OBGYN PANCE Flashcards
The secretary phase of the menstrual cycle (Day 14 to 28) is dominated by what hormone?
Progesterone
Is a nullparous or multiparous Women more likely to get preeclampsia?
Nullparity is a risk factor for preclamsia
Since a genetic cause is the number one reason for primary amenorrhea what is one very important test?
Karyotype
Purulent cervical discharge should make you think of what diagnosis?
Neisseria gonorrhea
A description of a young girl with a Web neck or wide shield chest should make you think of what diagnosis?
Turner syndrome
A cervical biopsy Comes back as CIN1. What is the next step?
Repeat Pap smear in six months and repeat colposcopy in 12 months
What is the most common cause of secondary amenorrhea
Pregnancy
What three labs should you order if you are considering secondary amenorrhea?
Beta hCG, TSH, prolactin
Define premature birth
Delivery before 37 weeks
A unilateral, single, mobile, firm, nontender solid breast mass. Should make you think of what diagnosis
Fibroadenoma
Define metrorrhagia
Bleeding between menstrual cycles
Postmenopausal bleeding is immediately believe to be what diagnosis?
Endometrial cancer unless proven otherwise
During what portion of the menstrual cycle does PMS occur?
By definition it is in the second half and menstruation should relieve the symptoms
How do you treat bacterial vaginosis
Metronidazole for seven days
What location within the pelvis is endometriosis most commonly found
On an ovary
What lab test is the gold standard for chlamydia
Nucleic acid amplification test
Or fibrocystic breast masses usually unilateral or bilateral
Bilateral
How do you definitively diagnose endometriosis
Exploratory laparoscopy
What is the most common uterine tumor
Leiomyoma, also known as fibroids
What ethnic background is at an increased risk of fibroids?
African Americans are five times more likely to have fibroids compared to Caucasian woman
How do you treat vaginal candidiasis
Fluconazole PO for one dose or azole cream for one week
What is the first step of treatment for endometrial cancer
Total hysterectomy and bilateral salpingo-oophorectomy
If you see the term chocolate cyst, it should make you think of what diagnosis
Endometrioma
A surge in what hormone leads to ovulation
Luteinizing hormone
A patient presents with irregular menses, hirsutism, and infertility. What is the most likely diagnosis
Polycystic ovarian syndrome
What endocrine issues associated with PCOS
Insulin insensitivity
What are three treatments for uterine prolapse
Pessary, Keagle maneuvers, surgical repair
What is the most common organism that causes mastitis
Staph aureus
At approximately how many weeks pregnant is the uterus at the level of the umbilicus
20 weeks
What is the most common cause of postpartum hemorrhage
Uterine atony
Define missed abortion
No vaginal bleeding, cervix is closed, products of conception are still inside
At what age is primary amenorrhea diagnosed
Age 14 if no secondary sex characteristics. Age 16 if some secondary development
What is the first line treatment for mastitis
Diclocacillin is first line. Cephalexin or erythromycin or second one
Should a breast-feeding mother stop breast-feeding if she develops mastitis
Mastitis is not a reason to stop breast-feeding, but an abscess is
A physical exam revealing a retroverted uterus or uterosacral ligament nodularity should make you think of what diagnosis
Endometriosis
At how many weeks of pregnancy can in amniocentesis be done
15 to 20 weeks
List for risk factors for breast cancer
BRCA1 or BRCA2 positive, unopposed estrogen, early menarche, late menopause, nullparity
What is the average age of menopause
51
Cottage cheese discharged make you think of what diagnosis
Vaginal candidiasis
The follicular phase of menstruation is dominated by what hormone
