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OB/GYNE > OB/GYNE > Flashcards

OB/GYNE Flashcards

HIGH YIELD REVIEW

1
Q

A pregnant woman with b/p > 140/90 prior to conception or 20 weeks gestation has what?

A

Chronic Hypertension

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2
Q

The only advantage with gestational hypertension vs chroninc hypertension?

A

No end organ damage or proteinuria

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3
Q

Difference btw gestational hypertension and preeclampsia?

A

pre-eclampsia has proteinuria or signs of en-organ damage.

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4
Q

True or false, can a patient have chronic hypertension with superimposed pre-eclampsia?

A

yes. This is when a patient with chronic hypertension ends up having new-onset proteinuria, worsening of existing proteinuria at >20 weeks gestation, sudden worsening of htn and s/s of end-organ damage.

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5
Q

SERM used to treat post-menopausal osteoporosis?

A

Raloxifene

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6
Q

SERM that has the side effect of edometrial hyperplasia and carcinoma?

A

Tamoxifen (adjuvant treatment for breast cancer).

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7
Q

80% of moms with placenta abruption will present this way.

A

Sudden-onset vaginal bleeding.

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8
Q

2 substances that place a patient at risk for placental abruption?

A

Cocaine and tobacco use

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9
Q

Fasting blood glucose of how less than add equal to what is the cutoff point for gestational diabetes?

A

< and equal to 95mg/dl

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10
Q

First line treatment for gestational diabetes?

A

Dietary modifications

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11
Q

Congenital anomalies that occur in women with first trimester hyperglycemia.

A

congenital heart disease, neural tube defects, small left colon syndrome, spontaneous abortion.

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12
Q

The 4 consequences of fetal hyperinsulinemia due to maternal hyperglycemia.

A

Increased metabolic demand (fetal hypoxemia, increased erythropoesis, polyceythemia)
organomegaly (liver and heart)
Macrosomia (shoulder ditotia, birth injuries)
Neonatal hypoglycemia

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13
Q

Painless third trimester bleeding is a clinical feature of?

A

Placenta previa

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14
Q

Next step in management of placenta previa ?

A

Transabdominal, followed by transvaginal sonogram

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15
Q

Risk factors of placenta previa?

A

Prior placenta previa
prior c-section or other uterine surgery
multiparity
advanced maternal age

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16
Q

Treatment for confirmed gonorrhea?

A

Ceftriaxone

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17
Q

Treatment for confirmed chlamydia?

A

Doxycycline or Azithromycin

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18
Q

A polymicrobial infection characterized by fever, purulent vaginal discharge and uterine tenderness. Dx & Tx?

A

Clindamycin plus gentamycin

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19
Q

Contraindication to copper IUD

A

Wilson disease

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20
Q

Contraindication to progestin IUD

A

Active liver disease and current breast cancer

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21
Q

What are the family history risk factors for breast cancer?

A
  • 2 first degree relatives with breast cancer including one <50
  • 3 or more 1st or 2nd degree relatives with breast cancer.
  • First or second degree relative with breast or ovarian cancer.
  • First degree relative with bilateral breast cancer
  • Breast cancer in a male relative
  • Ashkenazi Jewish women with any 1st or second degree relative with breast or ovarian cancer.
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22
Q

Age of breast cancer screening recommendation q 2 yrs?

A

50 -75 yrs of age

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23
Q

treatment options for uretheral diverticula?

A

Manual decompression, surgical repair, needle aspiration

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24
Q

How to manage preterm premature rupture of membranes between 34 - 37 weeks?

A

Delivery
GBS prophylaxis/PCN G
+/- Steroids

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25
Q

How to manage preterm prelabor rupture of membranes in <34 weeks gestation when mother is infected and there is fetal/maternal compromise?

A

Delivery
IAI treatment (ampicillin, gentamycin)
steroids
Magnesium if < 32 weeks

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26
Q

How to manage preterm prelabor rupture of membranes in <34 weeks in an uncomplicated situation?

