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OB/GYN > SHELF > Flashcards

SHELF Flashcards

1
Q

Best screening for trisomy 21

A

Cell-free DNA testing

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2
Q

Preventing Meconium Aspiration Syndrome

A

Newborn depression with present meconium

=»Intubate the trachea and suction meconium from beneath the glottis

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3
Q

Infant appearance from a maternal Type I Diabetic

A

Small and hypoglycemic

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4
Q

Septic baby appearance

A

Pale, elevated temperature, and lethargic

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5
Q

RFs for babies born to diabetic mothers

A

Hypoglycemia

Polycythemia

Hyperbilirubinemia

Hypocalcemia

Respiratory distress

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6
Q

Safest method to suppress lactation

A

Breast binding, ice packs, and analgesics

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7
Q

Signs of adequate feeding in an infant

A

3-4 stools/24hrs

6 wet diapers/24hrs

Weight gain

Swallowing sounds

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8
Q

First evaluation in suspected ectopic

A

Repeat B-hCG in 48 hrs

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9
Q

Uterine perforation signs

A

2-3 days post D/C:

N/V

Abdoinal pain

Scant bleeding

Fever

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10
Q

Immediate management of unstable spontaneous abortion

A

D/C

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11
Q

Tx for respiratory depression due to Mag therapy

A

Calcium gluconate

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12
Q

Greatest gestational concern for obese women

A

Development of HTN

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13
Q

SLE outbreak tx.

A

Corticosteroids

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14
Q

Teratogenic SSRI

A

Paroxetine

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15
Q

Diagnostic test for appendicitis in pregnant ladies

A

Graded Compression Ultrasound

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16
Q

Hydrops fetalis signs

A

Can be identified by the collection of fluid in 2 or more body cavities (pleural/pericardial effusion, ascites, cerebral edema)

  • Due to failure of liver to produce protein
  • Can also see hepatosplenomegaly
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17
Q

Prevention of preterm delivery in multifetal gestation

A

Adequate weight gain

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18
Q

Sequelae of TTS in surviving twin

A

Neurologic sequelae

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19
Q

Cytotec

A

Misoprostol; used to induce labor

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20
Q

Terbutaline

A

B-agonist used to decrease uterine intracellular cAMP and decrease contraction rate

ADRs: Tachycardia
Hypotension
Anxiety
Chest pain

-Do not use this drug for more than 48 hrs

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21
Q

Greatest RF for PROM

A

Genital tract infxns

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22
Q

Decreased amniotic glucose in amniocentesis may indicate what?

A

Chorioamnionitis

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23
Q

CI’d drugs after PPH

A

Ergot alkaloids

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24
Q

PPH management

A
  • Uterine massage
  • Oxytocin
  • If necessary, a Bakri Balloon
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25
Q

Most common source of fever on post partum Day 1

A

Lungs

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26
Q

Post term pt. testings

A

Biweekly NSTs and AFIs

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27
Q

Crown-rump length

A

Measured on transvaginal ultrasound to accurately date a pregnancy within 5-7 days

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28
Q

Most likely complication following BTL

A

Pregnancy

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29
Q

Hysteroscopic Tubal Occlusion

A

Essure

The placement of coils into the fallopian tubes that cause scarring to block the tubes

  • must use back OCP for 3 months
  • confirm blockage w/ HSG
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30
Q

Antiphospholipid antibody syndrome tx

A

Aspirin + Heparin

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31
Q

Lichen planus

A

Chronic dermatologic disorder manifesting as inflammatory mucocutaneous eruptions characterized by remissions and flare ups

Symptoms: irritation, burning, pruritis, bleeding, dyspareunia

-Pts. may also have extra vulvar lesions such as oral ulcers and alopecia

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32
Q

Urge incontinence tx.

