Ob-Gyn Flashcards
1
Q
The secretory phase of the menstrual (day 14 - 28) is dominated by what hormone?
A
Progesterone
2
Q
Who is more likely to get pre-eclampsia, a nulliparous or multiparous woman?
A
Nulliparous
3
Q
Since a genetic cause is the number one reason for primary amenorrhea, what is one very important test?
A
Karyotype
4
Q
Purulent cervical discharge should make you think of what diagnosis?
A
Neisseria Gonorrhea
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
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
7
Q
What is the most common cause of secondary amenorrhea?
A
Pregnancy
8
Q
What 3 labs should you order if you are considering secondary amenorrhea?
A
TSH, Prolactin, bHCG
9
Q
Define premature birth?
A
Delivery of uterine contents between 20-36
10
Q
A unilateral, single, mobile, firm, non-tender, solid breast mass should make you think of what diagnosis?
A
Fibroadenoma
11
Q
Define metrorrhagia
A
Bleeding between periods
12
Q
Post-menopausal bleeding is immediately believed to be what diagnosis?
A
Endometrial cancer (until proven otherwise)
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
14
Q
How do you treat bacterial vaginosis?
A
Metronidazole (Flagyl) for 7 days.
15
Q
What location within the pelvis is endometriosis most commonly found?
A
In the ovary
16
Q
What lab test is the gold standard for chlamydia?
A
Nucleic acid amplification test
17
Q
Are fibrocystic breast masses usually bilateral or unilateral?
A
Bilateral
18
Q
How do you definitively diagnose endometriosis
A
Exploratory Laparoscopy (Ex-Lap)
19
Q
What is the most common uterine tumor
A
Leiomyoma (Fibroids)
20
Q
What is the ethnic backgrounds that has increased risk for fibroids?
A
Blacks (5x more likely than whites)
21
Q
How do you treat vaginal candida
A
Flucazole PO one day, or Azole cream x 1 week.
22
Q
First step of treatment for endometrial cancer?
A
TAH-BSO (Total Abdominal Hysterectomy with Bilateral Salpingo-oophorectory)
23
Q
If you see the term chocolate cyst it should make you think of what?
A
Endometrioma
24
Q
A surge in what hormone leads to ovulation?
A
LH
25
A patient presents with irregular menses, hirsutism, and infertility, what is the diagnosis?
PCOS
26
What endocrine issue is associated with PCOS?
Insulin insensetivity
27
You have a patient with PCOS, and she wants to get pregnant, what meds are you going to give her?
Clomid, and Metformin (if insulin sensetivity)
28
What is the medical treatment for early ectopic pregnancy?
Methotrexate
29
An ovarian cyst that contains hair and teeth, what is the diagnosis?
Terratoma
30
What is the mean age for ovarian cancer?
63 (think of this in older patients with vague abdominal symptoms)
31
Define the second stage of labor?
Full dilation to delivery
32
A 66 year old female presents with bouts of nausea, weight loss, and vague abdominal pain, what is the diagnosis?
Ovarian cancer
33
When is recommended to begin PAP smears?
21
34
Cervical biopsy comes back as CINII or CINIII, what is your next step.
LEEP (Loop endoscopic electrocautery procedure, cold knife, or cryotherapy, worry about imcompetent cervix post procedure with the first two)
35
What are two risk factors for cervical cancer?
Smoking, multiple sex partners
36
How much time needs to pass before diagnosing secondary amenorrhea?
If cycle has been normal: 3 months
| If cycle has been abnormal: 6 months
37
What is a cystocele?
Herniation of the bladder into vagina
38
What is the treatment for Turner's syndrome?
Cyclical estrogen/progesterone replacement therapy
39
What are the 3 treatments for uterine prolapse?
Kegel excersize, Pessary, Surgical fixation
40
What is the most common organism that causes mastitis?
S. Aureus
41
How many weeks pregnant is the uterine at the level of the umbilicus?
20 weeks
42
What is the most common cause of Post-Partum hemorrhage?
Uterine atony
43
Define missed abortion?
Death of the fetus with closed cervical os, no vaginal bleeding, products of conception still inside.
44
What age is primary amenorrhea diagnosed?
14 is no secondary sex characteristics
| 16 is some secondary sex characteristics
45
What is the first line of treatment for mastitis?
