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OBGYN EOR > OBGYN > Flashcards

OBGYN Flashcards

1
Q

What is the contraindication for ergotrate in postpartum hemorrhage?

A

hypertension

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2
Q

What gives a false positive syphilis test?

A

rapid plasma reagin

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3
Q

What are painless fleshy papules?

A

HPV

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4
Q

What malignancy is most likely following PCOS?

A

endometrial

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5
Q

What type of mucous do you have during ovulation?

A

soft thin stringy

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6
Q

What is -2.0 on DEXA scan?

A

osteopenia

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7
Q

Why shouldn’t a woman exercise supine?

A

hypotension

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8
Q

What is a hyperpigmented rash in sun exposure on a woman’s face?

A

Malar Rash

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9
Q

Women is 19 and has a new breast mass, what do you do?

A

ultrasound

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10
Q

A women in her 50’s, has irregular bleeding, hot flashes, menopause symptoms, what is she in?

A

perimenopasue

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11
Q

Active bleeding postpartum

A

Uterine Atony

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12
Q

Baby’s knees and hips flexed

A

complete breech

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13
Q

Non-ruggated mass in intritus, posterior, what kind of prolapse?

A

Uterine prolapse

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14
Q

16 year old has signs of premenstrual dysphoric disorder what is the treatment?

A

paroxetine

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15
Q

Women has painful vesicles and ulcers and lymphadenopathy, how do you treat?

A

valacyclovir

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16
Q

How much calcium should a women take?

A

1200 mg

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17
Q

Women has ovarian cancer symptoms, what do you check?

A

Ca - 125

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18
Q

What is the most common sign of ovarian cancer?

A

ascites

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19
Q

When is the first menses after pregnancy?

A

6-12 weeks

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20
Q

Women is 19 and wants to know when to go to the GYN doctor?

A

Go 21 and older every 3 years

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21
Q

What causes LH surge?

A

increase in estogren

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22
Q

Women is large for gestational age and something else is wrong

A

molar pregnancy

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23
Q

What is the caustive agent of Chancroid?

A

H. ducreyi

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24
Q

Ectopic pregnancy but stable, how do you treat?

A

methotrexate

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25
Q

pH is <4.5, what do you expect the discharge to be (candida)

A

curd like

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26
Q

When is the uterus not palpable?

A

2 weeks

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27
Q

Women need birth control postpartum, what do you give?

A

progesterone mini pill

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28
Q

Women has vaginal atrophy, what is the treatment?

A

Vaginal estrogen tablet (its estrogen cream in a tablet) all the other options are estrogen tablets that are PO to confuse you

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29
Q

What stage of labor is the placenta delivered?

A

third

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30
Q

Uterus larger than expected for dates and excess weight gain

A

multiple gestations

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31
Q

When is the fundal heights at umbilicus?

A

20 weeks

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32
Q

Long-term but reversible contraception?

A

IUD

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33
Q

Pregnant patient comes in at 19 weeks, which vaccination is given?

A

influenza IM

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34
Q

MC sx with preterm labor?

A

regular uterine contraction

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35
Q

Cough, laugh, wet

A

stress incontinence

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36
Q

Cough, wet, + ferning test?

A

ruptured membranes

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37
Q

+breast and + uterus?

A

outflow obstruction

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38
Q

LLQ pain?

A

ruptured ovarain cyst or torsion

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39
Q

contraindication of hysteroscopy?

A

pregnancy

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40
Q

side effects to look out for while taking aromatase inhibitors?

A

loss of bone density

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41
Q

What is the benefit of oral contraceptive pills?

A

decrease endometrial hyperplasia (combo)

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42
Q

No ovulation?

A

progesterone bc unopposed estrogen

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43
Q

BV treatment?

A

metronidazole

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44
Q

Unique to trichomoniasis

A

cervical punctate hemorrhages

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45
Q

Most common STD?

A

chlamydia

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46
Q

What is the first-line treatment for prolapse?

A

do kegels - first thing you do for asx prolapse

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47
Q

What is the tx for bartho cyst?

A

warm sitz, I&D, Bactrim, augmentin + clindamycin

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48
Q

What is the tx for a fluid-filled cyst in breast?

A

OCP’s, danazol bromocriptine

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49
Q

What is the causative agent of mastitis?

A

staph aureus

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50
Q

When is fibrocystic disease pain worse?

A

pain worse with caffeine

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51
Q

What is the tx for breast abscess?

A

I&D and dicloxacillin

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52
Q

Induration with fluctuance

A

breast abscess

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53
Q

Pt is experiencing painful contractions for 24 hrs, 10 min apart and 3cm dilated what phase of contractions is this patient experiencing?

