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DIT Step 2 > OBGYN study guide incorrect > Flashcards

OBGYN study guide incorrect Flashcards

1
Q

causes of peripheral precocious puberty

A

adrenal tumors
other hormone secreting tumors
exogenous hormones
congential adrenal hyperplasia

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2
Q

mean age menarche in US

A

13

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3
Q

definition precocious puberty

A

< 8 yo F
< 9 yo M
incomplete or complete si/sx pubertal change

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4
Q

lab fings distinguish central precocious puberty from peripheral precocious puberty

A

central: increased LH
peripheral: decreased LH

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5
Q

tx central precocious puberty

A

GnRH continuous
if approp age, nothing
if mass, surg

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6
Q

phase menstrual cycle fixed at 14 is

A

luteal phase

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7
Q

FSH stimulates release of H from follicle

A

estradiol

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8
Q

as periods are decreasing in perimenopause, what hormonal changes are occurring

A

increased FSH

decreasted/fluctuating estrogen

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9
Q

what determines wheter a woman taking estrogen need to take progesterone as well?

A

if has uterus, needs progesterone

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10
Q

inducers of P450 mnemonic

A

Guiness, Corona, PBRs induce chronic alcoholism

griseofulvin
carbamazepine
phenytoin
barbital
rifampin
st. johns wort
chronic EtOH
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11
Q

MOA OCPs

A

inhibit follicle development
prevent endometrial proliferation/change endometrial quality
decrease mucous secretions/thicken cervical mucous

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12
Q

OCPs decrease incidence of which types of cancer

A

endometrial
ovarian
colon

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13
Q

four different options for emergency contraception

A

levonorgestrel (plan B)
levonorgestrel and high dose ethinyl estradiol (OCPs)
mifepristone/ulipristal (anti-progestins)
copper IUD

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14
Q

tx of choice for primary dysmenorrhea

A

NSAIDs

OCPs

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15
Q

timing of the pain of primary dysmenorrhea during menstrual cycle

A

starts with menses x several days

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16
Q

meds effective in tx of PMS and PMDD

A 
NSAIDs
SSRIs (esp PMDD)
GnRH continuous agonists
exercise
relaxation
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17
Q

timing sx PMS and PMDD

A

2-3 days before period

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18
Q

definitively diagnose endometriosis

A

laparoscopy

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19
Q

definition dysmenorrhea and causes

A

pain with menses

primary: PG driven, starts with menses, follicular phase
secondary: endometriosis, PID, fibroids, cysts, etc. starts during luteal phase

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20
Q

MC cause irregular heavy uterine bleeding in non-pregnant, premenopausal woman

A

ovulatory dysfunction/anovulation

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21
Q

MC cause of regular heavy menstrual bleeding in non-pregnant, premenopausal woman

A

fibroids

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22
Q

when endometrial biopsy necessary for abnL uterine bleeding

A

> 45 yo
<45 yo with persistent bleeding and RF endometrial cancer
multiple RF

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23
Q

MC cause of secondary amenorrhea

A

pregnancy

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24
Q

androgen insensitivity syndrome from Mullerian agensis

A

BOTH: breasts, no uterus

AIS: no secondary sexual characteristics, high testosterone, 46 XY

Mullerian agenesis: has secondary sexual characteristics, low (normal for female) testosterone, 46 XX

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25
Q

progesterone withdrawal test tells you….

A

if there is a problem with estrogen (primary ovarian insufficiency, anatomic abnL) or a problem with ovulation

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26
Q

diagnostic criteria for PCOS

A

> =2 of:
irregular menses
increased androgens
polycystic ovaries on US

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27
Q

45 F G4P4 no complains, PEx shows mild descent of bladder into agine, dx and tx

A

cystocele

observe bc asx
pelvic floor muscle exercises

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28
Q

classic presentation of TSS

A 
tampons
hypotension
fever
sunburn rash involving palms and soles 
multiorgan dysfxn
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29
Q

STI: “groove” sign

A

lympohgranuloma venereum

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30
Q

STI: donovan bodies

A

granuloma inguinale

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31
Q

STI: ulcer with beefy-red base

A

granuloma inguinale

32
Q

STI: GNR in “school of fish” pattern

A

charcroid

33
Q

primary syphilis sx

A

painless ulcer

34
Q

secondary syphilis sx

A

generalized fever, myalgias, palm and sole rash, condyloma lata

35
Q

tertiary syphilis sx

A

aortitis, aortic regurg, gummas

36
Q

neurosyphilis sx

A

dementia
tabes dorsalis
Argyll-Robertson pupils
general paresis

37
Q

Tx syphilis per stage

A

PENICILLIN G

primary: x one
secondary: x one
latent: x one
tertiary: weekly x three
neuro: IV x 10-14 days

