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STEP 2 AG > OBGYN & male repro > Flashcards

OBGYN & male repro Flashcards

1
Q

MC complication of PCOS

A

DM

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2
Q

Fournier’s gangrene

A

scrotal edema, bullae, crepitus SURGERY

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3
Q

DM in pregnancy

A

Insulin (target fasting 95, 1h pp 140, 2h pp 120)

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4
Q

Spermicide/diaphragm

A

recurrent UTIs

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5
Q

Blighted ovum

A

gestational sac, no ca activity

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6
Q

Placenta accreta

A

Prior cs

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7
Q

Turner syndrome

A

neonates: webbed neck, hand/feet edema, coarctation aorta murmur midback

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8
Q

Forceps delivery

A

genital lac

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9
Q

Lithium

A

Ebstein’s anomaly (enlarged RV, ASD)

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10
Q

Can bilateral ureteral ligation occur during TAH?

A

YES. Anuria, AKI, hydronephrosis

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11
Q

IUFD

A

> 24w induction of labor

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12
Q

Chorioamnionitis

A

Labor induction

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13
Q

Hyperemesis gravidarum

A

Thiamine deficiency, wernicke’s, urine ketones=severe

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14
Q

HTN

A

<20w chronic, risks=IUGR, abruption, preterm del (NOT ROM), GDM

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15
Q

Labor stages

A

1=latent (<6cm) active (>=6cm 1cm/2h, protracted 2h–>pit, arrest 4h/6h–>CS)
2=arrest >3h/4h (epid) OR exhaustion OR cat III OR CHF–>operative vag

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16
Q

Poly/oligohydramnios

A

> 24cm, <5cm

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17
Q

RFs for breech

A

submucosal fibroids, AMA, <37w, oligo/poly, plac previa

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18
Q

Sertoli-Leydig tumor

A

Looks like PCOS but <1y and clitoromegaly, test–>virilization, GnRH inh–>menopause sx

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19
Q

Primary amenorrhea

A

13 w/o dev, 15 w/, w/u US–>FSH (+ut) karyotype (-ut)

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20
Q

Pre-eclampsia

A

> 20w!!!!!
HTN (140), +proteinuria (300 24h, p/Cr 0.3) OR end organ damage, severe fts: plt<100, LFTs, Cr>1.1, SBP 160
PULMONARY EDEMA
Del 37w, severe fts 34 induction

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21
Q

Uterine inversion

A

REPLACE THE UTERUS

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22
Q

Exercise in pregnancy

A

contact sports, risk of falling

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23
Q

Operative vaginal delivery

A

lac

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24
Q

OCPs

A

don’t cause weight gain, dec risk ov ca IN BRCA PTS

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25
Q

IUGR

A

<10th, fetal prob: 1st tri, symmetric

mom prob: 2nd-3rd, bigger head

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26
Q

Copper IUD

A

best emergency contraception

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27
Q

Polyps

A

intermenstrual bleeding

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28
Q

PPROM

A

> 34w deliver, <34 hospitalize (infx, abruption, cord prolapse)

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29
Q

HPV

A

condyloma accumunata, flesh-colored papules, friable, pruritic, >4yo abuse

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30
Q

Pregnancy vaccinations

A

flu, Tdap (no live=varicella, inhaled flu, MMR)

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31
Q

CAH

A

(21, 17 high), virilization F

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32
Q

vWD

A

nl PT, plt, abnl BT, +/- PTT, DDAVP ppx or acute bleed

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33
Q

Vulvar cancer

A

lichen sclerosis, plaque, itchy, bx

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34
Q

Chlamydia

A

azith only (empiric OR gon azith + CTX)

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35
Q

Fetal heart tracings

A

Cat I var 6-25, +/- acels, +/- early decels
Cat III no var, late/var decels
CS for Cat III, otherwise repositioning, amnioinfusion

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36
Q

Vaginal cancer

A

posterior, superior 1/3, DES clear cell adeno, smoking squamous

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37
Q

Chorioamnionitis

A

Deliver (MOC fever, WBC, fHR>160)

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38
Q

Ectopic pregancy

A

rupture can have CMT, RF abnl uterine anatomy cornu rupture hemorrhage fluid in cul-de-sac