A

Latent Phase

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54
Q

Bone scan of -2

A

osteopenia

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55
Q

1st physical sign of menopause?

A

vasomotor instability

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56
Q

Has a breast mass got period 3 weeks ago come back?

A

1 week

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57
Q

Best age where there is no uterine structure path and increase prostaglandins?

A

20 years

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58
Q

PCOS

A

increased free testosterone

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59
Q

Brawny discoloration, edma?

A

inflammatory carcinoma

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60
Q

What do you do about a white lesion on the vagina?

A

bx the lesion

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61
Q

What is a symptom of late-stage ovarian cancer?

A

ascites

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62
Q

Patient presents with a very high Beta hCG indicating Molar pregnancy (Hydatidiform mole), what is the treatment?

A

D and E of the molar pregnancy followed by surveillance of serial human chorionic gonadotropin levels to confirm resolution of disease

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63
Q

How do you initially check if you suspect rupture of membranes?

A

speculum to see pooling

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64
Q

What trimester is the Tdap vaccine administered?

A

3rd

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65
Q

Mexican woman with spots on her face would make you think of what diagnosis?

A

chloasma

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66
Q

Why do you avoid supine position in pregnancy?

A

Hypoxia (compression IVC)

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67
Q

Mosaic vasculature pattern on colposcopy indicates what?

A

CIN (cervical intraepithelial neoplasia)

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68
Q

Symmetric face hyperpigmentation after sun exposure is called what?

A

Malar Rash

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69
Q

How often do you repeat pap smears in a patient with normal pap results in ages 21-24?

A

Every 3 yrs

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70
Q

How often do you repeat pap smears in a patient with normal pap results in ages 25-29?

A

Every 3 yrs

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71
Q

How often do you repeat pap smears in a patient with normal pap results with negative HPV in patients 30 years older?

A

Co-screening every 5 years or pap alone every 3 years

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72
Q

What medication is contraindicated in pregnancy?

A

isotretinoin

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73
Q

How often do you repeat pap smears in a patient with ASC-US pap results in ages 21-24?

A

Repeat pap in 12 month. Acceptable to also do reflex HPV testing.

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74
Q

How often do you repeat pap smears in a patient with ASC-US pap results in ages 25-29?

A

Preferred reflex HPV test. Acceptable to repeat pap in 12 months.

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75
Q

How often do you repeat pap smears in a patient with ASC-US pap results with negative HPV in patients 30 years older?

A

Repeat co-testing in 3 years

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76
Q

How often do you repeat pap smears in a patient with LSIL pap results in ages 21-24?

A

Repeat pap in 12 mos

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77
Q

Pregnant lady comes in for normal routine check-up and she has complains of feeling wet/water whenever she laughs but has a positive ferning test

A

premature rupture of membranes

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78
Q

How often do you repeat pap smears in a patient with LSIL pap results with negative HPV in patients 30 years older?

A

Preferred repeat pap test in 12 months. Acceptable to do Colposcopy.

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79
Q

What is the next step in a pt with LSIL pap results with postive HPV in patients 30 years older?

A

Colposcopy

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80
Q

What is the next step in a pt with ASC-H pap results in ages 21-24?

A

Colposcopy

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81
Q

What is the next step in a pt with ASC-H pap results in ages 25-29?

A

Colposcopy

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82
Q

What is the next step in a pt with ASC-H pap results with negative HPV in patients 30 years older?

A

Colposcopy

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83
Q

What is the next step in a pt with ASC-H pap results with positive HPV in patients 30 years older?

A

Colposcopy

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84
Q

Most likely cause of ROM

A

e coli for UTI

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85
Q

What is the next step in a pt with HSIL in ages 25-29?

A

Immediate excision treatment OR colposcopy

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86
Q

What is the next step in a pt with HSIL pap results with negative HPV in patients 30 years older?

A

Immediate excision treatment OR colposcopy

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87
Q

What is the next step in a pt with HSIL pap results with postive HPV in patients 30 years older?

A

Immediate excision treatment OR colposcopy

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88
Q

What test are performed in a pap finding of AGC?

A
  • Follow up
  • Colposcopy
  • Endocervical sampling
  • Endometrial sampling
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89
Q

many painless ulcers and groin LAD

A

lymphogranuloma venereum

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90
Q

Treatment for lymphogranuloma venereum?

A

doxycycline or azithromycin

erythromycin in pregnant people

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91
Q

Cervical ripening

A

misoprostol or laminara

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92
Q

When do you do test for gestational diabetes mellitus?

A

24-28 weeks

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93
Q

What are the characteristics of inevitable abortion?

