Obstetrics and Gynecology

Question 1

Name the breast mass:

• History of recent breast trauma/surgery
• Firm, irregular mass
• ± Ecchymosis, skin/nipple retraction

Answer 1

Fat necrosis

Question 2

Name the breast mass:

• Solitary, well-circumscribed, mobile mass
• Cyclic premenstrual tenderness

Answer 2

Fibroadenoma

Question 3

Name the breast mass:

• Multiple, diffuse nodulocystic masses
• Cyclic premenstrual tenderness

Answer 3

Fibrocystic changes

Question 4

Name the breast mass:

• Solitary, well-circumscribed, mobile mass
• ± Tenderness

Answer 4

Breast cyst

Question 5

Name the breast mass:

- Bloody nipple discharge, usually unilateral

Answer 5

Intraductal papilloma

Question 6

Which screening tests may be used in the first trimester of pregnancy?

Answer 6

Combined test: maternal beta-HCG, maternal PAPP-A, and nuchal translucency

Question 7

Which screening tests may be used in the second trimester of pregnancy?

Answer 7

Triple screen: maternal AFP, beta HCG, estriol

Quad screen: maternal AFP, beta hCG, estriol, AND inhibin A (increases sensitivity)

Question 8

Which quad screen results are seen in Trisomy 18?

Answer 8

Edward Syndrome

AFP ↓, beta hCG ↓, estriol ↓, inhibin A normal

Question 9

Which quad screen results are seen in Trisomy 21?

Answer 9

Down syndrome (all Down except BA - BAD(owns)
AFP ↓, beta hCG ↑, estriol ↓, inhibin A ↑

Question 10

Which quad screen results are seen in neural tube defects?

Answer 10

AFP ↑, beta hCG normal, estriol normal, inhibin A normal

Question 11

Describe Symmetric IUGR

Answer 11

• Brain is in proportion to the rest of the body
• Usually occurs before 20 weeks GA
• Caused by intrinsic factors (e.g. genetics, fetal infection)

Question 12

Describe Asymmetric IUGR

Answer 12

• Brain weight is not decreased
• Abdomen is smaller than the head
• Occurs after 20 weeks
• Caused by extrinsic factors (uteroplacemental insufficiency)