A

Oxybutinin (anticholinergic)

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33
Q

RFs for pelvic organ prolapse

A

Increasing parity

Increasing age

Obesity

CT disorders

Chronic constipation

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34
Q

Urethral bulking procedure

A

Treats intrinsic urethral sphincter deficiencies

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35
Q

Tx. of hemorrhagic cyst

A

Ultrasound monitoring

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36
Q

Tx of ovarian torsion

A

Exploratory surgery

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37
Q

Precocious puberty tx

A

Clomiphene (GnRH agonist)

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38
Q

Imperforate hymen

A

Incomplete genital plate separation

Sx: Abdominal pain worse with periods; amenorrhea

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39
Q

Test indicated for amenorrhea

A

FSH

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40
Q

Postpartum Telogen Effusion

A

High E2 levels following delivery and during pregnancy that can potentially lead to hair loss

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41
Q

OCP mechanism of pain reduction in dysmenorrhea

A

Endometrial atrophy caused by the progestin reduces the amount of prostaglandins produced by the proliferating endometrium

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42
Q

Post-menopausal womens daily Ca2+ requirement

A

1200mg/day

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43
Q

Severe menopausal tx.

A

Lowest effective dose of OCP for the shortest time possible

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44
Q

Estrogen Hormone therapy effect on lipid levels

A

Increased: HDL, TGLs

Decreased: LDL

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45
Q

Imipramine

A

SSRI assoc. w/ hyperprolactinemia

-If pt. desires to be pregnant, they should be weened off this drug

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46
Q

Clomiphene Challenge Test

A

Helps to determine ovarian reserve in perimenopausal pts.

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47
Q

Vitamin Deficiencies assoc. w/ PMDD

A

Vitamin A, E, and B6

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48
Q

Most common location of vulvar adenocarcinoma beginning

A

Bartholin gland

-Be on the lookout for non-tender masses here

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49
Q

Multifocal VIN 2 tx.

A

CO2 laser ablation

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50
Q

Most common sx. w/ fibroids

A

Menorrhagia

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51
Q

Biggest RF for endometrial carcinoma

A

Complex atypical hyperplasia

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52
Q

Workup following endometrial cancer diagnosis

A

CXR

-Lungs are the most common site of metastasis

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53
Q

General Stress Incontinence tx.

A

Retropubic urethopexy (urethral bulking procedure)

-This fixes the urethral hypermobility

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54
Q

Tx of thyroid storm in pregnancy

A

Radioactive iodide

-Only use because it’s so dangerous

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55
Q

Bleeding in a woman > 40 yrs old

A

Always get an endometrial biopsy

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56
Q

RFs for FGR

A

CVD

HTN

COPD

Diabetes

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57
Q

Late deceleration

A

Alteration in uteroplacental diffusion that can be caused by any maternal disease that causes vascular damage

-Can progress to placental abruption

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58
Q

Tx for secondary arrest of acute phase of labor

A

Amniotomy

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59
Q

Initial tx. for fetal hypoperfusion (signaled by late decels)

A

Differentiate from maternal heart rate

Assess for umbilical cord prolapse

Change in maternal position to left lateral decubitis
***Also do this first for variable decels

Maternal O2 supplementation

Tx of HTN

Discontinue oxytocin

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60
Q

Lichen sclerosis

A

Chronic inflammatory skin condition presenting w/ extreme vulvar pruritis, burning, pain, resorption of the clitoris, and dyspareunia

  • Skin changes include purple, polygonal papules or a waxy sheen on the labia
  • Can progress to fissures and erosions secondary to the chronic itching
  • Small increased risk for SCC

Tx: Topical corticosteroids

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61
Q

Precocious puberty tx

A

GnRH agonist

-Observation if pt. is nearly 10

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62
Q

Tamoxifen ADRs

A

Hot flashes (MC); works via antiestrogenic activity in the CNS causing anterior hypothalamic dysfnxn

DVTs

Endometrial hyperplasia/carcinoma

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63
Q

Hypothyroid pts. in pregnancy

A

Should have increased dosing of their levothyroxine

-These pts. are unable to adequately increase their prod. of thyroid hormone to meet the new levels of SHBG so they need some help

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64
Q

Management of Threatened Abortion

A
  1. US to determine fetal status
  2. Reassurance
  3. Return US in one week
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65
Q

Diagnosing ectopic pregnancies

A

B-hCG + transvaginal US

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66
Q

NAAT testing on gonorrhea and chlamydia

A

With this test, you only have to treat whatever comes back positive due to its high specificity

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67
Q

Placenta previa delivery date

A

36-37 weeks

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68
Q

Endometritis RFs

A

Prolonged ROM (>24 hrs)

Prolonged labor (>12 hrs)

C-sec

Use of IUPCs or fetal scalp electrodes

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69
Q

Endometritis Symptoms

A

Fever

Uterine tenderness

Foul-smelling lochia

Leukocytosis

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70
Q

Endometritis tx.

