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PANRE Key Points Quick Flip > Ob-Gyn > Flashcards

Ob-Gyn Flashcards

1
Q

The secretory phase of the menstrual (day 14 - 28) is dominated by what hormone?

A

Progesterone

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2
Q

Who is more likely to get pre-eclampsia, a nulliparous or multiparous woman?

A

Nulliparous

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3
Q

Since a genetic cause is the number one reason for primary amenorrhea, what is one very important test?

A

Karyotype

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4
Q

Purulent cervical discharge should make you think of what diagnosis?

A

Neisseria Gonorrhea

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5
Q

A description of a young girl with a webbed neck, or wide shield chest should make you think of what diagnosis?

A

Turner’s Syndrome

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6
Q

Cervical biopsy comes back as CIN 1, what is the next step?

A

Repeat pap smear in 6 months

Repeat colposcopy in 12 months

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7
Q

What is the most common cause of secondary amenorrhea?

A

Pregnancy

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8
Q

What 3 labs should you order if you are considering secondary amenorrhea?

A

TSH, Prolactin, bHCG

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9
Q

Define premature birth?

A

Delivery of uterine contents between 20-36

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10
Q

A unilateral, single, mobile, firm, non-tender, solid breast mass should make you think of what diagnosis?

A

Fibroadenoma

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11
Q

Define metrorrhagia

A

Bleeding between periods

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12
Q

Post-menopausal bleeding is immediately believed to be what diagnosis?

A

Endometrial cancer (until proven otherwise)

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13
Q

During what portion of the menstrual cycle does PMS occur?

A

The second half of the menstrual cycle, and the symptoms are relieved by menstruation

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14
Q

How do you treat bacterial vaginosis?

A

Metronidazole (Flagyl) for 7 days.

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15
Q

What location within the pelvis is endometriosis most commonly found?

A

In the ovary

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16
Q

What lab test is the gold standard for chlamydia?

A

Nucleic acid amplification test

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17
Q

Are fibrocystic breast masses usually bilateral or unilateral?

A

Bilateral

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18
Q

How do you definitively diagnose endometriosis

A

Exploratory Laparoscopy (Ex-Lap)

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19
Q

What is the most common uterine tumor

A

Leiomyoma (Fibroids)

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20
Q

What is the ethnic backgrounds that has increased risk for fibroids?

A

Blacks (5x more likely than whites)

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21
Q

How do you treat vaginal candida

A

Flucazole PO one day, or Azole cream x 1 week.

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22
Q

First step of treatment for endometrial cancer?

A

TAH-BSO (Total Abdominal Hysterectomy with Bilateral Salpingo-oophorectory)

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23
Q

If you see the term chocolate cyst it should make you think of what?

A

Endometrioma

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24
Q

A surge in what hormone leads to ovulation?

A

LH

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25
Q

A patient presents with irregular menses, hirsutism, and infertility, what is the diagnosis?

A

PCOS

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26
Q

What endocrine issue is associated with PCOS?

A

Insulin insensetivity

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27
Q

You have a patient with PCOS, and she wants to get pregnant, what meds are you going to give her?

A

Clomid, and Metformin (if insulin sensetivity)

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28
Q

What is the medical treatment for early ectopic pregnancy?

A

Methotrexate

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29
Q

An ovarian cyst that contains hair and teeth, what is the diagnosis?

A

Terratoma

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30
Q

What is the mean age for ovarian cancer?

A

63 (think of this in older patients with vague abdominal symptoms)

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31
Q

Define the second stage of labor?

A

Full dilation to delivery

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32
Q

A 66 year old female presents with bouts of nausea, weight loss, and vague abdominal pain, what is the diagnosis?

A

Ovarian cancer

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33
Q

When is recommended to begin PAP smears?

A

21

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34
Q

Cervical biopsy comes back as CINII or CINIII, what is your next step.

A

LEEP (Loop endoscopic electrocautery procedure, cold knife, or cryotherapy, worry about imcompetent cervix post procedure with the first two)

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35
Q

What are two risk factors for cervical cancer?

A

Smoking, multiple sex partners

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36
Q

How much time needs to pass before diagnosing secondary amenorrhea?

A

If cycle has been normal: 3 months

If cycle has been abnormal: 6 months

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37
Q

What is a cystocele?

A

Herniation of the bladder into vagina

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38
Q

What is the treatment for Turner’s syndrome?

A

Cyclical estrogen/progesterone replacement therapy

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39
Q

What are the 3 treatments for uterine prolapse?

A

Kegel excersize, Pessary, Surgical fixation

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40
Q

What is the most common organism that causes mastitis?

A

S. Aureus

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41
Q

How many weeks pregnant is the uterine at the level of the umbilicus?

A

20 weeks

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42
Q

What is the most common cause of Post-Partum hemorrhage?

A

Uterine atony

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43
Q

Define missed abortion?

A

Death of the fetus with closed cervical os, no vaginal bleeding, products of conception still inside.

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44
Q

What age is primary amenorrhea diagnosed?

