OBGYN 4

Question 1

meds for acute abnormal uterine bleeding

Answer 1

high dose estrogens
high dose OCPs
high dose progestins
tranexamic acid (antifibrinolytic)

Question 2

workup of secondary amenorrhea (for at least 3 cycles or at least 6 months)

Answer 2

pregnancy test
if h/o uterine infection, do hysteroscopy
prolactin, TSH, FSH

Question 3

2 vaginal cancers

- location

Answer 3

squamous cell: upper 1/3 vagina, posterior wall

clear cell adenocarcinoma: upper 1/3 vagina, anterior wall

Question 4

h/o prior classic c-section or extensive myotomy, and now pregnant. management?

Answer 4

scheduled c section 36-37 weeks

Question 5

severe features of preeclampsia

Answer 5

BP over 160/110
platelets less than 100,000
Cr greater than 1.1 or doubled
incr AST or ALT
pulm edema
visual or cerebral sxs

Question 6

management of preeclampsia

Answer 6

deliver baby if term
seizure proph: magnesium
HTN: labetalol, hydralazine, nifedipine (NHL)

Question 7

CI in placenta previa

Answer 7

sex
digital cervical exam
vag delivery

Question 8

indications for GBS prophylaxis (PCN) when GBS status unknown

Answer 8

delivery less than 37 weeks
membrane rupture at least 18 hours
GBS bacteriuria during pregnancy
h/o infant with GBS sepsis

Question 9

indication for antenatal corticosteroids

Answer 9

PPROM before 32 weeks (for RDS, NEC, intraventricular hemorrhage, and death)

Question 10

pregnant woman with Hep C. Next step?

Answer 10

make sure immunized to Hep A and Hep B

Question 11

most effective post coital contraceptive

Answer 11

copper IUD

Question 12

menopause labs

Answer 12

FSH incr
LH incr
FSH/LH less than 1

Question 13

reason to do amniocentesis

Answer 13

determine fetal lung maturity

Question 14

management of eclampsia-preeclampsia syndrome

Answer 14

mg sulfate for seizures
labetalol or hydrazine if BP greater than 160/110
augmentation or IOL

Question 15

indications for c section

Answer 15

less than 32 weeks and unfavorable cervix
h/o many prior c sections
persistent non reassuring fetal heart tones
breech presentation

Question 16

platelet transfusion in preeclampsia eclampsia is indicated when

Answer 16

less than 20,000

if c section, when less than 40-50,000

Question 17

clinical presentation and US findings of epithelial ovarian CA

Answer 17

SOB
constipation/vomiting
abd distention
pelvic pain
early satiety

solid mass
thick septations
ascites

Question 18

management if BPP is 6/10

Answer 18

repeat in 24 hours

Question 19

characteristics of fetal hydration syndrome (from phenytoin)

Answer 19

midface hypoplasia
microcephaly
cleft lip and palate
digital hypoplasia
hirsutism
developmental delay

Question 20

biggest risk factor for cerebral palsy

Answer 20

prematurity

Question 21

management of endometrial hyperplasia without atypia

Answer 21

progestin therapy

Question 22

management of endometrial hyperplasia with atypia

Answer 22

if want future pregnancy: progestin therapy

no plans for pregnancy or failed meds: hysterectomy

Question 23

hormone that maintains corpus luteum

Answer 23

hCG

Question 24

hormone that inhibits uterine contractions

Answer 24

progesterone

Question 25

hormone that induces prolactin production in pregnancy

Answer 25

estrogen

Question 26

indications for magnesium sulfate

Answer 26

prevent eclamptic seizures

imminent preterm delivery to decrease risk of cerebral palsy

Question 27

tx of magnesium toxicity

Answer 27

calcium gluconate