A

Clindamycin + Gentamicin

-is usually due to a broad-spectrum infxn

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71
Q

Mammary Paget Disease of the Breast

A

Persistent eczematous or ulcerating rash located around the nipple and areola that indicates an underlying adenocarcinoma

Sx: Bloody discharge
      Nipple retraction 
      Scales 
      Pain
      Itching
      Burning
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72
Q

Uterine Rupture

A

Typically occurs in pts. w/ prior uterine surgery @ the site of the scar

Sx prior to rupture: Focal, intense abdominal pain
Hyperventilation
Agitation
Tachycardia

Sx after rupture: Retraction of fetal position (*Pathognomic)
Abnormal FHTs

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73
Q

Oxytocin ADRs

A

Uterine tachysystole ( > 5 contractions in 10 mins) =» possible fetal hypoxia

Tetanic contractions

Hypotension

Hyponatremia

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74
Q

Symmetric IUGR

“Fetal causes”

A

Genetic disorders (aneuploidy)

Congenital Heart Disease

Intrauterine infxn (CMV, rubella, toxo, malaria, varicella)

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75
Q

Intraductal papilloma

A

Benign breast condition of a single dilated breast duct usually found on biopsy or US

Sx: Unilateral blood discharge w/ no assoc. mass or lymphadenopathy

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76
Q

After confirming a benign breast cyst, what should be done?

A

Repeat breast exam in 2 months

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77
Q

Transverse fetal lie

A

Transient condition which spontaneously converts to vertex or breech; evaluate w/ US at 37 weeks to be sure

RFs: Prematurity
Uterine anomalies
Placenta previa
Multiple gestation

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78
Q

Pts. who have chronic HTN and OCPs

A

Discontinue OCPs if BPs are elevated on two separate occasions

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79
Q

First line test for adnexal mass

A

Pelvic US

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80
Q

Thin, clear cervical mucous around time of ovulation

A

Normal

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81
Q

Assymetric IUGR

“Maternal causes”

A

Vascular Disease (HTN, Pre-E, Diabetes)

Antiphospholipid antibody syndrome

AI disease

Cyanotic cardiac disease

Substance abuse

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82
Q

Endometrial thickness finding alongside a granulosa cell tumor

A

Biopsy the endometrium first because endometrial cancer is a more grave disease

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83
Q

HER-2

A

Is normally a bad prognostic factor for breast cancer BUT allows for tx. w/ Herceptin

-Can be determined via FISH or immunohistochemical staining

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84
Q

OCP ADRs

A

Breakthrough bleeding (MC; is assoc. w/ lower E2 doses)

Breast tenderness

Nausea

Bloating

Amenorrhea

HTN

DVT

Hepatic adenoma

Increased TGLs

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85
Q

Severe Pre-eclamptic features

A

> 160/>110 on 2 occasions at least 4 hrs apart

Thrombocytopenia

Increased serum Creatinine

Increase hepatic transaminases

Pulmonary edema

Visual changes/neurologic symptoms

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86
Q

Tx of Maternal Hypertensive Crisis

A
  1. IV hydralazine (vasodilator)
  2. IV labetalol (a1, B1, B2 blocker; CI’d w/ bradycardia tho)
  3. PO nifedipine (Ca2+ channel blocker)
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87
Q

Stress incontinence

A

Caused by a loss of urethral support and intrabdominal pressure exceeds urethral sphincter pressure causing loss of urine

Sx: Leaking w/ coughing, sneezing, laughing, lifting

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88
Q

Urge incontinence

A

Caused by detrusor muscle overactivity

Sx: Sudden, overwhelming or frequent needs to empty the bladder

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89
Q

Overflow incontinence

A

Impaired detrusor contractility or bladder outlet obstruction

Sx: Constant involuntary dribbling of urine and incomplete emptying of the bladder

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90
Q

Pseudocyesis

A

Conversion disorder where pts. who desire pregnancy present to the office with the signs of pregnancy (amenorrhea, positive test per their statement), however, all in-office testing is negative

