Obstetrics & Gynecology

Question 1

What is a contraindication to an estrogen-containing patch?

Answer 1

-BMI > 30

Question 2

How many hours can someone be late taking a progestin-only pill?

Answer 2

Within 3 hours of usual time (or 48 hours of backup contraception needed)

Question 3

Which oral contraceptive is associated with reversible bone loss after 2 years+ of use?

Answer 3

Medroxyprogesterone

Question 4

What are disadvantages of estrogen/progesterone products?

Answer 4

-Increased BP
-Increased risk of stroke + MI
-Increased risk of thromboembolic events

Question 5

What are contraindications to estrogen-containing products?

Answer 5

-> 35 years old and smoking
-History of thromboembolism

Question 6

What are disadvantages of progestin-only products?

Answer 6

-Irregular menses and increased risk of breakthrough bleeding
-Increased need for adherence

Question 7

What are symptoms of estrogen deficiency?

Answer 7

-Vasomotor symptoms
-Breakthrough bleeding/spotting
-Decrease libido
-Dyspareunia

Question 8

What are symptoms of progestin deficiency?

Answer 8

-Weight loss
-Heavy menstrual bleeding
-Dysmenorrhea

Question 9

When may levonorgestrel be ineffective?

Answer 9

BMI > 25

Question 10

When may ulipristal be ineffective?

Answer 10

BMI > 35

Question 11

Why is transdermal estradiol w/ cyclin progestin used in amenorrhea?

Answer 11

to prevent bone loss

Question 12

What medication is used to treat hyperprolactinemia?

Answer 12

Cabergoline

Question 13

How much folic acid is recommended during pregnancy?

Answer 13

0.4 mg daily

Question 14

How much iron is recommended during pregnancy?

Answer 14

27 mg daily (during 2nd and 3rd trimesters)

Question 15

What is recommended first-line for N/V during pregnancy?

Answer 15

Vitamin B6 +/- doxylamine

Question 16

What is recommended second-line for N/V during pregnancy?

Answer 16

-Diphenhydramine
-Prochlorperazine
-Promethazine

Question 17

What is recommended third-line for N/V during pregnancy?

Answer 17

-Metoclopramide
-Ondansetron
-Trimethobenzamide

Question 18

What medication used for GERD should be avoided in pregnancy?

Answer 18

Sodium bicarbonate

Question 19

What medications used for constipation should be avoided in pregnancy?

Answer 19

-Castor oil
-Mineral oil

Question 20

What medication used for diarrhea should be avoided in pregnancy?

Answer 20

Diphenoxylate + atropine

Question 21

What medications used for pain should be avoided in pregnancy?

Answer 21

NSAIDs + aspirin (for longer than 48 hrs after 20 weeks gestation)

Question 22

What is goal BP for gestational HTN?

Answer 22

120-160/80-110 mmHg

Question 23

What is goal BP for chronic HTN in pregnancy?

Answer 23

< 140/90 mmHg

Question 24

What is recommended first-line for HTN in pregnancy?

Answer 24

-Nifedipine
-Labetalolol

Question 25

What is recommended second-line for HTN in pregnancy?

Answer 25

-Methyldopa

Question 26

What is recommended first-line for DM in pregnancy?

Answer 26

Insulin -Long-Acting: glargine or detemir, NPH -Short-Acting: aspart or lispro

Question 27

Which seizure medications should be avoided in pregnancy?

Answer 27

-Phenobarbital -Phenytoin -Valproic acid

Question 28

Which anticoagulant(s) is preferred in pregnancy?

Answer 28

-Heparin (> 36 weeks or near delivery) -Enoxaparin (< 36 weeks)

Question 29

What must be given to postmenopausal women with an intact uterus?

Answer 29

Progestins

Question 30

What are absolute contraindications to HT/ET in symptomatic postmenopausal women?

Answer 30

-VTE -Known or suspected pregnancy -Undiagnosed vaginal bleeding -Breast cancer -Active liver disease -MI, stroke, or TIA

Question 31

What are concerns with oral estrogen?

Answer 31

-GI intolerance -Increase in triglycerides -Liver disease -Gallbladder disease

Question 32

What forms of contraception should be avoided in patients with structural abnormalities of the uterus?

Answer 32

-IUDs -Contraceptive sponge

Question 33

What forms of contraception should be avoided in patients with history of cerebrovascular accident?

Answer 33

-Estrogen-containing -Progestin-only

Question 34

What is the first-line treatment for dysmenorrhea?

Answer 34

NSAIDs

Question 35

What is the second-line treatment for dysmenorrhea?

Answer 35

Estrogen-progestin contraceptives (extended-interval dosing can decrease frequency of menses)

Question 36

What type of contraception is contraindicated if SBP > 160 mmHg and/or DBP > 100 mmHg

Answer 36

Estrogen-containing

Question 37

What is the optimal dosing window for levonorgestrel?

Answer 37

72 hours

Question 38

What is the optimal dosing window for ulipristal

Answer 38

120 hours

Question 39

What are contraindications to getting an IUD inserted?

Answer 39

Active purulent cervicitis, chlamydia, or gonococcal infection