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Shelf Exams > OBGYN > Flashcards

OBGYN Flashcards

1
Q

letrozole

A

aromatase inhibitor
↓ estrogen
PCOS

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2
Q

Breech presentation

A

C-section, unless baby is already halfway out

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3
Q

nifedipine

A

Ca+2 channel blocker
tocolytic
Can be used to control BP in preganancy/preeclampsia
available sublingually for fast action

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4
Q

Turner Syndrome
FSH/LH levels
Estrogen levels

A

Primary amenorrhea and short stature
↓ estrogen (streak ovaries)
↑ FSH and LH

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5
Q

Chlamydia tx

A

azithromycin or doxycycline

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6
Q

Gonorrhea tx

A

ceftriaxone

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7
Q

CA-125

A

epithelial ovarian cancer

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8
Q

Hyditaform mole sequela

A

gestational trophoblastic neoplasia (GTN)

monitor ß-hCG until it is zero
if elevated ß-hCG persists → GTN

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9
Q

Uterine rupture

A

loss of fetal station
FHR monitoring abnormalities (late decelerations?)
intense abdominal pain
bleeding

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10
Q

Abruptio placentae

A

tectonic contractions (sinusoidal, frequent, small amplitude)

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11
Q

Hyditaform mole diagnosis

A

↑ ß-hCG
cyst-filled uterus that is larger than it should be for age
snowstorm appearance
vaginal bleeding

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12
Q

Ulipristal

A

Contraceptive
Can be taken up to 120 hours after intercourse
progestin receptor blocker
Delays ovulation and impairs implantation

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13
Q

inadequate contractions

A

<200 Montevideo units

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14
Q

Non-stress test

Reactive vs Nonreactive

A

Continuous FHR monitoring for 20-40 minutes
≥2 accelerations → Reactive (normal)
<2 accelerations → Nonreactive (abnormal)

accelerations = increase of 15bpm for 15 seconds

if nonreactive, complete a biophysical profile
biophysical profile of 8-10 = normal
0-7 means delivery (induction or C-section depending on how bad it is)

Nonreactive is nonspecific for fetal hypoxia/acidemia, or it could just mean baby is sleeping

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15
Q

Lochia

A

postpartum vaginal discharge
Lochia rubra → blood and clots (day 0-4)
Lochia serosa → serosanguinous (clear to pink) (day 4-10)
Lochia alba → white/yellow creamy (day 10-28)

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16
Q

retained products of conception

A

heavy postpartum bleeding

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17
Q

BV tx

A

Clindamycin or metronidazole

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18
Q

intrahepatic cholestasis of pregnancy

A

Risk of fetal demise due to bile acids in blood, which are toxic
the higher the bile acid levels, the higher the risk
pruritus of hands and feet

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19
Q

Syphilis tx

A

penicillin

Penicillin allergy → doxy or ceftriaxone

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20
Q

Phenytoin birth defects

A

Distal finger hypoplasia
cleft lip/palate
microcephaly

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21
Q

tamoxifen

A

SERM
treats and prevents breast cancer
↑ risk of endometrial cancer or uterine sarcoma

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22
Q

Osteogenesis imperfecta type II

A

Bone fractures
limb shortening
hypoplastic thoracic cage
fetal demise

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23
Q

lichen sclerosus tx

A

topical corticosteroids

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24
Q

Preeclampsia

A

HTN
proteinuria (elevated protein-creatinine ratio)
Lower extremity hyper-reflexia and ankle myoclonus

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25
Q

Interstitial cystitis

A

Chronic bladder pain without infection

amitryptiline is first line tx

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26
Q

Fetal heart block

A

SLE

bradycardia

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27
Q

Uterine tachysystole

A

> 5 contractions/10 minutes

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28
Q

Methylergonivine

A

Second line Uterotonic (↓ postpartum bleeding)

Contraindicated in HTN

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29
Q

Carbaprost

A

Second line uterotonic (↓ postpartum bleeding)

contraindicated in asthma

30
Q

Tranexamic acid

A

Decreases blood loss after delivery

antifibrinolytic

31
Q

fetal fibronectin

A

detects cervical prostaglandin release, which may indicate preterm labor

32
Q

Magnesium toxicity

A

hyporeflexia, flushing, nausea
respiratory depression → drowsiness

tx → calcium gluconate

33
Q

diethylstilbestrol

A

discontinued abortion medication

can cause vaginal adenocarcinoma (and infertility)

34
Q

HSIL vs LSIL

A

HSIL → colposcopy

LSIL → HPV testing

35
Q

ACE inhibitor or ARB use in pregnancy

A

Teratogens

Cause oligohydraminos and underdeveloped kidneys

36
Q

Myomectomy

A

surgical removal of uterine fibroids

37
Q

Adenomyosis

A

endometrium invades myometrium (more common right after pregnancy)
heavy menstrual bleeding
chronic pain
uterus symmetrically enlarged and tender to palpation

tx: hysterectomy or levonorgestrel IUD

38
Q

Uric acid and LDH

A

elevated levels indicate hemolysis

used in workup of preeclampsia and possible HELLP syndrome

39
Q

Bishop score

A

predicts probability of vaginal delivery
based on cervical dilation, effacement, position, and fetal station

