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OB Shelf Flashcards

0
Q

Plasma osmolality is ??? during pregnancy

A

Decreased; increasing the susceptibility to pulmonary edema

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1
Q

An increase in maternal blood volume has a relative dilutional effect that ??? hemoglobin and ??? MCV

A

Hemodilution of Pregnancy: lowers Hg and has no change in MCV

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2
Q

During pregnancy, circulating estrogens cause an ??? in thyroid binding globulin(TBG) and total T4

A

Increase

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3
Q

Most common sight of metastatic disease in patients with gestational trophoblastic disease/molar pregnancy

A

Lungs (*order CXR)

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4
Q

Pregnancy weight gain recs:

BMI <18 = ???, BMI 18-25 = ???, BMI 25-30 = ???, BMI 30 = ???

A

28-40 lbs,
25-35 lbs,
15-25 lbs,
11-20 lbs

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5
Q

Best screen for Downs syndrome

A

Sequential screen: (1st trimester = Nuchal Translucency and PAPP-A) then (2nd trimester = quad screen)

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6
Q

Quad screen for Downs Syndrome

A

Alpha FP is normal, estriol is normal, hCG is elevated, Inhibin-A is elevated

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7
Q

Miscarriage risk associated with CVS

A

1%

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8
Q

Risks associated with gestational diabetes:

A

Shoulder dystopia, fetal macrosomia, polyhydramnios, preeclampsia, neonatal hypoglycemia

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9
Q

Folic acid amount given 4 weeks prior to conception in non-high risk patients and high risk patients?

A

0.4 mg and 4 mg

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10
Q

Short/less intense and irregular contractions that manifest as lower abdominal pain

A

Braxton-Hicks contractions

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11
Q

Labor Warnings:

A

Contractions every 5 minutes for 1 hour, ROM, fetal movement <10 per 2 hours, vaginal bleeding

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12
Q

Test to confirm ROM?

A

Nitrazine test

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13
Q

If fetal HR or well being cant be confirmed using external methods, most reliable way to document fetal well being?

A

Apply fetal scalp electrode

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14
Q

Variable decelerations are typically caused by ??? and are the most common decelerations seen in labor.

A

Umbilical Cord Compression

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15
Q

Late decelerations are associated with ???

A

Uteroplacental insufficiency

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16
Q

Magnesium Sulfate tx for preeclampsia carries risk of ??? 2/2 Mg use

A

Respiratory distress

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17
Q

Type 1 Diabetes is associated with ??? infants, and gestational diabetes is associated with ??? Infants

A

Small, Large(macrosomia)

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18
Q

An imbalance in the blood flow through communicating vessels across a shared placenta leading to under perfusion/anemia/oligohydramnios to one twin, and over perfusion/polycythemia/polyhydramnios to the other twin

A

Twin-twin transfusion syndrome

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19
Q

Infants born to diabetic mothers are at increased risk for developing:

A

Polycythemia, hyperbilirubinemia, hypocalcemia, hypoglycemia, respiratory distress

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20
Q

HIV positive mom post-labor protocol for newborn

A

Tx with Zidovudine(AZT) immediately, HIV testing at 24hrs, discourage breastfeeding

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21
Q

Define postpartum hemorrhage for vaginal delivery and Cesarean delivery

A

Vag: >500 ml blood loss
Cesarean: >1000 ml blood loss

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22
Q

Most common cause of postpartum hemorrhage

A

Uterine atony

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23
Q

Most common cause of postpartum fever

A

Endometritis

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24
Q

Signs/symptoms of depression that are less then two weeks post partum? Depressive s/s 2 wks - 6 mos postpartum?

A

Postpartum blues.

Postpartum depression.

