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PANCE Exam Review > Reproductive > Flashcards

Reproductive Flashcards

1
Q

Gono infection labs show:

A

Gram (-) Diplococci

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2
Q

Gono Tx

A

IM Ceftriaxone 250 mg +
PO Azithromycin 1 g
(can also use PO Doxy x 7d)

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3
Q

What procedure is done to help the odds of pregnancy in a patient with history of cervical incompetence and/or miscarriage?

A

Cervical Cerclage (stitch)

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4
Q

New onset HTN < 20 wks gestation, suspect _____.

A

Molar Pregnancy

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5
Q

What would labs show in ovarian torsion?

A

Leukocytosis (High WBC)

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6
Q

What is the GOLD standard for Dx of ovarian torsion?

A

Laparoscopy

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7
Q

RFs for Cervical Insufficiency:

A
  1. Ehlers-Danlos Syndrome (stretchy skin syndrome)
  2. Trauma to cervix
  3. Tx of cervical intraepithelial neoplasia
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8
Q

MCC of abnormal uterine bleeding in older, obese women

A

Endometrial Hyperplasia

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9
Q

Tumor marker for Ovarian CA ONLY

A

CA-125

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10
Q

PID Tx

A

IM Ceftriaxone + Doxycycline x 14d

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11
Q

Malodorous gray vaginal discharge. Dx?

A

Bacterial Vaginosis

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12
Q

BRCA -1 and BRCA-2 found in:

A

Breast and Ovarian CA

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13
Q

What is a Tocolytic?

A

Meds used to suppress premature labor. Uterine relaxant.

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14
Q

What is the Leopold maneuver?

A

PE maneuver used to help determine position of a fetus

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15
Q

What is the mgmt for Intrahepatic Cholestasis of Pregnancy?

A

Induce @ 36-37 wks.

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16
Q

What is a complication of Intrahepatic Cholestasis of Pregnancy?

A

Fetal demise.

Induce @ 36-37 wks. Demise usually >37wks.

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17
Q

Cycle length <21 d

A

Polymenorrhea

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18
Q

Preferred Abx for Mastitis

A

Dicloxacillin or Cephalosporins

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19
Q

Recommend continued breastfeeding with Mastitis to prevent:

A

Breast abscess

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20
Q

MC ovarian cyst

A

Follicular

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21
Q

Cycle length > 35d

A

Oligomenorrhea

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22
Q

What is the Disulfiram-like reaction?

A
  • Flushing
  • Tachycardia
  • Hypotension
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23
Q

MCC Mastitis

A

Staph aureus

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24
Q

During menopause, what happens to estrogen and FSH levels?

A
  • Estrogen decreases.

- FSH increases.

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25
Q

Mixing alcohol with Metronidazole causes:

A

Disulfiram-like reaction

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26
Q

HEAVY and prolonged mensuration

A

Menorrhagia

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27
Q

When do we give Rhogam?

A

28 wks

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28
Q

What diagnostic tests should be obtained 1st for ALL women of childbearing age presenting with pelvic complaints?

A

Urine beta-hCG (REGARDLESS of last period!)

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29
Q

Tx for Endometritis post C-section

A

Clindamycin + Gentamicin

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30
Q

With risks, when do we give Rhogam?

A

Within 72h onset of issues.

Risks: miscarriage, ectopic, trauma

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31
Q

Tx for Endometritis post natural delivery

A

Ampicillin + Gentamicin

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32
Q

MC non-viral STD in the world:

A

Trichomonas vaginalis

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33
Q

What is the initial lab for gestational diabetes screening?

A

1-hr glucose challenge test

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34
Q

Vaginal bleeding and/or pain, open os, products of conception within the cervical canal on exam.

A

Incomplete Abortion

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35
Q

Single dose SE of Azithromycin

A

Nausea

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36
Q

Early endometrial CA normally presents as:

A

Abnormal vaginal bleeding

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37
Q

> 50 yo presents to clinic with frequent urination and bloating. This presentation is MC in endometrial or ovarian CA?

A

Ovarian CA

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38
Q

Endometrial cancer Tx

A

Total hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO)

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39
Q

Ectopic pregnancy Tx

A

Methotrexate (or Mifepristone) or surgery (laparoscopy)

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40
Q

What is the next step if OCPs are ineffective for AUB?

A

Ablation

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41
Q

In women with poorly controlled infection, severe symptoms, instability or wide spread nipple excoriation, what med HALTS lactation?

A

Cabergoline (dopamine agonist antagonizes the release of prolactin.)

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42
Q

All products of conception (POC) have passed, cervix is closed and the uterus is firm and non-tender.

A

Complete Abortion

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43
Q

Definition of gestational hypertension:

A

HTN without proteinuria or other SxS of preeclampsia that develops after 20 wks gestation.

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44
Q

Prevention of seizures during pregnancy:

A

Mg Sulfate

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45
Q

1st line pharmacotherapy for Premenstrual Syndrome:

A

SSRIs

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46
Q

MC RFs for BV:

A
  1. Vaginal pH > 4.5
  2. Frequent douching
  3. Pregnancy
  4. IUD
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47
Q

What is the biggest RF for ectopic pregnancy?

