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Step 2 > OB/GYN Case Files and UWorld > Flashcards

OB/GYN Case Files and UWorld Flashcards

1
Q

Def. of secondary amenorrhea

A

6 months of no menses in a woman with previously normal menses

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2
Q

Patient with amenorrhea s/p d&c

A

Asherman’s syndrome- dx with hysterosalpingogram

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3
Q

Elevation in prolactin is assciated with elevation in what other hormone?

A

Throid releasing hormone in hypothyroidism

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4
Q

Causes of galactorrhea

A

pituitary adenoma

pregnancy

breast stimulation

medication

chest wall trauma

hypothyroidism

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5
Q

Treatment of a prolactin secreting adenoma during pregnancy?

A

Oral bromocriptine

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6
Q

Hormone ratio that is elevated in PCOS

A

LH:FSH >2.0

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7
Q

Elevated ______ is indicative of ovarian failure

A

FSH

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8
Q

The major difference between the Dx of sheehan and intruterine adhesions

A

Withdrawl bleeding will take place in sheehan but not in intruterine adhesions

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9
Q

Treatment of post partum endometritis?

A

Clindamycin and Gentamicin

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10
Q

Insufficient tissue on endometrial biopsy of postmenopausal woman with abnormal uterine bleeding, next step?

A

D&C before ablation to ensure lack of endometrial CA

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11
Q

Diagnostic test for a patient with suspected PCOS

A

TSH, prolactin, DHEA-S, 17-hydroxyprogesterone, pelvic ultrasound

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12
Q

OCP of choice in PCOS?

A

Combination oral contraception (estrogen and progestin)

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13
Q

treatment of grade 1 endometrial adenocarcinoma in a patient the desires future pregnancy?

A

High dose progestin therapy

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14
Q

Patient in her 40s with new onset male pattern hair growth and clitoromegaly. 9cm ovarian mass palpated. Dx?

A

Sertoli-Leydig tumor. Androgen secreting.

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15
Q

6 year old girl with breast development, early menses, and an ovarian mass. Dx?

A

Granulosa-theca cell turmor– estrogen producing counterpart to the sertoli-leydig tumor

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16
Q

By what age are a lack of secondary sexual characteristics considered delayed puberty?

A

14

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17
Q

What lab test can help determine whether the cause of delayed puberty is central or ovarian?

A

Serum FSH

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18
Q

Low FSH points to a _____ cause, while high points to a _____ cause. (in delayed puberty)

A

Central (hpothalamic-pituitary axis)

Peripheral– no (-) fedback by the ovary

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19
Q

Most likely cause of primary amenorrhea in a Pt with normal breast and pubic hair development as well as urinary tract abnormalities?

A

Mullarian agenisis.

If no urnary tract abnormalities present, androgen in sensitivity is most likely

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20
Q

Testosterone level in mullarian agenisis?

A

normal

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21
Q

Five basic factors to examine in infertility:

A

ovulatory

uterine

Tubal

male factor

peritoneal factor (endometriosis)

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22
Q

Female with dymenorrhea, dyspareunia, and dyschezia

A

endometriosis

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23
Q

Most common cause of postmenopausal bleeding

A

atrophic endometritis

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24
Q

Age of initial pap smear

A

21 regardless of sexual practices

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25
Q

benign cystic ovarian tumor that can cuase hyperthyroidism

A

Struma Ovarii

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26
Q

Treatment for struma ovarii

A

exploratory laporotomy with ovarian cystectomy

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27
Q

Patient <30 with complex cyst, differential dx?

A

Dermoid or cystic teratoma

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28
Q

Thin white and puritic vulvar tissue

A

lichen sclerosis

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29
Q

Diagnostic test and treatment of lichen sclerosis

A

vulvar biopsy showing thinned epidermis, hyperkeratosis, and elongation of rete ridges

-Tx Corticosteroids

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30
Q

Patient reports symptoms of being pregnant and a +home preg test but her US is non-preg and the office test is negative

A

pseudocyesis

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31
Q

itchy palms and soles

A

intrahepatic cholestasis of pregnancy

increased bile salts

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32
Q

Abx of choice for lactation mastitis

A

Dicloxacillin and cefalexin

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33
Q

Bright red painless bleeding

A

placenta previa

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34
Q

risk factors for placenta previa

A
  • previous c section
  • smoking
  • advanced maternal age
  • prior placenta previa
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35
Q

length of a variable deceleration

A

<30s

36
Q

patient with a LEEP or a cone biopsy of the cervix is at greatest risk for…

A

cervical incopetence/insufficiency

37
Q

Gold standard method to diagnose cervical incompetence

A

transvaginal ultrasound

38
Q

Threashold B-hCG level

A

1500-2000

39
Q

this 2 hour glucose tolerance level is associated with insulin resistance

A

>140

40
Q

A patient with PCOS and insuline resistance should be perscribed what medication

A

Metformin

41
Q

BUN and sCr have this change during pregnancy

A

both decrease

42
Q

At how many weeks are fetal lungs mature?