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25
Q

Breast-feeding has shown to decrease the incidence of ??? cancer

A

Ovarian

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26
Q

Infant-mother position for breastfeeding

A

Belly to belly

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27
Q

After delivery, prolactin is no longer inhibited by ??? and ???, causing milk synthesis

A

Estrogen and progesterone

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28
Q

Mastitis 2/2 candida presents as

A

Intense nipple pain/sensitivity

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29
Q

??? is responsible for milk ejection and is stimulated by suckling

A

Oxytocin

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30
Q

??? intake can increase the pain associated with fibrocystic breast changes

A

Caffeine

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31
Q

Mastitis ABX?

A

Dicloxacillin; or Erythromycin if allergic to penicillins

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32
Q

Most common cause of abnormal vaginal discharge?

A

Bacterial Vaginosis

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33
Q

Most accurate estimator of GA in 1st trimester? 2nd trimester? 3rd trimester?

A

Crown-rump length.
Biparietal diameter, femur length.
Ab circumference, BP diameter, femur.

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34
Q

Management of LSIL is initial colposcopic examination unless patient is ???

A

Pregnant, postmenopausal, adolescent

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35
Q

Mammogram protocol:

A

Every two years between ages 40 to 50, and yearly after age 50

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36
Q

Colposcopy resulting in CIN-I, what is following management?

A

Follow-up Pap smear in 6 to 12 months or HPV DNA testing at 12 months

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37
Q

Definitive treatment for pelvic pain secondary to endometriosis?

A

Hysterectomy and B/L salpingoopherectomy

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38
Q

Best initial work up for an adnexal mass?

A

Transvaginal US

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39
Q

Emergency contraception should be started within ?? hours and no later then ?? hours

A

72; 120 hours

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40
Q

Contra indications to estrogen OCP:

A

History of thromboembolic disease, current lactation, > 35 smoker, history of severe nausea with previous OCP use

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41
Q

OCP’s will decrease risk of ??? and ??? cancer

A

Ovarian and endometrial

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42
Q

Higher dose OCP’s will increase risk of ??? cancer

A

Breast

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43
Q

Tubal ligation has slight reduction in risk of ??? cancer

A

Ovarian

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44
Q

Management of septic abortion?

A

Uterine evacuation and broad-spectrum antibiotics

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45
Q

Antibodies associated with recurrent pregnancy loss?

A

Antiphospholipid antibody’s

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46
Q

Treatment of recurrent abortions secondary to antiphospholipid antibody syndrome?

A

Aspirin and heparin

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47
Q

Medical abortion is associated with higher ??? than surgical abortion

A

Blood loss

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48
Q

Abortion is legal until ??? weeks gestation, unless a fetal anomaly inconsistent with extrauterine life is identified

A

24 wks

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49
Q

Surgical abortion method if fetus < 16 weeks?

A

Dilation and curettage

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50
Q

Surgical abortion method if fetus >16 weeks?

A

Dilation and evacuation

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51
Q

Management of heavy bleeding secondary to medical abortion?

A

D & C

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52
Q

Curdish vaginal discharge with organisms on KOH or Gram stain?

A

Candidiasis

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53
Q

Initial management of pelvic prolapse?

A

Pessary fitting

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54
Q

What size should ovarian cyst be referred to gynecologist?

A

6 cm

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55
Q

Most common cause of failure to progress labor?

A

Cephalopelvic disproportion

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56
Q

Dysfunctional uterine bleeding is from anovulation increases risk for ??? cancer

A

Endometrial

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57
Q

Percentage of infants born to HIV infected mothers who will be infected?

A

25%

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58
Q

Transdermal and vaginal ring delivery of estradiol bypasses GI conversion of estradiol to estrone, causing ???

A

No association with increased risk of venous thromboembolism

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59
Q

G & C ABX’s?

A

Ceftriaxone (cefotetan) and Doxycycline (azithromycin)

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60
Q

Infertility secondary to history of STI’s most commonly due to ??

