Reproductive Flashcards
1
Q
Gono infection labs show:
A
Gram (-) Diplococci
2
Q
Gono Tx
A
IM Ceftriaxone 250 mg +
PO Azithromycin 1 g
(can also use PO Doxy x 7d)
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)
4
Q
New onset HTN < 20 wks gestation, suspect _____.
A
Molar Pregnancy
5
Q
What would labs show in ovarian torsion?
A
Leukocytosis (High WBC)
6
Q
What is the GOLD standard for Dx of ovarian torsion?
A
Laparoscopy
7
Q
RFs for Cervical Insufficiency:
A
- Ehlers-Danlos Syndrome (stretchy skin syndrome)
- Trauma to cervix
- Tx of cervical intraepithelial neoplasia
8
Q
MCC of abnormal uterine bleeding in older, obese women
A
Endometrial Hyperplasia
9
Q
Tumor marker for Ovarian CA ONLY
A
CA-125
10
Q
PID Tx
A
IM Ceftriaxone + Doxycycline x 14d
11
Q
Malodorous gray vaginal discharge. Dx?
A
Bacterial Vaginosis
12
Q
BRCA -1 and BRCA-2 found in:
A
Breast and Ovarian CA
13
Q
What is a Tocolytic?
A
Meds used to suppress premature labor. Uterine relaxant.
14
Q
What is the Leopold maneuver?
A
PE maneuver used to help determine position of a fetus
15
Q
What is the mgmt for Intrahepatic Cholestasis of Pregnancy?
A
Induce @ 36-37 wks.
16
Q
What is a complication of Intrahepatic Cholestasis of Pregnancy?
A
Fetal demise.
Induce @ 36-37 wks. Demise usually >37wks.
17
Q
Cycle length <21 d
A
Polymenorrhea
18
Q
Preferred Abx for Mastitis
A
Dicloxacillin or Cephalosporins
19
Q
Recommend continued breastfeeding with Mastitis to prevent:
A
Breast abscess
20
Q
MC ovarian cyst
A
Follicular
21
Q
Cycle length > 35d
A
Oligomenorrhea
22
Q
What is the Disulfiram-like reaction?
A
- Flushing
- Tachycardia
- Hypotension
23
Q
MCC Mastitis
A
Staph aureus
24
Q
During menopause, what happens to estrogen and FSH levels?
A
- Estrogen decreases.
- FSH increases.
25
Mixing alcohol with Metronidazole causes:
Disulfiram-like reaction
26
HEAVY and prolonged mensuration
Menorrhagia
27
When do we give Rhogam?
28 wks
28
What diagnostic tests should be obtained 1st for ALL women of childbearing age presenting with pelvic complaints?
Urine beta-hCG (REGARDLESS of last period!)
29
Tx for Endometritis post C-section
Clindamycin + Gentamicin
30
With risks, when do we give Rhogam?
Within 72h onset of issues.
| Risks: miscarriage, ectopic, trauma
31
Tx for Endometritis post natural delivery
Ampicillin + Gentamicin
32
MC non-viral STD in the world:
Trichomonas vaginalis
33
What is the initial lab for gestational diabetes screening?
1-hr glucose challenge test
34
Vaginal bleeding and/or pain, open os, products of conception within the cervical canal on exam.
Incomplete Abortion
35
Single dose SE of Azithromycin
Nausea
36
Early endometrial CA normally presents as:
Abnormal vaginal bleeding
37
> 50 yo presents to clinic with frequent urination and bloating. This presentation is MC in endometrial or ovarian CA?
Ovarian CA
38
Endometrial cancer Tx
Total hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO)
39
Ectopic pregnancy Tx
Methotrexate (or Mifepristone) or surgery (laparoscopy)
40
What is the next step if OCPs are ineffective for AUB?
Ablation
41
In women with poorly controlled infection, severe symptoms, instability or wide spread nipple excoriation, what med HALTS lactation?
Cabergoline (dopamine agonist antagonizes the release of prolactin.)
42
All products of conception (POC) have passed, cervix is closed and the uterus is firm and non-tender.
Complete Abortion
43
Definition of gestational hypertension:
HTN without proteinuria or other SxS of preeclampsia that develops after 20 wks gestation.
44
Prevention of seizures during pregnancy:
Mg Sulfate
45
1st line pharmacotherapy for Premenstrual Syndrome:
SSRIs
46
MC RFs for BV:
1. Vaginal pH > 4.5
2. Frequent douching
3. Pregnancy
4. IUD
47
What is the biggest RF for ectopic pregnancy?