A

14 is no secondary sex characteristics

16 is some secondary sex characteristics

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45
Q

What is the first line of treatment for mastitis?

A

Dicloxacillin (2nd line: Keflex, or Erythromycin)

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46
Q

Should a breast feeding mother stop breast-feeding if she develops mastitis?

A

No (an abscess is however a reason to stop)

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47
Q

A physical exam revealing a retroverted uterus or uterosacral ligament nodularity should make you think of what diagnosis?

A

Endometriosis

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48
Q

At how many weeks of pregnancy can an amniocentesis be done?

A

15-20

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49
Q

List 4 risk factors for breast cancer?

A

Nulliparity, early menarche, late menopause, unopposed estrogen, BRCA1 or 2 positive.

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50
Q

What is the average of menopause?

A

51

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51
Q

Cottage cheese discharge should make you think of what diagnosis?

A

Candida (Vaginal Candidiasis)

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52
Q

The follicular phase of menstruation is dominated by what hormone?

A

Estrogen

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53
Q

How much weight should a woman gain during pregnancy?

A

20-35 pounds (note: it really depends on pre-gestational BMI)

54
Q

Thin, sticky, malodorous, vaginal discharge should make you think of what diagnosis?

A

BV

55
Q

A vaginal infection with motile flagellated protozoa should make you think of what diagnosis?

A

Trichomonas

56
Q

List 2 medications commonly used for hypertension in pregnancy?

A

Methyldopa and Lebatolol. (VanRhee’s book: Hydralazine if severe HTN in pre-eclampsia)

57
Q

What is classic triad of pre-eclampsia?

A

Proteinuria, HTN (>140/90), Edema

58
Q

Why is ovarian cancer so hard to diagnose?

A

Symptoms are vague and there are no good tumor markers?

59
Q

What are two important things you need to tell your patients before putting them on Metronidazole

A

Stay out of the sun and avoid alcohol

60
Q

Define inevitable abortion

A

Open cervical os, vaginal bleeding, all of the products of conception are still inside.

61
Q

How is the first day of the menstrual cycle defined?

A

First day of bleeding

62
Q

What is the karyotype for a patient with Tuner’s syndrome?

A

45, X (they are missing the other X)

63
Q

Give the time frame for pre-term labor?

A

20-37 weeks

64
Q

A patient presents with muco-purulent discharge and cervical motion tenderness, what is the diagnosis?

A

Chlamydia Cercvicitis

65
Q

What 4 human papilloma viruses are linked to cervical cancer?

A

16, 18, 31, 33

66
Q

Clue cells should make you think of what diagnosis?

A

BV

67
Q

What is the hallmark physical exam finding for a placenta previa?

A

Trick question! Never do a physical exam on a previa patient!

68
Q

What medium do you need to grow Neiserria Gonorrhea?

A

Thayer Martin

69
Q

What is the age range for HPV vaccination recommended?

A

9-26 years old

70
Q

A patient with primary amenorrhea and a low FSH should make you think of what?

A

Hypothalamic pituitary insufficiency

71
Q

What characteristic of PID will help to differentiate it in a question stem from ectopic pregnancy, appendicitis, ovarian torsion, and ovarian cyst?

A

Bilateral pain (the other complaints are unilateral)

72
Q

List 2 risk factors for ovarian cancer?

A

BRCA1, family history, nulliparity, late menopause, caucasian, asian.

73
Q

Define abortion

A

Delivery of uterine contents before 20 weeks.

74
Q

Does mastitis tend to be unilateral or bilateral?

A

Unilateral (and usually only 1 quadrant)

75
Q

Define full term

A

37-42 weeks

76
Q

When does quickening occur?

A

18-20 nulliparous

14-16 multiparous

77
Q

List 3 risk factors for placental abruption

A

Smoking, hypertension, AMA (?), cocaine use, Premature rupture of membranes.

78
Q

What is the treatment for ovarian cancer?

A

TAH-BSO, chemo, and radiation

79
Q

A pt. believes she is pregnanct, you notice her cervix appears blue, what is that called?

A

Chadwicks sign

80
Q

At approx. how many weeks pregnant is the uterus at the level of the symphysis pubis.

A

12 weeks

81
Q

A snowstorm appearance on u/s should make you think of what diagnosis?

A

Hyatidiform mole

82
Q

What med can be used to control bleeding due to uterine atony?

A

Oxytocin

83
Q

What is the term for when the placenta has implanted directly over the cervical os?

A

Placenta previa

84
Q

How many weeks of pregnancy can chorionic villous sampling be done?

A

10-13

85
Q

Why is folic acid given as a pre-natal vitamin?

A

To prevent open neural tube defects

86
Q

What is the most common endometrial cancer?

A

Adenocarcinoma (75%)

87
Q

A strawberry cervix with copious yellow green discharge should make you think of what?

A

Trich

88
Q

What organism causes of to warn pregnant patients to stay away from deli meats and soft cheeses?

