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Rosh > Prolog > Flashcards

Prolog Flashcards

1
Q

An elevated anti-Yo antibody level usually points to?

A

Paraneoplastic syndrome, most likely of breast or ovarian origin

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2
Q

Preferred initial therapy for VTE (except in the case of renal insuff)

A

LMWH

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3
Q

Stains for CK7, CA 125, PAX8, and WT1 are positive for ?

A

Serous ovarian tumors

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4
Q

Stains for CK20, CEA, and CDX2 are positive for?

A

GI tumors

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5
Q

Obese women who undergo bariatric surgery should use reliable contraception to avoid pregnancy for at least

A

12 months!

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6
Q

Osteopenia is defined as a T-score between??

A

-2.5 and -1.0

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7
Q

1st line medical therapy recommended for adolescents with depression?

A

Fluoxetine

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8
Q

PEP for HIV is ineffective thus not recommended if it has been more than how long since exposure?

A

72hrs

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9
Q

Use of hormonal contraceptives/HT is not recommended for pts w HIV on what antiretroviral bc they have been shown to decrease antiretroviral levels?

A

Fosamprenavir

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10
Q

Most sensitive test to detect local recurrence after hysterectomy for endometrial Ca. Is?

A

Physical exam

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11
Q

Recommended Tx of hyperthyroidism in 1st trimester?

A

PTU

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12
Q

Recommended Tx of hyperthyroidism in 2nd&3rd trimester?

A

Methimazole

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13
Q

Why is it recommend to switch from one thioamide anti thyroid agent to another after 1st trimester?

A

To balance the rare risks of hepatotoxicity ( assoc w PTU) and embryopathy (methimazole assoc aplasia cutis & esophageal/choanal atresia, so switch to this in 2nd trimester)

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14
Q

Cesarean delivery should be offered/ considered when the EFW is ??

A

> 5000g in a nondiabetic & >4500g in a diabetic woman

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15
Q

MC malformation assoc w an increased NT & normal karyotype?

A 
Cardiac defects 
(Septal defects are the MC)
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16
Q

Best initial Tx for gDM?

A

Lifestyle and dietary changes

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17
Q

All OBGYNs should be vaccinated aged against Hep B therefore are at greatest risk of infection by needlestick from a pt infected with what?

A

Hep C (risk is 1.8% compared with 0.3% for HIV)

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18
Q

The only approved therapy for PrEP is?

A

Combo of emtricitabine and tenofovir

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19
Q

If placenta previa is dxed in 2nd trimester, repeat US is recc when?
Follow up from there?

A

32wks; if placental edge is >2cm from internal os-> routine antenatal care,
if <2cm from os or still a previa-> repeat US @36wks

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20
Q

Best option to reduce vasomotor Sxs in a pt on Tamoxifen for breast Ca ? Which med should be avoided?

A

Venlafaxine ;
Not paroxetine since it may decrease the cnvsn of tamoxifen to its active metabolite
(V and T go together not P)

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21
Q

Tx is recommended for osteoporosis for pts with a T-score of ___ ? Or for women w a FRAX score w a 10-yr risk of what??

A

-2.5 or less ;

3% or greater for a hip fracture or a risk of 20% or greater for a major osteoporotic fracture

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22
Q

This galactagogue is a dopamine antagonist used to promote stomach emptying & GI motility, & has been shown to increase breast milk supply ?
Black box warning for?

A

Metoclopramide;

Tardive dyskinesia

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23
Q

Studies have shown an association btwn periodontal disease and what pregnancy complication?

A

Preterm birth

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24
Q

Preventing a disease process before it occurs through prevention of exposures that may cause the disease (ex is vaccination)

A

Primary prevention

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25
Q

Decreases the effect of a disease or injury that has already occurred, mainly by early detection & prompt Tx to hat or slow progression (ie cervical ca screening & mammography)

A

Secondary prevention

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26
Q

The thrombophilia test most influenced by pregnancy?