Hx of ectopic
48
MC patho of Endometrial CA
Adenocarcinoma
49
One-sided, LQ pain associated with normal ovulation.
Mittelschmerz
50
Dx TOC Leiomyoma
Transabdominal and Transvaginal US
51
Surgery used to remove leiomyomas with desired fertility:
Myomectomy
52
Prolactinoma Tx
Cabergoline
53
Recurring genital and oral ulcerations, relapsing uveitis. PE: necrotic center and surrounding red rim.
Behcet’s Syndrome
54
MC type of cervical cancer:
Squamous Cell Carcinoma
55
Sign for a blue cervix, normal during early pregnancy:
Chadwick's Sign
56
Rx MC used to induce labor with favorable cervix:
Oxytocin
57
Primary syphilis infection Tx:
Penicillin G
58
Ideal intrapartum glycemic target for patients with gestational diabetes:
Fasting < 95mg/dL
59
After implantation, when is beta-hCG detectable?
7–8 days after fertilization
60
MC type and 2nd MC of vulvar CA:
1st: Squamous Cell Carcinoma
2nd: Melanoma
61
Vaginal bleed with OPEN os, NO POC
Inevitable Abortion
62
MC type of gynecological cancer:
Uterine CA
63
Dx for Endometriosis:
Laparoscopy
64
Perihepatitis + PID
Fitz-Hugh-Curtis Syndrome
65
Fetal heart patterns indicative of uteroplacental insufficiency:
Late decelerations
66
In women with an intact uterus, what HRT should never be given and why?
- Conjugated, unopposed estrogen.
| - D/T risk of endometrial hyperplasia and carcinoma.
67
What is an appropriate therapy for a postmenopausal woman suffering from vaginal atrophy?
- Vaginal ring (2 mg Estradiol Q 3mo)
- Lube
- Moisturizers
68
Complication of preterm rupture of membranes:
Chorioamnionitis
69
What is HIGH risk for preeclampsia?
Autoimmune disease
70
What is the HELLP syndrome?
Severe form of preeclampsia characterized by:
- Hemolysis
- Elevated LFTs
- Low platelets
71
Is Metronidazole given during pregnancy?
Yes
72
What is the preferred diagnostic method for Placenta Previa?
Transvaginal US > Transabdominal
73
Tx for eclamptic seizures at any time period (before or after delivery):
Mg Sulfate
74
Is Azithromycin safe during pregnancy to treat Chlamydia?
Yes
75
1st line therapy for recurrent endometrial carcinoma:
HIGH dose Progestin
76
MC presenting symptom in a woman with vaginal cancer:
Vaginal bleed
77
MCC Bacterial Vaginosis
Decrease in Lactobacilli which leads to increase in Gardnerella vaginalis
78
New born infant that's cyanotic, tachycardic, tachypneic, and noted to have generalized edema. Mother had no prenatal care. Dx?
Erythroblastosis fetalis (Rh+ with mom Rh-)
79
If 1st line Tx for Atrophic Vaginitis fails, what is the next step?
Vaginal estrogen
80
Does Progesterone help with lubrication or elasticity of vagina in Atrophic Vaginitis?
No
81
Painless, firm, solitary, mobile, slowly growing breast mass (DOES NOT change with cycles**). Dx?
Fibroadenoma
82
What type of breast cancer presents as eczematous, itchy, scaly lesion of nipple or areola?
Paget's
83
Tx for Molar Pregnancy
Dilation and curettage
84
What are the MC causes of ovarian torsion? What are other RFs?
- MC Cyst or tumor (teratomas)
| - Pregnancy, ovary >5cm
85
To assess fallopian tube patency, what procedure is done?
Hysterosalpingography
86
Tubo-ovarian Abscess vs. PID
Both have CMT but TOA has UNIlateral pain on palpation.
87
What is the mgmt for Premature Rupture of Membranes at 24 to 34 wks?
Give corticosteroids to mature lungs.
88
Pap smear results come back as CIN stage 2. What is the next step in mgmt?
Colpo
89
Tx for Bacterial Vaginosis besides Metro that can be used in pregnancy
Clinda
90
Dysmenorrhea, Dyspareunia (pain during sex), Dyschezia (painful bowel movement). Dx?
Endometriosis
91
Prenatal care: When is maternal alpha fetal protein measured?