A

Tubal disease/scarring

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61
Q

Progesterone withdrawal induces ??? of endometrium

A

Sloughing

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62
Q

??? restores and causes endometrial proliferation

A

Estrogen

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63
Q

??? “stabilizes” endometrium

A

Progesterone

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64
Q

Most common dyscrasia in adolescents with uncontrolled ovulatory bleeding?

A

Von Willebrand disease

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65
Q

Abnormal ovulatory bleeding secondary to von Willebrand’s disease: Dx? Rx?

A

Dx-decreased vWF, increased bleeding time, normal plt count, decreased ristocetin-induced plt agg.
Rx-DDAVP (desmopressin) or Factor VIII

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66
Q

Estrogen breakthrough bleeding:

A

Growing follicle makes estradiol, E2 stimulates endometrial proliferation. *if no progesterone to stabilize endometrium or withdrawal sloughing, the E2 “driven” endometrium will outgrow blood supply, causing necrosis/detachment/bleeding and increased risk of CA

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67
Q

Progestin therapy for ovulatory AUB?

A

Continuous

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68
Q

Progestin therapy for anovulatory AUB?

A

Cyclic

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69
Q

Danazol: a synthetic ???, that ??? ovulatory AUB, adverse effects of acne, weight gain, deepening voice.

A

Androgen. Decreases.

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70
Q

T or F: endometrial ablation is meant to induce amenorrhea?

A

False it’s meant to resume a normal menses, but has a 50% chance of amenorrhea

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71
Q

Fetal macrosomia defined as > ??? grams

A

4500 g

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72
Q

GDM management glucose levels: fasting? 2 hour postprandial?

A

< 90 mg/dl; <120 mg/dl

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73
Q

Vaginal CA lymph node drainage: upper 2/3? Distal 1/3?

A

Pelvic nodes; Inguinal nodes

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74
Q

Vaginal CA stages: I? II? III? IVa? IVb?

A

Limited to mucosa. Infiltrate into parametria. Pelvic side wall involved. Spread to adjacent organs. Spread to distant organs.

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75
Q

Infant vaginal bleeding/grape-like clusters?

A

Sarcoma botryoides/Rhabdomyosarcoma

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76
Q

HSV vesicular genital lesions are preceded by prodrome of ???

A

Vulvar burning/irritation

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77
Q

Syphillis ulcers/chancres are preceded by ???

A

Painless pa piles

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78
Q

Dx antepartum vaginal bleeding 2/2 placenta previa? Tx?

A

Dx- transvaginal US. Tx- if hemodynamically stable, pelvic rest; if hemodynamically unstable, admit and tx.

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79
Q

Placenta Previa delivery?

A

C/S (low lying placenta offered trial of labor)

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80
Q

Placental villi attached to myometrium?

A

Placenta accreta

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81
Q

Placental villi invade myometrium?

A

Placenta increta

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82
Q

Placental villi penetrate through myometrium and into serosa/adj organs?

A

Placenta percreta

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83
Q

Fetal vessels close to internal os?

A

Vasa previa

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84
Q

Abruptio placenta presents with ???

A

Antepartum vaginal bleeding, non-reassuring fetal testing, uterine contrxns/tenderness

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85
Q

Vertex position? Breech position? Frank position?

A

Head first. Bottom/feet first. Bottom (feet superior/closer to head)

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86
Q

Frank position delivery method?

A

C/S

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87
Q

Breech position delivery method?

A

Pinard maneuver

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88
Q

Describe the McRoberts maneuver for managing shoulder dystocia?

A

Maximal flexion and ABduction of maternal hips

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89
Q

Most common histopathologic Dx found in evaluation of AGUS?

A

CIN

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90
Q

Tx of primary dysmenorrhea with ???, while symptoms often resolve after ???

A

NSAIDs. First pregnancy

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91
Q

Most reliable clinical symptom of uterine rupture?

