Brainscape's Knowledge GenomeTM

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


See full index

(1) Sara > OBGYN > Flashcards

OBGYN Flashcards

1
Q

when would you NOT treat fibroma w uterine artery embolization

A

pt wanting to get pregnant in future

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

key difference between uterine fibroid vs endometrial polyp

A

fibroid= MC in AA, “lumpy”/irregular/enlarged uterus on palpation
endometrial polyp= not palpable

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

postmenopausal uterine bleeding

A

endometrial cancer until proven otherwise

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

post-coital bleeding

A

MC presentation of cervical cancer

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

management of post-op fever

A

expectant - cytokine-mediated, 48 hours post-op

*after 48 hours: CBC, inspection of wound, full rectovaginal exam

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

first step in management of suspected domestic abuse

A

ask open-ended and nonjudgmental questions

once abuse is confirmed, then you can provide them with resources for victims

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

primary ovarian insufficiency
dx/tx

A

dx:
menopause (1 year w/o menses) in < 40yo + postmenopause range FSH (>40)

tx:
HRT (estrogen)

*risk of osteopenia/porosis without HRT*

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

increased risk of (three) with E/P combined hormone therapy

A

breast cancer
ischemic stroke
myocardial infarction

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

MCC pituitary adenoma

A

lactotroph adenoma - hyperprolactinemia

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

absolute contraindication to vaginal delivery with complete breech

A

absence of easily accessible OR

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

permanent treatment for severe uterine prolapse

A

colpocleisis – vaginal walls sewn together

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

treatment for cystocele vs rectocele

A

ant vag wall defect - anterior colporrhaphy
post vag wall defect - posterior colporrhaphy

reinforce/strengthen wall

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

uterine blood supply

A

aorta -> ovarian a (w/in suspensory ligament of ovary)

internal iliac a -> uterine a + vaginal a

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

screening indicated for BRCA-1/-2 positive

A

@ 25yo
1-2 clinical breast exams q1 year
1 mammogram q1 year

@ 30yo
1 MRI q1 year
2 CA-125 q1 year

**everyone should do self breast exam @ 18yo+

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

safe anti-HTN in pregnancy (4)

A

methyldopa
CCB- nifedipine
hydralazine
labetalol

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

what happens to kidneys during preg

A

inc GFR (renal protection)

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

when is ASA indicated in preg

A

when pt has inc risk of preeclampsia

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

4 steps of puberty in females in order

A

thelarche
pubarche
growth spurt
menarche

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

McCune-albright triad

A

precocious puberty (before 8yo)
fibrous bone dysplasia
cafe-au-lait spots

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

acceleration definition

A

< 32 WGA: 10x10

> 32 WGA: 15x15

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

what to do next when no accelerations?

A

fetal scalp stimulation
if acceleration occurs, fetal hypoxia/acidosis are ruled out

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

first step in managing postmenopausal bleeding ALWAYS

A

endometrial bx

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

combination vs estrogen-only hormone replacement

A 
combination= women w/ uterus 
estro-only= women w/o uterus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

scarred skin
chorioretinitis
limb hypoplasia

A

congenital varicella
< 20 WGA

Horner’s syndrome
cataracts
low birth weight
cortical atrophy
microcephaly

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

when is Tdap given

A

27-36 weeks

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

pre-term

A

< 37 weeks

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

post-term

A

> 42 weeks

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

early-term

A

37.0 - 38.6

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

full-term

A

39.0 - 40.6

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

late-term

A

41.0 - 41.6

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

low birth weight
ventriculomegaly
hearing impairment
periventricular calcification

A

CMV

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

PDA
hearing impairment
purpuric/petechial rash

A

rubella

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

intracranial calcifications
disseminated purpuric rash
seizure

A

toxo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

anemia
high output heart failure
cardiomyopathy

A

parvo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

inc nuchal translucency

A

inc NT = inc risk aneuploidy

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

diagnostic test for chromosomal defect

A

chorionic villous sampling @ 10-14 weeks
or
amniocentesis @ 15 weeks

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

painless bleeding in 2nd/3rd trimester

A

placentra previa
transabdominal U/S, then transvaginal U/S

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

when is color doppler U/S indicated

A

placenta accreta (placental villi attached to myometrium instead of decidua)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

continuous external fetal cardiotocography indications (3)

