Ob/Gyn

Question 1

PID: SSx

Answer 1

• Gradual onset
• Lower abd or pelvic pn (uni or bilateral)
• Low-grade fever (NO fever in ovarian torsion or endometriosis)
• Pelvic organ (adnexal) tenderness

Question 2

HIV Dx in pregnancy: Recommendations

1) Exposures
2) Tx
3) Delivery method
4) Breast feeding

Answer 2

1) Immediately assess risk of transmission to others (Test all exposed individuals)
2) Treat with ART immediately.
3) Vaginal delivery is recommended if acceptable plasma viral load suppression.
4) Breastfeeding is NOT recommended.

Question 3

Endometriosis: Sx

Answer 3

• Pelvic/adnexal pain and fullness (uni or bilateral)
• Dyspareunia
• Dysmenorrhea (regularly)
• Dyschezia
• Infertility

Question 4

Menopause with Vasomotor Sx & Hx of migraine: Initial Tx?

Answer 4

Combined hormonal therapy (Progestin needed if Pt still has uterus)

Question 5

Molar-pregnancy-associated Hyperthyroidism

1) SSx
2) Best initial Tx
3) Definitive Tx

Answer 5

1) Tremor, hyperthermia, delirium, tachycardia, HTN
2) Propranolol for HR and BP
3) Tx of underlying cause (i.e., GTD): D&C with suction in this case.

Question 6

Primary amenorrhea in teenager with normal pubertal develpment

1) Dx
2) Cause

Answer 6

1) Funtional hypothalamic amenorrhea
2) Over-excercise: Athletic triad (amenorrhea, disordered eating, and low bone mass). Thus Pt likely has very low BMI and lanugo.

Question 7

Adenomyosis

1) Def
2) Best Dx test

Answer 7

1) Endometrium breaks through myometrium without a discrete mass of cells. (Cf. endometriosis is endometrial tissue outside of uterus and is closely associated with adenomyosis.)
2) MRI

Question 8

Carbamazepine in pregnancy: Recommendation

Answer 8

Add a multivitamin with 1 mg of folic acid daily.

• Carbamazepine has moderate risk for NTD, but the risk of Sz to the patient and fetus is also great. Thus, continue taking it, but add folic acid (3 months prenatal & for the duration of breastfeeding) to prevent NTD.

Question 9

High risk Pre-ecmapsia: Prevention

Answer 9

Low-dose ASA: Start before 16 week GA and until delivery.

• High risk factors include chronic HTN, DM, or previous preterm pre-eclampsia.

Question 10

Corpus luteum cyst: Characteristics on US

Answer 10

• Complex cyst (cf. follicular cyst is a simple cyst.)