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MS3 > OBGYN > Flashcards

OBGYN Flashcards

1
Q

adenomyosis

A

cyclic pelvic pain with menstruation, heavy bleeding
typically in parous 40+ woman
- PE; soft, boggy, uniformly enlarged uterus

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2
Q

breast lump found on PE, now what?

A

> 30- mammaography +/- US

<30 - US+/- mammography

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3
Q

epidural anesthesia AE

A
  1. ) leakage of CSF into dura- symptoms: postural headache
  2. ) total spinal/high spinal: when anesthesia ascends to head and depresses brainstem- causes bradycardia, hypotension, and respiratory difficulty
  3. ) hypotension caused by sympathetic Ns involvement leads to venous pooling, decreased preload, decreased contractility
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4
Q

stroke/other thrombotic event + recurrent pregnancy loss

A

Antiphospholipid syndrome

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5
Q

for labor to be arrested, what needs to be met?

A
  • > 4 hrs of no cervical change with ADEQUATE contractions

- >6 hrs of no cervical change WITHOUT adequate contractions

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6
Q

treatment for arrested labor vs protraction of labor?

A

arrest- c section

protraction- oxytocin

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7
Q

whats adequate contraction

A

> 200 MVUs

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8
Q

how do you work up decreased fetal movement in a fetus WITH heart beat

A
  • do a non-stress test for >40min to assess if the fetus is just in regular sleep cycle or if something is wrong. Reactive= 2+ acc and is normal and can rule out fetal acidemia
  • if nonreactive, you can do either a BPP (biophysical profile) or CST (contraction stress test). dont do CST if there are contraindications to labor, like placental previa or prior mymectomy!
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9
Q

what is BPP

A

a test to assess fetal oxygenation, a score less than 8/10 suggests placental dysfunction. Each category gets either 0 or 2

  1. NST
  2. amniotic volume: single pocket >/=2 cm or index>5
  3. fetal movement>/=3
  4. > /=1 flex or ex
  5. > /=1 breathing in 30 sec
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10
Q

in a fetus without doppler heart beat whats next?

A

transabdominal US to find heart beat. if not there, it confirms fetal demise.

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11
Q

define pre-ecclampsia

A

BP > 140/90 on 2 occasion with proteinuria prot:creat>0.3 at greater than 20 wk

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12
Q

define pre-ecclampsia w severe features

A

either severe htt > 160/110

creat>1.1, elevated transaminases, plt <100,000, headache or visual changes

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13
Q

pt w nonviable fetus in breech position

A
  • do vaginal delivery not csection
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14
Q

how can you figure out cause of FGR?

A
  • if symmetric (aka head and body are smaller by same amt) its most likely a 1st tri prob such as chromosomal abnormality
  • if asymmetric (aka head and body smaller by diff amounts) most likely a 2nd/3rd tri prob like htt
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15
Q

what is intertrigo

A

red beefy plaques in skin folds usually due to candida

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16
Q

when to stop PAP

A

age 65 with no history of CIN 2+ and 3 consecutive neg paps

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17
Q

how can you tell normal pregnancy vomitting from hyperemesis gravidum

A

get a urine ketones

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18
Q

how do you treat a pt with confirmed chlamydia by NAAT

A

just azithromycin or doxy

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19
Q

what are causes of maternal virilization in pregnancy

A
  1. placental aromatase def
  2. luteoma - bilat solid mass on ovaries
  3. theca lutein cyst - bilat cystic (low risk of fetal vir)
  4. sertoli leydig tumor - solid unilat ovarian mass
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20
Q

lichen sclerosis on genitals treatment

A

high dose corticosteroid ointment, clobetasol

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21
Q

what do you do if uterus prolapses during placental traction

A
  • 2 large bore IVs with crystalline fluids and blood products
  • replace the uterus, LEAVE THE PLACENTA ON THE UTERUS to prevent massive hemorrhage
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22
Q

ovarian cyst with hyperechoic calcifications?

A

dermoid

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23
Q

loss of fetal station (fetus goes from station 0 to -3)

A

pathognomonic for uterine rupture

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24
Q

what is tachysystole?

A

increased rate of uterine contractions, More than 5 in 10 mins, for over 30 mins

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25
Q

what is the pathophys of gestational diabetes mellitus?

