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PANCE Questions combined > OBGYN PANCE > Flashcards

OBGYN PANCE Flashcards

1
Q

The secretary phase of the menstrual cycle (Day 14 to 28) is dominated by what hormone?

A

Progesterone

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2
Q

Is a nullparous or multiparous Women more likely to get preeclampsia?

A

Nullparity is a risk factor for preclamsia

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3
Q

Since a genetic cause is the number one reason for primary amenorrhea what is one very important test?

A

Karyotype

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4
Q

Purulent cervical discharge should make you think of what diagnosis?

A

Neisseria gonorrhea

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5
Q

A description of a young girl with a Web neck or wide shield chest should make you think of what diagnosis?

A

Turner syndrome

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6
Q

A cervical biopsy Comes back as CIN1. What is the next step?

A

Repeat Pap smear in six months and repeat colposcopy in 12 months

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7
Q

What is the most common cause of secondary amenorrhea

A

Pregnancy

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8
Q

What three labs should you order if you are considering secondary amenorrhea?

A

Beta hCG, TSH, prolactin

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9
Q

Define premature birth

A

Delivery before 37 weeks

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10
Q

A unilateral, single, mobile, firm, nontender solid breast mass. Should make you think of what diagnosis

A

Fibroadenoma

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11
Q

Define metrorrhagia

A

Bleeding between menstrual cycles

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12
Q

Postmenopausal bleeding is immediately believe to be what diagnosis?

A

Endometrial cancer unless proven otherwise

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13
Q

During what portion of the menstrual cycle does PMS occur?

A

By definition it is in the second half and menstruation should relieve the symptoms

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14
Q

How do you treat bacterial vaginosis

A

Metronidazole for seven days

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15
Q

What location within the pelvis is endometriosis most commonly found

A

On an ovary

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16
Q

What lab test is the gold standard for chlamydia

A

Nucleic acid amplification test

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17
Q

Or fibrocystic breast masses usually unilateral or bilateral

A

Bilateral

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18
Q

How do you definitively diagnose endometriosis

A

Exploratory laparoscopy

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19
Q

What is the most common uterine tumor

A

Leiomyoma, also known as fibroids

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20
Q

What ethnic background is at an increased risk of fibroids?

A

African Americans are five times more likely to have fibroids compared to Caucasian woman

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21
Q

How do you treat vaginal candidiasis

A

Fluconazole PO for one dose or azole cream for one week

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22
Q

What is the first step of treatment for endometrial cancer

A

Total hysterectomy and bilateral salpingo-oophorectomy

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23
Q

If you see the term chocolate cyst, it should make you think of what diagnosis

A

Endometrioma

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24
Q

A surge in what hormone leads to ovulation

A

Luteinizing hormone

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25
Q

A patient presents with irregular menses, hirsutism, and infertility. What is the most likely diagnosis

A

Polycystic ovarian syndrome

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26
Q

What endocrine issues associated with PCOS

A

Insulin insensitivity

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27
Q

What are three treatments for uterine prolapse

A

Pessary, Keagle maneuvers, surgical repair

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28
Q

What is the most common organism that causes mastitis

A

Staph aureus

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29
Q

At approximately how many weeks pregnant is the uterus at the level of the umbilicus

A

20 weeks

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30
Q

What is the most common cause of postpartum hemorrhage

A

Uterine atony

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31
Q

Define missed abortion

A

No vaginal bleeding, cervix is closed, products of conception are still inside

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32
Q

At what age is primary amenorrhea diagnosed

A

Age 14 if no secondary sex characteristics. Age 16 if some secondary development

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33
Q

What is the first line treatment for mastitis

A

Diclocacillin is first line. Cephalexin or erythromycin or second one

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34
Q

Should a breast-feeding mother stop breast-feeding if she develops mastitis

A

Mastitis is not a reason to stop breast-feeding, but an abscess is

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35
Q

A physical exam revealing a retroverted uterus or uterosacral ligament nodularity should make you think of what diagnosis

A

Endometriosis

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36
Q

At how many weeks of pregnancy can in amniocentesis be done

A

15 to 20 weeks

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37
Q

List for risk factors for breast cancer

A

BRCA1 or BRCA2 positive, unopposed estrogen, early menarche, late menopause, nullparity

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38
Q

What is the average age of menopause

A

51

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39
Q

Cottage cheese discharged make you think of what diagnosis

A

Vaginal candidiasis

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40
Q

The follicular phase of menstruation is dominated by what hormone

A

Estrogen

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41
Q

About how much weight should a woman gain during pregnancy

A

20 to 35 pounds

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42
Q

Thin, sticky, malodorous vaginal discharge should make you think of what diagnosis

A

Bacterial vaginosis

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43
Q

Vaginal infection with motile flagellated Protozoa should make you think of what diagnosis

