OBGYN Flashcards
What is the most common cause of infertility?
PCOS
Placenta previa classically presents how
Painless bleeding in the third trimester
What STI can be treated with metronidazole?
Trichomoniasis
What is the treatment for chlamydia cervicitis?
Doxycycline 100mg PO BID x7 days
Azithromycin 1g PO single dose for pregnant women - they should also be tested for cure 4 weeks after treatment
What causes gonorrhea?
Neisseria gonorrhoeae - gram negative diplococci
In a women in preterm labor less than 32 weeks gestation what should be given for fetal neuroprotection?
Anetenatal Magnesium
What class of medications should be given to prolong time of delivery in preterm labor to administer corticosteroids?
Tocolytics (Uterine Relaxants)
(It’s Not My Time)
* Indomethacin
* Nifedipine
* Magnesium sulfate
* Terbutaline
What is the appropriate duration of tocolytic therapy when using indomethacin?
< 72 hours
Frothy, yellow-green malodorous discharge should make you think of what diagnosis?
Trichomoniasis
What is the most common cause of pelvic inflammatory disease?
Chlamydia trachomatis infection
What is the most common cause of secondary amenorrhea?
Pregnancy
A neonate who demonstrates a weak cry with gasping and a heart rate < 100 bpm should receive what type of respiratory support?
Positive Pressure Ventilation
When are APGAR scores measured?
Calculated at 1 and 5 minutes after birth
What is the name of the uterine abnormality in which there is a congenital absence of the uterus and upper two-thirds of the uterus?
Mullerian agenesis
What are the expected lab results in a patient with primary ovarian insufficiency?
Increased follicle-stimulating hormone and decreased estradiol
Where should the umbilical cord be cut?
3 centimeters from the insertion point at the umbilicus
What are the initial diagnostic tests in working up endometrial cancer?
- Endometrial biopsy (gold standard)
- Transvaginal ultrasound
What is the underlying pathophysiology of the cyclic edema associated with premenstrual syndrome?
Alterations in the renin-angiotensin-aldosterone axis and altered antidiuretic hormone function
A physical exam revealing a retroverted uterus or uterosacral ligament nodularity should make you think of what diagnosis?
Endometriosis
A G4P3 woman presents in labor at 39 weeks. She has an active herpes infection with vesicles on the inner cervix. What is the recommended mode of delivery?
C-section
A “snowstorm appearance” or a “cluster of grapes” should make you think of what diagnosis?
Molar Pregnancy
In a suspected molar pregnancy what other imaging test should be ordered besides ultrasound?
Chest X-ray to evaluate for METS (choriocarcoma)
A woman who is 35 weeks pregnant and complains of diffuse pruritis on the palms and soles of her feet, that is worse at night should make you think of what diagnosis?
Intrahepatic cholestasis of pregnancy, most common in the third trimester
What medication is used to increase surfactant levels and help with lung maturity if you are worried about preterm labor?
Betamethasone
At what point during pregnancy is RhoGAM given if it is needed?
Once at 28 weeks and once within 72 hours postpartum
What is the first line treatment for mastitis?
Dicloxacillin
Cephalexin or Erythromycin are second line
Cottage cheese discharge should make you think of what diagnosis?
Vaginal candidiasis
What is the treatment for Turner Syndrome?
Cyclical estrogen and progesterone
When is it recommended to start pap smears?
Start at age 21 regardless of sexual activity
Which reproductive cancer carries the highest rates of death in women?
Ovarian Cancer
What is the karyotype for a patient with Turner’s syndrome?
(45, X) They are missing one sex chromosome
What is the most common benign breast finding?
Fibrocystic disease
What happens to beta-hCG in the presence of a hydatidiform mole?
It is extreamly high (> 100,00 mIU/mL)
Clue cells should make you think of what diagnosis?
Bacterial Vaginosis
A strawberry cervix with copious yellow/green discharge should make you think of what diagnosis?
Trichomonas vaginitis
How is the first day of the menstrual cycle defined?
The first day of menstrual bleeding
What endocrine issue is associated with PCOS?