A

increased insulin resistance because of HPL to help shunt more glucose to fetus. If the insulin resistance overpowers the pancreatic B cell insulin production, this leads to GDM

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26
Q

breast that is erythematous, warm, with dimpling in setting of no fever

A

Inflammatory Breast Carcinoma.
(not mastitis, not abscess).
peau dorange

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27
Q

physiologic changes during pregnancy for mom?

A
  • hypercoag. state: increase in fibrinogen, decrease prot C/s
  • gestation thrombocytopenia
  • dilutional anemia
  • renal: increased GFR and RBF causes decreased BUN and creat, BM more permeable so more urine protein
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28
Q

variable deceleration

A
  • “Intermittent”nadir does not correspond to contraction peak >50%
  • “recurrent” nadir does correspond to peak, BUT are sharper and steeper, must be <15 sec from onset to nadir
    causes: cord compression, cord prolapse,oligohydramnios
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29
Q

early contraction

A
  • nadir occurs at same time as contraction peak, must be >30 sec from onset to nadir
    causes: fetal head compression, or can be normal
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30
Q

late contraction

A

nadir occurs after contraction; must be >30 sec from onset to nadir
causes: placental insufficiency

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31
Q

what is the treatment for variable decelerations?

A
  • if intermittent, risk of fetal acidemia is low, and treatment not needed
  • if “recurrent” risk of fetal acidemia is greater, and treatment needed. 1st line is maternal repositioning. 2nd line amnioinfusion
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32
Q

how to manage endometriosis

A
  • NSAIDs, hormonal contraceptives

- if these fail do a laparoscopy

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33
Q

what is a main side effect of endometriosis

A

infertility

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34
Q

how do you manage pre-term labor?

A

if <34 wks try nifedipine or indomethacin which are tocolytics
>34 wks, deliver. if in breech or contraindication to labor do c-section

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35
Q

what is chorioamnitis

A
  • an intramniotic infection due migration of vaginal or enteric flora through cervix.
  • increased risk in prolonged ROM >18 hrs, protracted labor
  • to diagnose: maternal fever + either: fetal tachy (>160) or maternal tachy (>100), maternal leukocytosis, uterine fundal tenderness, purulent amniotic fluid
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36
Q

Raloxifene

A

estrogen antag in breast and uterus,agonist in bone

contraindication: VTE

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37
Q

ecoli bacturia treatment

A

1st tri-not bactrim!! can use nitrofurantain, ceflexin, amox-clav

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38
Q

how to suppress lactation?

A
  • engorgement of breasts itself leads to supression via negative feedback. it is not recommended to use dopamine agonists. Just advise a comfortable supportive bra and NSAIDS
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39
Q

how do you manage chorioamnitis?

A
  • broad spectrum antibiotics
  • NSAIDs to break maternal fever
  • labor augmentation
  • do NOT give tocolytics, and do NOT wait for expectant management
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40
Q

management of hyaditiform mole?

A
  • D&C, followup with quants until undetectable, then follow for 6 mo, do contraception and can TTC after 6 mo.
  • signs that HM has progressed to gestational trophoblastic neoplasia: if quant doesn’t become undetectable and plateaus, if quant increases in the 6 mo
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41
Q

cyst at 4 and 8 oclock of vaginal itroitus

A

Bartholin cysts

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42
Q

pararethral cysts

A

skenes glands

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43
Q

how to treat a positive PAP in a pregnant pt

A
  • if HSIL, then need immediate culposcopy and cervial biopsy DO NOT DO endocervix curettage! then follow up with LEEP if needed
  • if ASCUS or LSIL, then do HPV co test
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44
Q

when do you do rectovaginal swab for GBS

A

35-37 wk

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45
Q

painless vaginal bleeding in 3rd trimester pregnant woman with loss of FHR variability

A

placenta abruptio

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46
Q

what can a progestin challenge test show

A

if no bleeding occurs it can be suggestive of a low estrogen state

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47
Q

post coital bleeding+ friable cervix+ discharge

A

acute cervicitis
need NAAT testing to prove NG or CT
usually no organisms on light microscopy

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48
Q

obesity amennorrhea is caused by?

A

anovulation

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49
Q

what are the 3 D’s of endometriosis ?

A

Dysmenorrhia
Dysparuenia
Dyschezia

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50
Q

how much folic acid for woman with prior preg w neural tube defect

A

4mg

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51
Q

what is the first step of evaluating the risk of preterm labor?