A

Trichomonas vaginitis

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44
Q

List two medications commonly use for hypertension in pregnancy

A

Methyldopa and labetalol

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45
Q

What is the classic triad of pre-eclampsia

A

Hypertension, edema, proteinurea

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46
Q

Why is overian cancer so hard to diagnose

A

There are no good markers in the symptoms are very vague

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47
Q

What are two important things you need to tell your patients before putting them on metronidazole

A

Stay out of the sun and avoid alcohol

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48
Q

Define inevitable abortion

A

Vaginal bleeding, cervix is open, products of conception are still inside

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49
Q

How is the first day of the menstrual cycle defined

A

The first day of the menstrual bleeding is the first day of the cycle

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50
Q

What is the Karyotype for a patient with Turner’s syndrome

A

(45, X) they are missing one sex chromosome

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51
Q

Give the definition for preterm labor

A

Contractions that open the cervix before 37 weeks

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52
Q

You have a patient with PCOS who would like to get pregnant. What are two medications you may start her on

A

Metformin and Clomid

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53
Q

What is the medical treatment for an early ectopic pregnancy

A

Methotrexate

54
Q

An overian cyst that contains hair and teeth should make you think of what diagnosis

A

Teratoma

55
Q

What is the mean age for overian cancer

A

63, you will need to think of this in an older patient with vague abdominal symptoms

56
Q

Defined the second stage of labor

A

Fully dilated to delivery

57
Q

A 66-year-old female presents with bouts of nausea, weight loss, and vague abdominal pain. What is the most likely diagnosis

A

Ovarian cancer

58
Q

When is it recommended to begin Pap smears

A

Guidelines suggest beginning at age 21 regardless of sexual history

59
Q

A cervical biopsy comes back as CIN2 or CIN3. What is your next step

A

Excision – LEEP, cold knife (worry about incompetent cervix), cryotherapy

60
Q

List two risk factors for cervical cancer

A

Multiple sexual partners, smoking

61
Q

How much time needs to pass before diagnosing secondary amenorrhea

A

If cycles have been normal three months. If cycles have been irregular six months

62
Q

What is a cystocele

A

A herniation of the bladder into the vagina

63
Q

What is the treatment for turner syndrome

A

Cyclical estrogen and progesterone

64
Q

When does quickening occur

A

Nullparious 18 to 20 weeks

Multiparous 14 to 16 weeks

65
Q

List three risk factors for placental abruption

A

Smoking, hypertension, AMA, cocaine

66
Q

What is the treatment for ovarian cancer

A

Total hysterectomy and bilateral salpingo-oophorectomy. Then chemo and radiation

67
Q

A patient believe she’s pregnant. You notice that her cervix appears a little blue. What is the name of the sign

A

Chadwick sign

68
Q

At approximately how many weeks pregnant is the uterus at the level of the synthesis pubis

A

12 weeks

69
Q

A snowstorm appearance on ultrasound should make you think of what diagnosis

A

Hydatidform mole

70
Q

What medication can be used to control bleeding due to uterine atony

A

Oxytocin

71
Q

What is the term for when the placenta has implanted directly over the cervical os

A

Placenta previa

72
Q

At how many weeks of pregnancy can chorionic villus sampling be done

A

10-13 weeks

73
Q

Why is folic acid given as a prenatal vitamin

A

Low folic acid can lead to neural tube defect’s

74
Q

What is the most common endometrial cancer

A

75% are adenocarcinomas

75
Q

A strawberry cervix with copious yellow – green discharge should make you think of what diagnosis

A

Trichomonas vaginitis

76
Q

What is the number one cause of septic arthritis in sexually active young adults

A

N. Gonorrhea

77
Q

How many days after conception is a serum beta hCG positive

A

8 days

78
Q

If the Pap smear results come back anything other than negative or ASCUS what is your next step?

A

Colposcopy and biopsy

79
Q

List three risk factors for an ectopic pregnancy

A

Previous Ectopic, scarred tubes, IUD, history of PID or salpingitis

80
Q

Grape like vesicles or a sack of grapes on ultrasound should make you think of what diagnosis

A

Hydatidiform mole

81
Q

What medication is used to increase surfactant levels and help with lung maturity if you are worried about preterm labor

A

Betamethasone

82
Q

What are two tocolytics medications you should be aware of

A

Magnesium sulfate and calcium channel blocker’s

83
Q

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

A

Give IV fluids most often the patient is suffering from dehydration

84
Q

The Pap smear results on a 23-year-old patient come back as atypical squamous cell uncertain significance (ASCUS). What is your next step

A

Repeat Pap smear and 12 months although HPV test is acceptable

85
Q

What are three ways you can check for ruptured membranes

A

Ferning pattern on a slide, visualize leakage from the cervix, pooling in the vagina

86
Q

What is the normal range of a fetal heart rate

A

120-160

87
Q

A patient presents with mucopurulent discharge and cervical motion tenderness. What is the most likely diagnosis

