OB-GYN Halo-halo 4

Question 1

fetal bradycardia definition

Answer 1

<110 bpm for minimum of 2 mins (Williams)

Question 2

SGA definition

Answer 2

Small for Gestational Age

EFW < 10th percentile

Question 3

LGA definition

Answer 3

Large for Gestational Age

EFW >90th percentile

Question 4

if the fundal heigh varies by __________ from the gestational age, ultrasound is usually obtained

Answer 4

more than 3 cm

Question 5

remarks on leptospirosis’ human-to-human transmissiosn

Answer 5

The dogma that human-to-human transmission is very rare is challenged by recent findings on household CLUSTERING, asymptomatic renal COLONIZATION, and prolonged excretion of leptospires.
(Both of the latter features imply human infection sources that are not recognized.)
(Harrison)

Person to person transmission is rare. (CDC)

Question 6

transmission of leptospirosis

Answer 6

1. through skin or mucous membranes (eyes, nose, or mouth), especially if the skin is broken from a cut or scratch.
2. Drinking contaminated water can also cause infection.
3. Outbreaks of leptospirosis are usually caused by exposure to contaminated water, such as floodwaters.
4. Person to person transmission is rare
   (CDC)

Question 7

Number one cancer killer of WOMEN in the DEVELOPING world

Answer 7

cervical cancer

also the 4th most common cancer in women worldwide

Question 8

risk factors for cervical dysplasia

Answer 8

HPV EXPOSURE
early intercourse
multiple sexual partners
early childbearing

DECREASED ACCESS TO SCREENING
low socioeconomic status
hispanic ethnicity

HIGH-RISK HPV INFECTION
-MOST IMPORTANT RISK FACTOR FOR CIN

OTHERS
Cigarette smoking
Immunodeficiency
Immunosuppression

Question 9

% of ASC Pap tests that harbor severe dysplasia

Answer 9

10-15%

Question 10

Majority of women with HPV infection will NOT develop cervical cancer. this is because ____% of HPV infections resolve in their own in women with intact immune system

Answer 10

90%

Question 11

risk factors for cervical cancer

Answer 11

HIGH-RISK HPV INFECTION (16,18,31,45)

Cigarette smoking (2x)
Immunosuppression
Immunodeficiency
/cervical cancer is considered an AIDS-defining illness/

Chlamydial infection (past/current)
DES in utero exposure
OCP, long term use (>5 years)
3 or more full-term pregancies
First full-term BEFORE 17 y/o
Family history

Question 12

Cervical cancer, confined to cerfix 5 cm. what stage?

Answer 12

Ib-2 (>4.0cm)

Ib-1 if no greater than 4.0 cm (≤4.0 cm)

Ia is microscopic

Question 13

cervical cancer involves upper 2/3 of vagina with no parametrial involvement, 4.0cm

Answer 13

IIa-1

IIa-2 if 4.1 cm and above
IIb if with obvious parametrial involvement

Question 14

cervical cancer withhydronephrosis

Answer 14

IIIb

IIIa if involves the lower 1/3 of vagina
IIIb if with extension to the pelvic wall and/or hydronephrosis or nonfunctioning kidney

Question 15

cervical cancer with spread to rectum

Answer 15

IVa (adjacent organs)

IVb if distant spread

Question 16

estrogen and FSH levels stabilize _____ after FMP

Answer 16

2 years

Question 17

primary ovarian insufficiency is the onset of spontaneous menopause when?

Answer 17

before the age of 40

this requires further testing

Question 18

up to ___ of women in menopause will have persistent VMS

Answer 18

25%

average medial duration of VMS symptoms is reported to be 7.5 years

Question 19

larges benefit of MHT in control of vasomotor symptoms and prevention of bone loss when?

Answer 19

beginning of MHT before age 60 years or WITHIN 10 YEARS of the FMP

Question 20

Contraindications to MHT

Answer 20

Chronic liver impairment
known estrogen-dep neoplasm (breast, ovary, endometrium)
active thromboembolic disease
undiagnosed uterine bleeding`

Question 21

only approved nonhormonal medication to treaet VMS

Answer 21

paroxetine sulfate

others are in clinical trials (including clonidine)

Question 22

glucocorticoid risk in osteoporosis

Answer 22

≥5 mg/day prednisone for >3 months

other risk factors
alcohol >3/day
BMI <22; weight <127 lbs

🎃a woman can lose 20% of her orignal bone density in the first 5-7 years after menopause

Question 23

Vit D levels of _____ were associated with a decreased risk of bone fracture

Answer 23

> 30 ng/dL

Question 24

RDA for calcium and vitamin D for 26 years old

Answer 24

Calcium: 1,000 IU
Vitamin D: 600 IU

CALCIUM
9-18y: 1,300 IU
19-50y: 1,000 IU
over 50y: 1,200 IU

VITAMIN D
most everyone: 600 IU
>70y: 800 IU

Question 25

Repeat BMD screenings are performed no more frequently than

Answer 25

every 2 years

unless a patient’s response to medicatiotn is being evaluated

Question 26

human monoclonal antibody to the receptor activator of nulcear factor-KB ligand

Answer 26

Denosumab

-blocks proliferatiotn and differentiation of osteoclasts

Question 27

remarks on clomiphene

Answer 27

When clomiphene is administered in a dosage of 100 mg/day for 5 days, a rise in plasma LH and FSH is observed after several days

in patients who ovulate, the initial rise is followed by a SECOND RISE of gonadotropin levels just PRIOR to ovulation

Question 28

in androgen insensitivity, the undescended testes should be removed to prevent the development of

Answer 28

gonadoblastoma (Lobo)

Gonadoblastoma almost always is seen in patients with dysgenetic gonads or undescended testis (Tickoo et al, 2009)

In some cases, the germ cell component becomes malignant, giving rise to SEMINOMAª (Robbins)

ªcounterpart in the female: dysgerminoma