16-18 wks
92
Expected lab results with primary ovarian failure
- ↑ FSH
- ↑ LH
- ↓ Estradiol
93
Dx for Endometrial Cancer
Transvag. US or Endometrial Bx (suction curette)
94
Colposcopy: white, sharply demarcated cervix after application of acetic acid. Dx?
Cervical dysplasia
95
1st line BC for adolescents
Etonogestrel Implant (L/A reversible contraception) or IUD
96
Two MC SEs of hormonal contraception
- Breakthrough bleeding
| - Amenorrhea
97
Painful vulvar ulcers and swollen inguinal lymph node. Patho? Dx?
- Haemophilus ducreyi
| - Chancroid
98
Condyloma lata is found in what STI?
Treponema pallidum (syphilis)
99
What home remedies can you give to a non-breast feeding postpartum female with a tender breast engorgement?
Supportive bra, cold cabbage leaves, ice packs.
100
In what scenarios is breastfeeding CI?
- HIV mom
| - Type 1 Galactosemia
101
What phase of the menstrual cycle occurs at the time of the progesterone surge?
Luteal (Secretory)
| -Corpus luteum secretes progesterone
102
What is the mgmt for Premature Rupture of Membranes at >34 wks?
Delivery
103
Dx for Tubo-ovarian Abscess
US
104
Tx for Primary Dysmenorrhea
NSAIDs (antiprostaglandin action)
105
Regular cycles that have xs flow and duration. Dx?
Menorrhagia
106
Adolescent females taking inj. Depo >2 yrs should be monitored for which SE?
Bone mineral density loss
107
What is a potential complications of undergoing surgical repair of a rectocele?
Dyspareunia (painful sex)
108
Is Gynecomastia in males during early pubertal changes normal?
Yes, reassure.
109
Complication of vaginal delivery that occurs when obstetrical maneuvers beyond gentle traction are needed to enable delivery of the fetal shoulders
Dystocia
110
What is a lab finding in Placental Abruption?
Hypofibrinogenemia
111
For HRT in a woman that has a uterus, what is the Tx?
Estrogen + progestin (prevent endometrial hyperplasia).
112
Tx for Breast CA
Lumpectomy, sentinel lymph node biopsy and radiation therapy
113
Extremely high levels of HCG. Dx?
Gestational trophoblastic disease
114
Fluctuating menstrual intervals and PE showing 1 ovary is appreciably larger than the other. Dx?
Functional ovarian cyst
115
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?
Treat her laceration, perform hCG quantitative level and pelvic US
116
What is the definition of premature labor?
Labor < 37 wks
117
MC type of breast cancer
Infiltrating ductal (80%) > Infiltrating lobular (15%)
118
What meds are considered risk-reducing for women who are at an increased risk of breast cancer?
Tamoxifen and Raloxifene
119
When should Folic Acid be started in women?
Anyone that may become pregnant. At least 1 month before conception.
120
What is the MC cell type of ovarian cancer?
Epithelial
121
What phase of the menstrual cycle occurs at the time of the luteinizing hormone surge?
Ovulation
122
What 5 vaccines are safe in pregnancy?
- Hep B
- Flu (inactive)
- Tdap
- Meningococcal
- Rabies
123
When do mammo screenings start for breast cancer and how often?
50-74yo biennially
124
Tx for Ectopic Pregnancy that's unstable
Laparoscopy
125
Fundal height 4cm higher than where it should be. Dx?
Multiple gestations
126
Tx for Preeclampsia
Mg Sulfate (prevent seizures)
127
Painless nodule in genital area that progresses to a painless ulcer with rolled borders that is highly vascular, with “beefy-red” appearance. Dx?
```
Granuloma inguinale (D/T Klebsiella granulomatis)
-Common in India, Africa, Australia
```
128
Can NSAIDs be used during pregnancy?
No bc they are Prostaglandin-Inhibitors
129
A pregnant HIV positive patient presents to clinic. What med do you start and when?
Azidothymidine (AZT) @ 28 weeks.
130
Pap smear results come back as CIN stage 1. What is the next step in mgmt?
Repeat pap
131
What phase of the menstrual cycle occurs at the time of the estrogen surge?
Follicular (Proliferative)
132
31 yo presents for pap smear results. She has (+) HPV DNA test but (--) pap smear. What is the next step?
Repeat in 1 yr
133
At what age can women stop getting pap smears?
65 yo with Hx of THREE negative paps prior