Estrogen
About how much weight should a woman gain during pregnancy
20 to 35 pounds
Thin, sticky, malodorous vaginal discharge should make you think of what diagnosis
Bacterial vaginosis
Vaginal infection with motile flagellated Protozoa should make you think of what diagnosis
Trichomonas vaginitis
List two medications commonly use for hypertension in pregnancy
Methyldopa and labetalol
What is the classic triad of pre-eclampsia
Hypertension, edema, proteinurea
Why is overian cancer so hard to diagnose
There are no good markers in the symptoms are very vague
What are two important things you need to tell your patients before putting them on metronidazole
Stay out of the sun and avoid alcohol
Define inevitable abortion
Vaginal bleeding, cervix is open, products of conception are still inside
How is the first day of the menstrual cycle defined
The first day of the menstrual bleeding is the first day of the cycle
What is the Karyotype for a patient with Turner’s syndrome
(45, X) they are missing one sex chromosome
Give the definition for preterm labor
Contractions that open the cervix before 37 weeks
You have a patient with PCOS who would like to get pregnant. What are two medications you may start her on
Metformin and Clomid
What is the medical treatment for an early ectopic pregnancy
Methotrexate
An overian cyst that contains hair and teeth should make you think of what diagnosis
Teratoma
What is the mean age for overian cancer
63, you will need to think of this in an older patient with vague abdominal symptoms
Defined the second stage of labor
Fully dilated to delivery
A 66-year-old female presents with bouts of nausea, weight loss, and vague abdominal pain. What is the most likely diagnosis
Ovarian cancer
When is it recommended to begin Pap smears
Guidelines suggest beginning at age 21 regardless of sexual history
A cervical biopsy comes back as CIN2 or CIN3. What is your next step
Excision – LEEP, cold knife (worry about incompetent cervix), cryotherapy
List two risk factors for cervical cancer
Multiple sexual partners, smoking
How much time needs to pass before diagnosing secondary amenorrhea
If cycles have been normal three months. If cycles have been irregular six months
What is a cystocele
A herniation of the bladder into the vagina
What is the treatment for turner syndrome
Cyclical estrogen and progesterone
When does quickening occur
Nullparious 18 to 20 weeks
Multiparous 14 to 16 weeks
List three risk factors for placental abruption
Smoking, hypertension, AMA, cocaine
What is the treatment for ovarian cancer
Total hysterectomy and bilateral salpingo-oophorectomy. Then chemo and radiation
A patient believe she’s pregnant. You notice that her cervix appears a little blue. What is the name of the sign
Chadwick sign
At approximately how many weeks pregnant is the uterus at the level of the synthesis pubis
12 weeks
A snowstorm appearance on ultrasound should make you think of what diagnosis
Hydatidform mole
What medication can be used to control bleeding due to uterine atony
Oxytocin
What is the term for when the placenta has implanted directly over the cervical os
Placenta previa
At how many weeks of pregnancy can chorionic villus sampling be done
10-13 weeks
Why is folic acid given as a prenatal vitamin
Low folic acid can lead to neural tube defect’s
What is the most common endometrial cancer
75% are adenocarcinomas
A strawberry cervix with copious yellow – green discharge should make you think of what diagnosis
Trichomonas vaginitis
What is the number one cause of septic arthritis in sexually active young adults
N. Gonorrhea
How many days after conception is a serum beta hCG positive
8 days
If the Pap smear results come back anything other than negative or ASCUS what is your next step?