A

suspected growth restriction
maternal T1 DM
preeclampsia

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

normal fetal heart rate range

A

110-160 bpm

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

decelerations

A

> 15 bpm decrease for > 15 seconds

indicates fetal compromise

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

early vs late decelerations

A 
early= begin when contraction begins, ends when contraction ends 
late= begin when contraction peaks, ends after contraction ends
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

when is MTX indicated for management of ectopic pregnancy

A

hemodynamically stable
b-HCG < 5,000
no fetal heart tones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

when to give second dose of MTX in management of ectopic pregnancy

A

if beta-HCG difference between day 4 and day 7 is < 15%

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

> 20 weeks gestation w sudden-onset:
vaginal bleeding
abd pain
back pain
uterine contractions

A

placental abruption (incomplete or complete separation from decidua)

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

placenta previa vs. abruption:
diagnostic method
delivery options
digital cervical exam

A

diagnosis
previa= U/S
abruption= clinical diagnosis, (but would still do U/S during initial workup of > 20 WGA bleeding to rule out PP)

delivery
previa= requires C/S
abruption= does not require C/S

digital exam
previa= abs contraindi
abruption= not contraindi

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

< 20 WGA
vaginal bleeding
U/S shows viable fetus

A

threatened miscarriage

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

< 20 WGA
vaginal bleeding
no abd pain
U/S shows hypo-/an-echoic crescent-shaped area behind fetal membranes

A

subchorionic hematoma

inc risk of:
abruption,
preterm labor

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

top three breast masses in women < 30 yo

A

fibroadenoma= MCC= glandular + fibrous tissue (smooth, rubbery, mobile, solid)
breast cyst
fibrocystic change= luteal phase, caffeine

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

initial workup for breast mass in
< 30 yo
> 30 yo

A

< 30= U/S
> 30= U/S + mammo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

when is IV iron supplement indicated (3) during preg

A

2nd or 3rd tri
oral not effective or not tolerated
severe anemia (hgb @ 8-10)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

asymptomatic thrombocytopenia in preg

A 
immune thrombocytopenia (ITP)= plt \< 100,000 
tx= steroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

initial serum test for PCOS

A

androgens/testosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

false vs latent labor

A

false (braxton hicks)= contractions diminish, < q8 minutes, no cervical change

latent (first stage of active labor)= contractions intensify, > q5 minutes, cervical change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

von willebrand dz
prothrombin deficiency

A

bleeding tendency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

factor V leiden mutation
antithrombin III deficiency

A

clotting tendency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

triple test of breast mass

A

clinical exam
imaging
biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

biopsy of choice for breast mass

A

if solid -> core needle biopsy
if bloody on FNA -> excisional bx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

first trimester weeks

A

weeks 1-13

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

second trimester weeks

A

weeks 14-26

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

third trimester weeks

A

weeks 27-40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q 
AFP= dec 
estriol= dec 
hCG= dec 
inhibin-a= same
A

trisomy 18

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q 
AFP= dec 
estriol= dec 
hCG= inc 
inhibin-a= inc
A

trisomy 21

“HI”= high hCG & inhibin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q 
AFP= inc 
estriol= same 
hCG= same 
inhibin-a= same
A

open neural tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

thyroid in first trimester

A

estrogen -> inc TBG
hCG mimics TSH -> dec TSH + inc T3/T4

total thyroid hormone= inc
free/active thyroid hormone= unchanged

*similar process w sex hormone binding globulin and androgens/testosterone during preg*

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

female @ puberty
no ovaries, blind vaginal pouch
normal breasts, no pubic/axillary hair
high serum testosterone

A

androgen insensitivity syndrome
genotypic male

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

female
no uterus, shallow vaginal pouch
normal breasts, pubic hair
normal ovaries
normal serum testosterone

A 
mullerian agenesis (mayer-rokitansky-kuster-hauser) 
geno-/pheno-typic female
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

anosmia

A 
kallman 
zero GnRH (zero LH, FSH, testo/estro) 
XX= primary amenorrhea, no breasts, no pubic hair, normal mullerian structures (vagina, cervix, uterus)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

