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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
progesterone withdrawal test tells you....
if there is a problem with estrogen (primary ovarian insufficiency, anatomic abnL) or a problem with ovulation
26
diagnostic criteria for PCOS
>=2 of: irregular menses increased androgens polycystic ovaries on US
27
45 F G4P4 no complains, PEx shows mild descent of bladder into agine, dx and tx
cystocele observe bc asx pelvic floor muscle exercises
28
classic presentation of TSS
``` tampons hypotension fever sunburn rash involving palms and soles multiorgan dysfxn ```
29
STI: "groove" sign
lympohgranuloma venereum
30
STI: donovan bodies
granuloma inguinale
31
STI: ulcer with beefy-red base
granuloma inguinale
32
STI: GNR in "school of fish" pattern
charcroid
33
primary syphilis sx
painless ulcer
34
secondary syphilis sx
generalized fever, myalgias, palm and sole rash, condyloma lata
35
tertiary syphilis sx
aortitis, aortic regurg, gummas
36
neurosyphilis sx
dementia tabes dorsalis Argyll-Robertson pupils general paresis
37
Tx syphilis per stage
PENICILLIN G primary: x one secondary: x one latent: x one tertiary: weekly x three neuro: IV x 10-14 days
38
DES exposure cancer assoc
clear cell adenocarcinoma of vagina
39
current recs cervical cancer screening
``` start age 21 q3 years 21-29 yo > 30 q5 with HPV > 30 q 3 without HPV stop > 65 if nL or hysterectomy ```
40
next step: pt with pap HSIL
LEEP if > 25 y
41
next step ASC-H
colposcopy
42
classic present ovarian cancer
abd pain early satiety new ascities previously healthy
43
RF ovarian cancer
``` uninterupted ovulation early menarche late menopause nulliparity FHx: HNPCC, BRCA 1/2 infertility ```
44
drugs causing gynecomastia
``` STACKED spironolactone thc alcohol cimetidine ketoconazole estrogen digoxin ```
45
tx for ductal carcinoma in situ of breast
lumpectomy +/- radiation | no rx
46
once you have ruled out invasive cancer, what is most approp tx of LCIS
observe tamoxifen +/- b/l ppx mastectomy tamoxifen works bc all LCIS are ER and PR positive!
47
sign of softening of cervix in early pregnancy
Goodell sign
48
sign of early pregnancy: dark bluish-red discoloration of vaginal mucosa
Chadwick sign
49
how does CO, plasma volume, BP, and Cr change during pregnancy
CO increases plasma volume increases BP decreases Cr decreases
50
when screen for syphilis in prenatal
1st and 3rd if high risk
51
when do quadruple screen in prenatal visits
15-20 w
52
when do screening for GDM
24-28 w
53
when screen for GBS
35-37 w
54
conditions suggestbed by increased alpha fetoprotein
NTD multigestation abd wall defect incorrect dating
55
wt gain for overweight woman during pregnancy
15-25 #
56
wt gain for nL wt woman during pregnancy
25-35 #
57
wt gain for underweight during pregnancy
28-40 #
58
wt gain for obese during pregnancy
11-20 #
59
definintive test for Down syndrome at 11 w
chorionic villous sampling | 10-13 w
60
tx N/V during pregnancy
1st line: vitamin B6 doxylamine (Unasom) 2nd line: zofran, meclizine, metocloperamide, diphenhydramine
61
pregestational diabetes puts infants at risk of
``` macrosomia fetal hypoglycemia congenital cardiac/caudal regression malform SAB stillbirth ```
62
diagnostic criteria for preeclampsia
``` 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
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
amniotic fluid embolism looks just like PE with the addition of DIC
64
tx amniotic fluid embolism
ACLS protocol
65
susceptible pregnant woman is exposed to someone with chickenpox next step
VZV immune globulin
66
pregnant woman develops chickenpox rash around time of delivery next step
acyclovir to mom | VZV immune globulin to infant
67
pregnant woman develops chickenpox rash early in pregnancy next step
acyclovir
68
management options for intrauterine fetal demise
expectant manage (risk inf and DIC) D&E Rx: misoprostol, oxytocin
69
components of biophysical profile
``` NST fetal tone fetal movement fetal breathing amniotic fluid volume ``` 8-10 is reassuring
70
definition of IUGR
< 10% expected fetal weight
71
definition macrosomia
<4500 g
72
recipient twin in twin-twin transfusion syndrome is at risk for what complications
polyhydramnios polycytoemia heart failure volume overload
73
tocolytic agents
MgSo4 CCB nifedipine indomethacin terbutaline
74
classic present uterine rupture
``` 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
meds in management of uterine atony
oxytocin methylergonovine misoprostol carboprost
76
abx tx postpartum endometritis
gentamicin and clindamycin

DIT Step 2 (8 decks)

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