-Requires psychiatric consult

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91
Q

IUD to use in breast cancer pts. about to start chemo

A

Copper IUD

-Progesterone is CI’d

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92
Q

Menopausal Genitourinary Syndrome

A

Hypoestrogenemia leads to atrophy of the urethral mucosal epithelium because it also possesses E2 receptors

-Loss of urethral compliance and closure pressure =» urgency, frequency, UTIs

Tx: 1st line - vaginal moisturizes and lubricant

  2nd line- topical vaginal E2
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93
Q

Protective Modifiers from Breast Cancer

A

BSO - not routinely performed due to other consequences but definitely is a biggie

OCPs

Age

94
Q

Bilateral renal agenesis

A

Condition that is incompatible with life due to the accompanying pulmonary hypoplasia; will see pockets of fluid on ultrasound

95
Q

Quad Screen

A

AFP

Inhibin A

B-hCG

Conjugated estriol

-If this comes back abnormal, perform US to assess for abnormalities

96
Q

CA-125 screening

A

Is not routinely recommended due to the large number of things that can cause an increased level

97
Q

Bartholin Cyst

A

Mobile, soft, non-tender mass located behind the labium majora @ the 4 and 8 oclock positions

-Can caused discomfort during sex or while walking

98
Q

NST

A

Fetal heart rate is recorded and monitored for spontaneous fetal movement; test is performed routinely on high-risk pregnancies

-Abnormal if

99
Q

Breast engorgement tx

A

Ice and NSAIDs

100
Q

Tx. of Grade 1 endometrial carcinoma in a woman who still desires pregnancy

A

High-dose progestin therapy and frequent endometrial sampling

101
Q

Removal of postmenopausal ovaries

A

Still leads to further decrease in E2 due to loss of androgen prod. from the ovaries that can be converted peripherally to E2

102
Q

Endometriosis pts. w/ infertility tx.

A

Clomiphene citrate (to stimulate the ovaries) and possible IUS

103
Q

Lichen simplex chronicus

A

Result of chronic scratching and rubbing causing skin damage

=»Increased susceptibility for infxn and further itching

-Labia will appear thick, lichenified, and edematous

Tx: Topical corticosteroids

104
Q

Recent ab therapy and vulvar itching

A

Candidiasis

105
Q

Pts. w/ PPROM at 36 weeks

A

Augment labor and deliver

106
Q

Preventing shoulder dystocia

A

Cant; it’s unpredictable but it is more likely in macrosomic infants

-Also, Cesarean delivery is not routinely recommended since it is unpredictable

107
Q

Androgen Insensitivity Syndrome

A

X-linked mutation of androgen receptors

Findings: Normal breast development
46 XY karyotype
Minimal axillary and pubic hair
Absent uterus and upper vagina
Cryptorchid testes

108
Q

Mullerian Agenesis

A

Hypoplastic/absent mullerian ductal system

Findings: Normal breast development
46 XX karyotype
Normal axillary and pubic hair
Absent uterus and upper vagina
Normal ovaries

109
Q

IUFD follow-up

A

Placental and fetal autopsy to prevent reoccurrence

110
Q

External Cephalic Version can be performed at…

A

> = 37 weeks

111
Q

Tocolytic drugs

A

Indomethacin

Nifedipine

Terbutaline

112
Q

Delivery at

A

Mag is also given to prevent neurologic complications in the infant alongside the usual corticosteroids and tocolytics

113
Q

Ruptured Ectopic Pregnancy

A

Presents as amenorrhea, pelvic pain, and acute vaginal bleeding

Blood in the abdomen =» hypotension, syncope, tachycardia, diffuse abdominal pain, cervical motion tenderness, shoulder pain, and urge to defecate

114
Q

Klumpke’s Palsy

A

Caused by Excessive traction on C8 and T1 during delivery; possibly due to shoulder dystocia

Sx: Extended wrist
Hyperextended metacarpophalangeal joints
Flexed intercarpalphalangeal joints
Absent grasp reflext
Horner syndrome
Intact macro and biceps reflexes

115
Q

Fractured neonatal clavicle

A

Complication of shoulder dystocia

Sx: Clavicular crepitus/bony irregularity
Decreased macro reflx (due to pain; usually only on the fractured side)
Intact biceps and grasp reflexes

116
Q

Endometriosis pain

A

Occurs 1 week before menses and peaks just before

-Also is associated with dysmenorrhea, dyspareunia, and dyschezia

117
Q

UTI tx. in pregnancy

A

Amoxicillin

Nitrofurantoin

Cephalexin

118
Q

Bactrim teratogenic effect

A

Kernicterus; due to folic acid antagonism

119
Q

Anorexia and pregnancy complications

A 
Infants: Prematurity
             IUGR
             Miscarriage
            Poor growth
            Intellectual disability

Mother: Hyperemesis gravidarum
Cesarean delivery
PPD

120
Q

Genital warts tx.