PAP/HPV screening frequency

A

21-30yo: PAP+HPV q3 years
30-65yo: PAP q3 years, or PAP+HPV q5 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

cold knife colonization of cervix indications (2)

A
  1. CIN III
  2. cervical lesion extending into endocervical canal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

pre-eclampsia definition

A

proteinuria > 0.3g/day
HTN > 140/90
WGA > 20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

rib notching on CXR +
BP in UE >>> BP in LE

A

coarctation of aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

colposcopy indications (3)

A

HSIL
LSIL
ASCUS w/ HPV++++

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

adnexal mass
abnormal uterine bleeding
uterine hyperplasia

A 
granulosa cell tumor 
produces estrogen (-\> uterine hyperplasia -\> inc risk of endometrioid cancer type I)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

cells w scant cytoplasm
coffee bean nuclei
arranged in rosettes w central clearing

A

call-exner bodies
granulosa cell tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

clear cell carcinoma of ovary most characteristic risk factor

A

endometriosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

mittelschmerz

A

sudden-onset
mid-cycle pain
U/L to ovarian follicle that has ruptured during ovulation
no other acute abd findings (dx of exclusion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

postpartum hemorrhage definition + management

A

> 500mL blood post-vaginal delivery
> 1,000mL blood post-C/S

MCC= uterine atony (soft/boggy uterus) 
management= bimanual uterine massage; if unsuccessful, admin oxytocin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

PGE1 analog

A

misoprostol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

goserelin, leuprolide MOA

A

GnRH agonist
indicated for central precocious puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

umbilical cord prolapse management

A

immediate C/S
while awaiting delivery, elevate fetal presenting part to reduce pressure in prolapsed cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

MC sign of umbilical cord prolapse

A

bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

diagnosis of inflammatory breast cancer

A

diagnostic mammogram and/or U/S
previously normal mammos (develops in 6 months)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

large, obstructing genital warts inc risk of

A

dystocia (large enough to obstruct birth canal)
indication for C/S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

parchment-like labia tx

A

clobetasol
lichen sclerosus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

baby with maculopapular rash
“snuffles”
LAD
HSM
hemolysis

A

treponema pallidum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

indication for D&C in pt with prolonged heavy menstrual bleeding

A

hemodynamic instability (hypotension, hgb < 7) + IV estrogen

in stable pt: combined OCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

MCC irregular bleeding < 21yo

A

anovulatory cycle= physiologic in adolescents!

(failure to produce corpus luteum, which makes progesterone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

clomiphene citrate

A

indicated for infertility secondary to PCOS
SERM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

endodermal sinus tumors secrete

A

AFP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

dysgerminomas secrete

A

LDH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

choriocarcinomas secrete

A

hCG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Mullerian malignancies of ovaries secrete

A

CA-125

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

histo: glomeruloid structures with nuclei palisading around capillaries

A

shiller-duval bodies
endodermal sinus tumor aka yolk sac tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

histo: syncytiotrophoblasts and cytotrophoblasts

A

choriocarcinoma
ass. w molar preg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