A

Hx of ectopic

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48
Q

MC patho of Endometrial CA

A

Adenocarcinoma

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49
Q

One-sided, LQ pain associated with normal ovulation.

A

Mittelschmerz

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50
Q

Dx TOC Leiomyoma

A

Transabdominal and Transvaginal US

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51
Q

Surgery used to remove leiomyomas with desired fertility:

A

Myomectomy

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52
Q

Prolactinoma Tx

A

Cabergoline

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53
Q

Recurring genital and oral ulcerations, relapsing uveitis. PE: necrotic center and surrounding red rim.

A

Behcet’s Syndrome

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54
Q

MC type of cervical cancer:

A

Squamous Cell Carcinoma

55
Q

Sign for a blue cervix, normal during early pregnancy:

A

Chadwick’s Sign

56
Q

Rx MC used to induce labor with favorable cervix:

57
Q

Primary syphilis infection Tx:

A

Penicillin G

58
Q

Ideal intrapartum glycemic target for patients with gestational diabetes:

A

Fasting < 95mg/dL

59
Q

After implantation, when is beta-hCG detectable?

A

7–8 days after fertilization

60
Q

MC type and 2nd MC of vulvar CA:

A

1st: Squamous Cell Carcinoma
2nd: Melanoma

61
Q

Vaginal bleed with OPEN os, NO POC

A

Inevitable Abortion

62
Q

MC type of gynecological cancer:

A

Uterine CA

63
Q

Dx for Endometriosis:

A

Laparoscopy

64
Q

Perihepatitis + PID

A

Fitz-Hugh-Curtis Syndrome

65
Q

Fetal heart patterns indicative of uteroplacental insufficiency:

A

Late decelerations

66
Q

In women with an intact uterus, what HRT should never be given and why?

A
  • Conjugated, unopposed estrogen.

- D/T risk of endometrial hyperplasia and carcinoma.

67
Q

What is an appropriate therapy for a postmenopausal woman suffering from vaginal atrophy?

A
  • Vaginal ring (2 mg Estradiol Q 3mo)
  • Lube
  • Moisturizers
68
Q

Complication of preterm rupture of membranes:

A

Chorioamnionitis

69
Q

What is HIGH risk for preeclampsia?

A

Autoimmune disease

70
Q

What is the HELLP syndrome?

A

Severe form of preeclampsia characterized by:

  • Hemolysis
  • Elevated LFTs
  • Low platelets
71
Q

Is Metronidazole given during pregnancy?

72
Q

What is the preferred diagnostic method for Placenta Previa?

A

Transvaginal US > Transabdominal

73
Q

Tx for eclamptic seizures at any time period (before or after delivery):

A

Mg Sulfate

74
Q

Is Azithromycin safe during pregnancy to treat Chlamydia?

75
Q

1st line therapy for recurrent endometrial carcinoma:

A

HIGH dose Progestin

76
Q

MC presenting symptom in a woman with vaginal cancer:

A

Vaginal bleed

77
Q

MCC Bacterial Vaginosis

A

Decrease in Lactobacilli which leads to increase in Gardnerella vaginalis

78
Q

New born infant that’s cyanotic, tachycardic, tachypneic, and noted to have generalized edema. Mother had no prenatal care. Dx?

A

Erythroblastosis fetalis (Rh+ with mom Rh-)

79
Q

If 1st line Tx for Atrophic Vaginitis fails, what is the next step?

A

Vaginal estrogen

80
Q

Does Progesterone help with lubrication or elasticity of vagina in Atrophic Vaginitis?

81
Q

Painless, firm, solitary, mobile, slowly growing breast mass (DOES NOT change with cycles**). Dx?

A

Fibroadenoma

82
Q

What type of breast cancer presents as eczematous, itchy, scaly lesion of nipple or areola?

83
Q

Tx for Molar Pregnancy

A

Dilation and curettage

84
Q

What are the MC causes of ovarian torsion? What are other RFs?

A
  • MC Cyst or tumor (teratomas)

- Pregnancy, ovary >5cm

85
Q

To assess fallopian tube patency, what procedure is done?

A

Hysterosalpingography

86
Q

Tubo-ovarian Abscess vs. PID

A

Both have CMT but TOA has UNIlateral pain on palpation.

87
Q

What is the mgmt for Premature Rupture of Membranes at 24 to 34 wks?

A

Give corticosteroids to mature lungs.

88
Q

Pap smear results come back as CIN stage 2. What is the next step in mgmt?

89
Q

Tx for Bacterial Vaginosis besides Metro that can be used in pregnancy

90
Q

Dysmenorrhea, Dyspareunia (pain during sex), Dyschezia (painful bowel movement). Dx?

A

Endometriosis

91
Q

Prenatal care: When is maternal alpha fetal protein measured?