A
  • TVUS in 2nd trimester to see how short the cervix is
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52
Q

how do you manage preterm labor risk

A
  1. ) no history of preterm labor but short cervix- progesterone vaginal pill
  2. ) history of preterm labor only- progesterone IM shot in 2nd trimester
  3. ) history of preterm labor + short cervix- progesterone IM shot+ cerclage.
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53
Q

Methylergonovine is a ? contraindications are?

A
  • uterotonic

- contraindication: htt

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54
Q

carboprost is a ? contraindications are?

A
  • uterotonic

- contraindication: asthma

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55
Q

US shows adnexal mass with debris in the setting of fever, leukocytosis, and increase of Ca 125 and inflamm markers in a 40 yo?

A

tubo-ovarian abscess.

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56
Q

DCIS vs intraductal papilloma

A

while they might both present with unilateral bloody nipple discharge, but DCIS would show mammogram abnormalities

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57
Q

placenta previa management

A

diagnosed @ 18- 20wk.
advise no intercourse, no digital cervical exams
delivery by Csection at 36-37 wk

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58
Q

kleihauer betke test

A

may need higher dose of rhogham post partum, this test can determine that

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59
Q

when should you schedule a planned C-section

A

only at 39 wk or later

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60
Q

mammogram at?

A

40+

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61
Q

colonoscopy at?

A

50+ repear every 10 yr ; if you have a fam member with Colon ca under 60 then you can get it at 40 and repear every 5 years

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62
Q

biggest osteoporosis risk factor

A

family history

age > 60

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63
Q

what are the respiratory changes seen in pregnancy

A

IRV, TV, and IC increases
RR stays the same
- FRC decreases by up to 80%
hence the resp alkalosis of pregnancy

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64
Q

how do thyroid hormone levels change in pregnancy

A

there is more TBG, so total levels of T3 and T4 will increase but free levels of T3 and T4 should be the same

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65
Q

what are the wt gain recs for preg

A

underwt: 30-40
normal- 25-35
overweight: 12-25
obese: 11-20

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66
Q

CVS can detect what

A
  • karyotype abnormalities

- CF

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67
Q

folic acid doses ?

A

0.4 if no risk

4 if previous NT defect

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68
Q

MOST common cause of increased AFP?

A
  • underestimated GA
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69
Q

amniocentesis vs quad screen vs CVS

A

amnio is for women who are >35 and have an abnormal finding to asses chrom abnorm
quad screen is for everyone to asses chrom abnorm
CVS is specific for DS.

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70
Q

what do you do if you can’t obtain fetal heart rate and pt is in labor

A

apply fetal scalp electrode

DO NOT give epidural until FHR is monitored

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71
Q

BRCA positive patient contraception

A

copper IUD, no hormones whatsoever

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72
Q

what are the different ABO incompatibility

A

if a mom is O, she most likely has ab preformed to A and B which can cross the placenta. fetus might experience mild hemolytic disease
if mom is A or B, the antigens on the RBC are too large IgM pentamers and will not cross the placenta

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73
Q

Tamoxifen where are its effects? whats its side-effect?

A

-antagonist in the breast
- agonist in the uterus
- can prevent ovarian ca, not enough studies
most common side effect is hot flash

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74
Q

PPROM management?

A

if under 34 wk, and with infection or if over 34 wk deliver. give penicillin+ corticosteroids, do not give tocolytics
- if under 34 wk and without infection give penicillin and corticosteroids and wait

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75
Q

HIV in pregnancy management

A

best way to prevent transmission is the 3 drug therapy

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76
Q

gait ataxia, eye nystagmus, and alt mental status in pt with hyperemesis gravidum

A

Thiamine Def- Wernicke’s encephalopathy

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77
Q

Todd paralysis

A

transient unilateral weakness post seizure

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78
Q

anterior vs posterior shoulder dislocation

A

ant: FOOSH, causes slight abducation and ex rot
post: ex seizure, causes adduction and in rot

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79
Q

post partum endometritis

A

uterine cavity gets polymicrobial infection from vaginal flora during delivery.
usually presents >24 hr after delivery. signs= fever, purulent lochia, uterine tenderness
treatment: gent + clinda

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80
Q

condyloma acuminata

A

genital warts

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81
Q

what is the discretion area for bHCG levels

A

> 1500 you should see something on US

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82
Q

recurrent candida + urinary symptoms like increased frequency

A

check Hba1c

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83
Q

do OCPs cause wt gain?

