OBGYN Stepwards - high yield

Question 1

hydrocephaly, intracranial calcifications, hydrocephalus, chorioretinitis, and experiences seizures

Answer 1

Congenital Toxoplasmosis

Question 2

Lethargic/fatigued
Hypotension
Failure to lactate
Cold intolerance

Answer 2

Sheehan Syndrome

Decreased TSH: fatigue cold intolerance, slowed deep-tendon reflexes
Decreased Prolactin: inability to lactate
Decreased ACTH: hypotension, weight loss, hypoglycemia
Decreased FSH/LH:

Question 3

lower abd pain, chills, 2 days post c-sec, temperature, low bp, tender uterus

Answer 3

Postpartum Endometritis

Question 4

large amount of bleeding + soft/enlarged uterus

Answer 4

Postpartum Hemorrhage - (in this case it is likely caused by uterine atony given the size soft and enlarged uterus

Question 5

firm pale mass in the vagina + unable to palpate the uterus

Answer 5

Uterine Inversion

Question 6

past C-section + loss of fetal station (going from 0 to -3)

Answer 6

Uterine Rupture (feeling fetal parts above the uterus)

Question 7

GDM, large weight gain during preg, large fundal height, fetal head delivers then retracts

Answer 7

Shoulder Dystocia

Question 8

Early contractions, temperature, inc HR, nl BP, tender fundus, high WBC, possible rupture of membranes

Answer 8

Chorioamnionitis

Question 9

High pH, high paCO2, high bicarb

Answer 9

Hyperemesis Gravidarum

Question 10

headache, blurred vision, and constant right upper quadrant pain

Answer 10

HELLP Syndrome - hemolysis (anemia + increased bilirubin)+ elevated liver enzymes + low platelets 
Complete blood count:
Hemoglobin: 7.8 g/dL
Platelets: 85,000/µL
Liver function studies:

Total bilirubin: 2.7 mg/dL
Direct bilirubin: 0.9 mg/dL
Alkaline phosphatase: 150 U/L
Aspartate aminotransferase: 313 U/L
Alanine aminotransferase: 225 U/L
Lipase: 75 U/L

Question 11

hypertension + vision changes+ right upper quadrant pain + seizures

Answer 11

Eclampsia

Question 12

hypertension (2 measurements) + proteinuria (urine dipstick will be confirmed with additional study)

Answer 12

Preeclampsia

Question 13

sudden onset third trimester bleeding + painless uterus

Answer 13

Placenta Previa

Question 14

sudden onset third trimester bleeding + painless uterus

Answer 14

Abruptio Placentae

Question 15

Abdominal pain + positive beta-hCG + no intrauterine pregnancy + ovarian mass with free fluid

Answer 15

Ectopic Pregnancy

Question 16

Severe abodminal pain + vaginal bleeding + surgical abdomen (rebound tenderness and guarding) + positive pregnancy test + empty uterus on ultrasound

Answer 16

Ruptured ectopic

Question 17

intense itching on palms + elevated total bile acids

Answer 17

Intrahepatic Cholestasis Of Pregnancy

Question 18

funneled lower uterine segment with dilated internal cervical os

Answer 18

Cervical Incompetence

Question 19

Minutes to hours after delivery - SOB and HoTN

Answer 19

Amniotic Fluid Embolism

Question 20

Normal development of secondary sexual characteristics: breast development, pubic hair 
Short vagina (no upper vagina): can be seen on a physical exam. 
Variable uterine development: can be absent or underdeveloped (can be seen on ultrasound)
Normal ovaries: will be seen on ultrasound.

Answer 20

Mullerian Agenesis

Question 21

stress inconctiennce + urethral hypermobility

Answer 21

Urethrocele

Question 22

loss of Doppler flow, acute abdominal pain, no temperature

Answer 22

Ovarian Torsion

Question 23

primary amenorrhea + unable to visualize vaginal canal + anterior tender mass on rectal exam

Answer 23

Imperforate Hymen (blueish***)

Question 24

secondary amenorrhea + recent dilation and curettage + unremarkable physical exam + reference range TSH, FSH, prolactin + not pregnant + lack of withdrawal bleeding