A

Trichloroacetic acid
Podophyllin
Imiquimod

121
Q

Women at age >35 should be offer what prenatal screening

A

Cell-free DNA testing

-If positive, follow-up with chorionic villus sampling or amniocentesis depending on the stage of pregnancy

122
Q

MCC of PPH

A

Uterine atony; even during a c-sec

123
Q

Most common cause of late postpartum hemorrhage 7-10 days after deliver

A

Sub involution of the uterus in which the placental i plantations site has not increased in size

124
Q

Endometriosis appearance

A

Homogenous cystic mass on the adnexae

125
Q

Mag excretion

A

Kidneys; therefore, dose should be altered for pts. w/ renal insufficiency

126
Q

Modifiable Breast Cancer Risks

A

Hormone replacement therapy

Nulliparity

Age at first childbirth

Alcohol consumption

127
Q

Chronic retention of products of conception

A

Consumptive coagulopathy due to chronic release of tissue factor from the placenta

  • Fibrinogen levels may be in the low-normal range
  • Deliver the stillborn child in any mother with signs of coagulopathy
128
Q

Peripartum cardiomyopathy

A

Rapid onset of systolic HF @ 36 weeks or later

129
Q

Amniotic fluid embolism

A

Presents as respiratory failure, cardiac shock, DIC, and coma/seizure

RFs: Advanced maternal age
        Gravia >5 
        Cesarean/Instrumental delivery 
        Placenta previa/abruption 
        Preeclampsia

Tx: Respiratory and hemodynamic support

130
Q

Placental abruption tx

A

IV fluid bolus and left lateral decubitus position

-Packed RBCs if necessary

131
Q

Luteoma of pregnancy

A

Yellow-brown mass of large lutein cells; often bilateral

  • Can be asymptomatic but on a test, likely hyperandrogenic
  • Spontaneously regress post-partum
  • Female fetus at GREAT risk of virilization
132
Q

Post term pregnancy complications

A 
Fetal: Oligohydramnios 
          Meconium aspiration 
          Stillbirth 
          Macrosomia
          Convulsions

Maternal: C-sec
Infxn
PPH
Perineal trauma

133
Q

Neonatal thyrotoxicosis

A

Transplacental passage of maternal anti-TSH abs causes transient hyperthyroidism in the neonate

Tx: Short term methimazole and BBs if necessary

-Resolves after 3 months

134
Q

Mittelschmerz

A

Pain on ovulation

-Occurs due to the small amount of blood released into the peritonem w/ follicle rupture

135
Q

Ovarian cancer diagnosis follow-up

A

Exploratory laparotomy

-Biopsy would cause seeding

136
Q

Postpartum urinary retention

A

Presents as inability to void bladder w/ a sensation of fullness and dribbling

RFs: Nulliparity
        Prolonged labor
        Perineal injury
       C-sec
        Instrumental delivery
       Regional injury =>> decreased sensory impulse =>> decreased microtuition reflex and detrusor tone

Tx: Analgesics
Ambulation
***Urinary catheterization

137
Q

Pt. w/ spontaneous abortion who desires prompt treatment

A

D/C

138
Q

HSV (+) pt at 36 weeks

A

Give prophylactic acyclovir

139
Q

Palpable breast mass

A

> US

> 30 years old =» Mammogram

140
Q

Intrahepatic cholestasis of pregnancy

A

Benign condition caused by idiopathic increased production of bile acids

-Presents w/ unbearable pruritis

Labs: Increased bile acids and bilirubin
Increased liver aminotransferases

141
Q

MC ADR of epidural anesthesia

A

Hypotension; due to blockage of sympathetic nerve fibers

***Can lead to fetal acidemia from hypoxia

Tx: Left lateral decubitus position; IV fluids; vasopressors

142
Q

Hyperemesis gravidarum pH

A

Metabolic alkalosis due to volume contraction

143
Q

Placenta accreta tx.

