Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

USMLE Step 3 > OBGYN > Flashcards

OBGYN Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
1
Q

By week _____ , fetal heart can be seen beating, BHcG: 1500, Yolk sac visualized

A

5 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

_____ is given to baby for HIV + mother on heart following delivery

A

Zidovudine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

_______ cause increases in AFP during early trimester villious/chorio/CF-DNA sampling

A

Neural tube defect, ventral wall defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

increased AFP, + acetylcholinesterase a sign of _____ during early trimester screening

A

neural tube defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

decreased AFP + estriol, increased inhibin and HcG sign of ____ during early trimester screening

A

Downs Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Decreased AFP, Estriol, Inhibin, HcG is a sign of _____ during early trimester screening

A

Edwards Syndrome (Trisomy 18) : small head, jaw, overlapping clenched fingers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Gestational Diabetes Screening (Not Just A1C) : Glucose Load Test

Screen: 50 gram load, abnormal if glucose >_____

Definitive: 100 gram load, time series of glucose measurements

Fasting: ____
1 Hour: 180
2hr: ____
3hr: 140

A

130

95

155

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When to give an RH(-) mother Rhogam for a child that’s RH (+)

1) ________, regardless
2) Post Delivery (peri window = 72hrs)
3) Miscarriage/Abortion
4) Instrumentation: Amniocentesis , CVS
5) _________

A

28 weeks

heavy vaginal bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When is trimester screening recommended, ______ age

A

35+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Minimum age for amniocentesis _____

A

15 weeks (3+ months)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Thirst Trimester Bleeding Actions

1) ______
2) Pelvic Exam

A

Abdominal/Pelvic US, if placental previa you don’t want to rupture the placenta unknowingly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

_______ cause of 3rd trimester bleeding usually results in painless bleeding, risk includes advanced age, multiple gestations, smoking/cocaine

A

Placenta Previa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Delivery Bleeding

1) ______ caused by placenta cemented to uterus
2) ______ caused by vilamentous cord insertion, umbilical vessels migrating across cervix

A

1) Placenta Accreta
Accreta: On top of myometrium
Increta : Into myometrium
Percreta : Through serosa, even into the bladder

2) Vasa Previa : Emergency C section, since fetus is affected and will become bradycardic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

If GBS (+), plan for C section, Abx needed for GBS: Y/N

A

N

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Indications for GBS treatment

1) GBS (+) Screen
2) _______
3) Maternal Fever
4) Pre-term labor

A

Extended membrane rupture >18hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Maternal toxoplasmosis treated with ______

A

Bacterim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

limb hypoplasia, microcephaly, cataract, chorioretinitis, skin lesions in newborn, caused by ________

A

Varicella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Treatment for Varicella (+) pregnant mother

1) Acyclovir
2) _____
3) Vaccine

A

IgG immunoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Treatment for neonate, if varicella suspected from maternal screen

1) ____
2) Acyclovir

A

IgG Immunoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

deafness, PDA, cataract, retardation, hepato-splenomegaly, thrombocytopenia –> blueberry muffin rash in newborn ________

A

Rubella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Two TORCH notorious for neonatal deafness

1) Rubella
2) ____

A

CMV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

microcephaly, jaundice, periventricular calcifications, chorioretinitis, hepatosplenomegaly in newborn_______

A

CMV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Mother testing (+) for CMV, treat with ______

A

IgG + Gancicyclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

_____ is a safe ART for HIV in mother and neonates. Neonates treated for ______ weeks

A

Zidovudine

6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

anemia, thrombocytopenia, hepatosplenomegaly, swollen placenta, hydrops fetalis –> hutchison teeth, mulberry molars, saddle nose, sabre shins, deafness (bone effects are late infection______ neonatal infection

A

Syphillis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

HepB post exposure prophylaxis_____

A

Vaccine + IgG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

IUGR (Growth<10th percentile on US)

A

Symmetric [Systemic : Infection, Body Structure]
Aneuploidy
TORCH
Structural : NTD, congenital heart, ventral wall defect
Dx: karyotype, infection screen

Asymmetric [Fetal Connection Structures, Maternal]
Fetus : placental abruption, twin-twin steal, vilamentous cord insertion, infarction of placenta
Maternal : HTN, malnutrition, vasculitis, drugs, fetal hypoxia
Dx; Serial sono-grams , nonstress test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

_____ is an evolution of preeclampsia, all warning sign s present (end organ damage: transaminases, RUQ, thrombocytopenia, AKI, pulm edema, headache/vision changes)

A

HELLP

Tx: Deliver (past 34 weeks) immediately

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Preclampsia with seizure____