Answer 24

Asherman Syndrome

Question 25

``` Physical complaints: Bloating Fatigue Headaches Breast tenderness Behavioral complaints: ``` Anxiety Irritably Mood swings Decreased interest

Answer 25

Premenstrual Syndrome

Question 26

irregular menstrual periods + obesity + acanthosis nigricans + acne

Answer 26

Polycystic Ovarian Syndrome (PCOS)

Question 27

Infertility + pelvic pain + adnexal enlargement/mass + homogenous cystic appearing mass on ovary

Answer 27

Endometriosis (3Ds - Dysmenorrhea + deep dyspareunia + dyschezia )

Question 28

Vaginal dryness,Menopausal owman, smoking, pain during penetration

Answer 28

Atrophic Vaginitis

Question 29

Mass and hirsuitism/*viriliuzation*

Answer 29

Sertoli-Leydig Cell Ovarian Tumor

Question 30

Irregular bleeding, mass, complex endometrial hyperpalisa wihtout atypia. Precous puberty

Answer 30

Granulosa Cell Ovarian Tumor

Question 31

Abodminla distention/ascities Weight loss Decreased appetite CA125

Answer 31

Epithelial Ovarian Cancer

Question 32

very high beta-hCG value + snowstorm appearance in the uterus on ultrasound

Answer 32

Hydatidiform Mole

Question 33

vulvar itching + low risk for sexually transmitted diseases + ulcerated lesion on vulva

Answer 33

vulvuar cancer

Question 34

vaginal bleeding + mass + hydrometer

Answer 34

Cervical Cancer

Question 35

no signs of infection + abdominal pain right after sex + ovarian mass + free fluid in the pelvis

Answer 35

Ovarian Cyst Rupture

Question 36

Ovarian cystic structure + areas of calcifications/hyperechoic nodules

Answer 36

Teratoma Dermoid Ovarian Cyst (Mature Cystic Teratoma

Question 37

urinary issues + irregular shaped uterus + larger then expected uterus

Answer 37

Leiomyoma Uteri

Question 38

multiple small papules with ubilicated centers

Answer 38

Molluscum Contagiosum

Question 39

frothy, malodorous, green vaginal discharge + increased vaginal pH

Answer 39

Trichomoniasis

Question 40

painless genital lesion + current rash that covers palms/soles of feet

Answer 40

Syphilis

Question 41

Fever, cervical motion tenderness, adenexal/uterine tendenress, STI risk

Answer 41

Pelvic Inflammatory Disease (PID)

Question 42

multiple small papules, verrucous

Answer 42

Condylomata Acuminata (Genital Warts) - 6/11

Question 43

white “cigarette paper” skin on vulva + retraction of clitoris

Answer 43

Lichen Sclerosus

Question 44

painful grouped genital ulcers (multiple), recent stress or immunosupression

Answer 44

Genital Herpes

Question 45

painful ulcer

Answer 45

Chancroid (Haemophilus Ducreyi)

Question 46

bleeding post-coitally in young woman

Answer 46

Acute Cervicitis

Question 47

wet mount shows budding yeast + psuedohyphae

Answer 47

Candida Vulvovaginitis

Question 48

Painful vulvar swelling | Fluctuant vaginal mass can be palpated

Answer 48

Bartholin Gland Abscess

Question 49

elevated vaginal pH + positive “whiff” test + “clue cells”

Answer 49

Bacterial Vaginosis

Question 50

Itchy rash breast, edematous plaque, pruitic

Answer 50

Paget Disease Of Breast

Question 51

asymptomatic patient + normal breast exam + microcalcifications on mammography + histological findings (distended ducts with pelimorphic class, contained in basement membrane)

Answer 51

Ductal Carcinoma In Situ

Question 52

pathological discharge (unilateral bloody) + no palpable breast mass + nothing on mammography

Answer 52

Intraductal Papilloma

Question 53

Lump on young girl. Fluctuates with menses, tnder.

Answer 53

Fibroadenoma - SINGLE LUMP (fibrocystic, older women and multiple)

Question 54

no solid components on ultrasound + needle aspiration with clear liquid + resolution of mass upon needle aspiration

Answer 54

Breast Cyst

Question 55

no fever + tender breast mass + fluctuant breast mass + no erythema on breast

Answer 55

Galactocele

Question 56

fever + erythema of breast + no fluctuance

Answer 56

Mastitis

Question 57

calcifications on imaging + foamy macrophages/fat globules on biopsy

Answer 57

Fat Necrosis Of The Breast

Question 58

erythema + fluctuance on breast

Answer 58

breast abscess

Question 59

Hydrops fetalis, polyhydramnios, ascities, skin thickening

Answer 59

ParvoB19 from cardiac cannot keep up with Parvo's induced anemia