A

Protein S activity level

ie testing for Protein S deficiency is NOT reliable in preg

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27
Q

The component of the umbilical cord blood that is most consistent with a neurologic injury that is a result of an acute intrapartum event?

A

Base deficit

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28
Q

Most likely congenital infection w the US finding- echogenic bowl/intraabdominal calcifications & symmetric fetal growth restriction?

A

CMV

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29
Q

Most likely congenital infection w the US finding- placentomegaly?

A

Syphilis

30
Q

Microcephaly primarily associated with what 3 congenital infections?

A

Toxo and Zika and varicella

31
Q

Most likely congenital infection w the US finding- ascites?

A

Parvovirus B19

32
Q

Most likely abnormal fetal karyotype w the US findings- cerebral ventriculomegaly & echogenic bowl

A

47, XX, +21 (trisomy 21)

33
Q

Holoprosencephaly is assoc w fetal aneuploidy in ~40% of cases, of aneuploid fetuses w this finding, 75% are a result of ?

A

Trisomy 13

34
Q

Most likely abnormal fetal karyotype w the US findings- overlapping fingers or clenched hands, cardiac & CNS anomalies, CPCs?

A

Trisomy 18

35
Q

Urticarial papules and plaques that begin on abdomen esp around umbilicus

A

Pemphigoid gestationis

36
Q

Urticarial papules and plaques that begin on abdomen with sparing of the umbilical region

A

Polymorphic Eruption of Pregnancy

37
Q

APGAR score for HR?

A

2 pts if HR >100bpm
1 pt if <100bpm
0 if absent

38
Q

Thickened NT (>3mm), elevated b-hCG (>2 MoM), & low PAPP-A (<0.5 MoM)

A

Down syndrome

39
Q

Lithium exposure assoc w increased risk of what cardiac malformation?

A

Ebstein’s anomaly (tricuspid valve is displaced into the RV)

40
Q

Risk of fetal malformation from exposure to this drug is as high as 20 -25%, with defects including craniofacial ie microtia, hydrocephalus, CV, neurologic, Thymic, and neurocognitive impairment in 30-60%

A

Isoretinoin for acne

41
Q

Best test to screen for glucose intolerance/ DM in a pt with PCOS?

A

75-g 2-hr oral GTT

42
Q

Pts who sustain spinal cord lesions above what spinal column level are at risk of autonomic hyperreflexia?

A

Above T6

43
Q

For a pt having surgical repair of a symptomatic urethral diverticula, who also has known SUI, best concomitant anti-incontinence surgery is? Why?

A

Autologous fascial sling; would serve as an additional tissue layer btwn the repaired urethra and vaginal epithelium, decreasing risk of fistula formation

44
Q

For a pt having surgical repair of a symptomatic urethral diverticula, who also has known SUI, need to avoid what kind of anti-incontinence surgery? Why?

A

Avoid synthetic midurethral sling And periurethral bulking agents; Placement of foreign body materials should be avoided in pts w urethral diverticula bc they could increase risk of fistula formation

45
Q

What size rectovaginal fistulas have up to a 40% chance of spontaneous closure so a period of expectant management is advised?

A

Less than 4 mm

Fistulas >5mm in size however rarely close without surgical intervention

46
Q

The characteristic of pelvic mesh that results in the lowest rate of mesh extrusion is ?

A

Monofilament

Type 1 mesh is best it’s monofilament and macroporous

47
Q

Most likely complication after vaginal placement of synthetic mesh is?

A

Mesh exposure

48
Q

Nitrofurantoin carries what rare but real risk in older adults?

A

Chronic interstitial lung disease

therefore would not be ideal in a patient with COPD

49
Q

What used to be recommended for evaluation of painful bladder syndrome but is no longer recommended unless there exists a concern for calculi, bladder foreign body, carcinoma, or bladder diverticulum ?