A

Myth. No they do not

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84
Q

intrauterine demise with bone fractures and hypoplastic thoracic cavity

A

OI 2

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85
Q

how does abruptio placentra present

A

back pain or abdominal pain in a pt w/ or w/o bleeding (b/c bleed can be behind + contained by placenta) and FHR variations can indicate severity. sometimes uterine height can be larger than expected.

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86
Q

when would you offer external cephalic version?

A
  • if the fetus is atleast 37 wks, in breech position, and mom has no contraindications to vaginal delivery and desires a vaginal delivery.
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87
Q

when in a pregnancy do you give RhD ?

A

28-32 wks Gest

and 72 hr post delivery if (+)

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88
Q

most likely cause of bleeding in an operative vaginal delivery

A

some unresolved laceration. check GU tract, check GI tract, check vaginal canal

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89
Q

signs of pre-ecclampsia at less than 20wk is due to?

A

Hyaditiform Mole

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90
Q

management of IUFD

A

> 24 wk vaginal delivery

<24 wk D+C

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91
Q

delivery of PPROM is usually >34 wk GA, but what are indications to deliver prior to that?

A
  • signs of infection: increased fetal HR, fever
92
Q

management of finding atypical glandular cells

A

this is concerning for cervical or endometrial adenocarcinoma. need to do the following: (1) colposcopy (2) endometrial biopsy (3) endocervical curettage

93
Q

no urination 6 hours post partum, with overflow incontinence?

A

acute post partum urinary retention usually due to epidural causing detrusor underactivity aka bladder atony, cath her!

94
Q

what are exercise rec for pregnant women?

A

20-30 min of moderate activity a day. Contact sports, gymnastics, skiing, high fall risk sports are contraindicated.
exercise contraindicated in women with pre-ecclampsia, risk of preterm delivery,

95
Q

what causes enlarged ovaries in Hyatidiform Mole?

A
  • the proliferative trophoblastic tissue makes a lot of BHCG that stimulates the ovaries to make theca lutein cysts
96
Q

low pregnancy wt can cause

A

preterm labor

FGR

97
Q

if youve had a classic c-section what is contraindicated

A

a vaginal delivery. must do next birth as csection

98
Q

aromatase def?

A

normal internal genitalia, virilization, osteoporosisat puberty, small breasts, and acne/hair

99
Q

when do you do oral glucose tolerance test

A
  • at end of 2nd trimester
100
Q

clear mucus from vagina?

A

can be due to ovulation

101
Q

sexually active w RUQ pain and lower abdominal pain

A

Fitz Hugh Curtis

102
Q

ovarian cancer vs teratoma

A

keep an eye on the age

also ca will show ascites, and septations with solid components.

103
Q

why can oxytocin prolonged exposure cause seizure?

A

oxytocin looks like ADH, which can cause increased water retention leading to seizure. note that this will be in the setting of hyponatremia

104
Q

Mg toxicity after MG administration

A

due to renal insuff.

105
Q

pseudocyesis

A

when pt has somatization of pregnancy. feels pregnancy symptoms and may even read a NEG pos test as POS

106
Q

whats the best way to estimate gestational age?

A
  • first trimester US has less discrepency than 2nd or 3rd
107
Q

how to medically manage preterm labor

A

> 34 wk +/- bethamethosone and penn
32-34 wk: bethamethasone, penn, and tocolytics (nifedipine or indomethacin)
less than 32 wk: bethamethsone, penn, tocolytics, and MgSO4 (for neuroprotective)

108
Q

primary amenorrhea ages

A

13 w/o 2ndary sex

15 w/o 2ndary sex

109
Q

if you suspect granulosa tumor what else do you have to check

A

EMB bc endometrial hyperplasia.

110
Q

what is septic thrombophelbitis

A

post partum or post op phlebitis of ovarian or pelvic veins. it is a diagnosis of exclusion which has a fever unresponsive to ab

111
Q

how do infants born to moms with graves disease present

A

with thyrotoxicosis vs the anti TSH ab cross placenta and cause hyperthyroid in baby

112
Q

acute maculopap rash involving palms and soles

A

TSS

113
Q

what puerperineum

A

shaking, chills, and lochia

114
Q

how to eval 2ndary amenn

A

TSH, FSH, PRL

115
Q

pt with active HSV in labor

A

do csectin

do 36 wk acyclovir treatment to lower risk of active infection

116
Q

umbilical cord prolapse management

A

elevate fetal head, call for emergent csection

DO NOT try to put the umbilical cord back, do not tell pt to start pushing, do not use forceps

117
Q

when do you give Pitocin to bring along labor?