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39
Q

Placental abruption

A

low-vol cont, +/- bleeding, non-reassuring FHT, give IVfluid

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40
Q

SERMs

A

both DVT, hot flashes, tamoxifen endometrial ca, raloxifene used for osteoporosis

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41
Q

Varicocele

A

L > b/l, R ca or thrombus get US, infertility

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42
Q

Syphilis

A

RPR/VLDR may be negative primary dz, give penG anyway

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43
Q

Vaginal pH

A

3.8-4.5

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44
Q

Osteogenesis imperfecta Type II

A

fatal

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45
Q

Fibroadenoma DIAGNOSIS

46
Q

Endometrial bx indications

A

abnormal bleeding OR atypical glandular cells

47
Q

Placenta previa

A

> 20w, transabd–>transvag US, nl FHT painless bleeding, give fluids

48
Q

Mammo guidelines

49
Q

Obesity anovulation

A

fat pt–> inc androstendione + estrone, LH/FSH messed up

50
Q

Ovarian ca

A

Epithelial ovarian carcinoma MC postmen, urinary sx, constipation, rectovag=met, pulm eff met, ovary fallopian tube peritoneum, US thick septations solid CT CA-125

51
Q

When to get a UPT

A

Reproductive age before any radiation imaging

52
Q

Atrophic vaginitis - can you have petechiae?

A

YES, Lichen sclerosis sx but no plaques, +vag involvement, pH high >4.5 2/2 low lactate production

53
Q

Ureteroplacental insufficiency

A

BPP–>30 min Nonstress test (reactive), amnio (>5 index, >2 pocket), mvmt (>3), tone (>1 flex/ext limbs or spine), breathing (1), 8nl, <4 deliver

54
Q

Anti-epilleptics

A

Phenytoin, carbamazepine, depakote wide fontanelle, cleft palate, tiny hands/feet, microcephaly

TAPER PRIOR TO PREG if sz free >2y

55
Q

Vulvar lichen sclerosis

A

Pre-menarche postmen, vag architecture (labia, anal fissures), NO VAGINA

56
Q

Copper IUD

A

Don’t give if anemia or h/o heavy menstrual bleeding

57
Q

Penile fracture

A

uro emergency tunica albuginea if they can’t pee uretherography

58
Q

Early decels

A

Symm w/ contractions, head compression, benign

59
Q

Late decels

A

Fetal hypoxia, abruption, uteroplacental insuff

60
Q

Variable decels

A

Umb cord compression

61
Q

Endometriosis

A

Starts 2 days before

62
Q

Breast cancer prognosis

A

TNM staging

63
Q

Breast cancer birth control

A

Copper IUD, ABSOLUTELY NO HORMONAL INCLUDING PROG IUD

64
Q

Breast mass eval

A

<30 US, >30 mammo, dx bx

65
Q

BPH

A

a-1 inh tamsulosin, finasteride 5-a-reductase inh adjunct or hypotension

66
Q

Surgical site infx

A

> 24h after surg, induration, erythema, obesity, emergency

67
Q

Short interpregnancy interval

A

<18mo, inc risk of preterm, PPROM, anemia, low birth wt

68
Q

Chronic bacterial prostatitis

A

UTIs that get better w/ short course abx (NO URETHRAL DISCHARGE=urethritis), tx cipro x6w

69
Q

Indications for endometrial bx

A

postmen AUB, endometrial cells on pap, atypical glandular cells on pap

70
Q

Androgen insensitivity syndrome

A

46XY no internal sex organs test–>estrogen periphery have some secondary F sexual characteristics

71
Q

Mammary paget’s disease

A

85% ca, adeno

72
Q

Simple breast cyst

A

Clear fluid, f/u 2-4mo then q1y

73
Q

Oxytocin toxicity

A

ADH, hypoNa

74
Q

Endometrial hyperplasia

A

RF inc estrogen=obesity, early menarche, nulliparity

75
Q

hCG function

A

corpus luteum–>prog until placenta does it

76
Q

Urethral diverticulum

A

Pain, discharge from meatus

77
Q

Uterine tachysystole

A

> 5 contractions in 10 min, reposition, tocolysis, stop pit

78
Q

Superficial dehiscience

A

Wound dressing, don’t need abx or anything

79
Q

Tubo-ovarian abscess

A

Comp of PID, complex multi-loculated thick walls internal debris

80
Q

Hyperprolactinemia

A

Pit tumor or hypothyroid (other s/s, inc hypothalamic upreg)

