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EOR - Women's Health > Rosh Material #1 > Flashcards

Rosh Material #1 Flashcards

1
Q

usual age for menarch

A

11-15

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2
Q

work up amenorrhea if it has not occured by:
_ age if secondary sexual charcteristics present
_ age if no secondary sexual characteristics present

A

no secondary characteristics: 13 yo
secondary characteristics present: 15 yo

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3
Q

mc cause of primary amenorrhea

A

gonadal dysgenesis

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4
Q

name 4 tocolytics

A

Mg sulfate
indomethacin
terbutaline
nifedipine

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5
Q

endometrial stripe measurements in relation to hyperplasia in postmenopausal women

A

</= 4 mm -> low likelihood
>4 mm -> high likelihood

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6
Q

endometrial stripe in relation to hyperplasia in premenopausal women

A

< 5 mm -> exclude hyperplasia

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7
Q

stages of uterine prolapse

A

1: upper 1/2 of vagina, > 1 cm from introitus
2: nearly to opening -> >/= 1 cm from introitus
3: outside vagina -> < 1 cm
4: outside vagina -> >/= 1 cm

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8
Q

what med is used to induce labor

what is mc s.e

A

oxytocin
s.e: tachysystole

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9
Q

which level of cervical dilation is considered active labor

A

> /= 6 cm

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10
Q

sx of end organ damage with preeclampsia

A

CNS: photopsia, scotomata, HA
hepatic: severe RUQ pain, thrombocytopenia, pulmonary edema
renal: SCr > 1.1

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11
Q

new onset HTN < 20 weeks gestation should make you think

A

molar pregnancy

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12
Q

contraindication for labetalol for gestational HTN

A

asthma

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13
Q

IV meds used to acutely lower BP in pregnant pt

A

labetalol
hydralazine

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14
Q

with FHR monitoring, what does “variable deceleration” make you think of

A

umbilical cord compression

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15
Q

ovarian torsion is mc on which side

A

right

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16
Q

tx for breast abscess

A
  1. abx, continue bf’ing, needle aspiration
  2. surgical drainage if needle aspiration is unsuccessful
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17
Q

FIGO classification of abnormal uterine bleeding

A

PALM: polyp, adenomyosis, leiomyoma (submucosal vs other), malignancy/hyperplasia

COINE: coagulopathy, ovulatory dysfxn, iatrogenic, not yet classified, endometrial

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18
Q

FIGO staging of fibroids

A

SM (submucosal): pedunculated intracavitary
other: intramural, subserosal, cervical

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19
Q

contraindications for bf’ing

A

galactosemia
HIV/antiretroviral drugs
active TB
HTLV 1 or 2
active illicit drug use
active chemotherapy/xrt

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20
Q

what type of birth control is contraindicated in the first 6 weeks postpartum

A

combined OCP -> due to increased risk of VTE

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21
Q

t/f: progestin only contraceptives can be used immediately following birth

A

t!

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22
Q

lyte abnormalities assocaited w. hyperemesis gravidarum

A

hypochloremia -> metabolic alkalosis
hypokalemia

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23
Q

tx for hyperemesis gravidum

A

IVF w. 5% dex
antiemetics

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24
Q

what does this make you think of

A

giant multinucleated cells -> trichomoniasis

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25
Q

hCG concentration normally doubles every _ during the first 30 days of prenancy

A

29-53 hr (2 days)

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26
Q

hCG levels that rise slower than expected make you think (2)

A

ectopic
embryonic death

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27
Q

hCG levels decline after _ weeks gestation
and plateau _ weeks gestation

A

decline: 8-10 weeks
plateau: 20 weeks

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28
Q

hCG levels should remain constant at _ from 20 weeks gestation til term

A

2,000-50,000

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29
Q

hCG level used as discriminatory zone for when gestational sac should be visualized on transvaginal US