A

Eclampsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

BP control for preclampsia

A

BP>160/110 , over control leads to lower perfusion to the fetus. Hydralazine/Labetolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Suspected PE in pregnant female, ______ test

A

VQ scan, avoid CT due to radiation exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

VSD that becomes R–> L shunt is called_____ syndrome

A

Eisenmenger syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

PE during pregnancy = ____ chance of underlying clotting disorder, therefore send anti-coag workup

A

50%

Common thrombophilia
   Antithrombin 3
   Factor 5 Leiden
   Prothrombin
   Antiphospholipid
   Hyperhomocystein
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

PE during pregnancy = ____ chance of underlying clotting disorder, therefore send anti-coag workup

A

50%

Common thrombophilia
   Antithrombin 3
   Factor 5 Leiden
   Prothrombin
   Antiphospholipid
   Hyperhomocystein
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

How much to dose adjust up for hypothyroid ______ in pregnant

A

25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

___ is indicated for preeclampsia prophylaxis among gestational diabetes patients

A

Aspirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

_____ is ok to use during pregnancy, but not breast feeding

A

Metformin, Glyburide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

_____ is a fetal syndrome associated with diabetes, not macrosomia

A

Caudal regression syndrome

  • Non development of sacrum, lower extremities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Target LS ratio for fetal lung maturity

A

2.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

nocturnal pruiritis on palms/soles, increase Tbili, dark urine among pregnant women is caused by ________

A

Intrahepatic Cholestasis of Pregnancy

Tx: Ursodeoxycholic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

______ can occur in pregnant women, in which RUQ pain, ascites, jaundice, encephalopathy

Tx: _____

A

Fatty Liver of Pregnancy

Tx: Deliver as soon as possible, as appropriate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Tx for pyelonephritis in a pregnant woman_____

A

Ceftrioxone + Gentamycin , can’t use quinolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

halperidol, risperidone, SSRI, metoclopramide are groups of medications famous for causing _____ side effect

A

Galactorrhea

  • Medication gallactorhea is typically bilateral, unilateral needs to be investigated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Treatment for fibrocystic breast changes_____

A

OCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Women>35 with first degree relative history, may do prophylaxis with _____ for breast cancer

A

Anastrazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

DCIS Treatment

1) Lumpectomy
2) Adjuvant radiation
3) _______ for 5 years

A

Tamoxifen/Anastrazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Indication for Masectomy instead of Lumpectomy

1) Size > _____
2) 2+ quadrants
3) + margins

A

5cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Indication for Adjuvant Chemo for ductal breast carcinoma

1) Size>____
2) Lymph node (+)

A

1cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Premenarchial Bleeding Lesions

1) _______
2) Pitutiary/Ovarian tumor producing estrogen

Dx: _____

A

Sarcoma Botyroides

Pelvic exam under anesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

_____ for uterine fibroid therapy increases risk of ____ during delivery

A

Myemectomy, uterine rupture

51
Q

Both endometrial hypertrophy and atrophy can cause bleeding (T/F)

A

True

52
Q

Screening pattern of downs

1) ___ AFP
2) _____ Estriol
3) ______ b HCG
4) ______ Inhibin A

A

Low, Low, high, high

53
Q

Screening pattern of Downs

1) ___ AFP
2) _____ Estriol
3) ______ b HCG
4) ______ Inhibin A

A

Low, Low, high, high

54
Q

Screening pattern of Edwards

1) ____AFP
2) ___ estriol
3) ___ BHcG
4) ____ Inhibin A

A

low, low, low, low

Pan-down

55
Q

Causes of increased AFP

1) NTD Defect
2) Ventral Wall Defect
3) Renal disease/Teratoma
4) __________

A

Twin pregnancy

56
Q

When is RhoGAM not needed in RH negative mother______

A

When anti-D antibodies are developed, and no villious sampling/amniotic, instrumentation before pregnancy

57
Q

____ is the premature separation of placenta from uterus, results in painful vaginal bleeding

A

Placental abruption , obstretric emergency ; DIC is a common complication (check fibrinogen)

58
Q

____ is a cause of painless, third trimester bleeding

A

Placenta Previa

Dx: Transabdominal US

Tx: Serial US, if 2cm away from cervical Os can do vaginal delivery

Placenta previa increases risk for placenta accreta

59
Q

Vasa previa bleed ______

A

immediate C section

60
Q

Penicillin to mother with prior child with GBS sepsis, even if GBS test negative (T/F)