Insulin insensitivity
What is the term for when the placenta has implanted directly over the cervical os?
Placenta Previa
What is the most common cause of secondary amenorrhea?
Pregnancy
Are fibrocystic breast masses usually bilateral or unilateral?
Bilateral
The follicular phase of menstruation is dominated by what hormone?
Estrogen
If the pap report comes back on a 23 y.o. as ASCUS or LSIL, what is the recommended follow up?
Repeat cytology in 1 year
Thin, sticky, malodorous vaginal dischargeshould make you think of what diagnosis?
Trichomonas vaginitis
What are some risk factors for breast cancer
- BRCA1 or BRCA2 positive
- Unopposed estrogen
- Early menarche
- Nulliparity
- Late menopause
Define procidentia
Uterine prolapse beyond the introitus
Painless vaginal bleeding after 20 weeks gestation should make you think of what diagnosis?
Placenta previa
What ethnic background is at an increased risk of fibroids?
African Americans are 5x more likely than caucasian
Define inevitable abortion
Vaginal bleeding, cervix is open, products of conseption are still inside
What is the most common type of cervical cancer?
Squamous Cell
What are the vaccines contraindicated in pregnancy?
- HPV
- MMR
- Live flu
- Varicella
A woman presents with bilateral hemianopsia, headache, amenorrhea, and bilateral milky nipple discharge. What is the most likely diagnosis?
Prolactinoma
What medium do you need to grow out Neisseria gonorrhoeae?
Thayer-Martin
What is the leading cause of infertility and ectopic pregnancy?
Pelvic inflammatory disease (PID)
A patient believes she is pregnant. You notice her cervix is a light blue. What is the name of the sign?
Chadwick’s Sign
Define the third stage of labor
Delivery of baby to delivery of placenta
What is the leading cause of maternal death?
Postpartum hemorrhage
About how much weight should a woman gain during pregnancy?
20-35 lbs
What is a normal APGAR score?
Greater than or equal to 7
Interference with work or school is part of which diagnosis, premenstrual syndrome or premenstrual dysphoric syndrome?
Premenstrual dysphoric syndrome
A unilateral, single, mobile, firm nontender breast mass should make you think of what diagnosis?
Fibroadenoma
Gestational diabetes puts mom and baby at increased risk for what
- Preeclampsia
- Macrosomia (traumatic birth)
- Slowing of fetal lung development
- Hypoglycemia
What is the most common infection following a C-section?
Metritis
A rope-like breast mass should make you think of what diagnosis?
Fibrocystic breast mass
What three labs should you order if you are considering secondary amenorrhea?
- Beta hCG
- TSH
- Prolactin
A patient presents with mucopurulent discharge and cervical motion tenderness. What diagnosis and organism should you be considering?
Chlamydia - Cervisitis
If the pap report comes back on a 30 year old woman as ASCUS, what is the recommended follow up?
- Check HPV
- If ASCUS and HPV positive = colposcopy
- If ASCUS positive and negative for HPV = repeat in 3 years
During what portion of the menstrual cycle does PMS occur?
Second half and menstruation should relieve symptoms
How is cervical insufficiency defined
The cervix is < 25 mm long prior to 24 weeks gestation
An elevated 17-hydroxyprogesterone plus sx of PCOS should make you think of what diagnosis?
Adrenal hyperplasia
How do you treat bacterial vaginosis?
Metronidazole x 7 days
What diagnosis is associated with painful third trimester bleeding placental abruption or placenta previa?
Placenta abruption
Define threatened abortion
Vaginal bleeding, closed cervix, products of conception are still inside
A surge in what hormone leads to ovulation?
Luteinizing hormone (LH)
What is the ideal position of the occiput for delivery of a fetus?
Vertex presentation with anterior occiput
What medications can be used to induce labor?
- Cervidil - prostoglandin gel applied to the cervix to ripen
- Oxytocin - encourages uterine contractions
What is the formula for calculating estimated due date?
First day of last period + 7 days - 3 months
How many days after conception is a serum hCG positive?
8 days