A

if contractions are not powerful enough, you need to place iUPC to determine this

118
Q

fetal hydantoin features are ?? caused by?

A

features are small body, microcephaly, mid face hypoplasia , microcephaly,cleft lip and palate, digital hypoplasia, hirsutism, devptl delay
caused by anticonvulsants- like phenytoin and carbamazepine

119
Q

how can you tell apart placenta previa and vasa previa

A

placenta is loss of mother’s blood for FHR is normal. vasa is fetal blood so FHR shows deterioration

120
Q

twin twin transfusion syndrome

A

monochorionic pregnancy where donor twin is small and pale and recipient twin in large and plethoric.
recipient twin is at risk for: polycythemia, hydrops, polyhyrdamnios
donor twin at risk for oligohydramnios, and IUGR

121
Q

infants born to diabetic moms are at risk for

A 
hypoglycemia 
hypocalcemia 
RDS
hyperbilirubinemia 
polycythemia
122
Q

what are contraindications to giving newborn nalaxone

A

any history of substance use in mom during pregnancy

123
Q

breast feeding decreases the risk of what cancer

A

ovarian

124
Q

methylergonovineiscontraindicated in what

A

pre-ecclampsia and hypertension

has vasoconstrictive properties

125
Q

what are the milk hormones

A

progesterone is for PROduction

oxytocin is for ejection. oxy is stimulated by suckling

126
Q

whats the progesterone level for a viable uterine pregnancy?

A

> 25

127
Q

when do you screen for gest diabetes

A

at 24 and 28 wks if no other risk. but if over 30 BMI do it at first visit. Do 1 hr GTT then do 2 hr

128
Q

systolic ejection murmur with a click in pregnancy is?

A

MVP give Bblocker if symptomatic

129
Q

T/F Chest Xray is ok if you suspect pneumonia?

A

True its ok

130
Q

being overweight puts you at risk for what pregnancy things

A
  • htt

- pre-ecclampsia

131
Q

what drug can you not use for depression in pregnancy

A

cannot use Paroxetine!! will cause cardiac defects

132
Q

what causes excess itching in pregnancy?

A

intrahepatic cholestasis of pregnancy. bile salt deposited in the dermis which causes itching.
treatment: ursodeoxycholic acid or naltrexon

133
Q

when is the risk of congenital varicella the lowest?

A

first trimester

134
Q

what does mg tox look like and what do you do

A

when pt has resp failure (suddenly less RR) or has loss of deep tendon reflexes.
stop MgSO and give CaGluconate

135
Q

What is the goal of antihypertensive therapy in a pre-ecclampsia exacerbation

A

90-100 is considered ‘safe’

136
Q

what can be seen with RH disease on US?

A

collection of fluid in 2+ cavities ex ascites, pericarditis, scalp edema.
also extramedullary hematopoiesis like helpatosplenomegaly

137
Q

100 mcg of Rhogham neutralizes how many fetal RBC? how much blood?

A

RBC- 5 cc
blood- 10 cc
cc= mL

138
Q

which ab’s are concerning for isoimm in preg

A

Lewis Lives
Duffy dies
Kell kills

139
Q

if hemolytic disease is severe in utero what should you do?

A
  • deliver
  • if too young to delivery than do intrauterine transfusion
  • if that doesn’t work do maternal plasmapheresis
140
Q

twin twin transfusion occurs in

A

monochorionic diamniotic pregnancy

141
Q

when is radiation exposure most likely to cause intellectual disability

A

8-15 wk GA

142
Q

what is the turtle sign

A

fetal head retraction, a sign of fetal shoulder dystocia. do mcroberts manuever

143
Q

multiple prior csections puts mom at risk for what preg complication

A

placenta accreta

144
Q

what condition is MgSO4 contraindicatedin

A

MG

145
Q

bethamethason in preterm labordoes what

A

increase fetal pulm maturity and decrease RDS risk
decrease IVH risk
decrease nec enterocolitis risk

146
Q

fetal fibronectin

A

high NPV for preterm labor

a sticky protein btw the amniotic mem and decidua

147
Q

how does Magnesium sulfate work?