A

True

61
Q

When to antibiose for GBS

1) GBS +
2) Prior child with GBS sepsis
3) Any maternal fever
4) _____

A

rupture of membrane>18 hours

62
Q

When to antibiose for GBS

1) GBS +
2) Prior child with GBS sepsis
3) Any maternal fever
4) _____

A

Rupture of membrane>18 hours

63
Q

T/F: GBS+ mother with plan for C section does not need penicillin

A

True

64
Q

TORCH infection with chorioretinitis, diffuse intracranial calcifications, hydrocephalus_____

A

Toxoplasma

65
Q

TORCH infection with limb hyoplasia, microcephaly, chorioretinitis ______

A

Varicella

  • Give Ig to child congenital OR maternal infection during pregnancy
  • If congenital, IV acyclovir to child

Varicella is a live attenuated vaccine

66
Q

Mother exposed to Rubella during pregnancy_____

A

NTD, immunize after delivery given MMR is live vaccine, also no immunoglobin available

67
Q

TORCH infection with blueberry muffin rash, cataract, PDA, deafness, retardation, hepatosplenomegaly and therefore thrombocytopenia ______

A

Rubella

68
Q

Most common cause of sensorineural deafness in children ______

A

CMV

69
Q

TORCH infection with periventricular calcification hepatosplenomegaly, chorioretinitis, IUGR_____

A

CMV

Treat mother with gancicyclovir/foscarnet, CMV Ig reduces risk of congenital infection

70
Q

Active HSV mother should be ____ for delivery

A

C section, neonatal HSV has a 50% mortality rate

71
Q

You can vaginal deliver HIV mother with RNA>1000 with appropriate triple therapy HAART (T/F)

A

False, go to C section

72
Q

Hepatitis B mother

1) Child to receive HepB Ig + Vaccien
2) May deliver vaginally T/F

A

True: As long as mother is on therapy

73
Q

Hepatitis B mother

1) Child to receive HepB Ig + Vaccien
2) May deliver vaginally T/F

A

True: As long as mother is on therapy

74
Q

When is elective C section recommended in macrosomia

A

Weight >4.5Kg in diabetic mother, >5kg in non-diabetic mother

75
Q

DVT/PE during pregnancy

Dx________

Tx______

A

VQ Scan
Low molecular weight heparin

You may anti-coagulate empirically if

1) Low EF<30% HF
2) Eisenmenger syndrome

76
Q

DM2 control in pregnant patients very strict, POC>120 requires insulin

1Hr screening clamp >_____ diagnostic

A

130 - 140

77
Q

DM2 control in pregnant patients very strict, POC>120 requires insulin

1Hr screening clamp >_____ diagnostic

A

130 - 140

78
Q

Ectopic pregnancy therapy____

A

MTX for abortion, negative U/S does not mean rule out

When in doubt, repeat BHcG/US look for doubling if normal pregnancy

79
Q

Ectopic pregnancy therapy____

A

MTX for abortion, negative U/S does not mean rule out

When in doubt, repeat BHcG/US look for doubling if normal pregnancy

80
Q

Before cerclage for cervical insufficiency 2 conditions have to be met

1) Rule out of chorioamnionitis
2) _______

A

No active labor (dilated cervix)

81
Q

Most common cause of premature rupture of membrane______

A

Chorioamnionitis

PROM: Nitrazine test (+), speculum exam with clear fluid, ferning on microscopy

If chorioamnionitis = have to deliver
if PROM without chorioamnionitis
1) Pre-term (24 - 33) weeks: Hospitalize, betamethasone + empiric antibiotics (ampicillin + erythromycin)
2) Term: Deliver

82
Q

Umbilical cord collapse : Usually due to cord compression from breech position, results in fetal bradycardia/variable decelerations
Tx:________

A

Knee chest position
Terbutaline (reduces amplitude of contraction)
C section delivery

83
Q

Umbilical cord collapse : Usually due to cord compression from breech position, results in fetal bradycardia/variable decelerations
Tx:________

A

Knee chest position
Terbutaline (reduces amplitude of contraction)
- B agonist, weirdly relaxes myometrium
- May therefore cause fetal tachycardia
C section delivery

84
Q

Tracings

1) Early decelerations = _____
2) Variable deceleration = _____
3) Late deceleration = _____

A

Head compression (perfectly synced)

Cord compression (asyncronous, narrow complex)

Late bradycardia, off sync, uteroplacental insufficiency

85
Q

Have to wait____ weeks after pregnancy before combined estrogen/progestone birth control, you can use progestin only immediately. DVT risk