A

Expectant management
Latency antibiotics (ampicillin, Azitromycin)
Steriods
Fetal surveillance

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27
Q

Complex breast cysts must be biopsied. When should simple breast cysts be biopsied?

A

Biopsy and additional imaging is required if FNA aspirate was bloody.

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28
Q

A negative test result on a highly sensitive test does what?

A

Rules out the disease

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29
Q

The best epidemiological parameter used to compare screening tests when applied to individual patients?

A

Likelihood ratio: The probability of a given test result occuring in a patient with a given disorder vs a pt w/o the disorder. It does not vary with disease prevalence and provides clinically useful information for patients.

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30
Q

A type of measurement bias that uses gold standard testing selectively in order to confirm a negative or positive result of preliminary testing. This can result in overestimates or underestimates of sensitivity or specificity

A

Verification or work-up bias

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31
Q

Long philtrum, midfacial hypoplasia, short palpebral fissure, Microcephaly. Dx?

A

Fetal alcohol syndrome

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32
Q

Congenital deafness, congenital heart defects. What teratogen?

A

Isotretinoin/Accutane

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33
Q

Mother gets diabetes insipitus, baby gets Epstein’s anomaly. Teratogen?

A

Lithium

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34
Q

Damage to CN 8 leading to hearing impairment. Teratogen?

A

Streptomycin

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35
Q

Competes with calcium, teeth discoloration after 4 months, muscle contraction impairment, bone matrix. Teratogen?

A

Tetracycline

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36
Q

Ocular hypertelorism (misalignement of cornea), strabismus, short fingers (distal phalangeal hypoplasia), short nose and low bridge, fetal hydantoin syndrome. Teratogen?

A

Dilantin/Phenytoin

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37
Q

Fetal valproate syndrome. Neural tube defect, CVS abnormalities, GU defects, developmental delay, limb defects. Teratogen?

A

Valproic Acid/Depakote

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38
Q

Chondrodysplasia: stippled epiphysis and multiple ossification centers. leads to weakening of the bone and bone necrosis/breakage.

A

Warfarin

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39
Q

Independent risk factors for endometrial cancer

A

Diabetes and HTN

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40
Q

ENDOMETRIUM
Will need Anastrozole to stop peripheral conversion of fat to estradiol.

A

EXCESS EXOGENOUS ESTROGEN
N: NULLIPARTY
D: DIABETES
O: OBESITY
M: Late menopause
E:ESTROGEN
T:
R:
I:
U:UNOPPOSED ESTROGEN
M: MENOPAUSE LATE

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41
Q

side effects of progesterone therapy

A

bleeding

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42
Q

The 4 d’s of endometriosis

A

Dysmennoria
Dysparinuea (retroflex uterus)
Dysfertility/Infertility
Dyschezia (painful bowel movements)
Dysuria
Retrograde mentruation

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43
Q

Age range for fibrocystic breast disease vs fibroadenoma?

A

Fibrocystic : 20 - 50
Fibroadenoma: younger

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44
Q

what is a biophysical profile?

A

non-stress test: 2
Amniotic fluid volume: 2
fetal tone:2
fetal activity:2
fetal breathing movements:2
High score is good/placenta is doing well
4-6 is non-reaasuring
2-3, deliver baby

45
Q

key difference between mastitis and fat necrosis

A

staph in mastitis, give antibiotics and keep breastfeeding

46
Q

Most common benign breast lesion?

A

Fibroadenoma
rubbery, smooth, well circumscribed, non-tender
women < 30

47
Q

bartholin glad abscess or cyst position?

A

4pm or 8pm location

48
Q

bloody nipple discharge? Negative US and mammogram?

A

It is on the duct hence the serosanguinous discharge. Intraductal papillloma. Involved the epithelial lining of the breast ducts

49
Q

cluster Microcalcifications on mammography, no mass on mmammography =

A

DCIS
Does not spread to the stroma

50
Q

treatment for DCIS?

A

Simple mastectomy with wide margins & radiation plus tamoxifen for 5 years.

51
Q

Difference between lichen sclerosis and lichen planus chronicus

A

read

52
Q

How do you know we have placental abruption?