A

Listeria Monocytogens

89
Q

The baby was delivered several minutes ago, suddenly there is an increase of blood flow from the vagina, and the chord noticeably lengthens, what is the cause?

A

Placental separation

90
Q

What are 2 meds used to induce labor?

A

Oxytocin, Cervadil (a prostaglandin analog to ripen cervix)

91
Q

As part of the ante-partum testing, a baby has a positive stress test, how is this defined?

A

They have 2 hear rate accelerations in 20 minutes, of 15 beats above baseline for atleast 15 seconds.

92
Q

Is FSH high or low in Turner’s syndrome?

A

High, there are no ovaries to respond to FSH so there is no negative feedback.

93
Q

What is the most common type of ovarian cyst?

A

Functional cyst (no tx. necessary)

94
Q

Define threatened abortion?

A

Closed cervical os, vaginal bleeding, products of conception are still inside.

95
Q

List 4 risk factors for endometrial cancer?

A

Chronic unopposed estrogen, nulliparity, early menarche, late menopause, chronic tamoxifen use, diabetes, obesity, HTN, breast Ca, Ovarian Ca.

96
Q

What would you expect to see on a KOH prep if the pt. had vaginal candida?

A

Budding psuedohyphae

97
Q

What is the #1 cause for septic arthritis in sexually active young adults?

A

Gonorrhea

98
Q

How many days after conception is serum bHCG positive?

A

8 days

99
Q

If a PAP smear result comes back anything other than negative, or ASCUS, what is your next step?

A

Colposcopy and biopsy

100
Q

List 3 risk factors for ectopic pregnancy

A

History of IUD, history of previous ectopic, scarred tubes.

101
Q

Grape like vesicle or a sac or grapes on u/s should make you think of what?

A

Hyatidiform mole

102
Q

What medication is used to increase surfactant levels and help with lung maturity if you are worried about pre-term labor?

A

Betamethasone

103
Q

What are 2 tocolytic medications?

A

Magnesium sulfate and CCBs

104
Q

A woman presents to the ED concerned she is in preterm labor, what treatment should you begin before getting any imaging or lab results?

A

IV fluids (most often the patients are suffering from dehydration)

105
Q

A PAP smear comes back as ASCUS, what is your next step?

A

Repeat PAP in 4-6 months

106
Q

What are 3 ways you can check for ruptured membranes?

A

Ferning test, visual leakage of the cervix, or pooling in the vagina.

107
Q

What is the normal range of fetal heart rate?

A

120-160

108
Q

Define menorrhea

A

Heavy prolonged menstrual flow

109
Q

What Rh combination from mom and dad may cause the fetus to develop antibodies.

A

Dad is Rh+

Mom is Rh-

110
Q

At what point during pregnancy is Rhogam given during pregnancy if it is needed?

A

28 weeks, and again within 72 hours of delivery

111
Q

Define complete abortion

A

Open cervical os, vaginal bleeding, products of conception have passed.

112
Q

Gestational diabetes puts mom and baby at risk for what 3 things?

A

Pre-eclampsia, macrosomia, slowing of fetal lung development

113
Q

Which is associated with painful 3rd trimester bleeding, previa or abruption?

A

Placenta abruption

114
Q

What are the 3 causes for post-partum hemorrhage?

A

Uterine atony, genital laceration, retained placenta

115
Q

Define the 3rd stage of labor?

A

Delivery of the baby to delivery of placenta

116
Q

What meds are used to treat post-partum metritis

A

Clindamycin and Gentamycin together

117
Q

What organism is the most common STD?

A

Chlamydia

118
Q

Interference with work or school is part of which dx? Premenstrual syndrome or premenstrual dysphoric disorder?

A

Premenstrual dysphoric disorder

119
Q

Which reproductive cancer carries the highest rates of death in women?

A

Ovarian

120
Q

What is the most common infection following a c-section?

A

Metritis

121
Q

How do you treat Trichomonas infection?

A

Flagyl

122
Q

Define incomplete abortion?

A

Vaginal bleeding, open cervical os, products of conception partially passed.

123
Q

What is the most common site of an ectopic pregnancy?

A

Tubes

124
Q

Early on in pregnancy, serial bHCG should double over what period of time?

A

Every 48 hours.

125
Q

Define procidentia

A

Uterine prolapse beyond the introitus

126
Q

What is the most popular term for Stein-Leventhal syndrome

A

PCOS

127
Q

What is the formula for calculation estimated date of confinement or due date?

A

1st day of LMP + 7 days - 3 months, add a year. (Naegel’s rule)

128
Q

What are the 5 components of the biophysical profile as part of antepartum testing?

A

A non-stress test, fetal breathing, 2 gross body movements, fetal tone, amniotic fluid index

129
Q

Define the first stage of labor

A

Onset of contractions to full dilation of cervix

130
Q

Rope like breast mass should make you think of what dx?

A

Fibrocystic breast changes

131
Q

Rise in basal body temperature in order to increase chances of conception is due to a rise in which hormone

A

progesterone

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