A
  • it competes with Ca entry into the myometrium
148
Q

whats the point of tocolysis

A

to allow time for steroids to work

149
Q

amp and erythromycin apart from preventing chorio can do what else?

A

prolong latency for 5-7 days

150
Q

17 OH progesterone can decrease risk of

A

PPROM

151
Q

when is labor recommended for women with PPROM?

A

34 wks

later than that increases risk of chorio

152
Q

1st step in management of minimal fhr variation

A

fetal scalp stim

153
Q

methylergonovineiscontraindicated in what

A

pre-ecclampsia and hypertension

154
Q

whats the def of PPH

A

> 500 cc post vaginal delivery

>1000 cc post csection

155
Q

how to surgically manage uterine atony

A

B stitch

156
Q

endometritis treatment

A

amp and gent

or after csection gent and clinda

157
Q

t/f breast engorgement can cause low grade fever

A

T

158
Q

septic thrombophlebitis

A

a diagnosis of exclusion. post partum fever due to clot in one of the pelvic arteries

159
Q

SSRI side effects

A

sleep disturbance

sex def

160
Q

3rd trimester SSRI use can cause?

A
  • extrapyramidal symptoms, poor feeding, agitation
161
Q

post term pregnancy are associated with

A

fetal adrenal hyperplasia, placental sulfatase def, anencephaly, unknown dates

162
Q

post term pregnancies cause

A

macrosomia, oligohydramnios, meconium aspiration, placental insuff

163
Q

what does amniotic infusion cure

A

repetitive variable decelerations

164
Q

fetal dysmaturity

A

when fetus is more than 43 wk

withered, meconium stained, long nails, small placenta

165
Q

what an IUGR cause later in life

A
  • cardiac disease, T2DM, htt, stroke COPD
166
Q

DepotProvera side effects

A

usually causes irregular bleeding for 2-3 months, but by 1 year half of the pts are amenorrheic

167
Q

Insufficient urethral sphincter fix

A

urethral bulking techniques

168
Q

definitive tx for endometriosis

A

hysterectomy and BLSO

169
Q

chadwick sign

A

blue cervix, indicative of pregnancy

170
Q

dysmenorrhea within 2 years of menarche is most likely due to

A

prostaglandin production

171
Q

Factor Vleiden mom, IUFD, wheres the clot?

A

ureteroplacental A NOT the umbilical cord!! bc moms rbc dont cross placenta!

172
Q

what medication for women with hypothalamic amenorrhea

A

COCs

173
Q

in setting of normal DHEA, testosterone, andTSH what other lab could you order for hirsutism? why?

A

17OHProg for late onset CAH

174
Q

how to f/u suspected cushings

A

overnight dexamethasone

24 hr urinary cortisol

175
Q

what is postpartum telogen effulvium?

A

increased estrogen levels in pregnancy cause synchronized hair growth, with decrease in the estrogen all the hair is lost at the same time.

176
Q

after OCP what can be used as pharmacotherapy for hirsutism

A

Spironolactone

177
Q

what is danazol for

A

endometriosis

178
Q

primary vs secondary dysmennorrhea?

A

primary is unknown cause

secondary is KNOWN underlying cause like endometriosis

179
Q

what causes menopausal symptoms in a post menopausal pt s/p hysterectomy w LSO

A
  • menopausal ovaries create androgens still, so post TAL LSO they stop producing the adrogens which can be perpipherally converted, causing return of menopausal symptoms
180
Q

estrogen replacement therapy has what effect on lipid profile

A

HDL up

LDL and TG low

181
Q

how to eval infertility with a history of PID

A
  • hysterosalpingogram
182
Q

exercise induced hypothalamic amenorrhea has what hormone levels?

A

low FSH but low estrogen

183
Q

PMS treatment

A

Calcium 1200

184
Q

partial mole vs complete mole

A

partial HAS fetal parts and is XXY caused by dispermy
complete NO fetal parts bc empty egg and one sperm 46XX
complete has higher risk than partial for GTN

185
Q

molar pregnancy is often accompanied by what other symptoms?

