random OB floor day

Question 1

what is bishop score / how to use?

Answer 1

pre-labor scoring system to predict whether induction of labor is required
assesses odds of spontaneous delivery

Question 2

components of bishop score?

Answer 2

cervical dilation 
effacement
consistent 
position 
fetal station

Question 3

what bishop score predicts successful vaginal birth?

Answer 3

6-8

Question 4

management of incomplete/inevitable/missed abortion?

Answer 4

• surgical evacuation if: hemodynamically unstable/heavy bleeding
• mild bleeding - expectant, prostaglandins, surgical evac

Question 5

placental abruptions, uncommon presentation?

Answer 5

blood may be concealed, but cause a firm fundus

blood is uterotonic –> more freq. contractions

Question 6

what meds do you give for a lady in preterm labor with no indications for delivery?

Answer 6

tocolytics (beta-agonists, calcium channel blockers, NSAIDs - delay labor for 2 days)
corticosteroids + MgSO4 (neuro protection)

Question 7

singleton pregnancy + hx of preterm birth OR short cervix _ s given & during what duration?

Answer 7

16-36 wks - progesterone

Question 8

hpv vaccine indications

Answer 8

• all 9-26 (incl. hx of genital warts, anl cytology, positive HPV)
• males 9-21 (26 if MSM)
• immunocompromised to 26
• not used in pregnancy

Question 9

mullerian agenesis (MRKH syndrome)

Answer 9

46XX females: no upper vagina, cervix, uterus but nL female dev’t
nL pubic/axillary hair + female test levels

Question 10

when is chronic villus sampling done?

Answer 10

aspirate small quantity of chorionic villi from placenta b/w 10-12 wks

Question 11

how to manage 35 yo pregnant lady w/ abnL u/S?

Answer 11

CVS
serum screen does not provide a confirmatory diagnosis, unable to indicate a risk that is any greater than the risk of trisomy based solely on pt’s age

Question 12

mccune-albright syndrome:

Answer 12

precocious puberty (gonado-tropin-independent)
cafe au lait spots
polyostotic fibrous dysplasia
autonomous endocrine hyperfunction

Question 13

how does fetal distress proceed (in terms of fetal heart monitoring)?

Answer 13

tachycardia to bradycardia to a sinusoidal pattern

Question 14

what is an apt test?

Answer 14

differentiates maternal from fetal blood

Question 15

presentation of trichomoniasis

Answer 15

thin, yellow-green, malodorous, frothy
+vaginal inflammation
pH > 4.5
motile trichomonads

Question 16

how do does a fetus get thyrotoxicosis with a Graves mama?

Answer 16

thyroid stimulating immunoglobulin crosses the placenta

Question 17

candidiasis of the nipple

Answer 17

severe discomfort + pain

shiny, pink nipples with peripheral peeling

Question 18

when does bone density screening occur?

Answer 18

beginning at age 65, unless pre-existing risk factors for earlier screening

Question 19

risk factors for osteoporosis

Answer 19

early menopause, glucocorticoid therapy, sedentary lifestyle, EtOH consumption, hyperthyroidism, hyperparthyroidism, anticonvulsant, vit D deficiency

Question 20

theca lutein cysts are often unilateral or bilateral?

Answer 20

bilateral