Colposcopy and biopsy
List three risk factors for an ectopic pregnancy
Previous Ectopic, scarred tubes, IUD, history of PID or salpingitis
Grape like vesicles or a sack of grapes on ultrasound should make you think of what diagnosis
Hydatidiform mole
What medication is used to increase surfactant levels and help with lung maturity if you are worried about preterm labor
Betamethasone
What are two tocolytics medications you should be aware of
Magnesium sulfate and calcium channel blocker’s
A woman presents to the ER concerned she is in preterm labor. What treatment should you begin before even getting any imaging or lab results
Give IV fluids most often the patient is suffering from dehydration
The Pap smear results on a 23-year-old patient come back as atypical squamous cell uncertain significance (ASCUS). What is your next step
Repeat Pap smear and 12 months although HPV test is acceptable
What are three ways you can check for ruptured membranes
Ferning pattern on a slide, visualize leakage from the cervix, pooling in the vagina
What is the normal range of a fetal heart rate
120-160
A patient presents with mucopurulent discharge and cervical motion tenderness. What is the most likely diagnosis
Chlamydia – Cervictis
Which for human papilloma virus are linked to cervical cancer
HPV 16, 18, 31 and 33
Clue cells should make you think of what diagnosis
Bacterial vaginosis
What is the hallmark physical exam findings for placenta previa
Trick question – never do a physical exam on someone with presumed placenta previa
What medium do you use to grow out N. gonorrhea
Thayer-Martin
What age range is the HPV vaccination recommended for
9 to 26 years old
A patient with primary amenorrhea and a the low FSH should make you think of what diagnosis
Hypothalamus pituitary insufficiency
What characteristic of pelvic inflammatory disease will help to differentiate it in a question stem from ectopic pregnancy, appendicitis, ovarian torsion and ovarian cyst
It will be bilateral pain. Most other comment abdominal complaints have a unilateral pain
List 2 risk factors for ovarian cancer
BRCA1, family history, late menopause, caucasian, Asian, Nullparity
Define abortion
Delivery of uterine contents before 20 weeks
Does mastitis tend to be unilateral or bilateral
Unilateral and only in one quadrant
Define full-term
Delivery at 37 to 42 weeks
What organism cause us to warn pregnant patients to stay away from deli meats and soft cheese
Listeria
The baby was delivered several minutes ago. Suddenly there is an increase in blood flow from the vagina and the cord is noticeably longer. What is the most likely cause of the signs?
Placental separation
What are two medications used to induce labor
Cervidil (prostaglandin gel applied to the cervix) which encourages cervical ripening and
oxytocin which encourages uterine contractions
As part of the antepartum testing a baby has a positive stress test. What does that mean
They have had two heart rate accelerations in a 20 minute period of 15 beats above baseline for at least 15 seconds. This is a good thing
Is FSH high or low in turner syndrome
High, there are no ovaries to respond to FSH and so there is no negative feedback
What is the most common type of ovarian cyst
Functional cyst – no treatment necessary
Define threatened abortion
Vaginal bleeding, cervix closed, products of conception are still inside
List for risks factors for endometrial cancer
Chronic unopposed estrogen, early menarche, late menopause, tamoxifen, diabetes, obesity, hypertension, breast cancer, ovarian cancer, nullpariety
What would you expect to see on a KOH prep if the patient has vaginal candidiasis
Pseudohyphae
Define menorrhagia
Heavy prolonged menstrual flow
What Rh combination for mom and dad might cause the mother to create antibodies against the babies red blood cells
Mom Rh negative and dad Rh positive
At what point during pregnancy is RhoGAM given if it is needed
28 weeks
Define complete abortion
Vaginal bleeding, cervix open, products of conception have passed
Gestational diabetes puts mom and baby at increased risk for what three things
Preeclampsia, macrosomia, slowing in fetal lung development
Which is associated with painful third trimester bleeding placental abruption or placenta previa
Placental abruption
What are three causes for a postpartum hemorrhage
Uterine atony, genital laceration, retained placenta
Defined the third stage of labor
Delivery of baby to delivery of placenta
What medications are used to treat a postpartum metritis
Clindamycin and gentamicin together
What organism is the most common sexually-transmitted bacteria
Chlamydia
Interference with work or school is part of which diagnosis, premenstrual syndrome or premenstrual dysphoric disorder
Premenstrual dysphoric disorder
Which reproductive cancer carries the highest rates of death in women
Ovarian cancer
What is the most common infection following a C-section
Metritis
How do you treat a trichomonas infection
Metronidazole
Define incomplete abortion
Vaginal bleeding, cervix is open, products of conception partially past
What is the most common sight of an ectopic pregnancy
Within a fallopian tube
Early on in pregnancy serial beta- hCG should double over what time.
Every 48 to 72 hours
Define procidentia
Uterine prolapse beyond the introitus
What is the more popular term for stein-leventhal syndrome
Polycystic ovarian syndrome
What is the formula for calculating estimated date of confinement or due date
First day of the last menstrual period +7 days -3 months
What are the five components of the biophysical profile as part of the antepartum test
A nonstress test, fetal breathing, two gross body movements, fetal tone, amniotic fluid index
Defined the first stage of labor
Onset of contractions to full dilation of the cervix
A rope like breast mass should make you think of what diagnosis
Fibrocystic breast Mass