81
Q

Tocolytics

A

<32w indomethacin, 32-34 nifedipine (flushing, HA, tachycardia, palp), in the hosp terbutaline (NOT IF DIABETIC, arrhythmia, pulm edema)

82
Q

Sildenafil

A

Contraindicated nitro, a blockers

83
Q

Bacterial vaginosis

A

NO CERV INVOLVEMENT

84
Q

Nl postpartum

A

Low grade fever <24h, lochia, perineal edema

85
Q

Primary dysmenorrhea

A

(Physiologic), not endometriosis (+dysparaeunia, pain w/ defecation)

86
Q

Sterile pyuria

A

Chlamydia or HSV

87
Q

Inflammatory breast carcinoma

A

Looks infected, PEAU D’ORANGE, LN

88
Q

TOL contraindications

A

Classic CS, myomectomy w/ uterine cav entry

89
Q

Prenatal screening

A

10w cfDNA, 10-13 CVS, 15-20 amniocentesis

90
Q

Testicular torsion

A

pain w/ elev, 1 higher than other, no cremasteric reflex +/- hematoma

91
Q

Shoulder dystocia

A

C8 T1 = “claw hand” +/- Horner’s, C5 C6 = “waiter tip” no moro

92
Q

HSV in preg

A

ACYCLOVIR @36W REGARDLESS

AT DELIVERY –> no lesions vag, active lesions CS

93
Q

Exogenous steroids

A

Test labs can look nl

94
Q

Hyperandrogenism in preg

A

NO MASS (placental aromatase def, vir) VS MASS Malig=Sertoli-Leydig vir u/l resection 2nd tri or PP, benign=b/l luteoma solid vir, theca cyst (low risk vir in fetus)

95
Q

Fat necrosis

A

trauma/surg, dimpling nipple retraction calcifications c/f malig but is benign foamy mac fat globules bx no inc risk

96
Q

Hypertensive crisis

A

> 160/110, IV labetalol (HR), hydral, nifedipine (PO)

97
Q

Spinal epidural abscess

A

Epidural sequelia, IVDU, FEVER + back pain + neuro, dx MRI tx abx + surgical decomp

98
Q

Postpartum fever

A

> 24h MC endometritis vag flora clinda + genta

No imp 48h septic pelvic thrombophlebitis, pelvic abscess

99
Q

Cerebral palsy

A

Prematurity

100
Q

TAH

A

Ureteral injury e’rrrry damn time

101
Q

Cephalohematoma

A

Forceps vacuum DOES NOT CROSS MIDLINE (caput common nbd crosses midline)

102
Q

Hypogonadism (male)

A

PRIMARY not making test LH FSH high, SECONDARY LH FSH low/nl, get prolactin +/- MRI

103
Q

Galactokinase deficiency

A

Cataracts ONLY

G-1-P uridyl transferase cataracts + a lot of other bad shit hypotonia jaundice baby looks fucked up

104
Q

Down Syndrome

105
Q

External cephalic version

A

offer at 37w

106
Q

Ovarian hyperstimulation syndrome

A

B/l cysts, 1-2w, VEGF (ascites, pulm effusion), hemoconcentration, tx

107
Q

Disseminated gonorrhea

A

Arthritis + pustular rash extremities torso, blood clx negative, tx IV CTX + PO azithro

108
Q

GBS ppx

A

<37w, ROM >18h, fever (hx prior neonatal infx, pos any time during preg even if tx) penicillin

109
Q

Fetal fibronectin

A

<34w, ROM >18h, fever, 1w delivery, betamethasone

110
Q

Retained placenta

A

> 30m, hemorrhage (uterus doesn’t contract)

111
Q

PID

A

can still have pharyngeal erythema

STEP 2 AG (16 decks)

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