Ob Gyn UWorld

Question 1

What is polyhydramnios defined by? Normal limits?

Answer 1

AFI less than 5 cm (oligo) and more than 24 cm (poly), single deepest pocket more than 8 cm is defined as polyhydramnios too

Question 2

First line therapy for patientswith abnormal uterine bleeding?

Answer 2

Less than 45 years old, OCPs. If older then endometrial bx, if persistent sx then ednometrial biopsy

Question 3

Different ovarian tumors and their tumor markers

Answer 3

Yolk sac tumor - AFP
Dysgerminoma - LDH
Embryonal carcinoma - bHCG
Gestational trophoblastic disease - bHCG
Granulosa - Estrogen
Mature teratomas - sometimes elevated thyroxine

Question 4

Mnemonic for granulosa cell tumor

Answer 4

Tell your granny to call her Ex - Call Exner bodies, rosettes are seen

Question 5

Mandatory screening on 6 week post partum follow up

Answer 5

Edinberg depression screening scale due to high incidence

Question 6

If a patient comes in with a BMI of less than 18 and you diagnose with AN what is the next best step

Answer 6

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

Question 7

Normal level of uterus after delivery

Answer 7

Uterine fundus at the level of umbilicus

Question 8

Differential for Marfinoid habitus

Answer 8

Only 2, Marfan and homocysteinuria, marfan is not associated with thromboembolic events

Question 9

How do you differentiate between CGD and LAD

Answer 9

LAD doesnt form pus

Question 10

Preferred SSRIs

Answer 10

Sertraline and escitalopram

Question 11

Side effects of paroxetine

Answer 11

Inhibits P450 and weight gain

Question 12

Most common cause of placental abruption

Answer 12

HTN

Question 13

Inspiratory stridor is pathognomonic for which pediatric disease?

Answer 13

Croup, NOT Bronchiolitis

Question 14

What cancer is Sjrogen associated with?

Answer 14

Non hodgkins lymphoma

Question 15

Criteria for baceterial sinusitis

Answer 15

Symptoms for 10 days, acute worsening symptoms OR fever for > 3 days

Question 16

Longitundinal splitting of the basement membrane dx?

Answer 16

Alport syndrome

Question 17

Learn to differentiate bipolar I and II

Answer 17

In bipolar II manic episodes do not cause functional impairment, it is the hypomanic episodes that cause functional impairment

Question 18

For undescented testis when should we do orchopexy?

Answer 18

By age 1

Question 19

Reactive attachment disorder or social disinhibited disorder

Answer 19

In reactive attachment disorder child doesnt connect or talk to anyone, this is the opposite of social disinhibited disorder

Question 20

Which second generation antipsyhotics are weak D2 antagonist

Answer 20

Quetiapine, clozapine and pimavanserin

Question 21

What murmur has a dual upstroke?

Answer 21

HOCM

Question 22

Indications for hypertonic saline use in adults?

Answer 22

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

Question 23

Define dehiscence and evisceration

Answer 23

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

Question 24

Management of dehiscence and evisceration

Answer 24

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

Question 25

Initial eval of mixed urinary incontinence and what is the tx when it is urge vs stress

Answer 25

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

Question 26

What are the indications of giving rhogam

Answer 26

At 28 weeks and at any other time if there is uterine bleeding provided mother is Rh negative

Question 27

First step in posmenopausal woman with AUB

Answer 27

TVUS, if endometrium less than 4 mm observation, if more then do a biopsy

Question 28

What role does imaging have on endometriosis?

Answer 28

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

Question 29

Diagnosis of atlantoaxial instability in Down's syndrome

Answer 29

Lateral X rays of cervical spine

Question 30

Tethered cord syndrome

Answer 30

Same as atlantoaxial instability symptoms except that it happens below T12-L1 region and is associated with spina bifida, not Down's syndrome

Question 31

Most common cause of infection in asplenic patients, starting with most to least common

Answer 31

Step pneumo, HiB and Nisseria meningitidis

Question 32

Most common cause of meningitis in children older than 1 month

Answer 32

Step pneumo and Nisseria

Question 33

First step in management if meningitis is suspected

Answer 33

If hemodynamically stable, do LP followed by IV abx, if hemodynamically unstable do IV abx to avoid delay in therapy

Question 34

First step in management if meningitis is suspected

Answer 34

If hemodynamically stable, do LP followed by IV abx, if hemodynamically unstable do IV abx to avoid delay in therapy

Question 35

Which has high risk for virilization

Answer 35

Luteomas, not theca lutean cysts

Question 36

Inheritance of CGD

Answer 36

X linked

Question 37

What are Howell Jolly bodies?

Answer 37

Remnant of nuclear material remnants in RBCs

Question 38

Which genetic disorder has hypertonia

Answer 38

Edwards

Question 39

Normal value for 1 hour glucose test in pregnancy?

Answer 39

<140

Question 40

What iatragenic device is notorious for causing blood infections?

Answer 40

Central venous catheters

Question 41

Isopropyl alcohol ingestion

Answer 41

Present with a serum osmolar gap but does NOT present with metabolic acidosis

Question 42

Heat exhaustion and exertional heat stroke cut off temp

Answer 42

104, below this is heat exhaustion

Question 43

Complications associated with short pregnancy interval

Answer 43

Preterm labor, PPROM, maternal anemia, low birth weight

Question 44

How do you differentiate between acalculous cholecystitis and acute cholangitis

Answer 44

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

Question 45

How to differentiate between laryngomalacia and tracheomalacia

Answer 45

Laryngo presents with inspiratory stridor, tracheomalacia causes expiratory stridor

Question 46

Congenital hip dysplasia US/Xray cut off?

Answer 46

4 months

Question 47

First line treatment of OCD

Answer 47

SSRIs