A

Fetal distress

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92
Q

Patients must have ?/4 Amsel criteria to be Dx with BV

A

3/4

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93
Q

Amsel criteria for BV:

A

pH > 4.5 (most sensitive), clue cells (most specific), homogenous discharge, + whiff test

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94
Q

T or F: no current available method for screening for ovarian CA

A

True

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95
Q

If pregnancy is viable, hCG levels should double every ??? days

A

2-3

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96
Q

Tx of chlamydia during pregnancy?

A

Azithromycin

97
Q

Any attempt to convert breech into vertex is not indicated until ??? week of gestation

A

37th

98
Q

Tx of genital warts in pregnancy?

A

TCA or cryotherapy with liquid nitrogen

99
Q

Epidural anesthesia is associated with a longer ??? stage of labor

A

2nd

100
Q

Most accurate test to determine preterm labor?

A

Vaginal fetal fibronectin

101
Q

Diabetes drug for PCOS?

A

Metformin

102
Q

Early decelerations most likely due to ?

A

Head compression

103
Q

Intrauterine adhesions/scarring that occur 2/2 trauma from a D&C. Has clinical symptoms of amenorrhea, infertility, and recurrent miscarriages.

A

Ashermans Syndrome

104
Q

GnRH mechanism of action/physio for endometriosis tx: GnRH’s ??? regulate the hypothalamic-pituitary production/release of FSH & LH, leading to ??? in estradiol levels

A

Down. Reductions.

105
Q

??? suppresses the mid-cycle surges of LH & FSH, in tx of endometriosis.

A

Danazol, synthetic androgen

106
Q

??? classically presents in pregnancy, most commonly due to rheumatic heart Dz and increased blood volume. Presenting with symptoms of pulmonary edema and AFib

A

Mitral Stenosis

107
Q

Premature ovarian failure refers to menopause before age ???

A

40

108
Q

Exercise induced infertility is common in ???

A

Long distance runners

109
Q

B/l breast tenderness and swelling 24-72 hrs PP, without signs of infection, likely 2/2 ,

A

Breast engorgement

110
Q

Abdominal pain 2/2 HELLP syndrome occurs due to ???

A

Swelling/distention of liver capsule

111
Q

Mag sulfate causes neuromuscular depression, which presents as RDS and decreased ???

A

DTRs

112
Q

Anti-D immune globulin is given to Rh- moms at ??? wks and ??? hrs within delivery if baby is Rh+

A

28-32 was; 72 hrs

113
Q

Test/screen for GBS at ??? was

A

35-37

114
Q

ASCUS initial management: pts 21-24 yo? Pts 25 or older?

A

Repeat PAP in 1 yr. HPV DNA testing.

115
Q

Age 25 or greater pt with ASCUS with +HPV DNA test, next management?

A

Colposcopy

116
Q

Age 25 or greater pt with ASCUS with -HPV DNA test, next management?

A

Repeat PAP smear and HPV test in 3 yrs

117
Q

Painful ulcers DDx? Painless ulcers DDx?

A

HSV vs. H.ducreyi; Syphillis vs. chlamydia

118
Q

??? is indicated in pts in labor with active HSV lesions/prodrome

A

C/S

119
Q

HSV prophylaxis with -cyclovir beginning at ??? wks

A

36

120
Q

T or F: CDC recommends influenza vaccine in all pregnant women, vaccine given during any trimester.

A

True

121
Q

Infant postnatal management of HIV?

A

Zidovudine for at least 6 wks and HIV PCR testing

122
Q

Most important intervention to prevent HIV transmission from mom to infant?

A

Triple antiretroviral therapy THROUGHOUT pregnancy

123
Q

Menorrhagia is associated with ???, while oligo/amenorrhea is associated with ???

