Obgyne

Question 1

OCP decreases the incidence of what CA

Answer 1

Colorectal
Endometrial
Ovarian

Question 2

biochemical diagnosis of premature menopause

Answer 2

low estrogen
elevated FSH and LH
low number of follicles on ultrasound

before the age of 40

Question 3

First thing to do when a pregnant woman in her first trimester is exposed to rubella

Answer 3

serum IgM and IgG

Question 4

When is maternal rubella most harmful to the fetus?

Answer 4

first 8-10 weeks

fetal damage is rare after 16 weeks

Question 5

Proven rubella infection in the first trimester: treatment

Answer 5

counsel therapeutic abortion

Question 6

Diagnosis of premature ovarian failure

Answer 6

serum fsh (high) and estradiol (low)

Question 7

Criteria for diagnosis of PCOS

Answer 7

2 out of 3 of the ff:

1) Hyperandrogenism
2) Menstrual abnormalities
3) polycystic ovaries (enlarged or with 12 or more follices)

Question 8

High grade squamous intraepithelial lesion on pap smear: Next step

Answer 8

colposcopy and targeted biopsy

Question 9

Hyperprolactinemic anovulation: treatment

Answer 9

bromocriptine - dopamine agonists

confirm pituitary tumor diagnosis with MRI first

Question 10

painless cervical dilatation resulting in delivery of a fetus during the 2nd trimester

Answer 10

cervical insufficiency

Question 11

risk factors for cervical insufficiency

Answer 11

congenital disorders of collagen synthesis
prior cone biopsies
prior deep cervical lacerations usually secondary to vaginal or cesarean delivery
mullerian duct defects
more than 3 prior fetal losses during the second trimester

Question 12

most common symptom of endometriosis

Answer 12

dysmenorrhea

Question 13

symptoms suspicious of endometriosis

Answer 13

dysmenorrhea
dysuria
infertility
deep dyspareunia
painful abdominal bloating

Question 14

Absolute contraindications to using progesterone-only pills

Answer 14

1. suspected pregnancy
2. breast cancer
3. undiagnosed vaginal bleeding
4. past history of ectopic pregnancy or high risk for ectopic pregnancy

(Mnemonic: BABE - buntis, aub, breast ca, ectopic)

Question 15

relative contraindications to using progesterone-only pills

Answer 15

1. active viral hepatitis
2. severe chronic liver disease
3. malabsorption syndromes
4. severe arterial disease

Question 16

Features of hyperemesis gravidarum

Answer 16

nausea and vomiting
weight loss (>5%)
mod to severe dehydration
ketosis
electrolyte abnormalities

Question 17

treatment of hyperemesis gravidarum

Answer 17

NPO - gradual resumption
IV rescuscitation (2L of Ringer's lactate infused over 3 hours to maintain a urine output of more than 100ml/h)
Antiemetics - metoclopramide 
Vitamin b6 orally 
replace electrolytes as required

Question 18

Indication for cerclage

Answer 18

cervical shortening detected by utz before 22 to 24 weeks of gestation.

Question 19

Treatment for cervical insufficiency

Answer 19

cerclage

vaginal progesterone

Question 20

PRENATAL:

when to do first ultrasound

Answer 20

18-20 weeks aog

Question 21

PRENATAL:

when to do morphology scan

Answer 21

18 weeks aog

Question 22

PRENATAL:

when to do Rubella anti-D immunoglobulin

Answer 22

28 and 34 weeks

Question 23

PRENATAL:

when to do Group b streptococcus swab

Answer 23

36 weeks

Question 24

Fundic height landmarks

Answer 24

12 weeks - symphysis pubis
20 weeks - umbilicus
36 weeks - xiphisternum

Question 25

MSST for first trimester

Answer 25

B-Hcg - increased
PAPPA - decreased
Nuchal thickness- increased

Question 26

MSST for second trimester

Answer 26

AFP - decreased
B-Hcg - increased
Estriol, unconjugated - decreased
Inhibin A - increased

Question 27

Confirmatory tests for Down Syndrome (1st and 2nd trimester)

Answer 27

Chorionic Villus Sampling - 1st trimester (11 weeks)

Amniocentesis - 2nd trimester (16 weeks)

Question 28

Risk of miscarriage for CVS and amniocentesis

Answer 28

CVS - 1:100

Amniocentesis 1:200

Question 29

Routine prenatal checkups: how often?

Answer 29

initially: 8-10 weeks
up to 28 weeks - 4-6 weeks
up to 36 weeks - 2 weeks
up to term - weekly

Question 30

When to avoid travelling while pregnant? (AOG)

Answer 30

avoid travel after 28 weeks

not permitted after 34 weeks

Question 31

Criteria for abortion

Answer 31

<20 weeks, <500g

Question 32

Bluish discoloration of the cervix and vagina due to engorgement of the vasculature usually @ 6 weeks aog

Answer 32

Chadwick’s sign

Question 33

Softening of the cervix @ 4-6 aog

Answer 33

Goodell’s sign

Question 34

Softening of the uterine isthmus @ 6-8 weeks aog

Answer 34

Hegar’s sign

Question 35

In pregnancy when does B-hcg increase in serum? in urine?

Answer 35

serum - 9 days post conception

urine - 28 days after LMP

Question 36

Visible on transvaginal utz at 5 weeks? at 6 weeks? at 7 weeks?

Answer 36

5 weeks - gestational sac visible
6 weeks - fetal pole
7 weeks - fetal heart tones

Question 37

Onset of labor from 28-<37 weeks

Answer 37

preterm delivery

Question 38

Postterm delivery

Answer 38

42 weeks

Question 39

1st stage of labor: phases

Answer 39

latent phase - 0-3cm
active phase - 4-7cm
Transitional phase - 8-10cm

Question 40

occurs in the second stage of labor

Answer 40

delivery of infant, cardinal movements

Question 41

occurs in the third phase of labor

Answer 41

delivery of placenta 
lengthening of cord
uterus becomes globular
fundus rises
crede's maneuver

Question 42

fetal presentation - indication for CS

Answer 42

face presentation

footling breech

Question 43

Methods of induction of labor

Answer 43

1) sweeping of the membranes
2) cervical ripening with balloon catheter
3) vaginal prostaglandin
4) amniotomy
5) intravenous oxytocin

Question 44

Turtle sign (delivery)

Answer 44

shoulder dystocia