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Rosh (1/11 - ...) Flashcards

1
Q

Treatment for toxo

A

To stop transmission: spiramycin

To treat current infection in fetus: pyrimethamine, sulfadiazine, folinic acid

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2
Q

FRAX score indicating DEXA

A

> 9.3%

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3
Q

EPDS downside

A

Requires population validation

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4
Q

Most common mode of urinary tract injury

A

Electrosurgery

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5
Q

KRAS

A

Hereditary colorectal cancer

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6
Q

MSH2

A

DNA mismatch repair associated with lynch syndrome —> colorectal, endometrial, ovarian

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7
Q

PTEN

A

Cowden —> hamartomas with risk for breast, endometrial, colorectal, kidney, and thyroid cancer

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8
Q

Mastitis treatment if PCN allergy

A

Erythromycin

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9
Q

Fetal effect of MS

A

FGR, birth defects

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10
Q

Cervical cancer type by HPV type

A

Squamous 16

Adenocarcinoma 18

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11
Q

Chemo for cervical cancer

A

Cisplatin

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12
Q

To counteract toxic effects of MTX… it

A

Leucovorin

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13
Q

How do OCPs treat hirsutism?

A

Increase liver production of sex hormone binding globulin which then bind androgens

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14
Q

Second line agents for hirsutism

A

Spironolactone, flutamide, finasteride, cyproterone acetate

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15
Q

Mechanism of finasteride

A

5-alpha reductase inhibitor to stop testosterone conversion to active DHT

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16
Q

Spironolactone mechanism

A

Antagonist to aldosterone and androgen receptor

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17
Q

Flutamide mechanism

A

Anti androgen

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18
Q

Chemo for granulosa cell tumor

A

Bleomycin, etoposide, cisplatin (BEP)

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19
Q

Effects of ace inhibitors on fetus

A

Renal and limb abnormalities -> oligohydramnios and possible pulmonary hypo plasma

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20
Q

Embryologic origins of Gartner duct cysts

A

Mesonephric ducts

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21
Q

Embryologic origin of ovary

A

Genital ridge

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22
Q

Embryologic origin of uterus, fallopian tubes, upper vagina

A

Paramesonephric ducts

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23
Q

Embryologic origin of labia minora

A

Urogenital folds

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24
Q

Embryologic origin of the urogenital system

A

Intermediate mesoderm

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25
Q

Relationship of obesity and breast cancer risk

A

Premenopausal, protective

Postmenopausal, higher risk

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26
Q

Treatment for magnesium toxicity

A

15-30 mL of calcium gluconate 10% solution IV

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27
Q

Cancer risk with Paget’s disease

A

20% have invasive adenocarcinoma

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28
Q

Pre-operative evaluation in Paget’s disease

A

Mammogram, colonoscopy, pap – risk of additional sites of involvement

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29
Q

Treatment for hyperprolactinemia

A

Twice weekly cabergoline

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30
Q

Posterior pituitary hormones

A

ADH (vasopressin) and oxytocin

Neurohypophysis, cell bodies in hypothalamus and directly released through posterior pituitary

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31
Q

Hypothalamus hormones

A

Releasing hormones: GHRH, TRH, GnRH, etc

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32
Q

Anterior pituitary hormones

A

Prolactin, TSH, GH, ACTH, LH, FSH

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33
Q

Dopamine

A

Inhibits prolactin production

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34
Q

Cabergoline

A

Dopamine agonist

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35
Q

Endometriosis increases risk of what cancer?

A

Endometrioid adenocarcinoma or clear cell

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36
Q

Contraindications to live flu vaccine

A

Immunocompromised, pregnant, age >50 y/o

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37
Q

Most common site of endometriosis

A

Ovary, uterosacral ligaments

Bowel, after definitive hyst, BSO

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38
Q

Amsel criteria

A

To diagnose BV, 3/4 present:

  1. Whiff test
  2. Clue cells
  3. pH >4.5
  4. Thin white discharge
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39
Q

Fastest treatment of hirsuit hair growth

A

Eflornithine cream (6-8 wks), inhibits ornithine decarboxylase

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40
Q

Best SSRI’s while breastfeeding

A

Sertraline, paroxetine

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41
Q

Antidepressant contraindicated with history of seizure

A

Bupropion

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42
Q

Vaccines safe in pregnancy

A

Hep B, flu, Tdap, meningococcal, rabies

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43
Q

Embryologic origin of the Bartholin’s gland

A

Urogenital sinus

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44
Q

When to biopsy a Bartholin’s cyst

A

> 40 y/o

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45
Q

Characteristics of type 2 endometrial cancer

A

Papillary serous, clear cell, carcinosarcoma – no association with estrogen, occur at older age (>60y/o), more agressive, more often p53 mutation

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46
Q

Ideal day of embryo transfer after fertilization

A

Day 5 - blastocyst

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47
Q

Hormone causing lighter, finer hair growth

48
Q

Most common immune cell in decidua in early pregnancy

A

Natural killer cell

49
Q

Lynch syndrome screening

A

EMBx and pelvic exam annually starting at 30 y/o

50
Q

Serum marker associated with placenta accreta

51
Q

When to do EMBx

A

Age >45 y/o or risk factors like obesity

52
Q

Branches of SMA

A

Right, middle, and ileocolic arteries

53
Q

Branches of IMA

A

Left colic and sigmoid arteries

54
Q

Omental blood supply

A

R/L gastroepiploic, gastroduodenal, common hepatic, splenic

55
Q

Branches of external iliac

A

Inferior epigastric, deep circumflex iliac, becomes femoral artery

56
Q

Posterior division of internal iliac

A

Superior gluteal, iliolumbar, lateral sacral

57
Q

Anterior division of internal iliac

A

Umbilical (to superior vesicle), uterine (to vaginal), middle rectal, obturator, inferior gluteal, internal pudendal