histo: central nucleus with cytoplasm around it, “fried egg” like

A

dysgerminoma in F
seminoma in M

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

histo: eosinophilic/red intracytoplasmic inclusion

A

“reinke crystals”
leydig or sertoli-leydig tumor
secrete testosterone

98
Q

velvety red vulvar lesion w white plaques

A

paget’s dz of bartholin glands

99
Q

DES exposure causes which 3 cancers

A

vaginal adenocarcinoma
embryonal rhabdomyosarcoma
clear cell carcinoma

100
Q

cysts seen in molar pregnancy

A

theca lutein

101
Q

MCC elevated AFP

A

error in gestational age

102
Q

levonorgestrel

A

plan B

103
Q

AE: oral bisphosphonates

A

esophageal burning

104
Q

AE: IV bisphosphonates and denosumab

A

osteonecrosis of jaw

105
Q

vaccines for preg and HIV+

A

Tdap
inactivated influenza
Hep A
Hep B

106
Q

weight gain based on pre-conception BMI

SINGLETON- underweight, normal, overweight, obese

TWINS- normal

A

SINGLETON

UNDERWEIGHT= 28-40lbs

NORMAL= 25-35 lbs

OVERWEIGHT= 15-25lbs

OBESE= 11-20 lbs

TWINS

NORMAL= 37-54 lbs

107
Q

trichloroacetic acid

A

initial tx for condyloma acuminata in preg woman

108
Q

@ 15 WGA, fetal growth: ___ grams/day

@ 20 WGA, fetal growth: ___ grams/day

@ 32-34 WGA, fetal growth: ___ grams/day

A

15 WGA= 5 grams/day

20 WGA= 10 grams/day

32-34 WGA= 15 grams/day (???? unsure)

109
Q

therapeutic abortion < 10 WGA

A

mifepristone + misoprostol

110
Q

therapeutic abortion @ 10-14 WGA

A

D&C

111
Q

therapeutic abortion > 14 WGA

A

D&E

112
Q

bx for solid vs cystic breast mass

A 
solid= core needle bx 
cystic= FNA
113
Q

common complication of hysterectomy

A

urinary incontinence

114
Q

mechanism underlying symptoms of menopause

A

hormonal effects of anovulation

115
Q

3 elevated serum markers in acute phase HBV infection

A

HBsAg, HBeAg, anti-HBc IgM

window period= no anti-HBsAg or HBsAg, only anti-HBc

**ON EXAM: cannot have elevated anti-HBsAg and HBsAg at same time

116
Q

conjugated estrogens + progestins

A

turner syndrome

117
Q

leuprolide pre-surgical indication

A

reduce fibroids prior to surgery

118
Q

bromocriptine
cabergolin

A

DA agonists for hyperprolactinemia (d/t microprolactinoma, < 10 mm diameter)

*DA= prolactin-inhibiting factor*

119
Q

when to initiate antiviral therapy in HBV+ mom

A

only when viral load > 1,000 and/or signs of acute liver impairment

telbivudine or tenofovir (tenofovir also tx maternal HIV)

120
Q

most common complication FOR MOM forceps-assisted vaginal delivery

A

perineal laceration

121
Q

holoprosencephaly
single eye (cyclopia) or nose
cystic hyogroma

A

trisomy 13

122
Q

choroid plexus cyst
congenital diaphragmatic hernia
rocker bottom feet
clenched fists
overlapping digits

A

trisomy 18

123
Q

when is gestational DM screened for and why

A

24-28 WGA
placenta produces enough human placental lactogen at this time to cause insulin resistance

124
Q

congenital GnRH deficiency

A

Kallman
amenorrhea + anosmia

125
Q

mullerian agenesis

A

Mayer-Rokitansky-Kuster-Hauser syndrome

126
Q

androgen insensitivity

A

46, XY
x-linked recessive
female external genitalia
no axillary or pubic hair

127
Q

MCC hypergonadotropic hypogonadism

A

turner

128
Q

hypothalamic hypopituitarism

A

female athlete triad

129
Q

pathogenesis of preeclampsia

A

cytotrophoblast cells fail to migrate to spiral arteries -> insufficient spiral artery transformation/expansion @ 18-20 WGA -> PLACENTAL hypoperfusion

130
Q

cervical cytology vs biopsy

A 
cytology= pap; ASCUS, LSIL, etc; examines CELLS 
biopsy= CIN I-III, invasive cervical cancer; examines TISSUE
131
Q

initial management of visible lesion on cervix

A

always biopsy (not cytology)

132
Q

tx for syphilis in pregnant pt w PCN allergy

A

PCN desensitization -> IM PCN G
non-preg tx= alt abx (erythromycin, tetracycline)

133
Q

lower pelvic pain + mucopurulent discharge + cervical motion tenderness

A

PID

134
Q

inc estrogen, inc LH, dec FSH

A

PCOS

135
Q

inc LH, inc FSH, dec estrogen

A

turner

136
Q

hyperprolactinoma -> LH, FSH, estro levels?