Dicloxacillin (2nd line: Keflex, or Erythromycin)
46
Should a breast feeding mother stop breast-feeding if she develops mastitis?
No (an abscess is however a reason to stop)
47
A physical exam revealing a retroverted uterus or uterosacral ligament nodularity should make you think of what diagnosis?
Endometriosis
48
At how many weeks of pregnancy can an amniocentesis be done?
15-20
49
List 4 risk factors for breast cancer?
Nulliparity, early menarche, late menopause, unopposed estrogen, BRCA1 or 2 positive.
50
What is the average of menopause?
51
51
Cottage cheese discharge should make you think of what diagnosis?
Candida (Vaginal Candidiasis)
52
The follicular phase of menstruation is dominated by what hormone?
Estrogen
53
How much weight should a woman gain during pregnancy?
20-35 pounds (note: it really depends on pre-gestational BMI)
54
Thin, sticky, malodorous, vaginal discharge should make you think of what diagnosis?
BV
55
A vaginal infection with motile flagellated protozoa should make you think of what diagnosis?
Trichomonas
56
List 2 medications commonly used for hypertension in pregnancy?
Methyldopa and Lebatolol. (VanRhee's book: Hydralazine if severe HTN in pre-eclampsia)
57
What is classic triad of pre-eclampsia?
Proteinuria, HTN (>140/90), Edema
58
Why is ovarian cancer so hard to diagnose?
Symptoms are vague and there are no good tumor markers?
59
What are two important things you need to tell your patients before putting them on Metronidazole
Stay out of the sun and avoid alcohol
60
Define inevitable abortion
Open cervical os, vaginal bleeding, all of the products of conception are still inside.
61
How is the first day of the menstrual cycle defined?
First day of bleeding
62
What is the karyotype for a patient with Tuner's syndrome?
45, X (they are missing the other X)
63
Give the time frame for pre-term labor?
20-37 weeks
64
A patient presents with muco-purulent discharge and cervical motion tenderness, what is the diagnosis?
Chlamydia Cercvicitis
65
What 4 human papilloma viruses are linked to cervical cancer?
16, 18, 31, 33
66
Clue cells should make you think of what diagnosis?
BV
67
What is the hallmark physical exam finding for a placenta previa?
Trick question! Never do a physical exam on a previa patient!
68
What medium do you need to grow Neiserria Gonorrhea?
Thayer Martin
69
What is the age range for HPV vaccination recommended?
9-26 years old
70
A patient with primary amenorrhea and a low FSH should make you think of what?
Hypothalamic pituitary insufficiency
71
What characteristic of PID will help to differentiate it in a question stem from ectopic pregnancy, appendicitis, ovarian torsion, and ovarian cyst?
Bilateral pain (the other complaints are unilateral)
72
List 2 risk factors for ovarian cancer?
BRCA1, family history, nulliparity, late menopause, caucasian, asian.
73
Define abortion
Delivery of uterine contents before 20 weeks.
74
Does mastitis tend to be unilateral or bilateral?
Unilateral (and usually only 1 quadrant)
75
Define full term
37-42 weeks
76
When does quickening occur?
18-20 nulliparous
| 14-16 multiparous
77
List 3 risk factors for placental abruption
Smoking, hypertension, AMA (?), cocaine use, Premature rupture of membranes.
78
What is the treatment for ovarian cancer?
TAH-BSO, chemo, and radiation
79
A pt. believes she is pregnanct, you notice her cervix appears blue, what is that called?
Chadwicks sign
80
At approx. how many weeks pregnant is the uterus at the level of the symphysis pubis.
12 weeks
81
A snowstorm appearance on u/s should make you think of what diagnosis?
Hyatidiform mole
82
What med can be used to control bleeding due to uterine atony?
Oxytocin
83
What is the term for when the placenta has implanted directly over the cervical os?
Placenta previa
84
How many weeks of pregnancy can chorionic villous sampling be done?
10-13
85
Why is folic acid given as a pre-natal vitamin?
To prevent open neural tube defects
86
What is the most common endometrial cancer?
Adenocarcinoma (75%)
87
A strawberry cervix with copious yellow green discharge should make you think of what?
Trich
88
What organism causes of to warn pregnant patients to stay away from deli meats and soft cheeses?
Listeria Monocytogens
89
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?