58
Q

Ovarian arteries

A

From aorta, below renal arteries

Supply ovaries, fallopian tubes, broad ligament, ureters

59
Q

Ovarian veins

A

Left to renal vein, right to IVC

60
Q

Quad weakness, lost knee extension, thigh numbness (medial, upper)

A

Femoral nerve (retractor or extreme hip flexion / rotation)

61
Q

Anterior and posterior thigh pain / paresthesias

A

Lateral femoral cutaneous (retractor compression)

62
Q

Numb vulva

A

Genitofemoral (during LND)

63
Q

Lost adduction of thigh, upper medial thigh numbness

A

Obturator nerve (during LND or TOT)

64
Q

Sharp pain from incision downward

A

Ilioinguinal / iliohypogastric (entrapped during fascial closure)

65
Q

Sciatica

A

Sciatic nerve (long surgery, asst leans on thigh)

66
Q

Foot drop

A

Common peroneal (knee in stirrups)

67
Q

Butt pain

A

Pudendal (during sacrospinous ligament fixation)

68
Q

Unable to use arm

A

Brachial plexus (stretch)

69
Q

Claw hand

A

Ulnar (elbow compression)

70
Q

Nerve running along psoas

A

Genitofemoral

71
Q

Referral to onc for premenopausal adnexal mass

A

CA-125 > 200 and concerning TVUS

72
Q

Most common ovarian cancer mets

A

Endometrial, breast, GI tract

73
Q

VTE, hypercalcemia, hyperpyrexia, unilateral adnexal mass, early mets

A

Clear cell (epithelial) ovarian cancer

74
Q

Schiller Duval bodies

A

Endodermal sinus tumor (yolk sac)

75
Q

Virilization and amenorrhea with adnexal mass

A

Sertoli-Leydig tumor

76
Q

Dysgerminoma markers

A

Beta hcg, LDH

77
Q

Endodermal sinus markers

78
Q

Choriocarcinoma markers

79
Q

Immature teratoma markers

A

AFP, LDH, CA-125

80
Q

Embryonal carcinoma markers

A

Beta hcg, AFP

81
Q

Granulosa cell marker

82
Q

Ovarian cancer stage with chemo required

A

IC – capsule rupture and/or positive washings

83
Q

Stage 2 ovarian cancer

A

Pelvic organs

84
Q

Stage 3 ovarian cancer

A

Peritoneal surfaces with mets

85
Q

Stage 4 ovarian cancer

A

Pleural effusion with positive cytology, hepatic / splenic mets

86
Q

Endometrial hyperplasia classifications

A

Benign (no atypia) or intrapithelial neoplasia (atypia, precancer)

87
Q

Stage 1 endometrial cancer

A

A <50% myometrium

B >50% myometrium

88
Q

Stage 2 endometrial cancer

A

Cervical stroma

89
Q

Stage 3 endometrial cancer

A

A serosa or adnexa
B vaginal or parametrial
C1 pelvic LN
C2 paraaortic LN

90
Q

Stage 4 endometrial cancer

A

A bladder or bowel

B distant met

91
Q

Most common cause of death in cervical cancer

92
Q

HPV oncoproteins

A

E6 inhibits p53

E7 inhibits Rb

93
Q

Cancer associated with DES

A

Vaginal adenocarcinoma (most other vaginal cancer is squamous)

94
Q

Lymphtic drainage of vagina

A

Upper 2/3 to pelvic nodes

Lower 1/3 to inguinal

95
Q

Cervical cancer mets

A

Lung, liver, bony

96
Q

Theca lutein cysts associated with

A

Complete mole (not partial) – due to excessive beta hcg

97
Q

Percent of moles that become invasive

98
Q

Monitoring following mole

A

Weekly beta hcg until neg x 3 weeks, then q4wks x 6-12 mos

99
Q

Dx of GTN

A

Plateau of beta hcg x 4 measurements OR rise >10% in 3 wks, or hcg still detectable 6 mos later

100
Q

GTD treatment

A

MTX or actinomycin D for low risk

EMA-CO for high risk

101
Q

Mechanism of doxorubicin, bleomycin, antinomycin D

A

Free oxygen radicals

102
Q

Mechanism of etoposide, vincristine

A

Inhibits topoisomerase

103
Q

Mechanism of taxanes

A

Inhibits microtubule polymerization

104
Q

Mechanism of platinums

A

Cross links DNA subunits

105
Q

Mechanism of bavacizumab

A

VEG-F inhibitor

106
Q

Mechanism of cyclophosphamide

A

Cross-link

107
Q

Alopecia

A

Taxanes, antinomycin

108
Q

Cardiotoxicity

A

Doxorubicin

109
Q

Hemorrhagic cystitis

A

Cyclophosphamide

110
Q

Interstitial pneumonitis

A

Doxorubicin

111
Q

Nephrotoxicity

112
Q

Pulmonary fibrosis

113
Q

Secondary malignancy

114
Q

Peripheral neuropathy

115
Q

Timing for risk-reducing BSO

A

BRCA1: 35-40 y/o
BRCA2: 40-45 y/o

CREOG (8 decks)

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