A

open os, bleeding, no POC yet

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94
Q

pH of STDs

A

BV, trich, atrophic vag >4.5

candida and cytolytic is normal

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95
Q

Pt with hx of PCOS now having vaginal bleeding, what cancer are they at risk for?

A

endometrial

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96
Q

What vaccine do you not give at 12 weeks?

A

Varicella

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97
Q

You do a fine needle biopsy in a breast - what are they at risk for developing?

A

cellulits

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98
Q

The woman is seeking fertility help and there were no hormone or structural imbalance - what is it most likely caused by?

A

ovulation problems (Primary ovarian insufficiency or savage syndrome)

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99
Q

closed os and vaginal bleeding - what is the most likely cause?

A

threatened abortion

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100
Q

PE showed open os and active bleeding 3 weeks postpartum

A

Uterine Atony

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101
Q

G1P0 15-year-old girl who has a smoking history and is pregnant with twins - how many risk factors does she have for preterm labor?

A

3

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102
Q

Complete breech is when the baby is in what position?

A

Both knees and hips flexed and buttock is down near the cervical birth canal

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103
Q

What is Cystocele?

A

Loss of anterior sulcus - wall between the bladder and the vagina weakens.

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104
Q

Etiology of PMDD?

A

Serotonin (5-HT) deficiency

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105
Q

40 year old comes in with a hx of tubal ligation and she has AUB - giving her birth control pills will do what benefit for her?

A

it will prevent endometrial cancer or hyperplasia

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106
Q

most commonly reported infection in the US

A

chlamydia

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107
Q

Mom just gave birth and a few hours later she presents with 600 cc blood loss 90/60 BP, diaphoretic, tachycardia

A

uterine atony

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108
Q

What drug is indicated for abnormal uterine bleeding in order to limit or restrict endometrial growth

A

Provera or leuprolide

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109
Q

55 yo female who feels a lump - her aunt died of breast cancer - what test do you want to do?

A

diagnostic mammo

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110
Q

What test would you wanna do for first OB visit?

A

UA

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111
Q

Bartholin cyst treatment

A

I&D

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112
Q

LLQ pain and vomiting?

A

torsion

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113
Q

many painless ulcers and groin LAD

A

lymphogranuloma venereum

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114
Q

Had a baby with shoulder dystocia - wants to get pregnant again within the year - what should you test?

A

her A1c to see if she’s pre-diabetic or at risk for gestational diabetes

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115
Q

Subareolar mass treatment

A

I&D

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116
Q

Girl who misses 2 days every month because of period pain bloating etc.

A

primary dysmenorrhea

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117
Q

How do you dx PMS/PMDD?

A

log a journal of your symptoms

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118
Q

Average weight gain in pregnancy

A

25-35 pounds

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119
Q

At 12 weeks what sign would you expect to see?

A

Chadwicks sign- bluish coloration of the cervix and vulva and fetal heart tones.

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120
Q

When can you feel the fundal height at the umbilicus?

A

20 wks

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121
Q

Fetal distress indicates what?

A

Hypoxia

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122
Q

Patient presents with a very high Beta hCG indicating Molar pregnancy (Hydatidiform mole), what is the treatment?

A

D and E of the molar pregnancy followed by surveillance of serial human chorionic gonadotropin levels to confirm resolution of disease

123
Q

White ulcerative lesion on the vagina would make you think of what diagnosis?

A

Vulvar carcinoma

124
Q

What are PCOS diagnostic studies?

A
  • Labs: Total Testosterone, Androstenedione, DHEA-S

- US: Transvaginal

125
Q

How do you treat PCOS?

A
  • Lifestyle modification
  • Oral contraceptives
  • Metformin
126
Q

What is Lymphogranuloma Venereum (LGV) primary infection presentation?

A

Genital ulcer or a mucosal inflammatory reaction at the site of inoculation

127
Q

What is Lymphogranuloma Venereum (LGV) secondary infection presentation?

A
  • 2 to 6 wks later
  • Inflammatory reaction in the superficial and deep inguinal nodes “groove” sign
  • Anorectal: proctocolitis with rectal discharge, anal pain, constipation, fever, and/or tenesmus.
128
Q

What is Lymphogranuloma Venereum (LGV) late infection presentation?

A
  • Fibrosis and strictures in the anogenital tract

- Genital elephantiasis, anal fistulae and strictures, frozen pelvis, and infertility

129
Q

What is the treatment for Lymphogranuloma Venereum (LGV)?

A
  • Nonpregnant patients: doxycycline 100mg BID x21 days

- Alternative: Azithromycin 1 g once weekly x21 days

130
Q

What is the secretory phase of the menstrual cycle?