A

34

43
Q

Best contraception for once ovulation has occured?

A

Copper IUD

Effective 99% up to 5 days

44
Q

Most important side effect of raloxifene

A

DVT

45
Q

Abx used in pregnant woman with asymtomatic bacturia

A

Amoxicillin

Nitrofurantoin

Amoxicillin-clavinulate

Cefalexin

46
Q

What STD should all pregnant women be screened for regardless of risk factors?

A

Syphillis

47
Q

Most common cause of mucopurulent cervicitis in reprodutive age females

A

Chlamydia

48
Q

Clitoromegaly with high concentrations of gonadotropins and maternal masculinization during pregnancy

A

Aromatase deficiency

49
Q

Next dx test in a patient who has period pain refractory to OCPs and ibuprophen

A

laproscopy (endometriosis)

50
Q

Endometriosis carries a high risk for this future complication

A

infertility

51
Q

WHen to remove testes in ovarin insensitivity syndrome

A

after putberty to ensure proper breast development

52
Q

after rupture fetal heart tones assume a sinusoidal, tachycardia-bradycardia rhythm. There is profuse uterine bleeding. Dx?

A

Vasa previa leading to rupture of uterine vessels

53
Q

Best Dx test for acute appendacitis of pregnancy

A

Ultrasound

54
Q

Dx test of choice for renal colic in pregnancy

A

Ultrasound of the kidney and ureter

55
Q

Angle of cotton swap that indicates urethral hypermobility

A

>30 degrees

56
Q

Treatment for stress incontinence

A

Kegal exercises followed by urethorpexy (restoration of the vesicourethreal angle)

57
Q

When should Rho-Gam be administered, why?

A

28-32 weeks and again within 72hrs of birth

-because the half life of anti-d is about 6 weeks which will cover most of the third trimester

58
Q

Measurement of this is the most reliable index for fetal growth restriction

A

abdominal circumference

59
Q

causes of symmetric IUGR

A

Chromosomal abnormalities

TORCH infections

Maternal substance abuse

anemia

60
Q

Causes of assymtric IUGR

A

HTN, malnutrition and genetic abnormalities

61
Q

Appropriate management of incomplete abortion in a stable woman

A

Misoprostol

OR

Observation and Expectant management

62
Q

Bilateral solid cystic ovarian tumors in pregnant woman with hirsutism

A

luteoma

–expectant management

63
Q

Management of a female with intrauterine fetal demise and borderline coagulation studies

A

Induction of labor– suspicious for DIC

64
Q

Cause of DIC in an intrauterine fetal demise

A

release of tissue factor (thromboplastin) from the placenta into maternal circulation

65
Q

Tx of Trichomonas

A

Metronidazole for female and husband

66
Q

Biopsy shows hyperplasia without atypia in a woman who does no desire fertility- Tx?

A

Progestin therapy

67
Q

Ovarian torsion more common on this side

A

right

68
Q

B-hCg is produced in the _______ and functions to ________.

A

Produced by syncitiotrophoblast and maintains the corpus luteum

69
Q

Prolactin production is induced by

A

TRH and Serotonin

70
Q

Which two hormones are decreased in a quad screen indicative of down syndrome?

A

msAFP and Estriol

71
Q

What is mittleschmerz

A

mid cycle pain caused by ovulation

72
Q

Who are the only patients to get a CA-125 level?

A

Postmenopausal women with mass

73
Q

Combined OCPs cause worsened ______

A

HTN

74
Q

What is the genotype in Kallman syndrome?

A

Normal

75
Q

Trichomonas pH

A

>4.5

76
Q

Tx of high post void residuals in a patient with epidural anesthesia

A

intermittant catheterization

77
Q

Turner syndrome causes FSH to be _______

A

High

78
Q

Classic triad for hydatidiform mole

A

Hyperemisis

Gravid uterus beyond gestational dates

B-hCG >100,000

79
Q

Hyperemisis gravidum is associated with increased levels of what enzymes

A

LFT

80
Q

Goddell Sign

A

Softening of the cervix

Apparent at 4 weeks gestation

81
Q

Chadwick sign

A

blue discoloration of vagina and cervix

82
Q

elements in tripple screen? quad screen?

Performed when?

A

MS AFP

B-HCG

Estriol

Quad screen= above + inhibin A

15-20wks

83
Q

Time when chorionic villus sampling is performed

A

10-13 wks

84
Q

Pregnanacy that ends before 20wks gestation

A

abortion

85
Q

Critical mass for delivery of fetus

A

>2500g

86
Q

To be considered gestational HTN, it must occur after this point

A

20wks

Step 2 (14 decks)

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