A

Hysterectomy

144
Q

Defect in the decidua basalis

A

Possible placenta accreta

145
Q

Ectopic pregnancies needing surgical treatment

A

Unstable maternal vital signs, cardiac activity, or B-hCG > 5,000

146
Q

Fetal manifestations of gestational diabetes

A

Congenital anomalies (cardiac/limb, sacral agenesis)

Increased risk of stillbirth

Macrosomia

Pulmonary hypoplasia

Polyhydramnios

147
Q

Labor treatment of gestational diabetic

A

Begin IV dextrose; also do this if glucose

148
Q

Chlamydia screening

A

All women under 25 and older women w/ risk factors, like a new sexual partner

149
Q

C-sec viral load if mother is HIV pos

A

> 1,000

150
Q

Pap smears post-hysterectomy

A

Only continue if the pt. Had a subtotal hysterectomy

151
Q

ASC-US follow up

A

Repeat paps every 4-6 months until 2 consecutive negatives

152
Q

Luteal phase defect

A

Insufficient amounts of progesterone produced by the corpus luteum =» early endometrial shedding

-However, ovulation is still occurring

153
Q

Mild preeclampsia management

A

2x weekly NSTs and BPPs if suspected oligohydramnios or IUGR

US for fetal growth and amniotic fluid q3 weeks

Be on the lookout for rapid weight gain

154
Q

Severe preeclampsia management

A
  • Inpatient monitoring w/ daily lab values and fetal monitoring
  • Stabilize w/ Mag and antihypertensives
155
Q

Sclerosing adenosis

A

Firm, indurated, and ILL-DEFINED mass that is due to excessive tissue growth in the breast tissue lobules

-Painful, especially with the cycle

Dx: FNA; looks similar to carcinoma on mammogram

156
Q

Duct ectasia

A

Inflammatory dilation of the breast ducts that may present w/ BILATERAL green or brown discharge

-Requires biopsy but once confirmed, management is conservative

157
Q

Cystosarcoma phyllodes

A

Most common non-epithelial mass in the breast; is usually nontender and unilateral

  • Presents pretty similar to a fibroadenoma with more rapid growth
  • Slight chance for malignancy so removal is standard of care with monitor of recurrence
158
Q

Tests at first pregnancy visit

A

CBC

UA

G/C

TB

VDRL/RPR

HIV

Rh status

Rubella titer and HBsAg test

159
Q

Cardinal movments of labor

A

Engagement

Descent

Flexion

Internal rotation

Extension

External rotation

Expulsion

160
Q

Pathogenesis of endometriosis

A
  1. Retrograde menstruation
  2. Lymphatic dissemination
  3. Coelomic metaplasia (explains endometriosis in pre-pubertal girls)
161
Q

Infant of a mother with HBsAg (+) test

A

Receive vaccine within 12 hours of birth

162
Q

Risks of hormone replacement therapy

A

***BREAST CANCER

Stroke

Blood clots

Heart disease

163
Q

Thyroid Storm Treatment

A

B-blocker, PTU, and corticosteroids

164
Q

Postpartum thyroiditis

A

Transient hyperthyroidism following delivery and is associated with anti-microsomal and TSO antibodies (just like w/ Hashimotos)

-Temporary management w/ antithyroid medications during the hyperthyroid phase

165
Q

Hyperparathyroidism treatment in pregnancy

A

1 or 2nd trimester= surgery

3rd trimester= oral phosphates and a low calcium diet

166
Q

Reverse doppler flow

A

Assoc. w/ fetal death in 48 hrs

=»DELIVER

167
Q

Pt. w/ suspected pyelonephritis and no improvement after 48 hrs of antibiotics

A

Suspect urinary tract obstruction

-Getting a US will be helpful in this case

168
Q

Dyspnea in a pregnant woman being treated for pyelonephritis

A

Possible ARDS

-Due to endotoxin release from gram negative bacteria

169
Q

Septic pelvic thrombophlebitis

A

Bacterial infection at the placental implantation site spreads to thrombosed veins at the ovarian venous plexus or the common iliac veins