Bishop score greater than 6-7 is favorable

40
Q

Risk factors for preterm labor

A

prior hx

short cervical length

41
Q

Androgen insensitivity vs Mullerian agenesis

A

androgen insensitivity → XY, phenotypically female due to lack of testosterone receptors, vagina withOUT ovaries, breast development (because defective testosterone receptors cannot inhibit breast proliferation)

Mullerian agenesis → (Mayer-rokitansky-kuster, hauser)
they have ovaries, but absent uterus, cervix, and fallopian tubes

42
Q

ovarian mature cystic teratomas

A

calcified and hyperechoic on US

benign

43
Q

Dehydroepiandrosterone

A

DHEA
androgen produced by adrenal gland and gonads
elevated levels indicate excess androgen production from adrenals

44
Q

Sinusoidal wave pattern on FHR

A

Category III

indicate fetal anemia, (possibly secondary to hemorrhage)

45
Q

choriocarcinoma

A

Malignancy that arises from placental tissue post partum
irregular bleeding
enlarged uterus
pulmonary metastasis
(can also metastasize to brain, vagina, and liver)

ß-hCG levels to diagnose

46
Q

What Gestational age is external cephalic version attempted

A

37 weeks, as it may trigger labor

47
Q

Risk factors for endometrial cancer

A 
unopposed estrogen (medication)
obesity

smoking is protective, because it ↓ serum estrogen

48
Q

Uterine rupture vs abruptio placentae

A

Very similar
Late decelerations, vaginal bleeding, pain
Uterine rupture → irregular protruding vaginal mass

49
Q

maternal serum alpha fetal protein (AFP)

A

↑MSAFP → Neural tube defect

↓MSAFP → Down or Edward syn

50
Q

Magnesium sulfate

A

Seizure prophylaxis in preeclampsia
Neuroprotection in preterm births, helps prevent cerebral palsy

contraindicated in myasthenia gravis

51
Q

stages of labor

A

First stage ends at complete cervical dilation

  • Latent (0-6cm)
  • Active (6-10cm)

Second stage = cervical dilation → fetal expulsion

  • Passive
  • Active

Third stage = fetal expulsion → placenta expulsion

52
Q

5-α-reductase deficiency

A

46 XY, phenotypically female
testis in labia majora, clitoromegaly, blind ended vagina
no breast development (testosterone inhibits breast development)
5-α-reductase converts testosterone → DHT

53
Q

trimesters

A

1st → 0-14
2nd → 14-28
3rd → 28-40

54
Q

PPROM vs PROM

A 
PPROM = Preterm premature rupture of membranes
PROM = Premature rupture of membranes

PPROM is less than 34w
PROM is rupture of membranes without active labor

55
Q

folic acid prenatal dose

A

0.4 mg/day

previous NTD → 4 mg/day

56
Q

vasa previa

A

fetal vessels overlying cervix which are likely to tear during contractions causing some vaginal bleeding and fetal demise

57
Q

chorioamnionitis

A 
Intra-amniotic infection (IAI)
PPROM patients at risk
purulent amniotic discharge
uterine tenderness
immediate induction of labor

antibiotics (amp + gent + clinda)

58
Q

PAPP-A and NT

A

markers of trisomies, measured in 1st trimester
↓ PAPP-A (pregnancy associated plasma protein A)
↑ NT (nuchal translucency)

In Down's, ß-hCG will be ↑
In Edwards (18) and Patau (13), ß-hCG will be ↓
59
Q

Cardinal motions of delivery

A

Every Decent Family In England Eats Eggs

Engagement
Descent
Flexion
Internal rotation
Extension
External rotation
Expulsion
60
Q

Prolonged latent phase

A 
latent phase (0-6cm) should take <20 hours (nulliparous)
<14 (multiparous)
61
Q

Prolonged active phase

A

Failure to progress (in cervical dilation) for 4 hours w/ adequate contractions, or 6 hours w/ inadequate/unknown contractions

if contractions are adequate, then do C-section

62
Q

Prolonged second stage of labor

A

It should only take 2-3 hours of pushing, but you can continue as long as progress is being made
If baby is close to being out, and pelvic anatomy is adequate, consider operative vaginal delivery (vaccum, forceps)
If baby is not close, consider C-section

63
Q

Prolonged third stage of labor

A

Placental delivery should take 30 minutes

64
Q

α-methyldopa

A

CHTN

65
Q

Preeclampsia w/ and w/o severe features

A

Preeclampsia is BP > 140/90 + proteinuria >300mg/dL

Severe features (just need 1) include:

  1. BP > 160/110
  2. Cr > 1.1 or 2x baseline
  3. Plt <100,000
  4. ↑ AST/ALT
  5. RUQ or epigastric pain
  6. Pulmonary edema
  7. HA or visual distrubances

if pt is over 34 weeks, induce labor, or C-section if unstable

66
Q

GBS tx

A

Penicillin (ampicillin)

erythromycin if allergic

67
Q

Cerclage

A

suturing cervix to support cervical insufficiency and prevent premature labor

68
Q

Laceration grades

A

1st: vaginal
2nd: perineum
3rd: anal sphincter
4th: anal mucosa

69
Q

naloxone

A

reverses opioid OD

70
Q

Paget’s disease

A

Red vulvar lesion
benign, confined to epithelium
resection

Shelf Exams (1 decks)

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