A 
Office cystoscopy
( potassium sensitivity test also used to be but is no longer recommended)
50
Q

1st line Tx of vaginal mesh erosion?

A

Estrogen

51
Q

When a postop vesicovaginal fistula occurs, what evaluation must be done? Via?

A

Must confirm there is no ureteral injury which can occur in up to 12% of iatrogenic vesicovaginal fistulas, options for upper tract imaging inc CT urography or bilateral retrograde pyelography

52
Q

MC complication assoc w retropubic midurethral sling procedure is?

A

Postop UTI (~30% of cases, vs bladder perforation ~5% of the time)

53
Q

Will POP-Q point C be + or - in a pt with stage III prolapse?

A

+ (= cm below/distal to hymen; negative number is cm above/proximal to hymen)

54
Q

What type of cysts are commonly found along the posterior or lateral vagina cephalad to the hymen, many of which are asymptomatic?

A

Gartner duct cysts

Which is the embryonic remnant of the mesonephric duct

55
Q

Biggest RF for developing GTN?

A

Complete molar pregnancy in the antecedent pregnancy (which tend to have higher bhCG levels ie greater than 100,000)

56
Q

Stains strongly + for placental alkaline phosphatase and p63

A

Epitheliod trophoblastic tumors

57
Q

Stain strongly for Mel-CAM and human placental lactogen

A

Placental site trophoblastic tumors

58
Q

For Tx of low-grade serous ovarian Ca, presence of BRAF mutation Correlates to response to what kind of targeted therapy?

A

MEK inhibitors

59
Q

Ovarian cancer in patients with the BRCA mutations are particularly sensitive to??

A

PARP inhibitors

60
Q

This easy and inexpensive test can be performed in the office and can confirm the presence of a bladder injury immediately

A

Blue dye test = tampon test

61
Q

Tenderness’s erythema, or edema beyond the apparent confines of infection accompanied by systemic features of infection concerning for??

A

Necrotizing soft tissue infection

62
Q

NCCN guidelines recommend sentinel LN biopsies for vulvar Ca. When ??

A

The tumors are less than 4cm in diameter

63
Q

NCCN guidelines recommend full inguinofemoral lymphadenectomy for vulvar Ca. When ??

A

Tumors of 4cm or greater in diameter and when there is palpable lymphadenopathy

64
Q

When is ipsilateral LN evaluation sufficient for vulvar cancer?

A

For well lateralized vulvar tumors ie >1-2cm from the midline

65
Q

Which dopamine agonist is 1st line for the Tx of hyperprolactinemia 2/2 microadenoma in a pt wanting to get pregnant ?

A

Cabergoline

66
Q

Which dopamine agonist is preferred to manage pts that require them in pregnancy?

A

Bromocriptine

Needs to be cont in preg of tumor abuts the optic chiasm

67
Q

This drug has the strongest evidence of benefit in patients with advanced cancer with a nausea and vomiting without identifiable cause
It should be avoided if what is suspected?

A

Metoclopramide;

Malignant bowel obstruction

68
Q

Pts with a BMI of 30-34.9 are candidates for bariatric surgery if they have one of what 2 conditions?

A

Diabetes or metabolic syndrome

69
Q

Best test to predict patients clinical response to pembrolizumab?

A

Test for PD-L1

70
Q

Most appropriate anti-emetic comb for prevention in a patient with ovarian cancer scheduled to receive IV Carbo-taxel?

A

5-HT3 receptor antagonist (ie zofran), dexamethasone, and NK1 antagonist (ie aprepitant)

71
Q

What level of emetic- risk are cisplatin and cyclophosphamide? Ie need how many antiemetics?

A

High-risk, need 4 (zofran, dexamethasone, aprepitant, and olanzapine

72
Q

Fetus of obese women are adding increase risk of multiple malformations the highest attributable increased risk from obesity if for what structural malformation ?

A

Neural tube defects

Rosh (4 decks)

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