A

Hypothyroidism, hyperthyroidism

124
Q

Prenatal vitamins are started ??? prior to conception

A

3 months

125
Q

T or F: 1 ovary ovulates one month, then other ovary ovulates next month

A

True

126
Q

Uterus > ??? is considered enlarged

A

10 cm

127
Q

NST with greater than or equal to ? accelerations is normal/reassuring

A

2

128
Q

NST is performed ??? during 3rd trimester

A

Weekly

129
Q

Women 35 or older are at increased risk of fetal aneuploidy and should be offered ??? at 10 wks or later

A

Cell free fetal DNA testing (cffDNA)

130
Q

Abnormal cffDNA results can be confirmed by ??? @ 10-12 wks or by ??? @ 15-20 wks

A

CVS. Amniocentesis

131
Q

Most common adverse effect of CVS?

A

Fetomaternal hemorrhage/spotting

132
Q

Rh- pts are at risk for ??? during CVS

A

Alloimmunization

133
Q

Screening for ??? is recommended in all pregnant women, while screening for all other infections is based on risk factors

A

Syphillis, HIV, and Hep B

134
Q

Steroids should be started in pts with PPROM before ??? wks to decrease risks of RDS, necrotizing enterocolitis, neonatal IVH, death.

A

32

135
Q

Asymptomatic bacteruria of pregnancy tx?

A

Nitrofurantoin, amoxicillin-clavulonate, cephalexin, fosfomycin

136
Q

All pregnant woman should be screened for asymptomatic bacteruria @ ??? wks

A

12-16 wks

137
Q

Untreated bacteruria can lead to ???

A

Cystitis, acute pyelonephritis, preterm birth, low birth weight

138
Q

Tx for ectopic pregnancy?

A

Methotrexate

139
Q

Incontinence characterized by failure to empty bladder adequately, with PVR volume > 300 cc and continuous leakage. Usually due to underactive detrusor muscle or obstruction. Dx?

A

Overflow incontinence

140
Q

Incontinence characterized by uninhibited contraction of bladder while filling. Due to detrusor instability/overactivity. Dx?

A

Urge incontinence

141
Q

loss of urine 2/2 increased abdominal pressure in absence of a detrusor contraction. Majority are due to urethral hypermobility (q tip angle > 30), but also due to intrinsic sphinteric deficiency. Dx?

A

Stress incontinence

142
Q

Initial management of intrinsic sphincteric deficiency?

A

Urethral bulking

143
Q

Urge incontinence/detrusor instability medical management?

A

Anticholinergics (oxybutynin, tolterodine)

144
Q

??? may improve urethral tone in Tx of stress incontinence

A

Pseudoephedrine

145
Q

In tx of uterine prolapse: if pessary fittings fail, best surgical option is ???

A

Colpocleisis

146
Q

If NSAIDs can’t manage pelvic pain of endometriosis, next step in management is ???

A

OCPs

147
Q

Tx of mag sulfate toxicity

A

Calcium carbonate

148
Q

Hypothyroidism may result in amenorrhea and galactorrhea, because ??? stimulates ??? production.

A

TRH stimulates prolactin production

149
Q

To suppress milk production pts are advised to ???, as bromocriptine is no longer FDA approved

A

Wear tight fitting bras and apply ice packs (also avoid nipple stimulation)

150
Q

An intrauterine pregnancy should be seen on transvaginal US at beta-HCG levels of ???

A

1500-2000

151
Q

The amenorrhea that occurs in lactating mothers is 2/2 high levels of ??? which inhibits the production of ???

A

Prolactin; GnRH

152
Q

On wet mount, epithelial cells coated with bacteria are called?

A

Clue cells (BV)

153
Q

T or F: Tx of BV in pregnant and nonpregnant patients is metronidazole

A

True

154
Q

In a pregnant SLE pt, ??? will cause proteinuria, hematuria, and RBC casts.

A

Glomerulonephritis

155
Q

Overflow incontinence 2/2 epidural anesthesia is best treated with ???

A

Intermittent catheterization

156
Q

Infertility in premature ovarian failure is treated with ???