38
Q

DES exposure cancer assoc

A

clear cell adenocarcinoma of vagina

39
Q

current recs cervical cancer screening

A 
start age 21
q3 years 21-29 yo
> 30 q5 with HPV
> 30 q 3 without HPV
stop > 65 if nL or hysterectomy
40
Q

next step: pt with pap HSIL

A

LEEP if > 25 y

41
Q

next step ASC-H

A

colposcopy

42
Q

classic present ovarian cancer

A

abd pain
early satiety
new ascities
previously healthy

43
Q

RF ovarian cancer

A 
uninterupted ovulation
early menarche
late menopause
nulliparity
FHx: HNPCC, BRCA 1/2
infertility
44
Q

drugs causing gynecomastia

A 
STACKED
spironolactone
thc
alcohol
cimetidine
ketoconazole
estrogen
digoxin
45
Q

tx for ductal carcinoma in situ of breast

A

lumpectomy +/- radiation

no rx

46
Q

once you have ruled out invasive cancer, what is most approp tx of LCIS

A

observe
tamoxifen
+/- b/l ppx mastectomy

tamoxifen works bc all LCIS are ER and PR positive!

47
Q

sign of softening of cervix in early pregnancy

A

Goodell sign

48
Q

sign of early pregnancy: dark bluish-red discoloration of vaginal mucosa

A

Chadwick sign

49
Q

how does CO, plasma volume, BP, and Cr change during pregnancy

A

CO increases
plasma volume increases
BP decreases
Cr decreases

50
Q

when screen for syphilis in prenatal

A

1st and 3rd if high risk

51
Q

when do quadruple screen in prenatal visits

A

15-20 w

52
Q

when do screening for GDM

A

24-28 w

53
Q

when screen for GBS

A

35-37 w

54
Q

conditions suggestbed by increased alpha fetoprotein

A

NTD
multigestation
abd wall defect
incorrect dating

55
Q

wt gain for overweight woman during pregnancy

A

15-25 #

56
Q

wt gain for nL wt woman during pregnancy

A

25-35 #

57
Q

wt gain for underweight during pregnancy

A

28-40 #

58
Q

wt gain for obese during pregnancy

A

11-20 #

59
Q

definintive test for Down syndrome at 11 w

A

chorionic villous sampling

10-13 w

60
Q

tx N/V during pregnancy

A

1st line:
vitamin B6
doxylamine (Unasom)

2nd line:
zofran, meclizine, metocloperamide, diphenhydramine

61
Q

pregestational diabetes puts infants at risk of

A 
macrosomia
fetal hypoglycemia
congenital cardiac/caudal regression malform
SAB
stillbirth
62
Q

diagnostic criteria for preeclampsia

A 
new onset
> 20 w GA
>140/90
AND 
proteinuria
OR
end organ damage (dec PLT, inc LFTs, pul edema, CNS, HA, vision change, renal failure)
63
Q

33 F, 39w GA, active labor, second stage of labor she complains of dyspnea, suddenly becomes unresponseive, pulse cannot be detected, not to have bleeding from mouth and nose dx

A

amniotic fluid embolism

looks just like PE with the addition of DIC

64
Q

tx amniotic fluid embolism

A

ACLS protocol

65
Q

susceptible pregnant woman is exposed to someone with chickenpox next step

A

VZV immune globulin

66
Q

pregnant woman develops chickenpox rash around time of delivery next step

A

acyclovir to mom

VZV immune globulin to infant

67
Q

pregnant woman develops chickenpox rash early in pregnancy next step

A

acyclovir

68
Q

management options for intrauterine fetal demise

A

expectant manage (risk inf and DIC)
D&E
Rx: misoprostol, oxytocin

69
Q

components of biophysical profile

A 
NST
fetal tone
fetal movement
fetal breathing
amniotic fluid volume

8-10 is reassuring

70
Q

definition of IUGR

A

< 10% expected fetal weight

71
Q

definition macrosomia

A

<4500 g

72
Q

recipient twin in twin-twin transfusion syndrome is at risk for what complications

A

polyhydramnios
polycytoemia
heart failure
volume overload

73
Q

tocolytic agents

A

MgSo4
CCB nifedipine
indomethacin
terbutaline

74
Q

classic present uterine rupture

A 
constant pain (loss of contractions)
fetal bradycardia
change uterine shape
hypotension
tahcycardia
hx uterine surgery
induction of labor

go to surgery for C/S and hysterectomy

75
Q

meds in management of uterine atony

A

oxytocin
methylergonovine
misoprostol
carboprost

76
Q

abx tx postpartum endometritis

A

gentamicin and clindamycin

DIT Step 2 (8 decks)

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