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Physician Assistant Exam > ObGyn > Flashcards

ObGyn Flashcards

1
Q

How is the first day of the menstrual cycle defined?

A

The first day of menstrual bleeding is the first day of the cycle

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2
Q

Rope like breast mass should make you think of what diagnosis?

A

Fibrocystic breast mass

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3
Q

What is the formula for calculating estimated date of confinement or due date?

A

First day of last menstrual period + 7 days - 3 months

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4
Q

What is the more popular term for Stein-Leventhal syndrome.

A

Polycystic ovarian syndrome

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5
Q

What is the most common cause of postpartum hemorrhage?

A

Uterine atony

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6
Q

Define procidentia.

A

Uterine prolapse beyond the the introitus

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7
Q

What is the most common infection following a C-section?

A

Metritis

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8
Q

Which reproductive cancer carries the highest rates of death in women?

A

Ovarian cancer

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9
Q

Interference with work or school is part of which diagnosis premenstrual syndrome or premenstrual dysphoric disorder?

A

Premenstrual dysphoric disorder

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10
Q

What medication(s) are used to treat a postpartum endometritis?

A

Clindamycin and gentamicin together

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11
Q

What medication can be used to control bleeding due to uterine atony?

A

Oxytocin (pitocin)

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12
Q

What are three causes for a postpartum hemorrhage?

A

Uterine atony, genital laceration, retained placenta

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13
Q

What is the term for when the placenta has implanted directly over the cervical os?

A

Placenta previa

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14
Q

What is the hallmark physical exam finding for placenta previa?

A

Trick questions - NEVER do a physical exam on someone with presumed placenta previa

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15
Q

List three risk factors for placental abruption.

A

HTN, smoking, AMA, cocaine use, PROM

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16
Q

Which is associated with painful third trimester bleeding placental abruption or placenta previa?

A

Placental abruption

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17
Q

Who is the more likely to get pre-eclampsia a nulliparous woman or a multiparous woman?

A

Nulliparity is a risk factor for pre-eclampsia

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18
Q

What is the classic triad of pre-eclampsia?

A

HTN, edema and proteinuria

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19
Q

List two medications commonly used for hypertension in pregnancy.

A

Methyldopa and labetalol

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20
Q

List three problems that gestational diabetes increases the risk for in pregnant mom and baby.

A

Preeclampsia, macrosomia (traumatic birth), slowing in fetal lung development

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21
Q

At what point during pregnancy is Rhogam given if it is needed?

A

28 weeks

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22
Q

What Rh combination for mom and dad might cause the mother to create antiboides against the babies red blood cells?

A

Mom Rh negative, Dad Rh positive

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23
Q

What are three ways you can check for ruptured membranes?

A

Ferning pattern on a slide, visualize leakage from the cervix, pooling in the vagina

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24
Q

A woman presents to the ED concerned she is in preterm labor. What treatment should you begin before even getting any imaging or lab results?

A

Give IV fluids

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25
Q

What are two tocolytic medications you should be aware of?

A

Magnesium sulfate and calcium channel blockers

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26
Q

What medication is used to increase surfactant levels and help with lung maturity if you are worried about preterm labor?

A

Betamethasone

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27
Q

Give the time frame for preterm labor.

A

20-37 weeks

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28
Q

A snowstorm appearance on ultrasound should make you think of what diagnosis?

A

Hydatidiform mole

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29
Q

Grape like vesicles or a sack of grapes on ultrasound should make you think of what diagnosis?

A

Hydatidiform mole

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30
Q

What is the medical treatment for a small ectopic?

A

Methotrexate

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31
Q

List 3 risk factors for an ectopic pregnancy.

A

Previous ectopic, scarred tubes (hx of PID or salpingitis), IUD

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32
Q

What is the most common site of an ectopic pregnancy?

A

Within a fallopian tube

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33
Q

Early on in pregnancy serial beta HCG should double over what time period?

A

every 48-72 hours

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34
Q

How many days after conception is a serum beta HCG positive?

A

8

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35
Q

Define missed abortion.

A

No vaginal bleeding, cervix is closed, products of conception are still inside

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36
Q

Define complete abortion.

A

Vaginal bleeding, cervix open, products of conception have passed

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37
Q

Define Incomplete abortion.

A

Vaginal bleeding, cervix is open, products of conception partially passed

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38
Q

Define Inevitable abortion.

A

Vaginal bleeding, cervix is open, products of conception are still inside

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39
Q

Define threatened abortion.

A

Vaginal bleeding, closed cervix, products of conception are still inside

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40
Q

What is the normal range of fetal heart rate?

A

120-160

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41
Q

What are the five components of the biophysical profile as part of antepartum testing?

A

A non stress test, fetal breathing, two gross body movements, fetal tone, amniotic fluid index

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42
Q

As part of the antepartum testing a baby has a positive stress test. What does that mean?

A

They have had two heart rate acceleratins in a 20 minute period of 15 beats above baseline for at least 15 seconds. This is good

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43
Q

What are two medications used to induce labor?

A

Cervidil (prostoglandin gel applied to the cervix) which encourages cervical rippening and oxytocin which encourages uterine contractions

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44
Q

The baby was delivered several minutes ago. Suddenly there is a increase in blood flow from the vagina and the cord noticeably lengthens. What is the most likely cause of these signs?

A

Placental separation

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45
Q

Define the third stage of labor.

A

Delivery of baby to delivery of placenta

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46
Q

Define the second stage of labor.

A

Fully dialated to delivery

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47
Q

Define the first stage of labor.

A

Onset to full dilation

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48
Q

What organism causes us to warn pregnant patients to stay away from deli meats and soft cheeses?

A

Listeria

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49
Q

About how much weight should a woman gain during pregnancy?

A

20-35 lbs

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50
Q

Why is folic acid given as a prenatal vitamin?

A

Low folic acid can lead to neural tube defects

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51
Q

At how many weeks of pregnancy can an amniocentesis be done?

A

15-20 weeks

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52
Q

At how many weeks of pregnancy can chorionic villus sampling bed done?

A

10-13 weeks

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53
Q

At approximately how many weeks pregnant is the uterus at the level of the umbilicus?

A

20 weeks

54
Q

At approximately how many weeks pregnant is the uterus at the level of the symphysis pubis?

A

12 weeks

55
Q

A patient believes she is pregnant and you notice her cervix appears a blue tinged. What is the name of the sign?

A

Chadwick’s sign

56
Q

When does quickening occur?

A

Nulliparous 18-20 weeks, multiparous 14-16 weeks

57
Q

Define full term

A

Deliveray at 37-42 weeks

58
Q

Define premature birth

A

Deliveray of uterine contnts between 20-36 weeks

59
Q

Define abortion.

A

Deliveray of uterine contnts before 20 weeks

60
Q

What characteristic of pelvic inflammatory disease will help to differentiate it in a question stem from ectopic pregnancy, appendicitis, ovarian torsion and ovarian cyst?

A

It will be bilateral pain. Many other common gyn complaints are unilateral pain

61
Q

What age range is the HPV vaccination recommended for?

A

9 to 26 years old

62
Q

What medium do you need to grow out Neisseria gonorrhoeae?

A

Thayer martin

63
Q

What is the #1 cause of septic arthritis in sexully active young adults?

A

Neisseria gonorrhoeae

64
Q

Purulent cervical discharge should make you think of what diagnosis?

A

Neisseria gonorrhoeae

65
Q

What lab test is the gold standard for chlamydia?

A

Nucleic acid amplification test

66
Q

A patient presents with mucopurulent discharge and cervical motion tenderness. What diagnosis should you be thinking of?

A

Chlamydia - cervicitis

67
Q

What organism is the most common sexually transmitted infection?

A

Chlamydia

68
Q

What are two important things you need to tell you patients before putting them on metronidazole?

A

Stay out of the sun and avoid alcohol

69
Q

How do you treat a Trichomonas infection?

A

Metronidazole

70
Q

Vaginal infection with motile flagellated protozoa should make you think of what diagnosis?

A

Trichomonas

71
Q

A strawberry cervix with copious yellow/green discharge should make you think of what diagnosis?

A

Trichomonas

72
Q

How do you treat bacterial vaginosis?

A

Metronidazole x 7 days

73
Q

Clue cells should make you think of what diagnosis?

A

Bacterial vaginosis

74
Q

Thin, sticky, malodorous vaginal discharge should make you think of what diagnosis?

A

Bacterial vaginosis

75
Q

How do you treat vaginal candida?

A

Fluconazole po 1 dose, azole cream x 1 week

76
Q

What would you expect to see on a KOH prep if the patient had vaginal candidiasis?

A

Pseudohyphae

77
Q

Cottage cheese discharge should make you think of what diagnosis?

A

Vaginal candidiasis

78
Q

What is the average age of menopause?

A

51

79
Q

List four risk factors for breast cancer?

A

BRCA1 or BRCA2 positive, unopposed estrogen, nulliparity, early menarche, late menopause

80
Q

A unilateral, single, mobile, firm, nontender solid breast mass should make you think of what diagnosis?

A

Fibroadenoma

81
Q

Are fibrocystic breast masses usually bilateral or unilateral?

A

Bilateral

82
Q

Should a breast feeding mother stop breast feeding if she develops mastitis?

A

There is no reason to stop breast feeding at this point.

83
Q

Does mastitis tend to be unilateral or bilateral?

A

Unilateral and only one quadrant

84
Q

What is the first line treatment for mastitis?

A

Dicloxacillin is fist line. Cephalexin or erythromycin are second line.

85
Q

What is the most common organism that causes mastitis?

A

Staph aureus

86
Q

What are three treatments for uterine prolapse?

A

Pessary, Kegel’s maneuvers, surgical repair

87
Q

What is a cystocele?

A

A herniation of the bladder into the vagina

88
Q

Which four herpes viruses are linked to cervical cancer?

A

HPV 16, 18, 31 and 33

89
Q

List two risk factors for cervical cancer.

A

Multiple sexual partners, smoking,

90
Q

Cervical biopsy comes back as CIN2 or CIN3. What is your next step?

A

Excision - LEEP, Cold knife (worry about incompetent cervix), Cryotherapy

91
Q

Cervical biopsy comes back as CIN1. What is the next step?

A

Repeat pap smear in 6 months and repeat colposcopy in 12 months

92
Q

If the pap smear results come back anything other than negative or ASCUS what is your next step?

A

Colposcopy and biopsy

93
Q

A pap smear comes back as atypical squamous uncertain significance (ASCUS). What is your next step?

A

Repeat pap smear in 4-6 months

94
Q

When is it recommended to begin pap smears?

A

When a woman becomes sexually active or when she is 21 years old

95
Q

What is the treatment for ovarian cancer

A

Total hysterectomy and bilateral salpingo-oophorectomy. Chemo + radiation

96
Q

A 66 year old female patient presents with bouts of nausea, weight loss and vague abdominal pain. What diagnosis should you be thinking of?

A

Ovarian cancer

97
Q

Why is ovarian cancer so hard to diagnosis?

A

No good makers and very vague abdominal symptoms

98
Q

List 2 risk factors for ovarian cancer.

A

BRCA1, Family history, Nulliparity, late menopause, caucasian, asian

99
Q

What is the mean age for ovarian cancer?

A

63, you will need to think of this in an older patient with vague abdominal symptoms

100
Q

An ovarian cyst that contains hair and teeth should make you think of what diagnosis?

A

Teratoma

101
Q

You have a patient with PCOS who would like to get pregnant. What are two medications you may start her on?

A

Metformin and Clomid

102
Q

What endocrine issue is associated with PCOS?

A

Insulin insensitivity

103
Q

A patient presents with irregular menses, hirsutism and infertility. What diagnosis should you be thinking of?

A

Polycystic ovarian syndrome

104
Q

If you see the term chocolate cyst it should make you think of what diagnosis?

A

Endometrioma

105
Q

What is the most common type of ovarian cyst?

A

Functional cyst - no treatment necassary

106
Q

What is the first step of treatment for endometrial cancer?

A

Total hysterectomy and bilateral salpingo-oophorectomy

107
Q

List 4 risk factors for endometrial cancer.

A

Chronic unopposed estrogen, nulliparity, early menarche, late menopause, Tamoxifen, DM, obesity, HTN, breast CA, ovarian CA

108
Q

What is the most common endometrial cancer?

A

75% are adenocarcinomas

109
Q

What ethnic background is at an increased risk of fibroids?

A

African American are 5x more likely to have fibroids compared to Caucasian women

110
Q

What is the most common uterine tumor?

A

Leiomyoma, also known as fibroids

111
Q

How do you definitively diagnose endometriosis?

A

Exploratory laparoscopy

112
Q

A physical exam revealing a retroverted uterus or uterosacral ligament nodularity should make you think of what diagnosis?

A

Endometriosis

113
Q

Endometriosis is most commonly found in what location??

A

On an ovary

114
Q

During what portion of the menstrual cycle does PMS occur?

A

By definition it is in the second half and menstruation should relieve the symptoms

115
Q

Postmenopausal bleeding is immediately believed to be what diagnosis?

A

Endometrial cancer until proven otherwise

116
Q

Define metrorrhagia.

A

Bleeding between menstraul cycles

117
Q

Define menorrhagia.

A

Heavy prolonged menstraul flow

118
Q

What three labs should you order if you are considering secondary amenorrhea?

A

beta HCG, TSH, Prolactin

119
Q

What is the most common cause of secondary amenorrhea?

A

Pregnancy

120
Q

How much time needs to pass before diagnosing secondary amenorrhea?

A

If cycles have been normal 3 months. If cycles have been irregular 6 months.

121
Q

A patient with primary amenorrhea and a low FSH should make you think of what diagnosis?

A

Hypothalamic pituitary insufficiency

122
Q

What is the treatment for Turner’s syndrome?

A

Cyclical estrogen and progesterone

123
Q

A description of a young girl with a web neck or wide shield chest should make you think of what diagnosis?

A

Turner’s syndrome

124
Q

Is FSH high or low in Turner’s syndrome?

A

High, there are no ovaries to respond to FSH and so there is no negative feedback.

125
Q

What is the karyotype for patient with Turner’s syndrome?

A

(45, X) They are missing one sex chromosome

126
Q

Since a genetic cause is the number one reason for primary amenorrhea what is one very important test?

A

Karyotype

127
Q

At what age is primary amenorrhea diagnosed?

A

14 if no secondary sex characteristics. 16 if some secondary development.

128
Q

The secretory phase day 14-28 is dominated by what hormone?

A

Progesterone

129
Q

The follicular phase of menstruation is dominated by what hormone?

A

Estrogen

130
Q

A surge in what hormone leads to ovulation?

A

LH

Physician Assistant Exam (14 decks)

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