OBGYN

Question 1

Sheehan Syndrome

Answer 1

Infarction of pituitary d/t postpartum hemorrhage., Presents as failure of postpartum lactation, failure to resume menses after delivery, Labs: LOWWW TSH

Question 2

Tx. of Depression during pregnancy

Answer 2

ECT

Question 3

What method is used by gyn surgeons to ensure that ureters were not accidentally damaged?

Answer 3

IV Indigo Carmine Administration, The ureter is deep within the female pelvis and courses along lateral side of the uterosacral ligament where it then enters the base of the broad ligament. It also passes under the uterine artery at the level of the cervical os. 50-80% of ureteral damage during surgery is during gynecological procedures.

Question 4

Chlamydial bacterial conjunctivitis

Answer 4

mucopurulent discharge 5-14 days post delivery

Question 5

What do you give to pregnant mother with chlamydia?

Answer 5

Azithromycin

Question 6

Risk factors for Breast ca.

Answer 6

Female, older, hx. of breast ca. OR Fibrocystic change with cellular atypia, Breast ca. in 1st degree relative, Nulliparity

Question 7

Breast Ca. Staging

Answer 7

0: Cis, 1:

Question 8

Most common causal organism for Breast Abscess? Tx.

Answer 8

Staph species, Tx: Cephalexin and Dicloxacillin

Question 9

Erythema toxicum neonatorum

Answer 9

benign “eczema” of red pustules with halos, and Eosinophils that shows up 1-3 days after delivery and resolves in 1-2 wks without treatment

Question 10

Amniotic Band Syndrome (Streeter Dysplasia)

Answer 10

Multiple constricted bands (e.g. on fingers) due to fibrous bands that result from sac disruption

Question 11

Phocomelia

Answer 11

Seal flipper fins assoc. with Thalidomide use

Question 12

Radiation exposure in pregnancy

Question 13

Risk factors for Eclampsia

Answer 13

Multiple gestations, Hydatidiform mole/extrauterine pregnancy, African American/Hispanics, Age >35 y.o., DM, collagen vascular dz, thrombophilia

Question 14

Renal manifestation in Turner Syn

Answer 14

Horseshoe kidney

Question 15

Tx for chorioamnionitis and postpartum endometritis

Answer 15

Ampicillin + Gentamicin OR Clindamycin + Gentamicin

Question 16

Maternal complications associated with chorioamnionitis

Answer 16

Uterine atony, Endometritis, C-section

Question 17

Tx Incomplete Abortion?

Answer 17

Dilatation and curettage, Misoprostol if

Question 18

Rubella Ab Titers are to be obtained when? Why? Tx

Answer 18

Initial prenatal visits. Congenital rubella syndrome has defects with hearing, heart, eyes. Pregnant women should not receive rubella vaccine until postpartum

Question 19

HELLP

Answer 19

Hemolysis, Elevated Liver enzymes, Low Platelets, Dx: Peripheral blood smear showing schistocytes

Question 20

Premature Ovarian Failure (primary hypogonadism

Answer 20

Inc. FSH and LH, FSH:LH >1.0, Dec. Estrogen levels

Question 21

Asymptomatic Bacteruria, Risks? Tx?

Answer 21

> 100K CFU with no S&S UTI, cystitis –> acute pyelonephritis –> maternal/fetal morbidity, Tx: Amoxicillin x 10d, Nitrofurantoin, Cephalexin

Question 22

Tx. for Opioid-dependent pregnant woman

Answer 22

Methadone

Question 23

Post-partum blues resolve by

Answer 23

Wk 2

Question 24

Premenstrual Dysphoric disorder (PMDD) reolves when

Answer 24

1-2 days after onset

Question 25

Ovarian germ cell tumor/embryonal carcinoma tumor marker?