A

In vitro fertilization with donor oocytes

157
Q

??? and ??? are usually decreasedin pregnant pts due to increase in renal plasma flow and GFR.

A

BUN and Cr.

158
Q

Uterine rupture is differentiated from placental abruption by ???

A

Loss of fetal station vaginally or palpable fetal parts on abdominal examination.

159
Q

Infants born to pts with Graves Dz treated with surgery are at risk for thyrotoxicosis 2/2 passage of ??? across placenta

A

Thyroid stimulating immunoglobulin

160
Q

An intrauterine pregnancy should be seen on transvaginal US at beta-HCG levels of ???

A

1500-2000

161
Q

The amenorrhea that occurs in lactating mothers is 2/2 high levels of ??? which inhibits the production of ???

A

Prolactin; GnRH

162
Q

On wet mount, epithelial cells coated with bacteria are called?

A

Clue cells (BV)

163
Q

T or F: Tx of BV in pregnant and nonpregnant patients is metronidazole

A

True

164
Q

In a pregnant SLE pt, ??? will cause proteinuria, hematuria, and RBC casts.

A

Glomerulonephritis

165
Q

Overflow incontinence 2/2 epidural anesthesia is best treated with ???

A

Intermittent catheterization

166
Q

Infertility in premature ovarian failure is treated with ???

A

In vitro fertilization with donor oocytes

167
Q

??? and ??? are usually decreasedin pregnant pts due to increase in renal plasma flow and GFR.

A

BUN and Cr.

168
Q

Uterine rupture is differentiated from placental abruption by ???

A

Loss of fetal station vaginally or palpable fetal parts on abdominal examination.

169
Q

Infants born to pts with Graves Dz treated with surgery are at risk for thyrotoxicosis 2/2 passage of ??? across placenta

A

Thyroid stimulating immunoglobulin

170
Q

T or F: obese menopausal pt with mild symptoms is due to peripheral production of estrogen by adipose tissue

A

False, milder postmenopausal symptoms due to androgen conversion to estrogen by adipose tissue/AROMATASE**

171
Q

??? is the gold standard for evaluating the cervix for cervical incompetence

A

Transvaginal US

172
Q

Pt with normal internal genitalia, ambiguous external genitalia, clitoral hypertrophy, high FSH/LH levels, low estrogen levels. Dx?

A

Aromatase deficiency

173
Q

First line med for tx of hypertensive emergencies in pregnant pts?

A

Labetalol or hydralizine. (Meal dopa has slow onset so not for emergencies)

174
Q

Female infants < 3 months sometimes develop vaginal spotting/bleeding that is due to ???

A

Maternal estrogens crossing placenta and causing a pubertal effect which disappear hormone is cleared from circulation

175
Q

Hypotension is a common SE of epidural anesthesia, occurring 2/2 ???

A

Venous pooling from sympathetic blockade

176
Q

When NSAIDs and OCPs fail to manage endometriosis symptoms, next step is ???

A

Laparoscopy

177
Q

Corticosteroid tx of lung immaturity is limited in use to b’wn ?? - ?? wks, and requires ?? - ?? hrs to have max effect.

A

24-34 wks; 24-48 hrs (so no use in urgent/emergency deliveries)

178
Q

Psychiatric condition in which a woman presents with several signs of pregnancy but physical exam is normal and urine pregnancy test is negative

A

Pseudocyesis

179
Q

When Rx Bactrim, must assess for pregnancy because of risk of ???

A

Neural tube defects (trimethoprim is folic acid antagonist)

180
Q

Patients with decreased fetal movement should undergo antenatal fetal testing, starting with NST followed by ??? (If no contraindications to labor) or a ??? if NST is nonreactive.

A

Contraction Stress Test. Biophysical profile

181
Q

No fetal movement, but + fetal hear tones: evaluate with ???.
No fetal movement, no fetal heart tones: evaluate with ???.

A

NST.

