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Shelf Exams/USMLE Step 2 CK ❄️ > Ob/Gyn - UWorld > Flashcards

Ob/Gyn - UWorld Flashcards

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USMLE® Step 1 flashcards
1
Q

What should be avoided in patients with placental previa?

A

Coitus and requires pelvic rest

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2
Q

What is the cause of post epidural HoTN?

A

Vasodilation and venous pooling

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3
Q

How can you diagnose ovarian torsion?

A

Large edemamotous ovaries with decreases blood flow on ultrasound and Doppler velicometry studies

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4
Q

Complications from HTN during pregnancy?

A

Preterm labor and placental dysfunction

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5
Q

What is the most common cause of post partum hemorrhage?

A

Uterine Atony, resulting in decreased expulsion of contents and decreased myometrial contractions which leads to continued bleeding

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6
Q

What leads to the highest risk for clear cell adenocarcinoma of the vagina?

A

DES exposure in utero

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7
Q

What is the best first trimester test to rule out Down syndrome in pregnant. older women?

A

Cell free fetal DNA

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8
Q

Diagnostic criteria for preeclampsia?

A 
New onset HTN at >20 wk gestation 
AND proteinuria (prot/cr ratio >=0.3) OR s/s of end organ damage
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9
Q

When should anti-HTN meds be given in PreE?

A

BP > or = 160/110

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10
Q

What are the risks of OCP therapy?

A

Venous thromboembolism, HTN, Hepatic adenoma, Rarely - stroke/MI

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11
Q

What is the appearance and progression of a syphilitic chancre?

A

Painless papule at site of inoculation -> ulceration occurs forming chancre (punched out base, raised indurated margins)

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12
Q

Which pathological marker in breast adenocarcinoma is most important for future management?

A

Oncogene amplication by FISH to identify HER2 overexpression

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13
Q

What should be done for a laboring patient with ROM whose preterm fetus shows bilateral renal agenesis?

A

Allow normal delivery because fetus will not be compatible with life (associated pulmonary hypoplasia)

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14
Q

What are late term and post term pregnancies at risk for?

A

Uteroplacental insufficiency

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15
Q

Which premenopausal patients with abnormal uterine bleeding require endometrial biopsy?

A

Any age >45, those with cancer risk factors like diabetes, obesity, unopposed estrogen tx, PCOS

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16
Q

What is the most effective post coital contraceptive?

A

Copper IUD (but make sure no PID hx)

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17
Q

What is eczematous rash on the breast suggestive of?

A

Mammary Paget’s disease, which is often associated with underlying adenocarcinoma

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18
Q

What are the features of aromatase deficiency?

A

Normal internal genitalia, ambiguous external genitalia, clitoral hyper trophy, high FSH/LH ratio and low estrogen

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19
Q

What is Klumpke’s palsy?

A

Complication of shoulder dystocia resulting from excessive traction on C8 and T1

Can cause claw hand, hand paralysis, and horner’s syndrome

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20
Q

What is the treatment of intramniotic infection?

A

Oxytocin to hasten delivery and antipyretics to control maternal fever

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21
Q

What is the treatment of intramniotic infection?

A

Oxytocin to hasten delivery and antipyretics to control maternal fever

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22
Q

What is the main role of beta hCG in pregnancy?

A

Maintains the corpus luteum to preserve progesterone secretion until placenta can produce on its own.

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23
Q

What provides the best coverage for polymicrobial infections like endometritis?

A

Clindamycin and gentamicin

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24
Q

When should all women have oral glucose tolerance test?

A

24-28 weeks, earlier if risk factors present

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25
Q

What should be done in postpartum patients who are unable to voide urine after a few attempts at intermittent catheterization?

A

Insert indwelling catheter to to decompress bladder and regain detrusor muscle function

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26
Q

What may be the cause of anovulation in a woman with normal LH/FSH levels?

