OBGYN

Question 1

what gestational age is TDaP recommended during pregnancy?

Answer 1

27 to 36 weeks; every pregnancy gets vaccine regardless of time since last booster; family members should get vaccinated also at least 2 weeks before contact with baby

Question 2

What is the treatment for symptomatic uterine fibroids?

Answer 2

Removal by surgery

Question 3

What is best treatment of recurrent bartholin gland abscess and over what size should patient get referred to GYN?

Answer 3

Marsupialization (other options can be placing word catheter or Jacobi ring); >5cm

Question 4

what are the three Rotterdam criteria for dx of PCOS?

Answer 4

oligomenorrhea, hyperandrogenism, and cystic ovaries on pelvic US (don’t have to get the US for dx if patient clearly has first two on evaluation)

Question 5

next step in management of primary dysmenorrhea in a teenager who has tried OTC low dose NSAIDs?

Answer 5

high dose NSAIDs like naproxen 500 BID, OCP may be another option to try, if not improved after 3 months may refer to OBGYN, if concern for secondary dysmenorrhea then imaging with pelvic US and/or pelvic exam may be indicated

Question 6

True or False: Pityriasis rosea is a dangerous condition in pregnancy

Answer 6

True: increases risk before 15 weeks for spontaneous abortion

Question 7

expectant management for PROM in 34-36 week mom increases risk of what two conditions?

Answer 7

intrapartum/postpartum hemorrhage and intrapartum fever

Question 8

at what BP threshold do you treat chronic HTN in pregnancy?

Answer 8

consistently/average >150/100

Question 9

what is the recommended treatment to reduce symptoms/size of mass for premenopausal women with fibroid who want to preserve their uterus?

Answer 9

uterine artery embolization and occlusion; effect usually lasts up to 5 years

Question 10

USPSTF recommends what intervention to help in preventing perinatal depression in women with risk factors?

Answer 10

referral for counseling interventions such as CBT

Question 11

next step in management of a woman over age 45 that presents with abnormal uterine bleeding (even if premenopausal and has normal pelvic exam)

Answer 11

guidelines recommend endometrial bx due to increased risk of endometrial cancer; TV US is indicated if the bimanual exam is abnormal

Question 12

what is are the threshold average glucose levels to start insulin in pregnant patients with GDM?
- fasting > ____
- 1h post prandial > _____
- 2h post prandial > ____

Answer 12

fasting >95
1h >140
2h. >120

Question 13

smoking cessation decreases what two risks for pregnant women?

Answer 13

decreases risk of preterm delivery and fetal growth restriction