A

Luteal phase

131
Q

Chancroid causative agent?

A

Haemophilus ducreyi

132
Q

Presentation of Chancroid?

A

Painful, superficial non-indurated ulcers, often with regional lymphadenopathy.

133
Q

Leiomyomas (uterine fibroid) symptoms?

A
  • Abnormal uterine bleeding
  • Pelvic pain/pressure.
  • May also have reproductive effects (eg, infertility, adverse pregnancy outcomes).
134
Q

How do you diagnose Syphilis?

A

Rapid plasma reagin (RPR) and Venereal disease research laboratory (VDRL)

135
Q

Appearance of apgar score 0-2 indicate what?

A

0: blue/pale
1: pink body, blue extremities
2. pink

136
Q

Pulse of apgar score 0-2 indicate what?

A

0: absent
1: Below 100 bmp
2: Over 100 bpm

137
Q

Grimace of apgar score 0-2 indicate what?

A

0: absent
1: Minimal response to stimulation
2: Prompt response to stimulation

138
Q

Activity of apgar score 0-2 indicate what?

A

0: Absent
1: Flexed Arms and Legs
2: Active

139
Q

Respiration of apgar score 0-2 indicate what?

A

0: Absent
1: Slow and irregular
2: Vigorous cry

140
Q

How do you calculate Naegele’s rule?

A

Add 7 days to the first day of your LMP and then subtract three months.

141
Q

What birth control would you use for lactating woman?

A

Progesterone Only or IUDs

142
Q

What is the next step after feeling a breast lump?

A
  • Diagnostic Mammogram

- US

143
Q

Baby with symptoms of fetal alcohol syndrome, what should mom have been screened with?

A

CAGE questionnaire

144
Q

Side effect of anastrozole

A

loss of bone density

145
Q

Presentation of Fibroadenoma?

A

Smooth, well-defined, mobile mass

146
Q

How do you diagnose Fibroadeoma?

A
  • US

- Definitive: core biopsy or excision.

147
Q

When is the uterus not palpable after a pregnancy?

A

after 2 weeks

148
Q

What is the treatment for Chorioamnionitis?

A
  • Induction or augmentation of labor

- Ampicillin 2 g IV q6 hrs + Gentamicin 5 mg/kg IV daily

149
Q

Painless bleeding after 20 weeks?

A

Placenta Previa

150
Q

What week can the mother first feel the fetus move?

A

16-20 wks (it is called quickening)

151
Q

When will a patient get their first menses after pregnancy?

A

6 to 8 weeks (if not breast feeding)

152
Q

What is the lab test for menopause?

A

FSH assay

153
Q

What is the prophylaxis antibiotic given prior to C-section?

A

Cefazolin 2-3g IV

- penicillin allergy: Clindamycin 900 mg IV + Gentamicin 5 mg/kg IV.

154
Q

Pt postpartum with fever, diaphoretic, tachycardia

A

uterine atony endometritis

155
Q

What is the tx for Mastitis?

A

Dicloxacillin or Cephalexin 500mg 4x daily

156
Q

Pt with A- blood type and baby is A+ what would you do?

A

administer Rhogam when she is at 28 weeks

157
Q

17 yo girl describes primary dysmenorrhea ask you to diagnose

A
  • pain with menstruation, lower abdominal, intermittent, “labor-like” on days 1-3
  • nausea, vomiting, diarrhea, headache
158
Q

How would you diagnose uterine atony?

A

boggy and enlarged uterus

159
Q

What drug is responsible for stabilizing the endometrium?

A

leuprolide or provera

160
Q

What is the treatment for ovarian cysts <8cms?

A

Cysts <8cm are functional and usually spontaneously resolve.

  • Rest, NSAIDs, repeat US in 6 wks
  • OCPs prevent recurrence
161
Q

What is the treatment for ovarian cysts >8cms?

A
  • Persistent or cysts found post menopause

- Laparoscopy or Laparotomy

162
Q

How do you diagnose fibrocystic breast disorder?

A
  • US

- FNA (straw-colored fluid - no blood)

163
Q

How do you treat fibrocystic breast disorder?

A
  • Most spontaneously resolve

- FNA if symptomatic

164
Q

Does fibrocystic breast disorder or fibroadenoma wax and wane with menstrual cycles?

A

Fibrocystic wax and wane, fibroadenoma do not.

165
Q

What are s/sxs of PID?

A

Abdominal pain, dysuria, dyspareunia, vaginal discharge, nausea, vomiting.

166
Q

What is the outpatient tx for PID?