Ultrasonography

182
Q

Order a ??? to Dx acute appendicitis of pregnancy

A

US

183
Q

When moisturizers/lubricants fail to work, ??? is tx of choice for atrophic vaginitis

A

Vaginal estrogen

184
Q

??? typically presents with abdominal pain, cervical and adnexal tenderness, lightheadedness, hemodynamic instability, and amenorrhea.

A

Ruptured ectopic pregnancy

185
Q

??? is thought to result from abnormal placentation, triggering systemic inflammation and activation of the coagulation system and complement cascade.

A

HELLP Syndrome

186
Q

Vaginal CA: squamous cell commonly presents in the ??? of the vagina, whereas clear cell adenocarcinoma commonly present in the ???.

A

Upper 1/3 of posterior vaginal wall. Upper 1/3 of anterior vaginal wall.

187
Q

Agent of infection for postpartum endometritis is likely ???

A

Polymicrobial

188
Q

Tx of choice for endometritis is ??? and ???

A

Clindamycin and Gentamicin

189
Q

Re-current spontaneous abortions necessitates further workup, including ???

A

Hypercoagulability panel (factor V Leiden)

190
Q

Tx for postpartum endometritis?

A

Clindamycin and gentamicin

191
Q

Pharm agents for Tx of gestational HTN

A

Labetalol, hydralazine, methyldopa, nifedipine

192
Q

Bleeding: placenta previa vs. placental abruption

A

Painless, bright red vs. Painful, dark red

193
Q

During pregnancy, it is common to develop a compensated ??? alkalosis

A

Respiratory

194
Q

Pt with amenorrhea and anosmia (can’t smell): likely dx?

A

Kallmann Syndrome (46 XX, normal internal reproductive organs)

195
Q

External cephalic version can be performed between ??? and ???

A

37 weeks - onset of labor

196
Q

Important side effects of combined OCPs

A

HTN, VTE, increased triglycerides, increased risk of cervical CA

197
Q

HTN during pregnancy carries risks of ???

A

Placental abruption, IUGR, preterm birth, cesarean delivery, superimposed preeclampsia

198
Q

Painless vaginal bleeding with fetal deterioration that is preceded by ROM is most likely due to ???

A

Vasa previa

199
Q

Medical treatment options for acute abnormal uterine bleeding?

A

High dose Estrogen, combo OCP, progestin, Tranexamic acid (for pts with contraindications to estrogen/progestin)

200
Q

Etiology of amenorrhea in women athletes?

A

Decreased LH and GnRH, causing estrogen deficiency

201
Q

Tx for candida vulvovaginitis

A

*topical Nystatin or oral Fluconazole

202
Q

Quadruple screen results of a trisomy 18 fetus?

A

Normal inhibin, decreased aFP/hCG/estriol

203
Q

Test used to determine the dose of Rh Ig to prevent Rh sensitization?

A

Kleihauer-Betke

204
Q

Mild/unilateral midcycle pain due to normal follicular enlargement?

A

Mittelschmerz

205
Q

Acute onset of unilateral pelvic pain after strenuous activity of sexual intercourse; Pelvic US shows ovarian mass with free fluid. Dx?

A

Ovarian cyst rupture

206
Q

Pathophysiology of primary dysmenorrhea

A

Release of prostaglandins from endometrium causes uterine contractions

207
Q

Newborn with small body size, microcephaly, hypoplasia of the distal phalanges, excess hair and cleft palate. Mom probably was using ??? during pregnancy

A

Phenytoin

208
Q

A GnRH stimulation test is used to evaluate for ???

A

Precocious puberty

209
Q

Pt’s nucleic acid amplification test returns + for Chlamydia and - for Gonorrhea. Pt is still asymptomatic. Tx?

A

Single dose azithromycin or 7 days of doxycycline (if screen for Gono is -, no tx for Gono)

210
Q

Vaginismus tx?