A

morbid obesity

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27
Q

What is the effect of premature ovarian failure on LH and FSH levels?

A

Elevated levels with FSH >40 and LH > 25

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28
Q

What are the 3 key features of endometriosis?

A

3 D’s - dyspareunia, dysmenorrhia, and dyschezia

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29
Q

What are risk factors to ovarian torsion?

A

pregnancy, ovulation induction, ovarian masses (especially >=5 cm

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30
Q

What causes late deceleration in FHR?

A

Uteroplacental insufficiency

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31
Q

What is the cause of recurrent variable decelerations and what should be done?

A

LIkely cord compression, but now severe and can cause acidemia, reposition mother to left lateral side to relieve compression

Amnioinfusion if it persists

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32
Q

What is pseudocyesis?

A

psychiatric condition form of conversion disorder where women with great desire to be pregnant develop s/s of pregnancy -> breast fullness, amenorrhea, tympanic abdomen, amenorrhea (but negative bhcg and ultrasound

33
Q

What is the risk for a child with O+ mother and Ab+ dad?

A

Child will be either A or B, likely will have mild hemolytic disease of newborn –> neonatal jaundice, which will recover with phototherapy

34
Q

What are luteomas? What should be done?

A

benign condition mostly in AA women, which may cause hirsituism and acne

monitor for fetal virilization

35
Q

What is lochia rubra? What may appear along with this?

A

Normal bleeding postpartum, patient may have high WBCs and low grade fever

reassure and monitor

36
Q

What are the most common causes of secondary anemia? How do you check?

A

Pregnancy, beta-hcg
Hyperprolactinemia, prolactin
Thyroid abnl, TSH
Premature ovarian failure, FSH

37
Q

What is the treatment of candida vaginitis?

A

Fluconazole

38
Q

What is the gold standard for checking for cervical insufficiency?

A

Transvaginal ultrasound

39
Q

What are contraindications to tamoxifen or raloxifene?

A

Venous thromboembolism and hot flashes

Endo and ovary cancer with tamox

40
Q

How can you differentiate placenta previa from abruption?

A

Previa is usually painless bleeding

Abruption has rigid distended uterus and painful contractions

41
Q

What are the maternal and fetal complications of placental abruption?

A

Mom - DIC and hypovolemic shock

Baby - hypoxia and preterm delivery

42
Q

What is the preferred contraception in women with breast cancer?

A

Copper IUD, OCPs may cause breast tissue proliferation

43
Q

What is the gold standard for checking for cervical insufficiency?

A

Transvaginal ultrasound

44
Q

What should be done for breech presentation at 34 weeks?

A

Reassurance and followup, most self correct after 37 weeks, external cephalic version should be attempted only after this time

45
Q

What is the most common cause of postpartum hemorrhage?

A

Uterine atony

46
Q

When is the best time to measure prolactin levels?

A

During fasting to ensure accuracy (postpartum may have elevated prolactin up to 2 years)

47
Q

What is septic thrombophlebitis in pregnancy?

A

postoperative thrombi in pelvic venous system, leading to infection

treat with IV abx and heparin anticoagulation

48
Q

What is ruptured membranes and tender fundus of uterus indicative of?

A

Chorioamnionitis

49
Q

What is the biggest fetal risk in mom’s with type 1 insulin dependent diabetes?

A

Spontaneous abortion, congenital anomalies, and fetal growth restriction

50
Q

What is the cause of urge incontinence and what are the symptoms?

A

overactivity of the detrusor muscle -> uninhibited contractions -> increased bladder pressure over urethral pressure -> urine leakage

urinary incontinence, urgency, nocturia

51
Q

What are the symptoms of candidiasis of the nipple?

A

Severe discomfort and pain, pink/shiny nipples with peeling at periphery

52
Q

What are the s/s of acute salpingitis?

A

lower abdominal pain, adnexal tenderness, fever, cervical motion tenderness, and vaginal discharge

53
Q

What puts patients at risk for placenta accreta?