A

Doxycycline 100mg BID x14 days. + Ceftriaxone 250mg IM x1 +/- Metronidazole

167
Q

What type of vaginal d/c is seen in BV?

A

Copious discharge, thin, homogenous watery grey-white “rotten fish” smell.

168
Q

What type of vaginal d/c is seen in trichomoniasis?

A

Frothy yellow green discharge, worse w/ menses.

169
Q

What type of vaginal d/c is seen in candida?

A

Thick curd-like/ cottage cheese discharge

170
Q

What type of vaginal d/c is seen in cytolytic vaginitis?

A

Non-odorous discharge, white to opaque

171
Q

Baby is tachycarda, fever, patient is achy with a fever the baby will come out?

A

septic

172
Q

Most common diagnosed microorganism in the US?

A

chlamydia

173
Q

What is the candidiasis discharge description?

A

caseous, gray, mucoseraginous, purulent

174
Q

Most common symptom with trichomonas

A

cervical petechiae and pruritus

175
Q

Uterosacral nodules in the posterior fornix

A

endometriosis

176
Q

retroplacental hematoma

A

placental abruption

177
Q

Pt with breast mass most common complication of needle bx

A

cellulitis

178
Q

18 year old comes with Pap of ASCUS. what is the next step?

A

reflex HPV testing

179
Q

Risk factor for pre-eclampsia

A

1st pregnancy

180
Q

MC symptoms of chorioamnionitis

A

fetal Brady, uterine tenderness, vaginal bleed

181
Q

18 year old G1P0 31EGA, % postcoital bleed for 2 days. no other sx. Dx?

A

placenta previa

182
Q

What is the tx of gestational trophoblastic neoplasia?

A

D and C

183
Q

9 weeks pregnant, daily n/v, what other symptoms would she have?

A

abdominal pain, headache, rash, weight loss

184
Q

Routine of 1st prenatal visit

A

speculum exam

185
Q

What is the tx for stable ectopic pregnancy?

A

Methotrexate and Leucovorin x4 doses

186
Q

What indicated stable ectopic pregnancy?

A

Hemodynamically stable, early gestation <4cm, b-hCG <5,000, no fetal tones

187
Q

Mammogram guidelines

A
  • baseline mammogram every 2 years form age 50-74
  • every 2 years beginning at age 40 if increased risk factors - 10 years prior to the age the 1’st degree relative was diagnosed
  • clinical breast exam every 3 years in women age 20-39 years then annually after age 40
  • breast self exam monthly beginning at age 20 - immediately after menstruation on days 5-7 of menstrual cycle
188
Q

women has constant leakage of fluid postpartum for a few weeks that is clear - its a bladder fistula, how do you diagnose?

A

x-ray study with contrast - blue dye scan or something like that

189
Q

HRT in menopause causes what?

A

thrombosis

190
Q

What does progesterone do?

A

keeps the endometrium lining

191
Q

Obesity causes most likely what complication?

A

miscarriage or fetocardioval malformation

192
Q

What are the indications or hospitalization for PID?

A
  • diagnosis is uncertain
  • ectopic and appendicitis cannot be rule out
  • pregnancy
  • pelvic abscess suspected
  • HIV positive
  • unable to follow or tolerate outpatient regiment
  • failed to respond to outpatient therapy
193
Q

tender right inguinal lymphadenopaty + right painless labial ulcer on PE what is the dx?

A

primary syphilis

194
Q

55 yo, 2 weeks of painless vaginal bleeding. LMP was 3 years ago. Last pap was also negative. PE shows small blood in the vault and an enlarged uterus. Initial dx study?

A

transvaginal ultrasound

195
Q

What is the tx of a breast abscess?

A

I&D and anti-staph antibiotics

  • regiment: nafcillin/ocacillin IV or cefazolin PLUS metronidazole
  • alternative is vancomycin
  • women should be encouraged to continue breast-feeding following breast infection, even in the setting of incision and drainage
196
Q

When do you administer RhoGAM?

A

28 weeks and 72h of delivery.

- OR given after any potential mixing of blood.

197
Q

What maneuver is done with shoulder Dystocia?

A
  • McRoberts Maneuver (increase pelvic opening with hip hyperflexion)
198
Q

Pelvic pressure and prolonged menses x 1 year. what is expected on pe?

A

irregular uterus because this described leiomyoma

199
Q

Seat belt during pregnancy

A

lap belt should be placed below your belly, touching your thighs, low and snug on your hip bones
-never wear above or across your belly

200
Q

RF to PROM in 26-year-old at 32 weeks?