A

dec LH, dec FSH, dec estrogen

137
Q

dec LH, dec FSH, inc estrogen

A

granulosa-theca tumor, OR
exogenous estrogen

138
Q

when is endometrial bx indicated in pre-menopausal (< 45 yo) - three

A

persistent abnormal uterine bleeding in setting of:

  • obesity or anovulation - unopposed estrogen
  • failure to respond to previous medical tx
  • high risk for endometrial CA
139
Q

three hematologic considerations for heavy menses

A

VWD, plt dysfunction, immune thrombocytopenic purpura

140
Q

next step in managing symptomatic pt with positive 1hr GTT

A

give diagnosis (GDM) + lifestyle modifications

3hr GTT in asymptomatic w pos 1hr GTT

141
Q

first-line med for GDM

A

insulin
second-line is glyburide

142
Q

fasting and 2hr PP glucose cutoff in preg pt

A

normal=
fasting < 95
2hr PP < 120

143
Q

three factors influencing pap testing frequency and/or testing over 65yo

A

hx of HIV/HPV diagnosis
hx of cervical cancer
cervical dysplasia

144
Q

smoking cessation tx

A

buproprion

145
Q

placental abruption w > 50% separation of placenta from uterine wall -> MC complication?

A

DIC

146
Q

MC neonatal complication of vacuum-assisted delivery

A

cephalohematoma -> JAUNDICE

147
Q

medication-induced hirsuitism

A

phenytoin, danazol

148
Q

pregestational (first tri) diabetes causes

A

caudal regression syndrome
endocardial cushion defects and/or VSD

149
Q

gestational (2nd and 3rd tri) diabetes causes

A

diabetic fetopathy (hyperglycemia-induced hyperinsulinemia)

in utero:

  1. macrosomia: insulin acts like growth hormone, using mom’s sugar to build
  2. hypoxia: inc insulin -> inc BMR-> using up all oxygen
  3. polyhydramnios (leading to PPH, cord prolapse, PROM)

neonatally:

  1. hypoglycemia: insulin without mom’s sugars
150
Q

next step in managing PPROM w unknown WGA

A

fetal biometry - estimate WGA in second/third tri
biparietal diameter, femur length, humerus length, abd circumference

151
Q

dating method in first tri

A

CRL

152
Q

HCG produced by ___ cells and peaks at ___

A

trophoblasts; 8-11 WGA

153
Q

four conditions where hx of condition is greatest RF for recurrence

A

ectopic preg
preterm labor
shoulder dystocia
preeclampsia

154
Q

two findings on mammo suspicious for cancer

A
  1. microcalcifications, especially linear (irregular more likely benign)
  2. spiculated, irregular soft tissue mass

A spiculated mass is a centrally dense lesion seen on mammography with sharp lines radiating from its margin.

155
Q

hx suspicious for PID + presenting w mucopurulent discharge and signs of sepsis

A

ruptured tuboovarian (fallopian tube or ovary) abscess - d/t untreated PID - emergent surgery

156
Q

hysterosalpingogram showing uniform uterine filling and symmetric bilateral spillage

A

NORMAL
spillage of dye from fallopian tubes into peritoneum

157
Q

uterine synechiae

A

intrauterine adhesions - when symptomatic= Ashermann syndrome

158
Q

HNPCC (Lynch) inc risk of which cancer

A

endometrioid CA

159
Q

endometriosis inc risk of which cancer

A

ovarian CA

160
Q

bisphosphonate AE

A

esophageal ulcer
esophagitis
osteonecrosis of jaw

161
Q

-dronic acid/-dronate

A

bisphosphonate

162
Q

osteoporosis T-score

A

< -2.5 = osteoporosis

163
Q

prolonged retention of tissue after intrauterine fetal demise ->

A

DIC

164
Q

uterotonics- three

A

misoprostol - PGE1 analog
carbaprost - PGF2-alpha analog - CI in asthma
methylergonovine - ergot alkaloid - CI in HTN

165
Q

lochia

A

superficial endometrial decidua tissue
begins as bloody -> turns pinkish/watery
lasts = 6 weeks PP

166
Q

when can twins undergo trial of vaginal delivery

A

only when DIAMNIOTIC with presenting fetus in VERTEX

167
Q

prevention of transmission to fetus when mom is HBsAg+/IgG anti-HBcAg+ (chronic infection)

A

immediately after birth, baby gets HBV immune globulin & HBV vaccine

168
Q

flunitrazepam
gamma-hydroxybutyrate

A 
flunitrazepam= roofie 
gamma-hydroxybutyrate= unspecific date rape drug

both cause amnesia

169
Q

most important aspect of PE in sexual assault victim

A

photographs!!

