OBGYN 2

Question 1

indication for antibiotics after delivery

Answer 1

foul smelling lochia

tender uterus

Question 2

when do you do Kleihauer Betke test

Answer 2

after delivery to see if you need higher dose of Rh Ig

Question 3

ovarian torsion vs ruptured ovarian cyst

Answer 3

ovarian torsion has nausea and vomiting

ruptured ovarian cyst happens with strenuous physical activity and may have light vaginal bleeding

Question 4

who should be offered cell free DNA testing of maternal plasma

Answer 4

women at least 35 at increased risk of aneuploidy and at least 10 weeks gestation

Question 5

abnormal cell free fetal DNA testing, next step in 1st vs 2nd trimester

Answer 5

1st trimester 10-12 wks: fetal karyotyping with chorionic villus sampling
2nd trimester 15-20 wks: amniocentesis

Question 6

Downs syndrome tests for people who don’t have high risk in 1st vs 2nd trimester

Answer 6

1st: combined test of plasma protein A, beta hCG, and nuchal translucency
2nd: quad screen of maternal serum AFP, beta hCG, unconj estriol, inhibit A

Question 7

tx of genital warts

Answer 7

trichloroacetic acid

or podophyllin

Question 8

loss of fetal station

Answer 8

uterine rupture

Question 9

symmetric vs asymmetric fetal growth restriction

Answer 9

symmetric is fetal

• genetic disorders
• congenital heart disease
• intrauterine infection

asymmetric is maternal

• vascular disease (HTN, DM)
• antiphospholipid antibody syndrome
• autoimmune (SLE)
• cyanotic heart disease
• substance abuse

Question 10

workup of adnexal mass in postmenopausal woman

Answer 10

transvaginal US and CA125

Question 11

NST is nonreactive. Next step?

Answer 11

BPP or CST (but CST CI if have CI to labor like placenta previa)

Question 12

how long should NST be done to account for fetal sleep cycle

Answer 12

at least 40 min

Question 13

when to use umbilical artery flow velocimetry

Answer 13

when monitoring growth restricted fetuses (less than 10th percentile)

Question 14

what does it mean to have a BPP score of 0-4/10? management?

Answer 14

fetal hypoxia due to placental dysfunction (placental insufficiency)
deliver

Question 15

management of incomplete, inevitable, or missed abortion

Answer 15

hemodynamically unstable: dilation and suction curettage

hemodynamically stable: can do expectant management, prostaglandins, or surgical evacuation

Question 16

management of septic abortion

Answer 16

blood and endometrial cultures
broad spectrum antibiotics
surgical evacuation

Question 17

thyroid levels in pregnancy vs pre pregnancy

Answer 17

fT4 and fT3 incr

TSH decr

Question 18

cause of late decels

Answer 18

uteroplacental insufficiency (see placental calcifications)

Question 19

causes of variable decels

Answer 19

cord compression
cord prolapse
oligohydramnios

Question 20

when should you do something about variable decels

Answer 20

when associated with at least 50% of contractions

Question 21

pruritic vaginal area with white, cigarette paper quality

• dx
• next step
• tx

Answer 21

lichen sclerosus
punch biopsy
topical corticosteroids

Question 22

clotrimazole cream used for

Answer 22

vaginal candidiasis

Question 23

after how many weeks gestation should you try to convert a breech baby? and what is it called? what are CIs?

Answer 23

37 weeks
external cephalic version
placental abnormalities, fetopelvic disproportion, hyperextended fetal head

Question 24

age cutoff for premature ovarian failure

Answer 24

less than 40

Question 25

differential for nonreactive NST

Answer 25

fetal sleep cycle
fetal hypoxia from placental insufficiency
fetal cardiac or neurologic abnormalities

Question 26

indication for magnesium sulfate

Answer 26

less than 32 weeks gestation for neuroprotection

Question 27

fetal viability starts at how many weeks

Answer 27

23 weeks

Question 28

indication progesterone supplementation

Answer 28

16-36 weeks gestation in pregnant with singleton and history of preterm delivery

Question 29

things to give in a preterm labor if less than 34 weeks (preterm is technically less than 37)

Answer 29

corticosteroids (lung maturity)
magnesium (neuroprotection)
tocolytic

Question 30

weeks that indicate preterm labor

Answer 30

less than 37