Ob Gyn UWorld Flashcards
What is polyhydramnios defined by? Normal limits?
AFI less than 5 cm (oligo) and more than 24 cm (poly), single deepest pocket more than 8 cm is defined as polyhydramnios too
First line therapy for patientswith abnormal uterine bleeding?
Less than 45 years old, OCPs. If older then endometrial bx, if persistent sx then ednometrial biopsy
Different ovarian tumors and their tumor markers
Yolk sac tumor - AFP Dysgerminoma - LDH Embryonal carcinoma - bHCG Gestational trophoblastic disease - bHCG Granulosa - Estrogen Mature teratomas - sometimes elevated thyroxine
Mnemonic for granulosa cell tumor
Tell your granny to call her Ex - Call Exner bodies, rosettes are seen
Mandatory screening on 6 week post partum follow up
Edinberg depression screening scale due to high incidence
If a patient comes in with a BMI of less than 18 and you diagnose with AN what is the next best step
Only 2 options: CBT for AN or hospitalization. Following criteria apply for hospitalization:
HR <40, T <35, BP <80/60, BMI <15, organ compromise and electrolyte disturbance
Normal level of uterus after delivery
Uterine fundus at the level of umbilicus
Differential for Marfinoid habitus
Only 2, Marfan and homocysteinuria, marfan is not associated with thromboembolic events
How do you differentiate between CGD and LAD
LAD doesnt form pus
Preferred SSRIs
Sertraline and escitalopram
Side effects of paroxetine
Inhibits P450 and weight gain
Most common cause of placental abruption
HTN
Inspiratory stridor is pathognomonic for which pediatric disease?
Croup, NOT Bronchiolitis
What cancer is Sjrogen associated with?
Non hodgkins lymphoma
Criteria for baceterial sinusitis
Symptoms for 10 days, acute worsening symptoms OR fever for > 3 days
Longitundinal splitting of the basement membrane dx?
Alport syndrome
Learn to differentiate bipolar I and II
In bipolar II manic episodes do not cause functional impairment, it is the hypomanic episodes that cause functional impairment
For undescented testis when should we do orchopexy?
By age 1
Reactive attachment disorder or social disinhibited disorder
In reactive attachment disorder child doesnt connect or talk to anyone, this is the opposite of social disinhibited disorder
Which second generation antipsyhotics are weak D2 antagonist
Quetiapine, clozapine and pimavanserin
What murmur has a dual upstroke?
HOCM
Indications for hypertonic saline use in adults?
Sodium less than 130 with any kind of symptoms in an acute setting, in chronic hyponatremia use Na when there is severe hyponatremia (<120), severe symptoms like seizures or intracranial pathology like masses or hemorrhagic stroke
Define dehiscence and evisceration
Dehiscence is seperation of the layers, it can superficial like seperation of the cutaneous tissue or deep which is seperation of the rectus abdominis, evisceration is herniation of the underlying organs like loop of bowel coming out
Management of dehiscence and evisceration
Dehiscence is managed conservatively with careful dressing changes, deep dehiscence can result in exposure of the internal organs and if with evisceration is definitely a surgical emergency
Initial eval of mixed urinary incontinence and what is the tx when it is urge vs stress
Voiding diary, urge predominant is managed with antimuscarinic and timed voiding (voiding at fixed schedule) whereas stress predominant is Kegel exercises and miduretheral sling surgery
What are the indications of giving rhogam
At 28 weeks and at any other time if there is uterine bleeding provided mother is Rh negative
First step in posmenopausal woman with AUB
TVUS, if endometrium less than 4 mm observation, if more then do a biopsy
What role does imaging have on endometriosis?
NO ROLE, any form of imaging has no role in dx endometriosis including US, hence the best way to diagnose is first clinical and then do diagnostic laparoscopy
Diagnosis of atlantoaxial instability in Down’s syndrome
Lateral X rays of cervical spine
Tethered cord syndrome
Same as atlantoaxial instability symptoms except that it happens below T12-L1 region and is associated with spina bifida, not Down’s syndrome
Most common cause of infection in asplenic patients, starting with most to least common
Step pneumo, HiB and Nisseria meningitidis
Most common cause of meningitis in children older than 1 month
Step pneumo and Nisseria
First step in management if meningitis is suspected
If hemodynamically stable, do LP followed by IV abx, if hemodynamically unstable do IV abx to avoid delay in therapy
First step in management if meningitis is suspected
If hemodynamically stable, do LP followed by IV abx, if hemodynamically unstable do IV abx to avoid delay in therapy
Which has high risk for virilization
Luteomas, not theca lutean cysts
Inheritance of CGD
X linked
What are Howell Jolly bodies?
Remnant of nuclear material remnants in RBCs
Which genetic disorder has hypertonia
Edwards
Normal value for 1 hour glucose test in pregnancy?
<140
What iatragenic device is notorious for causing blood infections?
Central venous catheters
Isopropyl alcohol ingestion
Present with a serum osmolar gap but does NOT present with metabolic acidosis
Heat exhaustion and exertional heat stroke cut off temp
104, below this is heat exhaustion
Complications associated with short pregnancy interval
Preterm labor, PPROM, maternal anemia, low birth weight
How do you differentiate between acalculous cholecystitis and acute cholangitis
Acute choleangitis usually happens when there is an obstruction, there will be high alk phos. Acalculous cholecystitis happens when the patient is severly ill like on ventilator or on TPN etc, there is no obstruction and normal alk phos is the hallmark which effectively rules our acute choleangitis
How to differentiate between laryngomalacia and tracheomalacia
Laryngo presents with inspiratory stridor, tracheomalacia causes expiratory stridor
Congenital hip dysplasia US/Xray cut off?
4 months
First line treatment of OCD
SSRIs
