OBGYN

Question 1

Endometriosis

Answer 1

pain a couple days before period and lasts throughout
dyspareunia
chocolate cysts
most common spot is ovaries
Gold standard diagnostic- Laparoscopy
Tx- Nsaids 1st, oral contraceptives 2nd

Question 2

Asherman syndrome

Answer 2

adhesions within the uterus
usually caused by D&C
can be due to endometritis or past OB problem
could cause secondary ammenorhea

Question 3

Bacterial Vaginosis

Answer 3

caused by Gardnerella
Change in vaginal flora (not an sti)
Fishy odor (KOH prep)
Clue cells
Positive amine test
PH >4.5
Thin, grey/white discharge
Tx Metronidazole (Flagyl) 500 mg bid 7 days
If nursing/pregnant women then Clindamycin

Question 4

Candidiasis (yeast infection)

Answer 4

Thick/ white/cottage cheese
satellite lesions
PH 4-4.5
Tx Fluconazole (Diflucan) 150 mg x 1 dose

Question 5

Trichomonas

Answer 5

Most common STI
PH 5-6
Strawberry cervix
Punctate hemorrhages on cervix
frothy, green/ yellow discharge
Tx metronidazole

Question 6

HPV subtypes

Answer 6

Cervical cancer 16 and 18

Genital warts 6 and 11

Question 7

Atrophic Vaginitis

Answer 7

decrease in estrogen
vaginal dryness
pale, smooth shiny vagina
loss of elasticity, narrowing of introitus
dyspareunia
uti sxs
tx first is vaginal moisturizers, 2nd topical estrogen

Question 8

Lichen sclerosis

Answer 8

main symptom is pruritus of vulva and anus

Question 9

Bartholin cyst

Answer 9

first tx- word catheter

if fail word 2-3 times then marsupilization

Question 10

Dysfunctional uterine bleeding

Answer 10

problem with adolescents girls or perimenopause women
hormonal problem and bleed too much or too often
tx- hormone (OCP) and nsaids (nsaids decrease bleeding in uterus)

Question 11

primary amenorrhea

Answer 11

by 13 without secondary sexual characteristics

or 16 with sexual characteristics

Question 12

secondary amenorrhea

Answer 12

cessation of period for 3 months if previous cycles normal

cessation of 6 months if irregular menses

Question 13

FSH to diagnose menopause

Answer 13

FSH >30 is diagnostic

Question 14

HRT for menopause side effects

Answer 14

increase cardiovascular disease
breast cancer

can’t use if unexplained vaginal bleeding, h/o dvt or PE, gynecology cancers

Question 15

fibrocystic vs fibroadenoma in breasts

Answer 15

fibrocystic are painful (fluctuating size)

fibroadenoma are painless (round, firm, mobile, non tender)

Question 16

mastitis tx

Answer 16

penicillinase resistant abx- naficillin or dicloxacillin or cephalosporin with hot compress

mastitis is usually staph (especially lactating mothers-continue to breast feed or pump and dump)

Question 17

most common breast cancer

Answer 17

invasive ductal cancer

Question 18

what does US show on PCOS

Answer 18

string of pearls

oyster ovaries

Question 19

Physical exam sign in PID

Answer 19

chandler sign- cervical motion tenderness

Question 20

infertility

Answer 20

haven’t got pregnant within a year of having unprotected sex

Question 21

How to calculate due date

Answer 21

subtract 3 months and add 7 days

Question 22

Where is pregnancy at 20 week

Answer 22

umbilicus

Question 23

When should you get quickening (movement)

Answer 23

18 weeks

Question 24

normal fetal HR

Answer 24

120-160

Question 25

what do contractions do to fetal hr

Answer 25

deceleration (decrease flow to placenta) | compress head

Question 26

Stages of labor

Answer 26

1st- from contractions to full dilation 2nd- full dilation to delivery of baby 3rd delivery of placenta

Question 27

late decelerations

Answer 27

bad uteroplacental insufficiency (early decels are ok and are due to contraction)

Question 28

APGAR

Answer 28

1 and 5 min appearance (blue, pink trunk/blue extremities, pink) pulse (absent, 100) grimnance (absent, facial movement, sneeze/cough) activity (absent, some flexion, full) respiration (absent, slow irregular, good crying)

Question 29

variable decelerations

Answer 29

cord compression

Question 30

when is the uterus first palpable (above pelvis)

Answer 30

12 weeks

Question 31

HCG in ectopic pregnancy

Answer 31

less then expected HCG should double every 48 hours should see intra uterine pregnancy if HCG >1500 (discriminatory zone)

Question 32

TX for ectopic

Answer 32

methotrexate (folic acid antagonist)- if stable if unstable surgery must follow HCG to make sure it returns to normal

Question 33

Hydatidaform moles

Answer 33

complete more common then partial choronic villi that has grown like tumor US shows grape like clusters or snowstorm Signs- Uterine size greater then expected HCG greater then expected Hyperemesis gravidarum (extreme nausea from high HCG) Tx chemo

Question 34

Highblood pressure in pregnancy

Answer 34

``` 20 weeks (up to 6 weeks post partum)- If no symptoms- pregnancy induced HTN If asymptomatic- preeclampsia/eclampsia ```

Question 35

Preeclampsia triad

Answer 35

HTN proteinuria edema

Question 36

mild preeclampsia

Answer 36

140/90 w/ >3 g proteinuria (

Question 37

severe preeclampsia

Answer 37

160/110 w/ >5 g proteinuria

Question 38

HELLP syndrome

Answer 38

severe pre eclampsia hemolysis elevated liver enzymes low platelets

Question 39

most common risk factor for preeclampsia

Answer 39

null parity

Question 40

Fetal hydrops

Answer 40

when mom makes antibodies to RH factor and causes fetal anemia

Question 41

abx of choice for pregnant ladies w/ uti

Answer 41

macrobid (nitrofurantoin) amoxicillin cephalexin (beta lactams- ceftriaxone)