92
Q

Expected lab results with primary ovarian failure

A
  • ↑ FSH
  • ↑ LH
  • ↓ Estradiol
93
Q

Dx for Endometrial Cancer

A

Transvag. US or Endometrial Bx (suction curette)

94
Q

Colposcopy: white, sharply demarcated cervix after application of acetic acid. Dx?

A

Cervical dysplasia

95
Q

1st line BC for adolescents

A

Etonogestrel Implant (L/A reversible contraception) or IUD

96
Q

Two MC SEs of hormonal contraception

A
  • Breakthrough bleeding

- Amenorrhea

97
Q

Painful vulvar ulcers and swollen inguinal lymph node. Patho? Dx?

A
  • Haemophilus ducreyi

- Chancroid

98
Q

Condyloma lata is found in what STI?

A

Treponema pallidum (syphilis)

99
Q

What home remedies can you give to a non-breast feeding postpartum female with a tender breast engorgement?

A

Supportive bra, cold cabbage leaves, ice packs.

100
Q

In what scenarios is breastfeeding CI?

A
  • HIV mom

- Type 1 Galactosemia

101
Q

What phase of the menstrual cycle occurs at the time of the progesterone surge?

A

Luteal (Secretory)

-Corpus luteum secretes progesterone

102
Q

What is the mgmt for Premature Rupture of Membranes at >34 wks?

103
Q

Dx for Tubo-ovarian Abscess

104
Q

Tx for Primary Dysmenorrhea

A

NSAIDs (antiprostaglandin action)

105
Q

Regular cycles that have xs flow and duration. Dx?

A

Menorrhagia

106
Q

Adolescent females taking inj. Depo >2 yrs should be monitored for which SE?

A

Bone mineral density loss

107
Q

What is a potential complications of undergoing surgical repair of a rectocele?

A

Dyspareunia (painful sex)

108
Q

Is Gynecomastia in males during early pubertal changes normal?

A

Yes, reassure.

109
Q

Complication of vaginal delivery that occurs when obstetrical maneuvers beyond gentle traction are needed to enable delivery of the fetal shoulders

110
Q

What is a lab finding in Placental Abruption?

A

Hypofibrinogenemia

111
Q

For HRT in a woman that has a uterus, what is the Tx?

A

Estrogen + progestin (prevent endometrial hyperplasia).

112
Q

Tx for Breast CA

A

Lumpectomy, sentinel lymph node biopsy and radiation therapy

113
Q

Extremely high levels of HCG. Dx?

A

Gestational trophoblastic disease

114
Q

Fluctuating menstrual intervals and PE showing 1 ovary is appreciably larger than the other. Dx?

A

Functional ovarian cyst

115
Q

Pt. presents to ED with a finger lac. She is 8 wks pregnant and has had 2 days of vaginal spotting and lower abdominal cramping. She has a closed os and no tenderness or masses on palpation (~possible threatened abortion or ectopic pregnancy). What is the mgmt?

A

Treat her laceration, perform hCG quantitative level and pelvic US

116
Q

What is the definition of premature labor?

A

Labor < 37 wks

117
Q

MC type of breast cancer

A

Infiltrating ductal (80%) > Infiltrating lobular (15%)

118
Q

What meds are considered risk-reducing for women who are at an increased risk of breast cancer?

A

Tamoxifen and Raloxifene

119
Q

When should Folic Acid be started in women?

A

Anyone that may become pregnant. At least 1 month before conception.

120
Q

What is the MC cell type of ovarian cancer?

A

Epithelial

121
Q

What phase of the menstrual cycle occurs at the time of the luteinizing hormone surge?

122
Q

What 5 vaccines are safe in pregnancy?

A
  • Hep B
  • Flu (inactive)
  • Tdap
  • Meningococcal
  • Rabies
123
Q

When do mammo screenings start for breast cancer and how often?

A

50-74yo biennially

124
Q

Tx for Ectopic Pregnancy that’s unstable

A

Laparoscopy

125
Q

Fundal height 4cm higher than where it should be. Dx?

A

Multiple gestations

126
Q

Tx for Preeclampsia

A

Mg Sulfate (prevent seizures)

127
Q

Painless nodule in genital area that progresses to a painless ulcer with rolled borders that is highly vascular, with “beefy-red” appearance. Dx?

A 
Granuloma inguinale (D/T Klebsiella granulomatis)
-Common in India, Africa, Australia
128
Q

Can NSAIDs be used during pregnancy?

A

No bc they are Prostaglandin-Inhibitors

129
Q

A pregnant HIV positive patient presents to clinic. What med do you start and when?

A

Azidothymidine (AZT) @ 28 weeks.

130
Q

Pap smear results come back as CIN stage 1. What is the next step in mgmt?

A

Repeat pap

131
Q

What phase of the menstrual cycle occurs at the time of the estrogen surge?

A

Follicular (Proliferative)

132
Q

31 yo presents for pap smear results. She has (+) HPV DNA test but (–) pap smear. What is the next step?

A

Repeat in 1 yr

133
Q

At what age can women stop getting pap smears?

A

65 yo with Hx of THREE negative paps prior

PANCE Exam Review (32 decks)

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