170
Q

when to diagnose anemia in preg

A

first/third tri= hgb < 11
second tri= hgb < 10.5

171
Q

RBC & WBC levels in preg

A

RBC increase - MCV increases (young RBCs are largest)
WBC increase - esp neutrophils

172
Q

pregnancy is ___-coagulable state

A

HYPERCOAGULABLE - inc fibrinogen

173
Q

infant with lethargy, temp instability, hypoxia, poor perfusion, hypotension, resp distress

A

neonatal sepsis

174
Q

indications for intrapartum antibiotics in GBS-unknown

A

PROM
prolonged rupture of membranes (>18 hours)
fever

+/- ssx of chorioamnionitis

175
Q

“failure of germ cell meiosis” describes pathogenesis of

A

teratoma

176
Q

risk factor for endometriosis based on the most likely pathogenesis

A

anterograde outflow obstruction= inc risk of developing endometriosis

177
Q

rotterdam criteria for diagnosis of PCOS

A

*requires 2/3*

  1. oligo-/an-ovulation
  2. hyperandrogenism (measure serum testosterone)
  3. polycystic ovaries
178
Q

HPV 6/11 cause

A

benign warts/condyloma accuminata
respiratory papillomatosis

179
Q

APGAR components

A

@ 1 and 5 minutes
appearance, pulse, grimace, activity, respiration

heart rate (\>100, \<100, 0) 
respiratory effort (reg, irreg, none) 
muscle tone (active, moderate, limp) 
reflex irritability (crying, whimpering, silent) 
color (pink, extremities blue, totally blue)

> 7= normal
< 6= further evaluation

180
Q

twins separating @ 0-72 hours

A

dichorionic/diamniotic

181
Q

twins separating @ 4-8 days

A

monochorionic/diamniotic
MOST COMMON

182
Q

twins separating @ 8-12 days

A

monochorionic/monoamniotic

183
Q

twins separating @ > 13 days

A

conjoined

184
Q

why are NSAIDs CI in preg

A

risk of premature closure of ductus arteriosus in third tri

185
Q

one indication for all three drugs

indomethacin, nifedipine, mag sulfate

A

tocolysis??

186
Q

where is puberty initiated

A

hypothalamus - GnRH

187
Q

first step in managing 38 WGA with clear fluid leaking from vag, without cervical change

A

confirm that the fluid is amniotic fluid!!

188
Q

biophysical profile

A

fetal tone, fetal movement, fetal breathing, amniotic fluid

189
Q

biophysical profile 4/10 at >/= 32 WGA

A

DELIVERY

190
Q

GBS prophylaxis in - three settings

A
  1. preterm w unknown GBS status
  2. previous infant affected by GBS
  3. GBS bacteriuria anytime during pregnancy
191
Q

percentile at which infants are “large for gestational age”

A

>/= 90th percentile

192
Q

absent grasp reflex

normal biceps and radial reflex

A

klumpke palsy/claw hand deformity (C7-T1)

193
Q

erb duchenne palsy

A

C5-C6

194
Q

brachial plexus injury RF - 8

A
  1. multiparity
  2. LGA infants (>/= 90%ile)
  3. maternal DM
  4. breech presentation
  5. previous child w birth-related brachial plexus injuries
  6. shoulder dystocia
  7. prolonged 2nd stage labor (NOT 1st stage)
  8. vacuum or forceps assisted delivery
195
Q

amsel criteria for diagnosing BV

A
  1. positive whiff test (using KOH)
  2. vaginal pH > 4.5 (lactobacilli normally produce lactic acid, creating acidic enviro around pH 3.8-4.2)
  3. clue cells on saline microscopy
  4. thin, homogenous discharge coating vaginal walls
196
Q

according to comquest, when should mammo screening begin

A

age 50, then q2 years

197
Q

four questions to ask for any OB w contractions

A

contractions

vaginal bleeding

vaginal clear fluid

fetal movement

198
Q

first step in managing previously healthy pt w irreg menses and infertility

A

evaluate for ovulation:

cycle day 21 progesterone

FOLLICULAR –> LH surge –> ovulation (day 14) –> LUTEAL –> inc progesterone (day 21) –> inc basal body temp

