Ob/Gyn

Question 1

Menopause/Perimenopause

Answer 1

1. Perimenopause:2-8 yrs before menopause and 1 year after last period.
2. if there is heavy bleeding or dysfunctional bleeding for a 6 mos. period of time screening of endometrial lining should be done. (<4mm)
3. pathognomonic finding is elevated FSH

Question 2

Group B Strep/ Streptococcus agalactiae

Answer 2

1. Asymptomatic bacturia should be treated immediately with 10 days of abx (Cephelexin/Penicillin)

Question 3

Bacterial Vaginosis

Answer 3

1. Dx: thin gray vaginal discharge, pH>4.5, amine odor with KOH, clue cells
2. garderella vaginalis
3. Asymp: No treatment, Sympt/High RiskPretermlabor: Flagyl/Clind PO

Question 4

Trichomoniasis

Answer 4

1. pear shaped motile flagella and PMN cells
2. Strawberry cervix with green frothy discharge
3. STI
4. Tx flagyl, must treat both partners

Question 5

FDA Medication Categorization

Answer 5

A : Good
C: No studies on preg. women
D: Acceptable despite high risk
X: Very Bad

Question 6

Rhogham

Answer 6

1. Anti D should be given at 28 week and then <72 hours postpartum.
2. assessment of degree of hemorrhage should be made if hemorrhage was present

Question 7

PID

Answer 7

RF: multiple partners, no barrier protection, <35 y/o, h/o of previous PID

Question 8

Chlamydia Gonorrhea

Answer 8

1. Azithromycin 1g PO x 1 or doxy x 7 unless pregnant then erythromycin x 7

Question 9

Gestational Diabetes

Answer 9

Dx: Glucose Tolerance Test @24-28wks
50g: AC>130 1 hour post
100g: AC>95,180,155 @1,2,3 hrs post
Fasting AC <120

Question 10

Spina Bifida

Answer 10

1. Folic Acid
2. 4mg: normal risk female
   4mg: female with h/o child with NTD/on antiseizure medication
3. Increased Risk when 1st degree relative affected,

Question 11

Postpartum Endometritis

Answer 11

Dx: Fever, uterine tenderness, malodorous,vaginal discharge, leukocytosis
Tx: clindamycin and gentamicin
Flagyl is contraindicated in BF mothers
RF: c-section>NSVD

Question 12

PMS/PMDD

Answer 12

1. tx: Fluoxetine, Alprazolam

Question 13

Cervical Cancer Screening

Answer 13

1. Pap should be started at 21- done every 2 years and can go to every 3 with 3 negative consecutive neg. paps.

Question 14

OCP

Answer 14

1. h/o thromboembolic event, active liver disease, pregnancy, uterine bleed and estrogen dependent tumors.
2. Relative Contraindication for COCP is >35 y/o and h/o migraine headache