A

short cervical length, second or third trimester vaginal bleeding, uterine overdistension, nutritional deficiency of Cooper and ascorbic acid, connective tissues disorders, low body mass index, low socioeconomic status, cigarette smoking and illicit drug use

201
Q

What is the initial treatment for nausea during pregnancy?

A

vitamin B6

202
Q

How much folic acid should be consumed daily during pregnancy

A

400mcg, or 0.4mg, or 4g daily.

- To prevent spina bifida and anencephaly.

203
Q

How do you diagnose PID?

A

clinical findings suggested by direct abdominal tenderness, cervical motion tenderness, adnexal tenderness plus fever or WBC count or pelvic abscess found by manual examination or ultrasonography

204
Q

What is the inpatient tx of PID?

A
  • doxycycline + IV cefotetan or cefoxitin until condition improves than PO doxycycline
  • clindamycin + gentamicin until condition improves than PO doxycycline
205
Q

How do you treat condyloma accuminata in a pregnant women?

A
  • cryotherapy

- trichloroacetic acid

206
Q

What is a breast abscess?

A

a pocket of contained infection within the breast

-a progression from mastitis - symptoms are the same with the addition of localized mass and systemic signs of infection

207
Q

What is the tx of a breast abscess?

A

I&D and anti-staph antibiotics

  • regiment: nafcillin/ocacillin IV or cefazolin PLUS metronidazole
  • alternative is vancomycin
  • women should be encouraged to continue breast-feeding following breast infection, even in the setting of incision and drainage
208
Q

What does it mean when fetal fibronectin is found in the cervicovag?

A

fFN is released into cervicovaginal fluid prior to the onset of preterm labor (20-34 wks) and during episodes of threatened preterm labor (TPL).

209
Q

Baby is bottle feeding when would moms 1st menses postpartum occur?

A

6-8 wks

210
Q

What does “VEAL CHOP” mean for fetal heart tracings?

A

Variable decelerations -> Cord compression.
Early deceleration -> Head compression.
Accelerations -> OK.
Late decelerations -> Placental Insufficiency.

211
Q

ph of candida vaginitis

A

pH <4.5

212
Q

Pt with DUB TSH normal, BHCG negative, no hx of abnormal paps, what is your next step?

A

diagnosis of exclusion, uterine dilation and curettage is the gold standard diagnosis

  • progestin trial
  • Pap smear
  • pelvic u/s
  • endometrial biopsy
213
Q

what is a 2nd degree laceration?

A

in perineal area but not involving anus at all

214
Q

What is peau d’orange?

A

may be a symptoms of inflammatory breast cancer

-causes fluid to accumulate in the breast

215
Q

Screening test for fibrocystic breasts?

A

US

216
Q

What are the abnormalities of fetal alcohol syndrome?

A

-distinctive facial features, including small eyes, an exceptionally thin upper lip, a short, upturned nose, and a smooth skin surface between the nose and upper lip

217
Q

What medication predispose you to vaginal vulvar, and cervical cancer?

A

Diethylstilbestrol (DES)

218
Q

40 yo, 10 month amenorrhea, sleep disorder, thin vagina, narrow vagina, what is this pts greatest risk?

A

Premature Ovarian Failure

219
Q

Pt with Endometrial Dysplasia biopsy and d/c are done what are the next steps?

A

Progestins/Estrogens/Chemotherapy

220
Q

Preterm labor what should you rule out?

A

UTI - E. Coli

221
Q

What is the tx of Gonorrhea?

A

Cefriaxone 250mg IM x1

- co treat for chlamydia: Azithromycin 1g

222
Q

Screening test for Fiboradenoma?

A

Screening mammogram

223
Q

Tx for vaginal prolapse?

A

Pessary

224
Q

Molar pregnancy treatment?

A
  • Surgical uterine evacuation –> suction curettage mainstay. (hysterectomy can be an option)
  • METS: chemotherapy (methotrexate)
225
Q

Proteinuria levels in preeclampsia?

A

Mild: >300mg/24hrs (1+ on dipstick)
Severe: >5g/24hrs (3+ on dipstick)

226
Q

What is the Leopold maneuver?

A

Maneuver consisting of 4 distinct actions to determine the position and estimate the birth weight of a fetus inside the uterus and the shape of the maternal pelvis.
- It can indicate if delivery is going to be complicated or if c-section is necessary.

227
Q

What is threatened abortion?

A

Pregnancy may be viable or abortion may follow. MCC of 1st trimester bleeding.

  • No POC expelled form uterus
  • Cervical OS closed
  • Bloody vaginal d/c
  • Supportive therapy and serial B-hCG
228
Q

What is inevitable abortion?