199
Q

preg pt w vaginal bleeding + abd/low back pain + firm/tender uterus

DX

RF- 7

COMPLICATIONS- 3

A

placental abruption (separation of placenta from uterus prior to delivery)

RF: abd trauma, cocaine, HTN, polyhydramnios, multiparity, AMA, smoking

inc risk for: maternal hemorrhage, DIC, fetal death

200
Q

placental villi invasion –>

to superficial endometrial decidua basalis

to deeper endometrial decidua basalis

to myometrium

thru uterine serosa +/- bladder

A

NORMAL: to superficial endometrial decidua basalis

PLACENTA ACCRETA: to deeper endometrial decidua basalis

PLACENTA INCRETA: to myometrium

PLACENTA PERCRETA: thru uterine serosa +/- bladder

201
Q

next step in managing a pt measuring at WGA > LMP

and severe N/V

A

TVUS

**b-hCG only to confirm preg**

consider multiple gestation preg!!

202
Q

hCG > 1500 w/out evidence of intrauterine pregnancy

A

ectopic

203
Q

MC delayed complication of D&E

A

delayed= > 72 hours

most common= post-abortal endometritis

*pts given doxycycline before surgery*

204
Q

management of severe preeclampsia

A

immediate induction of labor to reduce risk of maternal death

205
Q

eclampsia inc risk of fetal

A

intrauterine demise – d/t hypoxia

206
Q

important allergies in surgical patients

A

latex (gloves, indwelling catheters)

iodine/betadine (pre-op antimicrobial)

207
Q

STD screening recommendation

A

women < 24 yo who have been sexually active before:

NG/CT and HIV testing annually

208
Q

when should you expect and how should you diagnose Rh alloimmunization in Rh (-) primip with potential Rh (+) baby

6 examples

A

whenever fetal blood may have come into contact with mom’s blood!!

TRAUMA, placenta previa, placental abruption, spontaneous AB, threatened AB, intrauterine procedures

209
Q

non-immune causes of hydrops fetalis - 4

A

lymphatic obstruction

obstructed venous return

hepatocellular dz

fetal infection – parvo B19

210
Q

methods for decreasing vertical HIV transmission

A

C/S when viral load > 1,000

baby: oral zidovudine for 6 weeks (regardless of mom’s viral load)
mom: IV zidovudine (only if vaginal delivery)

211
Q

severe maternal anemia (hbg < 6) is RF for

A

preterm delivery

212
Q

intrauterine adhesions secondary to D&C inc risk of - 3

A

dec flow/amenorrhea

cyclic pelvic pain

infertility (MOST COMMON), recurrent preg loss

213
Q

amenorrhea due to uterine synechiae

A

uterine synechiae= IU adhesions

Asherman’s Syndrome

214
Q

17-hydroxyprogesterone caproate

A

indication: pt w hx of preterm delivery –> reduce risk of preterm delivery in subsequent preg

215
Q

enterocele vs rectocele

A

enterocele= (small bowel) prolapse thru vaginal apex ***common in s/p total hysterectomy

rectocele= prolapse thru posterior vaginal wall

216
Q

darifenacin

tolterodine

oxybutynin

A

anticholinergics, muscarinic antagonists @ bladder

treat urge incontinence

217
Q

CFU when bacteriuria is diagnosed

A

> 100,000

218
Q

why is TMP/SMX contraindicated in preg

A

folic acid antagonist – developmental defects in first tri

219
Q

treatment of choice for fibroids in pt who desires future preg

A

myomectomy

leuprolide may be used to shrink fibroids, but contraindicated in women trying to conceive

continuous GnRH analog –> artificially induced menopause, aka infertility

220
Q

PALM-COEIN for abnormal uterine bleeding

A

polyps

adenomyosis

leiomyoma

malignancy

coagulopathy

ovulatory dysfunction – menarche, perimenopause, endocrinopathies

endometrial

iatrogenic

not yet specified

221
Q

BMI range for:

underweight

normal

overweight

obese

A

BMI

< 18.5 = underweight

18.5-24.9 = normal

25-29.9 = overweight

> 30 = obese

222
Q

pt with ssx mastitis/inflamm cancer

—she is breast feeding

—first step in management??