A

3

86
Q

Have to wait____ weeks after pregnancy before combined estrogen/progestone birth control, you can use progestin only immediately. DVT risk

A

3

87
Q

___ are common medications promoting galactorrhea

A

Anti dopamine (haldol, risperidone, metoclopramide), SSRI

88
Q

Treatment for breast fibroadenoma____

A

N/A

89
Q

Situation where core needle breast biopsy better than FNA_____

A

Older woman, microcalcifications

90
Q

When to avoid tamoxifen_____

A

Active smoker, thromboembolism risk

91
Q

For new LCIS______

A

Surveillance +/- tamoxifen

92
Q

When is a simple cyst removed______

A

seize >10cm

93
Q

When is complex cyst removed____

A

Basically always, never do fine needle aspiration (dissemination)

94
Q

_____ is a ovarian tumor that secretes testosterone

A

Sertoli-Leydig

95
Q

_____ is a type of gastric tumor metastasizing to the ovary

A

Krukenburg, also can be CEA positive

96
Q 
HPV+ (16,18) ASCUS requires\_\_\_\_
OR
LSIL with HPV+\_\_\_\_\_\_
OR
HSIL\_\_\_\_
A

Colposcopy with ECC

97
Q

2 ASCUS + Pap smears_____

A

Colposcopy with ECC

HPV (-) can try 2 paps before colposcopy in 1 year

98
Q

If colposcopy shows CIN II, III (High Grade), micro-invasion, indeterminate colposcopy______

A

Cone biopsy/LEEP

99
Q

If CIN 1 , or CIN II,III after colposcopy, pap q _____

If repeat CIN 2, 3 or stage 1 cancer

A

6 months , may add an additional colposcopy

Hysterectomy

100
Q

Cervical cancer therapy, when to give adjuvant therapy

1) Tumor>___
2) Positive margin, or poorly differentiated
3) lymph node involvement

A

4cm

101
Q

If cervical cancer diagnosed after 24 weeks pregnancy____

A

C section delivery, then treat

if <24 weeks, should do hysterectomy and abort

102
Q

____ can cause Ca-125 elevation, but is not cancer

A

Endometriosis

Tx: OCP +/- danazol

103
Q

When to operate on prolactinoma, size>____

A

1cm

104
Q

Progestin challenge (+) means____

A

bleeding, no ovulation

105
Q

Estrogen–> progesterone challenge (+) means____

A

Inadequate estrogen to develop the lining, if (-) then look for structural causes such as ashermans, outflow tract obstructions
- hysterosalpingogram

106
Q

Treatment of PMDD____

A

SSRI

107
Q

gold standard for CAH diagnosis____

A

cosyntropin stimulation test

108
Q

Another early marker for Downs syndrome ____

A

PAPP-A

109
Q

Increase in ____, results in iron sequestration and iron deficiency anemia in pregnancy

A

Hepcidin

110
Q

_____ grows on chocolate agar

A

Neisseria Gonorrhea

111
Q

Conditions causing low AFP _____, ______

A

Downs, Edwards

112
Q

Increased AFP and ____ indicate neural tube defect

A

acetylcholinesterase activity

113
Q

Increased AFP and ____ indicate neural tube defect

A

acetylcholinesterase activity

114
Q

In a normal RH(-) pregnancy, Rhogam given at ___weeks, and within 72 hours of delivery. Anti D antibodies means mother can inactivate Rh+ so its protected

A

28

115
Q

This pregnancy complication highly associated with DIC______

A

Placental abruption (pain, bleeding)

116
Q

First step in vasa previa______

A

Emergent C Section (fetal bradycardia)

117
Q

Varicella Prophylaxis

A 
Maternal = Acyclovir + Ig , vaccine is live attenuated
Child = Acyclovir + Ig
118
Q

CMV prophylaxis

A

IgG + gangicyclovir/foscarnet

119
Q

If HIV viral load >_____, then you cannot do vaginal delivery

A

1000

120
Q

HELLP syndrome characterized by : ____, thrombocytopenia, liver enzymes,

A

hemolysis

Transfuse if Plt<20,000, ideally to 50,000 for C section

121
Q

Pulm HTn, eisenmenger, history of post partum cardimyopathy should be adviseD_____

A

not to become pregnant

122
Q

HF EF<30%, eisenmenger, Afib due to underlying heart disease are criteria for _____

A

Anticoag during pregnancy

123
Q

T/F: Diabetes also associated with neural tube defects___

A

True

124
Q

Cholestasis of pregnancy treatment______

A

Ursodeoxycholic acid (reduces cholestrol absorption, gallstone dissolution)

USMLE Step 3 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions