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OBGYN Flashcards

1
Q

breast abscess etiology

A

S. aureus

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2
Q

fibroadenoma vs fibrocystic changes

A

fibroadenoma doesn’t change w/ menstrual cycle

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3
Q

fibroadenoma tx

A

observation
US Q3-6mo
surgery if mass changes or enlarges

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4
Q

straw colored fluid on FNA bx

A

fibrocystic changes

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5
Q

1st line fibrocystic changes

A

OCP
Mild mastalgia: NSAIDS
Severe mastalgia: Tamoxifen or Danazol

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6
Q

galactorrhea tx

A

Tx underlying
Dopamine (bro/cab): decrease prolactin
levothyroxine: if hypothyroidism

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7
Q

MC med that cause gynecomastia

A

spironolactone

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8
Q

tx gynecomastia

A

testosterone replacement
tamoxifen
mastectomy
tx underlying

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9
Q

risk factor breast cancer

A

BRCA1 BRCA2
FHx, >70yo, never breastfed, OCP use
estrogen exposure (obese, nulliparity, early menarche, late menopause, late 1st pregnancy)

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10
Q

protective against breast cancer

A

breastfeeding

parity

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11
Q

MC location breast cancer

A

upper outer quadrant

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12
Q

breast cancer mammogram

A

microcalcifications

spiculated

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13
Q

guidelines breast cancer prevention

A

Mammo 50-74 q 2yrs (40-49 if high risk)

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14
Q

tx high risk of breast cancer

A

tamoxifen or raloxifene

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15
Q

cervical cancer screen

A

21-65 yo
21-29 Q3yrs
>30 Pap + HPV or Pap Q3yrs

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16
Q

MC cervical cancer

A

squamous

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17
Q

DES exposure

A

clear cell cervical cancer

clear cell vaginal cancer

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18
Q

Gardasil

A

HPV vaccine
start 11-12
<15 (2 doses, 6mo apart)
>15 (day 0, 2mo, 6mo)

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19
Q

cervical dysplasia management

A

Repeat pap Q6mo, colopscopy, return to routine screening
ASCUS: <30 repeat Q1yr, >30 + HPV colpo, >30 no HPV repeat Q3yrs
LGSIL: mild dysplasia, colpo if HPV, cytology in 1yr
HGSIL: mod/severe, colpo or loop, cytology in 6mo

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20
Q

missed abortion

A

abnormal US w/ no bleeding

no cervical dilation

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21
Q

threatened abortion

A

normal US w/ minimal bleeding
no cervical dilation
no POC

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22
Q

inevitable abortion

A

abnormal US w/ bleeding

dilated cervix, no POC

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23
Q

incomplete abortion

A

abnormal US w/ bleeding

dilated cervix, loss of some POC but not all

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24
Q

completed abortion

A

closed cervix

empty contracted uterus

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25
Q

abortion tx

A

curettage in 1st trimester or D&E in 2nd trimester
misoprostol
rhogam

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26
Q

MC RF placental abruption

A

HTN

cocaine user

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27
Q

placental abruption tx

A

stable and <34w: management w/ fetal monitoring
>36w: induction, oxytocin, vaginal delivery preferred
unstable: C section

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28
Q

variable deceleration and bradycardia in fetus

A

cord prolapse

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29
Q

tx cord prolapse

A

digital disengatement
knee to chest
C section

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30
Q

MC location of ectopic pregnancy

A

ampulla

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31
Q

ectopic pregnancy triad

A

unilateral pelvic pain
vaginal bleeding
amenorrhea

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32
Q

ectopic pregnancy tx

A

stable: monitor w/ HcG or MTX if identified later (<4cm), rhogam
unstable (hypotensive, tachycardia): laparoscopy

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33
Q

tx endometritis

A

C section: IV clindamycin w/ gentamicin
Vaginal delivery: ampicillin and gentamicin
prophylaxis 1st gen ceps during c section

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34
Q

gestational diabetes screen

A

24-28w increased fasting plasma glucose >125
initial: 1h OGTT (>140)
3h OGTT (>180 1h, >155 2h, >140 3h)= confirm

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35
Q

gestational diabetes tx

A

insulin TOC
metformin/glyburide (refuse insulin)
induce at 38w if uncontrolled, 40w if controlled

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36
Q

molar pregnancy dx

A

bhcg >100k

transvaginal US: snowstorm, cluster of grapes, honeycomb

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37
Q

molar pregnancy tx

A

D&C
rhogam
chemo if choriosarcoma (MTX)
do not give misoprostol, risk of incomplete uterine evacuation

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38
Q

1st line hypertensive meds in pregnancy

A

BB (labetalol)
CCB (nifedipine)
hydralazine
methyldopa

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39
Q

IV magnesium sulfate toxicity

A

hyporeflexia

tx w/ calcium gluconate

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40
Q

pregnancy induced HTN diagnosis

A

BP >140/90 after 20wks

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41
Q

tx preeclampsia

A

definitive: delivery
prophylaxis: ASA
prevention of eclampsia: IV mg sulfate + diazepam

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42
Q

tx eclampsia

A

IV mg sulfate + diazepam

definitive: delivery

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43
Q

HELLP syndrome

A

preeclampsia + hemolysis + increased LFT + low plt

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44
Q

tx HELLP

A

BP management
Mg sulfate
deliver if term

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45
Q

tx cervical insufficiency

A

No hx: vaginal progesterone (no hx)
hx: PO progesterone a + cerclage
no sex

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46
Q

CI in placenta previa

A

pelvic exam

47
Q

preterm placenta previa tx

A

bed rest
tocolytics (mg sulfate)
CS

48
Q

tx postpartum hemorrhage

A

uterine massage
oxytocin
misoprostol

49
Q

PROM tests

A

+ fern test
+ nitrazine test (blue = ph > 6.5)
pooling of fluid in vaginal fornix

50
Q

PROM tx

A

betamethasone/CS if <34w

delivery if >34w

51
Q

preterm labor tx

A

tocolytics
CS
MG sulfate

52
Q

Rh incompatibility sx

A

hydros fetalis
hemolytic anemia, jaundice, hepatosplenomegaly
kernicterus

53
Q

rhogam when

A

28w

w/in 72h of delivery or potential mixing of blood

54
Q

klinefelter syndrom karyotype

55
Q

heart defect assoc w/ klinefelter

56
Q

klinefelter tx

A

testosterone for life

57
Q

Turner syndrome karyotype

58
Q

heart defect assoc w/ turner syndrome

A

coarctation of aorta

59
Q

tx turners syndrome

A

estrogen and progesterone substitution

60
Q

tx infertility

A

clomid (ovulation inducer)
male: therapeutic insemination, intrauterine insemination
corrective surgery if occlusion

61
Q

menopause labs

A

high FSH and LH

low estrogen/estradiol

62
Q

secondary amenorrhea due to hypothalamus tx

A

normal or low FSH/LH

clomiphene

63
Q

secondary amenorrhea due to pituitary tx

A

low FSH/LH, high prolactin

transphenoidal surgery

64
Q

secondary amenorrhea due to ovarian etiology labs

A

high FSH
high LH
low estradiol

65
Q

secondary amenorrhea criteria

A

menses absent for at least 3 cycles or 6 consecutive months

66
Q

athletic triad

A

amenorrhea
fatigue (eating disorder)
osteoporosis

67
Q

tx dysmenorrhea

A

NSAIDS
heat, exercise, OCP
laparoscopy if everything fails

68
Q

tx DUB

A

leuprolide
anovulatory: OCP first line
acute severe bleed: high dose IV estrogen, high dose OCP
ablation: pt that dont want hysterectomy
hysterectomy definitive

69
Q

PMS phase

A

must occur on 2nd half of menstrual cycle (luteal phase)

sx improve w/ menses

70
Q

PMS tx

A

diet and exercise 1st line

SSRI

71
Q

tx PMDD

A

1st line SSRI

72
Q

tx ovarian cyst

A

asx= observation (<8cm), repeat US Q6wks

laparoscopy: >6cm
rupture: pain management, observation. laparoscopy to control hemorrhaging if unstable