A

Chlamydia – Cervictis

88
Q

Which for human papilloma virus are linked to cervical cancer

A

HPV 16, 18, 31 and 33

89
Q

Clue cells should make you think of what diagnosis

A

Bacterial vaginosis

90
Q

What is the hallmark physical exam findings for placenta previa

A

Trick question – never do a physical exam on someone with presumed placenta previa

91
Q

What medium do you use to grow out N. gonorrhea

A

Thayer-Martin

92
Q

What age range is the HPV vaccination recommended for

A

9 to 26 years old

93
Q

A patient with primary amenorrhea and a the low FSH should make you think of what diagnosis

A

Hypothalamus pituitary insufficiency

94
Q

What characteristic of pelvic inflammatory disease will help to differentiate it in a question stem from ectopic pregnancy, appendicitis, ovarian torsion and ovarian cyst

A

It will be bilateral pain. Most other comment abdominal complaints have a unilateral pain

95
Q

List 2 risk factors for ovarian cancer

A

BRCA1, family history, late menopause, caucasian, Asian, Nullparity

96
Q

Define abortion

A

Delivery of uterine contents before 20 weeks

97
Q

Does mastitis tend to be unilateral or bilateral

A

Unilateral and only in one quadrant

98
Q

Define full-term

A

Delivery at 37 to 42 weeks

99
Q

What organism cause us to warn pregnant patients to stay away from deli meats and soft cheese

A

Listeria

100
Q

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?

A

Placental separation

101
Q

What are two medications used to induce labor

A

Cervidil (prostaglandin gel applied to the cervix) which encourages cervical ripening and
oxytocin which encourages uterine contractions

102
Q

As part of the antepartum testing a baby has a positive stress test. What does that mean

A

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

103
Q

Is FSH high or low in turner syndrome

A

High, there are no ovaries to respond to FSH and so there is no negative feedback

104
Q

What is the most common type of ovarian cyst

A

Functional cyst – no treatment necessary

105
Q

Define threatened abortion

A

Vaginal bleeding, cervix closed, products of conception are still inside

106
Q

List for risks factors for endometrial cancer

A

Chronic unopposed estrogen, early menarche, late menopause, tamoxifen, diabetes, obesity, hypertension, breast cancer, ovarian cancer, nullpariety

107
Q

What would you expect to see on a KOH prep if the patient has vaginal candidiasis

A

Pseudohyphae

108
Q

Define menorrhagia

A

Heavy prolonged menstrual flow

109
Q

What Rh combination for mom and dad might cause the mother to create antibodies against the babies red blood cells

A

Mom Rh negative and dad Rh positive

110
Q

At what point during pregnancy is RhoGAM given if it is needed

A

28 weeks

111
Q

Define complete abortion

A

Vaginal bleeding, cervix open, products of conception have passed

112
Q

Gestational diabetes puts mom and baby at increased risk for what three things

A

Preeclampsia, macrosomia, slowing in fetal lung development

113
Q

Which is associated with painful third trimester bleeding placental abruption or placenta previa

A

Placental abruption

114
Q

What are three causes for a postpartum hemorrhage

A

Uterine atony, genital laceration, retained placenta

115
Q

Defined the third stage of labor

A

Delivery of baby to delivery of placenta

116
Q

What medications are used to treat a postpartum metritis

A

Clindamycin and gentamicin together

117
Q

What organism is the most common sexually-transmitted bacteria

A

Chlamydia

118
Q

Interference with work or school is part of which diagnosis, premenstrual syndrome or premenstrual dysphoric disorder

A

Premenstrual dysphoric disorder

119
Q

Which reproductive cancer carries the highest rates of death in women

A

Ovarian cancer

120
Q

What is the most common infection following a C-section

A

Metritis

121
Q

How do you treat a trichomonas infection

A

Metronidazole

122
Q

Define incomplete abortion

A

Vaginal bleeding, cervix is open, products of conception partially past

123
Q

What is the most common sight of an ectopic pregnancy

A

Within a fallopian tube

124
Q

Early on in pregnancy serial beta- hCG should double over what time.

A

Every 48 to 72 hours

125
Q

Define procidentia

A

Uterine prolapse beyond the introitus

126
Q

What is the more popular term for stein-leventhal syndrome

A

Polycystic ovarian syndrome

127
Q

What is the formula for calculating estimated date of confinement or due date

A

First day of the last menstrual period +7 days -3 months

128
Q

What are the five components of the biophysical profile as part of the antepartum test

A

A nonstress test, fetal breathing, two gross body movements, fetal tone, amniotic fluid index

129
Q

Defined the first stage of labor

A

Onset of contractions to full dilation of the cervix

130
Q

A rope like breast mass should make you think of what diagnosis

A

Fibrocystic breast Mass

PANCE Questions combined (7 decks)

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