A

Multiple prior C-sxns

54
Q

What is pelvic congestion syndrome?

A

chronic pelvic pain (fullness/heaviness radiating down) occurring in the setting of pelvic varicosities

55
Q

What should be done if frank blood and fluid is seen coming from the cervical os after placement of IUPC?

A

withdraw, monitor fetal/maternal vital signs, if FHT reassuring re-attempt placement of IUPC

56
Q

Which patient’s are at the highest risk for maternal mortality during pregnancy?

A

pulmonary hypertension (25-50%) - and other cardiopulmonary disease

57
Q

What should be done for category 3 FHT?

A

emergent cesarean delivery

58
Q

What are the potential causes of elevated maternal serum AFP levels?

A

under-estimation of gestational age, fetal demise, multiple gestation, ventral wall defects and a tumor or liver disease in the patient, and in 5-10% of cases-> Neural tube defects

59
Q

What finding on aspiration of breast mass necessitates excisional biopsy?

A

bloody fluid

60
Q

What does irregular menses and hirsituism (of short duration) with elevated testosterone and significantly elevated DHEAS suggest?

A

Adrenal tumor

61
Q

What is the optimal mode of delivery for twins when one is in breech presentation?

A

c-section

62
Q

When is the best time to take herpes cultures and why?

A

Take early in the course, false negative rate can be 10-20% (poor sensitivity)

63
Q

What is the most effective therapy for hot flashes?

A

estrogen

64
Q

What is the preferred management for IUGR at 36 weeks gestation with oligohydramnios and abnormal umbilical artery Doppler studies?

A

induction of labor

65
Q

What can occur from treatment with imipramine in women?

A

hyperprolactinemia

66
Q

What uterotonic agent should be withheld in women with chronic HTN or preeclampsia/

A

Methylergonovine which is a potent smooth muscle vasoconstrictor

67
Q

Patients taking tamoxifen therapy are at greatest risk for developing what? What risk may it decrease?

A

Hot flashes

decreased risk for ovarian ca

68
Q

What is the typical presentation for adenomyosis?

A

Multiparous woman >40 with dysmenorrhea, menorrhagia, and progressive chornic pelvic pain

exam: boggy, tender, uniformly enlarged uterus

69
Q

What are indications for penicillin ppx in women with missed/unknown GBS screening?

A

18hrs

70
Q

What are s/s of neonatal thyrotoxicosis and how may it occur?

A

warm/moist skin, tachycardia, poor feeding, irritability, low birth weight or preterm

transplacental transfer of TSH-R abs

71
Q

What should be checked in patients who are to receive adjuvant herceptin (trastuzumab) therapy for breast cancer?

A

Echocardiography, as combo of Herceptin+chemo can cause cardiac toxicity

72
Q

Irregularly enlarged uterus with heavy menstrual bleeding?

A

FIBROIDS

73
Q

What are the fetal signs indicating uterine rupture?

A

loss of fetal station (effaced and dilated, but no fetal parts), fetal heart deccelerations,

74
Q

What is the usual cause of fetomaternal hemorrhage, and what are the associated s/s?

A

May occur after trauma

decreased fetal movement, sinusoidal FHT, and hydrops

75
Q

When should oxytocin not be administered in a laboring woman?

A

When adequate contractions are present, as additional oxy may cause tachysystole

76
Q

What is the effect of pregnancy on free T4?

A

Increases free t4

77
Q

What is the management of lactational mastitis?

A

Administer PO Abx and continue breastfeeding

78
Q

What are the signs and symptoms of uterine rupture? How can you differentiate from abruption?

A

Sudden vag bleeding, constant abd pain, cessation of contractions, loss of station and fetal deterioration

Abruption has frequent uterine contractions, hypertonicity, and tachysystole

Shelf Exams/USMLE Step 2 CK ❄️ (21 decks)

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