Placental separation
90
What are 2 meds used to induce labor?
Oxytocin, Cervadil (a prostaglandin analog to ripen cervix)
91
As part of the ante-partum testing, a baby has a positive stress test, how is this defined?
They have 2 hear rate accelerations in 20 minutes, of 15 beats above baseline for atleast 15 seconds.
92
Is FSH high or low in Turner's syndrome?
High, there are no ovaries to respond to FSH so there is no negative feedback.
93
What is the most common type of ovarian cyst?
Functional cyst (no tx. necessary)
94
Define threatened abortion?
Closed cervical os, vaginal bleeding, products of conception are still inside.
95
List 4 risk factors for endometrial cancer?
Chronic unopposed estrogen, nulliparity, early menarche, late menopause, chronic tamoxifen use, diabetes, obesity, HTN, breast Ca, Ovarian Ca.
96
What would you expect to see on a KOH prep if the pt. had vaginal candida?
Budding psuedohyphae
97
What is the #1 cause for septic arthritis in sexually active young adults?
Gonorrhea
98
How many days after conception is serum bHCG positive?
8 days
99
If a PAP smear result comes back anything other than negative, or ASCUS, what is your next step?
Colposcopy and biopsy
100
List 3 risk factors for ectopic pregnancy
History of IUD, history of previous ectopic, scarred tubes.
101
Grape like vesicle or a sac or grapes on u/s should make you think of what?
Hyatidiform mole
102
What medication is used to increase surfactant levels and help with lung maturity if you are worried about pre-term labor?
Betamethasone
103
What are 2 tocolytic medications?
Magnesium sulfate and CCBs
104
A woman presents to the ED concerned she is in preterm labor, what treatment should you begin before getting any imaging or lab results?
IV fluids (most often the patients are suffering from dehydration)
105
A PAP smear comes back as ASCUS, what is your next step?
Repeat PAP in 4-6 months
106
What are 3 ways you can check for ruptured membranes?
Ferning test, visual leakage of the cervix, or pooling in the vagina.
107
What is the normal range of fetal heart rate?
120-160
108
Define menorrhea
Heavy prolonged menstrual flow
109
What Rh combination from mom and dad may cause the fetus to develop antibodies.
Dad is Rh+
| Mom is Rh-
110
At what point during pregnancy is Rhogam given during pregnancy if it is needed?
28 weeks, and again within 72 hours of delivery
111
Define complete abortion
Open cervical os, vaginal bleeding, products of conception have passed.
112
Gestational diabetes puts mom and baby at risk for what 3 things?
Pre-eclampsia, macrosomia, slowing of fetal lung development
113
Which is associated with painful 3rd trimester bleeding, previa or abruption?
Placenta abruption
114
What are the 3 causes for post-partum hemorrhage?
Uterine atony, genital laceration, retained placenta
115
Define the 3rd stage of labor?
Delivery of the baby to delivery of placenta
116
What meds are used to treat post-partum metritis
Clindamycin and Gentamycin together
117
What organism is the most common STD?
Chlamydia
118
Interference with work or school is part of which dx? Premenstrual syndrome or premenstrual dysphoric disorder?
Premenstrual dysphoric disorder
119
Which reproductive cancer carries the highest rates of death in women?
Ovarian
120
What is the most common infection following a c-section?
Metritis
121
How do you treat Trichomonas infection?
Flagyl
122
Define incomplete abortion?
Vaginal bleeding, open cervical os, products of conception partially passed.
123
What is the most common site of an ectopic pregnancy?
Tubes
124
Early on in pregnancy, serial bHCG should double over what period of time?
Every 48 hours.
125
Define procidentia
Uterine prolapse beyond the introitus
126
What is the most popular term for Stein-Leventhal syndrome
PCOS
127
What is the formula for calculation estimated date of confinement or due date?
1st day of LMP + 7 days - 3 months, add a year. (Naegel's rule)
128
What are the 5 components of the biophysical profile as part of antepartum testing?
A non-stress test, fetal breathing, 2 gross body movements, fetal tone, amniotic fluid index
129
Define the first stage of labor
Onset of contractions to full dilation of cervix
130
Rope like breast mass should make you think of what dx?
Fibrocystic breast changes
131
Rise in basal body temperature in order to increase chances of conception is due to a rise in which hormone
progesterone