A

Change in fetal position
Painful
Lots of blood loss/transfuse mom after getting baby out

53
Q

90 yo f with estrogen positive breast cancer, Tx?

A

Aromatase inhibitor
Anatrozole, letrozole

54
Q

Hair, skin, teeth, nails in these tumors, fast growers, benigh, hemorrhhage necrose and produce pelvic pain. Tx

A

benighn cystic teratoma/Detmoid cyst of the ovary
Unilateral oohorectomy

55
Q

Hallmarks of a scc of the vulvar

A

ulcerated
slowly expanding
did not respond to topical treatments
labia majora
pruritus, pain and bleeding
tx with wide excision

56
Q

local inflammatory reaction toxic to sperm and ovum. use in sexual assault victims, avoid in Wilson disease or bleeding patient

A

Copper IUD

57
Q

Higher incidence of transforming into choriocarcinoma

A

Partial molar pregnancy

58
Q

Why do a quantitative HCG in a patient after resecting choriocarcinoma?

A

Monitor, did we get all of the cancer?

59
Q

How could a turner patient ave an extopic pregnancy?

A

IVF

60
Q

MOST COMMON SITE FOR ECTOPIC PREGNANCY

A

AMPULLA, ISTHMUS AND FIMBRIAE

61
Q

RF for ectopic pregnancy

A

PID, KARTAGENER,

62
Q

PREGNANCY WITH LOW HCG?

A

ECTOPIC PREGNANCY
GIVE METHOTREXATE

63
Q

Rh negative mom with Rh positive baby?

A

Give Rhogam

64
Q

3 sets of epithelial cancers
Epithelial
Germ cell
Sex cord

A

serous cystadenocarinoma
(most common ovarian neoplasm)
Subset of epithelial
CA-125
produces psammoma bodies

65
Q

Brenner Tumor

A

Bladder-like epithelium

66
Q

mucinous cystadenocarcinoma of the ovaries

A

pseudotumor peritonei
lined by mucin producing epithelium

67
Q

sex cord ovarian cancers

A

Granulosa
sertoli-leydig
thecoma
Fibroma

68
Q

Ovarian fibroma

A

Will lead to meig’s syndrome
fibroma
spindle shaped

69
Q

grey to yellow-brown mass, tubules/cords ined. Breast atrophy

A

Sertoli-leydig

70
Q

Abnormal menstrual bleeding in a post-menopausal woman.

A

Thecoma
sex cord tumor
produces estrogen

71
Q

4 types of germ cell ovarian cancers

A

Immature teratoma
Mature teratoma
dysgerminoma
yolk sac

72
Q

Fried egg apearance, uniform cells in the ovary, adolescent,

A

Dysgerminoma

73
Q

less than 20 yo
has all 3 germ layers

A

Immature Teratoma

74
Q

schiller-duval bodies
AFP markedly elevated
Yellow mass

A

yolk sac

75
Q

Call-exner bodies
post-menopausal women
breast tenderness

A

Granulosa tumor
most common
produces lots of estrogen, sexual percosity
endometrial hyperlasia
post-menopausal bleed

76
Q

male > 20
painless, testicular enlargement
large cells in lobule with fried egg apperance
increased placental alkaline phosphatase
no change in AFP
Increased b-HCG

A

seminoma
Brother tumor of dysgerminoma

77
Q

< 3 years old (mc testicular tumor in kids under 30
no change placental alkaline phosphatase
increase in AFP
Increased b-HCG
Schiller-Duval (resembles primitive glomeruli)

A

yolk sac tumor/endodermal sinus tumor
yellow in color

78
Q

no change placental alkaline phosphatase
no change in AFP
Increased b-HCG (leads to hyperthyroidism/since similar to TSH)
Gynecomastia
cytiotrophoblast and cytotrophoblast
malignant disorder
syn

