Answer 11

New onset hypertension at >20 wks gestation, NO proteinuria

Question 12

Effects of elevated prolactin during breastfeeding

Answer 12

Suppresses GnRH (hypothal.) –> decreased FSH and LH (pituitary) –> decreased ovarian estrogen production

hypoestrogeneic sx: amenorrhea, hot flashes, vulvovaginal atrophy and dryness

Question 13

First stage of labor- latent phase

Answer 13

cervical dilation from 0-6 cm, no set rate of change

Question 14

First stage of labor- active phase

Answer 14

cervical dilates rapidly from 6-10 cm, normal progression of >1 cm/2 hrs

Question 15

Management of prolonged active phase of labor (cervical change <1cm/2hrs)

Answer 15

Place IUPC to measure contraction strength (should be >200 MVU), augment with oxytocin if <200 MVU

Question 16

Causes of fetal tachycardia

Answer 16

Maternal fever
Med side effect (B agonists)
Fetal hyperthyroidism
Fetal tachyarrhythmia

Question 17

Causes of fetal bradycardia

Answer 17

Maternal hypothermia
B blockers
Fetal hypothermia
Fetal heart block (2/2 Sjogren’s Abs- anti-Rho and anti-La)

Question 18

Management of chorioamnionitis

Answer 18

Broad-spectrum abx, antipyretics, delivery (augmentation or induction)

Question 19

Mullerian agenesis dx and next steps

Answer 19

Vagina ends in blind pouch, but otherwise normal ovarian function and FSH

Get renal U/S- increased risk for renal abnormalities d/t shared embryologic origin of internal genitalia and ureters/kidneys

Question 20

Lichen planus

Answer 20

multiple purple pruritic plaques sometimes assoc. w/ thin white striae around vulva and labia

Question 21

Lichen sclerosis

Answer 21

multiple white papules that converge into plaques