Answer 25

AFP (will also have elevated BhCG)

Question 26

Sequelae of Gestational Diabetes

Answer 26

hypoglycemia (2ndary to hyperinsulin state), respiratory distress, polycythemia and hyperbilirubinemia, hypocalcemia/hypomagnesemia

Question 27

Breastfeeding Failure Jaundice

Answer 27

happens 1st wk of life, decreased bilirubin elimination (d/t lactation failure), S&S: dehydration, no yellow stools passed, Tx: Breastfeed 15 min per side q2-3 hrs

Question 28

Breast Milk Jaundice

Answer 28

starts at age 3-5d, high levels B-glucoronidase in breast milk deconjugates intestinal bilirubin and increased enterohepatic circulation

Question 29

Newborn with Milk Protein Allergy

Answer 29

diarrhea and vomiting 4-7d after starting cow-based formula, Note: Lactose is present in breast milk, and patients with a Congenital Deficiency of Lactase will also have symptoms while breastfeeding. Symptoms only after starting cow's milk is more of a Milk Protein Allergy.

Question 30

Fanconi Anemia

Answer 30

AutoRec. chromosomal breaks on genetic analysis, S&S: aplastic anemia, abnormal thumbs, cafe au lait, large freckles, deafness, Tx: Hematopoietic stem cell transplant

Question 31

Absence Seizures keywords

Answer 31

daydreaming episodes

Question 32

Fitz Hugh Curtis, d/t

Answer 32

Pain in: RUQ, RLQ, shoulder, gallbladder, Cervical os discharge and motion tenderness, d/t Chlamydia

Question 33

Tx. pyelonephritis in pregnancy

Answer 33

Ceftriaxone

Question 34

Hepatic Adenoma, S&S, assoc. w/, Tx.

Answer 34

benign epithelial tumor that shows up as encapsulated, well circumscribed mass with central area of necrosis and calcifications on CT, assoc. w/ women of childbearing age, OCP and steroid use, Tx: cessation of OCP/steroids

Question 35

Endometriosis keywords, Tx

Answer 35

dyspareunia and dysmenorrhea, radiating to rectum, Tx: COCPs - they induce atrophy of the ectopic endometrial tissue

Question 36

Postpartum Thyroiditis, Tx

Answer 36

diffusely enlarged, firm, painless thyroid, Tx: Propranolol

Question 37

Primary dysmenorrhea

Answer 37

recurrent crampy abdominal pain but no pelvic pathology present

Question 38

Secondary dysmenorrhea

Answer 38

recurrent crampy abdominal pain secondary to pelvic pathology

Question 39

What drug is used to prevent pre-term birth in patients with cervical insufficiency? When is it given?

Answer 39

17-a-Hydroxy-Progesterone Caproate, At 16 weeks

Question 40

When is an Anatomic Screen using Ultrasound indicated And for what?

Answer 40

Weeks 18-20, Used to diagnose NTDs, anencephaly, encephalocele, myelomeningocele

Question 41

When is a surgical cerclage be performed?

Answer 41

At weeks 13-14. (As gestational increases, risk of cervical dilation increases)

Question 42

Tx. Gestational HTN, pre-eclampsia (before delivery)

Answer 42

Labetalol (unless she has asthma), M-dopa, Hydralazine, Nifedipine

Question 43

Adding what med to Tamoxifen or Anastrozole will increase disease-free survival in premenopausal women with Stage I or II breast ca?

Answer 43

Zolendronic Acid (a bisphosphonate)

Question 44

What spinal levels is uterine contraction and visceral pain? | Descent of the head into perineum results in somatic pain of what spinal levels?

Answer 44

T10-L1 S2-S4

Question 45

Levels of TBG, TSH, Total T4, and Free T4 in Normal Pregnancy

Answer 45

Estrogen causes TBG to increase so... Inc. TBG No change TSH Inc. Tot T4 No change Free T4

Question 46

Treatment of choice for DVT in pregnancy?

Answer 46

SQ LMWH (e.g. Dalteparin, Enoxaparin)

Question 47

Phyllodes Tumor keywords Tx

Answer 47

large, solid (hypoechoic), well circumscribed, smooth, polylobulated mass that rapidly grows Tx: Wide Local excision

Question 48

Tx. Pelvic Inflammatory Disease (PID) inpatient and outpatient

Answer 48

Inpatient: Clindamycin + Gentamicin Outpatient: Ceftriaxone + Doxycycline (Azithromycin if pregnant)

Question 49

Which types of HPV are associated with vulvar cancer?

Answer 49

16, 18 | 31