A

Pregnancy is not salvageable

  • No POC expelled
  • Progressive
  • Progressive cervix dilation >3cm effaced +/- rupture of membranes
  • Moderate bleeding >7 days
  • Dilation and Evacuation
229
Q

First trimester screening test?

A
  • Maternal blood screening test: free B-hCG, PAPP-A, Nuchal translucency.
  • Uterine size and gestation
  • US
  • Chorionic villus sampling
230
Q

What blood test is elevated in PCOS

A

Testosterone

231
Q

The diagnosis of Dysfunctional Uterine Bleeding is known as what?

A

Dx of exclusion

232
Q

PMDD occurs during what phase?

A

Luteal

233
Q

Treatment of Condyloma acuminatum?

A

Cryotherapy, trichloroacetic acid, surgical excision, electrosurgery, and laser therapy.

234
Q

Treatment of Endometriosis?

A

OCPs, Leuprolide, Danazol, Depo Provera

235
Q

Estrogen contraceptives possible SEs?

A

Thromboembolism

236
Q

Initial test for postmenopausal bleeding?

A

Endometrial bx
US
Hysterscopy

237
Q

What do you feel for to diagnose retained products of conception postpartum?

A

Firm Uterus

238
Q

What age do you not give contraceptive pills to?

A

Smokers older than 35

239
Q

How do you treat endometrial hyperplasia?

A

Progestin (PO or IUD-Mirena)

240
Q

What is cystocele?

A

Bladder to drop or sag into the vagina

241
Q

Pregnant woman starts having seizures mid-exam, how do you treat?

A

Magnesium sulfate

242
Q

What position is best to have the pt in to observe for rectocele?

A

standing position

243
Q

S/Sxs of cervical cancer?

A
  • Post coital bleeding/spotting
  • Metrorrhagia
  • Pelvic pain
  • +/- watery vaginal d/c
244
Q

What test is used to monitor treatment progress in Ovarian cancer?

A

CA-125

245
Q

How do you diagnose lymphogranuloma venereum (LGV)?

A

PCR to detect for C. trachomatis.

246
Q

How do you diagnose for vulvar cancer?

A

Bx

247
Q

High risk cancerous strains of HPV?

A

16 and 18

248
Q

Genital Wart strains of HPV?

A

6 and 11

249
Q

Treatment of stage IIA Cervical cancer

A
  • TAH-BSO

- Radiation + Chemo tx (Cisplatin)

250
Q

How do you treat cervical insufficiency?

A

Cerclage

251
Q

Vaginal atrophy treatment?

A

Topical estrogens

252
Q

S/Sx of inflammatory breast cancer?

A
  • Red, swollen, warm, itchy breast, nipple retraction, peau d’orange (d/t lymphatic destruction)
253
Q

How do you diagnose inflammatory breast cancer?

A

Bx

254
Q

How do you diagnose Gardnerella vaginalis (BV) microscopically?

A
  • Clue cells

- Few WBC

255
Q

Regular period every 26 days what day does she ovulate?

A

Days 12-14 (LH surge causes ovulation)

256
Q

What is the treatment for choriocarcinoma?

A

Methotrexate (chemo) and Hysterectomy

257
Q

Best test for detecting abnormalities first trimester?

A

Chorionic villus sampling

258
Q

Trisomy 18 screening results?

A
  • a-FP: Low
  • B-hCG: Low
  • Estradiol: Low
259
Q

What is the treatment for gestational diabetes?

A
  • Insulin
  • Glyburide or metformin
  • Labor induction (@ 38 wks if uncontrolled/macrosomia)
260
Q

When do you do the 50g oral glucose challenge test?

A

24-28 wks

- if >140mg/dL after 1 hr then perform 3 hour oral GTT.

261
Q

When do you perform the 3 hr 100g oral glucose tolerance test?

A

Perform in the AM after overnight fasting

262
Q

Fetal early decelerations is a sign of what?

A

Head compression

263
Q

Fetal late decelerations is a sign of what?

A

Uteroplacental insufficiency

264
Q

When checking for cervical dilation, you note a pulsating structure what does that mean?

A

Prolapsed umbilical cord

265
Q

How do you diagnose infertility?

A

Hysterosalpingography

266
Q

S/Sxs of incomplete abortion?

A
  • Pregnancy not salvageable
  • Some POC expelled some still retained
  • Cervical Os is dilated
  • Heavy bleeding, mod-severe cramping, retained tissue, boggy uterus
  • D and E and 1st trimester
  • Pictocin
267
Q

S/Sxs of complete abortion?