Sx: Recurrent high fever
Pelvic mass

Tx: Antibiotics + heparin

170
Q

Most common organisms causing postpartum endometritis

A

Anaerobic bacteria

171
Q

Treatment for breast engorgement

A

Wear a comfortable bra

Avoid nipple stimulation

Ice packs

NSAIDs

  • DO NOT USE BREAST BINDING FOR LACTATION SUPPRESSION
    • may lead to infection or plugged ducts
172
Q

Test done to confirm ectopic pregnancy

A

Transvaginal US

173
Q

Delivery of woman with previous abruption

A

36-37 weeks

174
Q

TdAP vaccine and pregnancy

A

Give after 28 weeks regardless of when they last had it

175
Q

Pap smears in HIV women

A

Annual

176
Q

Most common location of a. Osteoporotic fracture

A

Thoracic spine

177
Q

Most common STIs after sexual assault

A

Gonorrhea, chlamydia, Trichomonas, and HBV

  • Go ahead and treat for these right off the bat
  • Also screen for HIV and Syphilis
178
Q

Woman complaining of flank pain and abdominal tenderness following a pelvic surgery

A

Probably ureteral damage, most likely at the cardinal ligament

-CT or IVP to confirm

179
Q

RFs for fascial dehiscence

A

Obesity

Diabetes

Cancer

Vertical incision

-Usually will occur 7-10 days following surgery

180
Q

Most common cause for suture dehiscence

A

Fascial disruption/breakdown by the suture

181
Q

Diagnostic tests for Stress incontinence

A

Physical examination

Loss of bladder angle

Cystocele

Hypermobile urethra

Tx: Urethropexy (sling)

182
Q

Pessary

A

Device that treats pelvic support problems and urinary incontinence; support the pelvic structures

-useful for women who do not want surgery for stress incontinence

183
Q

Diabetes and the bladder

A

Can cause a nuerogenic bladder =» overflow incontinence

-Basically because of neuropathy

184
Q

Most common cause of acute salpingitis

A

Multibacterial infxn

185
Q

Fitz-hugh-curtis cause

A

Purulent tubal discharge which ascends to the RUQ

-Patients will complain of pain here

186
Q

Most common cause of septic arthritis in young women

A

Gonorrhea; classically presents as migratory

187
Q

Signs and symptoms of acute salpingitis

A

Abdominal tenderness

Cervical motion tenderness

Adnexal tenderness

Vaginal discharge

Fever

Pelvic mass on physical examination or US

188
Q

IUD effect on PID

A

Increases risk

OCPs =» Lower

189
Q

Adnexal mass w/ PID

A

Possible tubo-ovarian abscess

  • US follow-up recommended
  • Treated w/ IV antibiotics
190
Q

Most common ADRs from metronidazole

A

N/V, abdominal bloating, diarrhea

-DO NOT CONFUSE W/ DISULFARIM RXN
=»headache, flushing, tachycardia, dizziness, N/V

191
Q

Bartholin gland abscess

A

On the vestibule of the labium majora

-Significant problem could be Cancer; especially in women > 40

192
Q

Greatest RF of multiple gestation

A

Premature or preterm labor

193
Q

Tx of polyhydramnios

A

Amniocentesis; even if vitals are stable and baby looks good at the moment

194
Q

Workup for Hyperemesis gravidarum

A

Work up for urine ketones

195
Q

Medical management of an inevitable abortion

A

Prostaglandins for ️Bleeding control

196
Q

Common history with cervical ectopic a

A

History of D/C

197
Q

DD of PPH

A

Atony (can be due to twins, fibroids, polyhydramnios, macrosomia)

Lacerations

PLACENTAL RETENTION

DIC

Hematomas

Coagulopathy

198
Q

Other drugs for uterine atony

A

Prostaglandin (Hemabate); don’t give to asthmatics

Ergot alkaloids; don’t give to HTN Pts.

199
Q

Target glucose levels in gestational diabetes

A

Fasting:

200
Q

RFs for placenta Previa

A

Previous PV

Previous c-sec

Uterine surgeries

Multiparity

Smoking

Cocaine

AMA

201
Q

Assessment of HDN severity

A

Bilirubin in the amniotic fluid

Usually between 1:8-1:32

Increase in Doppler flow

202
Q

Tx of HDN

A

Direct blood transfusion into the umbilical cord

203
Q

Swelling lateral to the insertion of e round ligament and no intrauterine pregnancy but a positive test

A

Cornu ectopic pregnancy

204
Q

Testes in Androgen Insensitivity Syndrome

A

Removed to prevent cancer development

205
Q

Positive withdrawal bleeding after progesterone challenge test in secondary amenorrhea work up…what next?