A

Relaxation, Kegels, desensitization via insertion of objects of gradually increasing size.

211
Q

Most accurate method of determining GA?

A

1st trimester US with crown-rump length

212
Q

Pear-shaped motile organisms on wet-mount?

A

Trichomonas

213
Q

Asymmetric FGR is due to ??? factors, whereas symmetric FGR is due to ??? factors

A

Maternal; fetal

214
Q

Turner syndrome pts have low estrogen levels due to ???, and high ??? levels due to lack of negative feedback.

A

Ovarian dysgenesis; FSH

215
Q

A L/S ratio < ???, indicates lung prematurity

A

2

216
Q

Infertility 2/2 PCOS is likely due to ???

A

Anovulation

217
Q

Most effective emergency contraceptive?

A

Copper IUD (99% efficacy)

218
Q

Emergency contraception options within 3-5 days after intercourse?

A

Copper IUD and Ulipristal pill

219
Q

???-sided adnexal torsions are more common due to longer utero-ovarian ligament on that side

A

Right

220
Q

Marked pruritus, elevated bile acids and liver enzymes. No jaundice. Dx?

A

Intrahepatic cholestasis of pregnancy (AFLP won’t have itching, will have jaundice)

221
Q

Screening tests for Syphillis? Confirmation test?

A

VDRL & RPR; dark field microscopy or FTA-ABS.

222
Q

Tx of choice for Syphillis in pregnancy

A

Penicillin

223
Q

In secondary amenorrhea, after negative pregnancy test what is next best test to order? If negative, then what?

A

Serum prolactin and TSH (to R/o prolactinoma or hypothyroidism).
FSH/LH to r/o ovarian failure or hypothalamic pituitary disorders

224
Q

Patients in preterm labor <34 wks should receive 3 meds?

A

Tocolyitc (CCB), mag sulfate, steroids.

225
Q

Arrest of labor in the 1st stage is Dx when dilation is >/equal to 6cm with ROM and 1 of following:

A

No cervical change for > 4 hours despite adequate contractions. Or
No cervical change for > 6 hours with inadequate contractions

226
Q

Elevated MSaFP is seen with what fetal abnormalities?

A

Neural tube defects, gastroschisis, omphalocele, multiple gestations.

227
Q

Preferred hormonal contraception for lactating moms?

A

Progestin-only OCPs

228
Q

Test of choice for Dx of ectopic pregnancy when b-hCG levels at 1500-6500?

A

Transvaginal US

229
Q

Endometrial hyperplasia without atypia, Tx?

A

Progestin therapy

230
Q

Endometrial hyperplasia with atypia, tx?

A

If considering future pregnancy = progestin therapy. If no pregnancy plans = hysterectomy

231
Q

T/F: B/l gonadectomy is recommended before puberty in androgen insensitivity pts to decrease risk of gonadal malignancy.

A

False, it’s recommended after puberty.

232
Q

In most hypothyroid pts who become pregnant, the levothyroxine dose is ???

A

Increased

233
Q

Tx for infertility in a PCOS pt?

A

Clomiphene citrate

234
Q

Raloxifene is contraindicated in pts with h/o ???

A

DVT

235
Q

Oligohydramnios is defined by an AFI < ?? cm. polyhydramnios has an AFI > ?? cm.

A

5 cm; 24 cm

236
Q

Smoking protects against ??? cancer

A

Endometrial

237
Q

Tests to differentiate maternal blood from fetal blood?

A

Apt test and Kleihauer-Betke test

238
Q

Stress incontinence is due to?

A

Weak pelvic floor muscles

239
Q

Continuous GnRH therapy induces ???, whereas Pulsatile GnRH therapy induces ???

A

Anovulation/Amenorrhea; Ovulation

240
Q

Hyperemesis gravidarum may cause volume depletion and loss of gastric acid, leading to a ??? Alkalosis

A

Metabolic

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