A

choriocarcinoma
mets in lungs (cannenball)
Mets in brain

79
Q

no change placental alkaline phosphatase
no change in AFP
Increased b-HCG

A
80
Q

Biopsy of testicle, golden brown color, eosinophilic, cytolplasic inclusion (Reinke crystals), produces androgens
gynacomastia (excess estrogen)

A

Sertol-leydig
benign

81
Q

Any cell with inclusions in it? Ex inclusion body

A

Benign

82
Q

Any cell with no inclusions

A

Cancerous

83
Q

GnRH analog with agonist (pulsatile) and antagonistic properties (continuous)

A

Shrink fibroids, cut down estrogen, prostate cancer (continuous)

Ex. Lupron/Leuprolide

84
Q

GnRh Antagonist

A

Ganirelix
Orlissa

85
Q

GnRh Agonist

A

Goserelin

86
Q

breast biopsy with orderly row cells and duct formation
can have bloody or non-bloody discharge

A

Intraductal papilloma

87
Q

paget cells

A

adenocarcinoma cells

88
Q

increased lymphocytes/plasma cells
large anaplastic cells growing i sheets, well circumscribed

A

Invasive medullary breast Cancer

89
Q

SERM Good for osteoporosis AND antagonist in the endometrium and agonist in the breast

A

Raloxifene

90
Q

progesterone receptor blocker/A

A

Mifipristone (progesterone/kills the baby)
Ullipristol (plan B)/RAPE KIT CART
Misopristol (prostaglandin/takes it out)

91
Q

Rape kit drugs

A

NRTI/NNRTI
Ceftriaxone and Azithro
Mifiprisone (abortion, higher dose) & Ullipristal (pregnancy termination)

92
Q

Synthetic androgen/agonist
Hereditary Angiodema and fibroids?

A

Danazol
SE:Hepatotoxicity
Elevated intracranial pressure

93
Q

Dihydrofolate reductase blocker

A

Finesteride
se: gynecomastia (give anastrazole)

94
Q

treat BPH, HTN, & PTSD

A

Prazosin
Do not give with nitrates

95
Q

Androgen Antagonist
Decreases steroid binding to the receptor

A

Flutamide
Good for protate cancer
gleason score of 9
Mets to the spine

96
Q

Alpha antagonist

A

Tamsulosin
SE: Orthostatic hypertension

97
Q

Direct arterial vasodilator
Used for refractive hypertension as well

A

Minoxidil
se: Reflex tachycardia, give them a beta blocker. If they are asthmatic and on a B2 agonist
‘hair loss

98
Q

Why not give hydralazine to pre-eclampsia patient?

A

Lupus-likereaction
causes reflex tachycardia
choose labetalol instead, will decrease blood pressure and heart rate

99
Q

outer layer of chorionic villi synthesis and secrete hormone like B-HCG (SIMILAT TO LH & FSH)

A

SYNCYTIOTROPHOBLAST: PRODUCE PROGESTERONE

100
Q

How does hypothyroidism cause amenorrhea?

A

TRH causes prolactin secretion

101
Q

hormones affected in sheehans

A

anterior pituitary

102
Q

type of necrosis caused by pituitary apolexy?

A

Necrosis

103
Q

paramesonephric duct/Mullerian duct

A

female parts: uterus, fallopian, proximal vagina

104
Q

Mesonephic Duct

A

Wolfian duct
male plumbing: vas deferens, seminal vesicles, ductus

105
Q

Associated with bladder extrophy and dorsal

A

Epispadias
dorsal

106
Q

failure of the uretheral folds to fuse. Associated with inguinal hernias

A

Hypospadias
Are testes descended?

107
Q
  1. genetic male XY
  2. No uterus
  3. No breasts
  4. Normal testes
  5. Normal penis
    High testosterone
    Converted to estradiol
    vagina made
A

AIS (Androgen Insensitivity syndrome). Insensitive to testosterone.

108
Q

Complete mole vs partial mole

A

Tripple,triplicates XXY= partial mole (Maternal contribution)
fetal arts

109
Q

Complete mole

A

No fetal parts
5% risk of choriocarcinoma/higher
snow storming
paternal contribution

OB/GYNE (1 decks)

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