A

Prolactin and TSH levels

Pts. May wind up needing Clomiphene treatment

206
Q

Benefits to OCPS

A

Less heavy periods

Decreased risk of endometrial and ovarian cancer, PID, and benign Breast disease

207
Q

Contraindications to IUD placement

A

Recent PID

STDs

Uterine tract malignancies

Breast cancer (preogesterone IUDs)

Fibroids

208
Q

Rapid growth of a uterine fibroid

A

Possible Leiomyosarcoma; take that motherfucker out

209
Q

Cervical cancer Tx.

A

Stages I and II = Hysterectomy

Stages III and IV = radiation therapy

210
Q

Abnormal uterine bleeding unresponsive to OCP Tx.

A

Endometrial ablation or hysterectomy

211
Q

Tx of fibrocystic changes in the breast

A

OCPs

Vitamin E

Decrease caffeine

FNA if you want I guess

212
Q

Breast cancer treatments

A

Depends on its receptor positivity

Radiation given after simple lumpectomy

Chemo give with hormone therapy

213
Q

Congenital syphilis

A

10 days after delivery: Maculopapular rash, snuffles, mucous patches on the pharynx, Hepatosplenomegaly,

Later in life: Hutchinson teeth, saddle nose, saber shin

214
Q

Gestational CMV

A

Transmitted via saliva, secretions, Breast milk, semen

-can see IUGR, petechiae, Hepatosplenomegaly, Microcephaly, seizure, chorioretinitis, hydrops,

IgG in mom does not confer immunity and baby is still susceptible

215
Q

Tx for congenital varicella

A

Give varicella Ig and check tigers

216
Q

Delivery date for a gestational diabetic

A

38-39 weeks

217
Q

Theory behind progesterone treatment for early endometrial changes

A

Converts estradiol to estrone and also decreases the number of E2 receptors on endometrial cells

218
Q

MCCo prenatal death

A

Preterm labor

219
Q

Antibiotics in PROM

A

Decrease likelihood of neonatal infection and also prolong the latent phase of labor

220
Q

Postpartum fever with no uterine or Breast tenderness

A

Consider pelvic thrombophlebitis; is a diagnosis of exclusion

-Can sometimes see thrombosis on CT

221
Q

Risk of HIV transmission without HAART

A

25%

222
Q

Drug to give prior to administration of epidural

A

Antacids

If these were not given and a patient has the signs of respiratory distress, consider aspiration pneumonitis

223
Q

Most common neonatal endocrine cause of death

A

Congenital adrenal hyperplasia

224
Q

Management goals for delayed puberty

A

Intimate sexual maturation, prevent osteoporosis from Hypoestrogenemia, and promote full height potential

Start on unopposed estrogen first to promote normal
Breast development

225
Q

Uterine septum

A

Incomplete dissolution of the fused midline septum of the Müllerian ducts; often presents with recurrent miscarriage

Dx: HSG, saline infusion sonohysterogram

Tx: Resection

226
Q

What follow up should be performed on a woman with blocked tubes on HSG?

A

Laparoscopy; tubal spasm can cause this finding so we should identify the exact blockage

-Plus, it can also provide treatment

227
Q

Persistent postmenopausal bleeding after a normal endometrial sampling

A

Perform hysteroscopy

-Even though the sample was negative, we gotta figure this shit out dont give up bruh

228
Q

Granulosa cell and Sertoli-Leydig tumors on US

A

Completely solid mass

229
Q

Pseudomyomaperitonei

A

Rupture of a large mucinous cystadenoma (can get VERY LARGE and can produce chronic pelvic symptoms (pain, constipation, bowel obstruction)

230
Q

Tx for epithelial ovarian cancer

A

Debulking of the tumor with follow-up chemo

231
Q

Follicular cyst size

A

Usually 5cm or less

-If bigger mass seen, follow-up is needed

232
Q

Exercise-induced hypothalamic amenorrhea lab finding

A

Decreased estrogen w/ lower end normal FSH

OB/GYN (8 decks)

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