A
  • HCG looks like T4, so youll be hyperthyroid with weight loss, increased DTRs, etc but with LOW TSH
  • also will have ovarian stim so see cysts
186
Q

T/F Bartholin Gland cyst in post menopausal women

A
  • most likely a bartholin gland malignancy
187
Q

invasive vs microinvasive cervical cancer

A

invasive invades past BM >3 cm

invasive invades past BM <3 cm

188
Q

when do you do cervical colonization

A

with a pos ECC

189
Q

most common symptom of fibroids

A

heavy menstrual bleeding

190
Q

vagismus therapy

A
  • vaginal dilators
191
Q

MS causes what kind of incontinence

A

urge- bladder hyperactive

192
Q

what is tachysystole

A

more than 5 contractions every 10 mins for 30 min period

193
Q

chickenpox during pregnancy

A

give baby Varicella IG

if baby shows signs of pox give acyclovir

194
Q

decreased breath sounds and fever 2 days s/p c-section

A

atelectasis

195
Q

why are younger women more susceptible to GC/CT

A

because bigger transitional zone on cervix. more columnar epithelium outside os than MUCH after puberty

196
Q

pregnant woman comes in for 1st prenatal visit with FH of DM, whats the management?

A

1 hour Glucola at initial visit.

if no FH you can wait til 28 wk screen for GDM

197
Q

1 hr Glucola limit

A

> 140

198
Q

under what pressure is it considered hypotonic contractions

A

> 40 mmHg

199
Q

what is idiopathic hirsutism

A

normal Test DHEA levels but hirsute

cause: increased 5a-reductase, which causes increased test–>DHT, which is more potent

200
Q

if VDRL + whats next in confirming syphillis

A

FTS-AB

201
Q

PAP tests for HIV pt

A

2x first year then annually

202
Q

sudden fetal decel after SROM when fetus is in -1

A

chance of cord prolapse

do pelvic exm

203
Q

contraindications to OCPs

A
  1. ) >35 yo smoker
  2. ) uncontrolled htt
  3. ) DVT
204
Q

vaginal bleeding, pelvic mass, + hydroureter

A

cervical cancer

205
Q

if GBS is unknown under what conditions do you give abx

A
  1. ) SROM for 18+hr
  2. ) fever
  3. ) history of GBS
  4. ) preterm
206
Q

fetal anemia shown by what on FHR

A

sinusoidal waves

207
Q

signs of virilization

A

clitoromegaly, changein voice, muscle distribution changes

208
Q

how to tell apart PCOS from sertoli leydig tumor

A

clitoremgaly and other signs of virilization are only seen in sertoli leydig

209
Q

bartholin duct cyst vs abscess

A

cyst can be symptomatic or asymptomatic but it is never tender or erythematous
the abscess meanwhile is tender and erythematous

210
Q

what are severe features of pre-ecclampsia

A

plt <100000
transamnitis
head ache visual changes
creatinine >1.1

211
Q

whats the most effective strategy in reducing HIV transmission during birth

A

combination HAART

c-section can also help if load >1000

212
Q

frequent complication of dermoid cyst is _____ but not so mch ___

A

torsion NOT rupture

213
Q

what do thyroid hormones look like in pregnancy

A

elevated total T3 and T4 (estrogen inc TBG)
decreased TSH (bHCG binds TSH receptors and causes neg feedback)
normal free T4

214
Q

what is genitourinary symptoms of menopause

A

urogenital atrophy causes urgency incontinence

215
Q

what is anemia in pregnancy

A

<10.5

216
Q

what is pubic symphysis diaphysis

A

progesterone loosens the pubic symphysis. macrosomia, multiparity, and forceps can cause a symptomatic pubic symphysis diastasis which causes midline abdominal pain that might shoot ot the back or down the legs in change of position

217
Q

FGR signs

A

thin loose skin, wide ant fontanelle, thin umbilical cord

218
Q

whats the first step in evaluating a pt’s risk for preterm labor

A

transvaginal US

digital cervical exam and abdominal US also work but are not as indicative.

219
Q

what is contraction stress test

A

external monitoring of FHR during labor or induced contractions

220
Q

define oligo

A

biggest pocket <2 cm , AFI < 5

221
Q

NST can ____ BPP assess ____

A

rule out fetal acidemia

BPP assess fetal oxygenation

222
Q

Behcet syndrome

A

vascular problem with oral andgenital ulcers

223
Q

condyloma accuminata treatment

A

trichloroacetoacid or pdophyllin resin

224
Q

MVA successful before??

A

8wk

225
Q

PID therapy

A

Cef + Doxy (or gent)

MS3 (6 decks)

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