A

2,000

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30
Q

macrosomia is defined as infant weight >

A

4,500 g

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31
Q

what does a long, thin, malnourished newborn make you think of

A

restricted intrauterine growth

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32
Q

physical characteristics of macrosomic infant

A

-meconium staining
-decreased/absent vernix caseosa and lanugo hair
-dry/parchment-like peeling skin
-loose skin over thighs/buttocks
-increased scalp hair
-long nails
-alert/wide eyed appearance

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33
Q

mc symptom of menopause

A

hot flashes

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34
Q

1st line tx for infertility in PCOS

A

ovulation inducing agents:
clomiphene
letrozole

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35
Q

indications for leuprolide in pt struggling w. infertility

A

endometriosis
fibroids

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36
Q

common s.e of clomphene citrate

A

hot flashes
abd distension/pain
n/v
breast discomfort

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37
Q

tubo ovarian abscess is mc a complication of

A

PID

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38
Q

gs tx for PID

A

inpt: cefoxitin
PLUS
doxy

outpt: add metro

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39
Q

indications for abx alone for tubo-ovarian abscess

A

-hemodynamically stable
-abscess < 7 cm
-premenopausal
-abscess > 7 cm who meet all the above criteria

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40
Q

sx of ruptured/leaking tubo-ovarian abscess

A

acute abdomen:
involuntary guarding
rebound tenderness
+/- hemodynamic instability

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41
Q

management of premature labor < 34 weeks

A

ampicillin (until GBS culture comes back)
betamethasone
Mg sulfate

42
Q

management of premature labor >/= 34 weeks

A

no meds
expectant management

43
Q

degrees of perineal lacerations

A

1st: perineal skin only
2nd: perineal body and deeper tissues
3rd: extends into rectal sphincter
4th: into rectal mucosa

44
Q

mc type of gonadal dysgenesis

A

turner syndrome (45, XO)

45
Q

what do you think when you see: short stature, low set ears, low hairline, high arched palate, webbed neck, widely spaced nipples

A

turner syndrome

46
Q

mc cause of infertility

A

PCOS

47
Q

anatomic landmark used to measure fetal station

A

ischial spine

48
Q

ground glass echogenicity
chocolate syrup material

A

endometrioma

49
Q

hypoechoic
complex and heterogenous

A

corpus luteal cyst

50
Q

heterogenous w. dots, fluid, acoustic shadowing

A

dermoid cyst

51
Q

smooth, thin walled
completely fluid filled -> no internal echoes

A

follicular cyst

52
Q

what cyst occurs from overstimulation of hCG and occurs during molar pregnancy, multiple gestation, or clomiphene therapy

A

theca lutein

53
Q

mc type of breech

A

frank -> hips flexed, kneex extended

54
Q

flagellated protozoa moving in corkscrew motions

A

trichomoniasis

55
Q

punctuate macular hemorrhages on cervix

A

trichomoniasis

56
Q

epithelial cells w. stippled borders

A

BV

57
Q

APGAR scoring system

A
58
Q

indications for workup for infertility (2)

A

< 35 yo w. 12 mo of infertility
>/= 35 yo w. 6 mo of infertility

59
Q

male evaluation of infertility

A

semen analysis

60
Q

imaging options to work up female infertility

A

US
hysterosalpingogram -> 1st line
hysteroscopy
endometrial bx
exploratory laparoscopy

61
Q

mc type of breast ca

A

invasive ductal (IDC)

62
Q

when is an infant considered full term

A

39 weeks

63
Q

management of pregnancy if RhD incompatability is suspected due to parental genetics

A
  1. measure maternal anti-D titers until critical titer levels are reached
  2. doppler velocimetry of MCA of the fetus
  3. if fetal anemia is found -> cordocentesis to determine need for transfusion
64
Q

1st line pharm for fibrocystic breast changes that have not responded to OTC/supportive care

A

tamoxifen

65
Q

management of endometrial hyperplasia w. atypia

A

-considering pregnancy -> progestin (megestrol acetate)
-no plans for pregnancy/refractory/declines intervention -> hysterectomy

66
Q

management of hyperplasia w.o atypia

A

progestin (megestrol acetate)

67
Q

mc sx of fibroids

A

heavy menses

68
Q

string of pearls sign

A

PCOS

69
Q

normal NST finding

A

110-160 w. moderate variability

70
Q

only factor significantly associated w. recurrant breast abscesses

A

cigs

71
Q

t/f: bleeding w. placental abruption can be internal or external

A

t!