73
Q

triad PCOS

A

hirsutism, amenorrhea, obesity

74
Q

PCOS US and lab

A

string of pearls
high testosterone, high DHEA
high LH/FSH >3:1

75
Q

tx PCOS

A

weight loss

OCP mainstay

76
Q

GYN cancer w/ highest mortality

A

ovarian cancer

77
Q

chlamydia tx

A

azithromycin (pregnancy) or doxycycline (tx partner)

test for gono but no need to tx

78
Q

lymphogranuloma venereum caused by

A

chlamydia trachomatis

79
Q

tx gonorrhea

A 
ceftriaxone 
tx chlamydia (azithromycin or doxycycline)
80
Q

fitz hugh curtis syndrome

A

complication of PID
peri-hepatitis
violin string adhesions
glisson’s capsule surrounds liver

81
Q

chandelier sign

82
Q

tx PID

A

outpt: ceftriaxone + doxy +/- metro
inpt: cefoxitin/cefotetan + doxy

83
Q

congenital syphilis hallmark

A

hutchington teeth

84
Q

syphilis sx

A

primary: chancre painless
secondary: rash palmes and soles, F, LAD, arthritis, hepatitis
tertiary: gummatous lesions, argyll robinson pupil, neurosyphilis

85
Q

tx chancroid

A

azithromycin, rocephin

86
Q

pregnancy systematic changes

A

hyperventilation (resp alk)
increased CO, dec peripheral resistance
high plasma vol, high RBC vol, hypercoagulable
inc GFR

87
Q

AFP low, BHCG high, estradiol low

A

Down syndrome (trisomy 21)

88
Q

when triple screen pregnancy

A

AFP, Bhcg, estradiol

15-20w

89
Q

high AFP in triple screen

A

spina bifida or multiple gestation

90
Q

low AFP, Bhcg, and estradiol

A

trisomy 18: stillborn or die w/in 1yr

91
Q

misoprostol indication

A

induce labor, cervical ripening

92
Q

terbutaline indication L&D

A

lung development

93
Q

normal fetal HR

A

120-160 bpm

94
Q

early decelerations on NST

A

compression of baby’s head
baby HR dec at same time as contractions
normal

95
Q

late decelerations on NST

A

HR declines after contraction ends
uteroplacental insufficiency or fetal growth restriction
needs intervention

96
Q

variable decelerations on NST

A

baby HR responding at different times
cord compression
needs intervention

97
Q

abdominal size in pregnancy

A

12w: pubic symphysis
20w: umbilicus
36w: xiphoid process

98
Q

group B strep screen during pregnancy

99
Q

endometriosis triad

A

cyclical premenstrual pelvic pain
dysmenorrhea
dysparenuria or dyschezia

100
Q

endometriosis dx

A

laparoscopy w/ bx definitive: powder burn appearance

101
Q

chocolate cyst

A

endometrioma

102
Q

endometriosis tx

A

observation if asx
1st: laparoscopic ablation to preserve fertility
2nd: hysterectomy w/ oophorectomy
OCP/ NSAIDS 1st line

103
Q

tx leiomyoma

A

asx observation w/ f/u q 6-12m
leupralide most effective
myomectomy if fertility desired
hysterectomy definitive

104
Q

vaginal prolapse tx

A

kegals, pessary

surgery

105
Q

MC endometrial cancer

A

adenocarcinoma

106
Q

endometrial cancer dx

A

PAP w/ endometrial bx

endometrial stripe >4mm

107
Q

tx endometrial cancer

A

total hysterectomy +/- rad

108
Q

tx endometrial hyperplasia

A

1st line: progestin therapy, repeat bx in 3-6mo

atypical: hysterectomy

109
Q

BV etiology

A

gardnerella vaginalis

110
Q

atrophic vaginosis tx

A

vaginal or PO estrogen

111
Q

MC vaginal cancer

A

squamous cell carcinoma

112
Q

MC valvular cancer

113
Q

APGAR score

A

appearance, pulse, grimace, activity, respiration
7+ normal
4-6: fairly low
<4 critically low

PNCE (33 decks)

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