A
  • Complete passage of all products
  • All POC expelled from uterus
  • Cervical os closed
  • Loss of pregnancy sx +/- brown discharge
  • D and E
  • Misoprostol
268
Q

How do you treat chronic HTN?

A

Methyldopa, Labetalol, or Hydralazine

269
Q

How do you treat preeclampsia?

A

Delivery

270
Q

What B/P readings of mild and severe preeclampsia?

A

Mild: >140/90
Severe: >160/110

271
Q

MC symptom of severe preeclampsia?

A

Scotoma (vision loss)

272
Q

MC severe symptom of severe preeclampsia?

A

Hyperreflexia

273
Q

How do you diagnose Placenta Previa?

A

TVUS

274
Q

Treatment of abruptio placentae?

A

C-section

275
Q

Diagnostic criteria for postpartum depression?

A
  • Onset: 2 wks - 2 mo postpartum
  • Duration: 3-14 mos
  • Clinical manifestations: irritability sleep and mood disturbances, hearing changes, anxiety.
  • May have thoughts of harming baby
  • May need antidepressants
276
Q

Multiple gestations is a risk factor for

A

Preterm labor

277
Q

How do you diagnose Molar pregnancy?

A

B-hCG and snow storm on TVUS

278
Q

Treatment for GERD in pregancy?

A

Lifestyle and dietary modification (eg, elevation of the head end of the bed, avoidance of dietary triggers).

  • Antacids followed by sucralfate.
  • H2RAs then PPIs
279
Q

How do you diagnose PROM?

A
  • Sterile speculum exam: visual inspection-pooling of secretions
  • Nitrazine paper rest: turns blue if pH >6.5
  • Fern test: amniotic fluid - fern pattern
  • US
280
Q

Sign of Latent phase of labor?

A

Cervix effacement with gradual cervical dilation

281
Q

Discontinuation of breastfeeding postpartum menses returns when?

A

~ 6 weeks after d/c breastfeeding

282
Q

What medication induces labor?

A

Oxytocin

283
Q

Treatment for Ovarian Torsion?

A

Emergency

284
Q

MCC of mastitis?

A

Staph aureus

285
Q

Most important thing to do to prosecute a rapist?

A

Immediately perform rape kit

286
Q

Signs of bladder (vesicovaginal) fistula, constant leakage of fluid what test do you do?

A

Indigo dye and tampon test

287
Q

Symptoms of chorioamnionitis?

A
  • Fever.
  • Fast heart rate in mother and baby.
  • Sore or painful uterus.
  • A bad smell from the amniotic fluid.
288
Q

What innocent murmur of pregnancy is heard and where?

A

Systolic murmur on left side

289
Q

Physiology of pregnancy?

A

BP lowers, physiologic anemia, etc

290
Q

Placenta previa presentation → transabdominal US vs. speculum exam?

A
  • Pelvic US: transverse line

- avoid speculum and pelvic exam if possible

291
Q

Strawberry cervix → cervical “hemorrhages is a sign of what?

A

Trichomonas

292
Q

(-) progesterone challenge test, what’s the problem?

A

Ashermans or outflow obstruction

293
Q

Amine odor on exam is a sign of what vaginal infection?

A

Bacterial vaginosis

294
Q

Tamoxifen increases risk for what cancer?

A

Endometrial cancer and uterine sarcoma

295
Q

Laxative used for a rectocele?

A

Osmotic and stimulant (bisacodyl) were options

296
Q

Causes of PPROM?

A
  • Infection: amniotis
  • Hx of PPROM
  • Cigarette smoking
  • Cord prolapse
  • Multiple pregnancy
  • Low weight
297
Q

What other dx. is fibrocystic breast related to?

A

Fibroadenoma –> both noncancerous conditions

298
Q

Two fetuses produced by the splitting of a single zygote would be considered what?

A

Monozygotic (Identical)

299
Q

Two fetuses produced by two zygotes would be considered what?

A

Dizygotic (Fraternal)

300
Q

Multiple fetuses produced by two or more zygotes would be considered what?

A

Polyzygotic

301
Q

Hypogonadism in a perimenopausal woman?

A

Yes

302
Q

What gene do you give radiation to breast cancer?

A

HER 2 negative

303
Q

Women present with AUB for 6 months and they ruled out organic causes. What do you do next?

A

if the patient is at risk for endometrial cancer (chronic anovulatory cycles, obesity, multiparty, age >35, Dm or on tamoxifen therapy) then do an endometrial biopsy

304
Q

38 wk induction of labor. Pt has chorioamnionitis diagnosis and is put on abx. Delivers the twins. Most likely complication she will have?

A

uterine atony

OBGYN EOR (1 decks)

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