A

ABX

no need to image

223
Q

screening in pt with fhx ovarian CA

—denies fhx breast CA

A

normal screens!!

CA-125 is not used for screening, only response to therapy

224
Q

torches infections

A

TOXO

OTHER

—varicella

—syphyllis

—parvo

—listeria

RUBELLA

CMV

HSV-2

225
Q

postpartum depression meds- whats the diff

amitryptiline

paroxetine

burpoprion

sertraline

A

amitryptiline= TCA, second-line (refractory depression), CI in suicidal thoughts

paroxetine= SSRI, CI in preg (cardiac malformation)

burpoprion= CI in seizure (dec seizure threshold)

sertraline= SSRI, first line PPD

226
Q

post-meno

hx tamoxifen or pelvic irradiation

rapid uterine growth

uterine mass

—dx?

A

uterine sarcoma

requires surgery + post-op path for definitive dx

227
Q

severe pre-eclampsia management

@ 34-40 WGA

@ >40 WGA

A

@ any WGA, signs of end-organ damage -> DELIVER

@ <40 WGA:

—hydralazine, mag sulfate

—no improvement: VD

@ >40 WGA: vaginal delivery

228
Q

two causes of asymmetric IUGR

A

maternal vascular abnormalities - HTN, DM, smoking, illicit drug use

placental abnormalities

usually abd circumference (low) <<<< head circ (normal)

229
Q

caudal regression syndrome is pathognomonic for

A

**maternal PRE-gestational DM only**

poorly controlled glucose in 2nd/3rd tri= only hyperinsulinemia

230
Q

definitive diagnosis of multiple gestation preg in first tri

A

TVUS - multiple fetal poles (only way to diagnose twins or more)

231
Q

MC nerves trapped in LTCS or other gyn surgery

A

ilioinguinal/iliohypogastric @ lateral edge

232
Q

rx for pt with hot flashes and emotional lability (d/t menopause), w hx of VTE

A

paroxetine (SSRI)

second line —- clonidine (alpha 2 agonist); gabapentin; pregabalin —- venlafaxine (SNRI)

233
Q

contraindications to hormone replacement therapy

A

PMHx of breast cancer, CAD, VTE, endometrial cancer, liver dz

234
Q

38 WGA

no cervical change

fluid leaking from vag

unknown GBS

hx of previous preg complicated by GBS

FIRST STEP?

A

amniotic fluid diagnostic test!!!

premature rupture of membranes diagnosis requires

  1. subjective – hx of fluid leakage
  2. objective/PE – fluid from cervical os/pooling in vag canal
  3. confirmed amniotic fluid - pH (alkaline) or microscopy
235
Q

most significant complication of multiple gestation pregnany

A

preterm delivery

236
Q

35 WGA

N/V, fever, anorexia, abd pain (periumbilical –> RUQ)

U/S shows blind-ended tubular structure extending from R bowel that is no compressible

A

APPENDICITIS

237
Q

when is fetal organogenesis complete

A

around 8 WGA

238
Q

pt presentation sus of endometriosis

sus endometrioma in adnexa

NEXT STEP??

A

LAPAROSCOPY W/ BIOPSY - PATH DIAGNOSIS

239
Q

KLEIHAUER BETKE — WHEN? circumstances?

A

after ABD trauma – tests for placental disruption

240
Q

when is DIRECT COOMBS test relevabt

A

testing for autoimmune hemolytic anemia

— etios —

idiopathic

lymphoproliferative do - CLL, NHL

meds - cephalosporins, levodopa, methyldopa, procainamide

infection - mono, mycoplasma pneumo, HIV

241
Q

ABD trauma to preg pt —- next step in managing??

MOM: O neg, previously anti-Rh-D neg

BABY: unknown blood type

A

INDIRECT COOMBS

testing for maternal anti-Rh-D IgG

U/S can be used later to look for hydrops fetalis when Rh alloimmunization is already known to have occured

(1) Sara (4 decks)

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