OBGYN

Question 1

How can you quantify a worrisome level of vaginal bleeding?

Answer 1

> 1 pad/hour

Question 2

What are causes of uterine bleeding in non-pregnant patients?

Answer 2

1. Dysfunctional (anovulatory) uterine bleeding
2. Fibroids/polyps/tumors
3. PID
4. Endometrial hyperplasia/cancer
5. Coagulopathies
6. Other

Question 3

What is the most common cause of uterine bleeding in the non-pregnant patient?

Answer 3

Dysfunctional (anovulatory) bleeding

Question 4

Post-menopausal uterine bleeding is

Answer 4

Cancer until proven otherwise

Question 5

What are the four main causes of first trimester uterine bleeding?

Answer 5

1. Spontaneous (or threatened) abortion
2. Ectopic
3. Molar pregnancy
4. Implantation bleeding

Question 6

What do all pregnant patients with uterine bleeding need?

Answer 6

Rh bloodwork

Question 7

Which pregnant patients need Anti-D immune globulin?

Answer 7

Those that are Rh negative

1. 50 mcg in first trimester
2. 300 mcg in second and third

Question 8

What finding on ultrasound DOES NOT rule out an ectopic pregnancy?

Answer 8

Normal looking adnexa. The only thing that does is an IUP.

Question 9

On an indeterminate US, what other findings would be concerning for ectopic?

Answer 9

1. No IUP but HCG > 1,500 already
2. Fluid in the cul de sac
3. Adnexal mass

Question 10

What is an inevitable abortion?

Answer 10

Os is open

Question 11

What is an incomplete abortion?

Answer 11

Os open and some tissue still present

Question 12

What is a spontaneous abortion?

Answer 12

Termination of pregnancy before 20w

Question 13

What is a threatened abortion?

Answer 13

Vaginal bleeding in early pregnancy with a closed os

Question 14

How many threatened abortions will result in a miscarriage?

Answer 14

50%

Question 15

In a women who is at risk for STDs that presents with lower abdominal or pelvic pain, who should be treated?

Answer 15

CDC recommends anyone with uterine, CMT, or adnexal tenderness