72
Q

daily micronutrient recs for pregnant women

A

iron: 27 mg
Ca: 1,000 mg
vit D: 600 IU
folate: 600 mcg
idodine: 220 mcg

73
Q

UTI tx in pregnant women

A

fosfomycin
augmentin
cefpodoxime

74
Q

single most common identifiable rf for PPROM

A

gardnerella vaginalis infxn

75
Q

the spectrum of complications where the placenta invades the myometrium

A

placenta accreta

76
Q

spectrum of placenta accreta from least to most severe

A

placenta accreta
placenta increta
placenta percreta

77
Q

black box warning for tamoxifen

A

increased risk for uterine malignancies and thromboembolic events

78
Q

leading cause of cancer related deaths in women

A

lung

79
Q

structures that can be visualized on US in 1st trimester of pregnancy

A

cardiac activity: 5 weeks
gestational sac: 5 weeks
yolk sac: 5.5 weeks
embryo/fetus: 6 weeks

80
Q

postpartum women should wait a minimum of _ weeks before returning to sexual activity

A

2

81
Q

mc cause of spontaneous abortion

A

fetal chromosomal abnormalities

82
Q

well demarcated, slightly raised, erythematous vulvar lesion w. an eczematoid appearance

+/- small dotted pale islands

A

paget dz of the vulva

83
Q

tx for paget dz of the vulva

A
  1. topical eczema therapy x 6 weeks
  2. if not resolved -> bx
  3. if paget -> wide local excision vs vulvectomy
84
Q

rf for umbilical cord prolapse

A

hx of malpresentation
PROM

85
Q

when must sx occur for dx of pmdd

A

luteal phase

86
Q

when are fetal quickenings (movements) mc first felt

A

18-20 weeks

87
Q

what gestational age does ectopic pregnancy mc occur

A

6-8 weeks

88
Q

benefits of colostrum

A

immunity: immunoglobulins, lactoferrin, leukocytes, macrophages
-higher protein content than mature milk

89
Q

types of leiomyomas with pics

A
90
Q

name 2 GnRH agonists

A

leuprolide
goserelin

91
Q

32 yo F 37 weeks gestation presents w. T 102.1, HR 115 - has fluid leaking from cervical os x 2 days - US shows baseline fetal tachy

what is her dx and what do you give her

A

chorioamnionitis

ampicillin PLUS gentamicin

92
Q

2 mc rf for chorioamniocentesis

A

prolonged labor
prolonged rupture of membranes

93
Q

3 causes of infxn for chorioamniocentesis

A

STI
GBS
BV

94
Q

4 causes of fetal tachy

A

fetal movement
maternal factors
fetal factors
placental abruption

95
Q

maternal factors that cause fetal tachy (6)

A

anemia
hyperthyroidism
hpoxia
dehydration
fever/sepsis
anxiety

96
Q

lower than normal volume of amniotic fluid

A

oligohydraminos

97
Q

mc cause of oligohydraminos

A

rupture of membrnes

98
Q

dx criteria for oligohydraminos

A

amniotic fluid index </= 5 cm
OR
deepest vertical pocket < 2 cm

in 2nd or 3rd trimester

99
Q

2 maternal conditions associated w. oligohydraminos

A

preeclampsia/chronic HTN
nephropathy

100
Q

2 complications of endometritis that you should think of when endometritis is unresponsive to abx

A

ovarian vein thrombophlebitis
deep spontaneous pelvic thrombophlebitis

101
Q

what PE finding makes you think of spontaneous pelvic thrombophlebitis

A

palpable cord like mass

102
Q

mc cause of AUB in adolescent women

A

immature hypothalamic-pituitary axis

EOR - Women's Health (15 decks)

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