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1
Q

Normal range of Amniotic fluid index (AFI)

A

5-23cm

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2
Q

Common causes of polyhydramnios

A

Maternal DM, multiple gestation and congenital abnormalities

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3
Q

What to do if at delivery patient has vaginal wart?

A

Patient can continue to deliver vaginally since cesare does not prevent vertical transmision

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4
Q

S+S of urethral diverticula

A

postvoid dribbling, dysuria, dyspareunia and anterior vaginal wall mass

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5
Q

Imaging of choice for urethral diverticula

A

MRI of the pelvis or TVUS

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6
Q

Range of transaminases in acute fatty liver of pregnancy

A

300-500 (usually occurs in third trimester

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7
Q

First line antibiotics for lactational mastitis

A

oral dicloxacillin and cephalexin

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8
Q

Treatment for breast abscess

A

Antibiotics and FNA (no I+D because of complications and poor cosmetic outcomes

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9
Q

When should pregnant women be screened for anemia and DM?

A

24-28 weeks gestation

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10
Q

Signs of uterine rupture

A

Abdominal pain, vaginal bleeding, loss of fetal station, abnormal tracing

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11
Q

Target fasting/1hr and 2hr glucoses for pregnant women

A

<95 asting, <140: 1hr, <120 2hrs

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12
Q

When should pregnant women have pelvic mass removed?

A

Early second trimester to avoid acute complications

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13
Q

What are WSW at higher risk for?

A

BV and cervical cancer

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14
Q

Ras starting in umbilicus on t2nd and 3rd trimester of pregnancy?

A

Pemphigoid gestationis

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15
Q

How to treat BV inpregnancy?

A

Same: flagyl or clinda

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16
Q

Effects of BV in pregnancy?

A

Increased risk of preterm labor but insufficient evidence so treatment mostly for symptom management

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17
Q

Management of preterm prelabor if ROM <34

A

Prophylactic antibiotics to prolong interval between ROM and delivery

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18
Q

What constitutes protracted active phase labor?

A

when dilated >6cm and rate of cervical change is <=1/2hr

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19
Q

How to prevent preeclampsia

A

Start low dose aspirin at 12 week gestation

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20
Q

When to give Anti-D immune glubulin?

A

At 28 weeks if women has negative anti-D antibody screen and repeat dose <72hours after delivery if child is Rh(D) positive

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21
Q

How to treat liscchen sclerosus

A

High dose topical corticosteroids

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22
Q

How to charact lichen sclerosus?

A

Vulvar pruritus and thinned skin with some thin white areas

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23
Q

Who gets endometrial biopsy for bleeding in menopausal transition?

A

> 45 with suspected anovulatory bleeding or <45 with risk factors for unopposed estrogen, persistent bleeding of failed medical management

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24
Q

What to do with specific BHCG quantification

A

a) >1500 and IUP, treat for abnormal IUP. B) if >1500 and EP unconfirmed, repeat BHCG in 48hrs, 3) <1500 and no IUP, repeat in 2 days, d) >1500 and TVS with adnexal mass, EP confirmed

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25
Q

Management of ectopic pregnancy

A

MTX if HDS no fetal cardiac act and BHCG <5K; laparoscopy if >5000, mass >3.5cm of fetal heart. If RH - get RH immunoglobulin

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26
Q

Highest risk factor for recurrent PID?

A

Multiple sexual partners

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27
Q

First line therapy for patient w/ PCOS wanting pregnancy?

A

Weight loss since it can restore ovulation, then letrozole if no effect

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28
Q

Other medications for hot flashes

A

SSRI

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29
Q

Preferred tx for trich

A

Single dose oral metronidazole

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30
Q

When to give steroids before delivery?

A

If preterm <37 weeks or <34 if DM (but can cause hyperglycemia

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31
Q

PID regimen inpatient

A

IV cefoxitin/cefotetan + doxy; IV clinda + gentmycin, IV unasyn+ doxy

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32
Q

PID regimen oral

A

CTXx1+ doxy x14; cefoxitin + probenecid PO + doxy

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33
Q

First division point in primary amenorrhea

A

Uterus abscent or present

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34
Q

What is considered primary amenorrhea

A

abscent of menses by 15 if breast present; or by 13 I fno breasts

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35
Q

A clue for androgen insensitivity syndrome

A

No hair

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36
Q

Treatment of pneumonia in kids

A

High dose Amox (if lobar) vs azithro if bilateral

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37
Q

S/S of congenital rubella

A

SNHL, patent DA, cataracts, low birth weight and purpuric lesions

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38
Q

Characteristics of mastoiditis

A

fever and otalgia, protrusion of the auricle, opacification of mastoid cells on CT/MRI

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39
Q

Treatment of mastoiditis

A

IV abx and drainage of purulent material

40
Q

Virus causing hand-foot-mouth disease

A

Coxsackievirus

41
Q

Treatmend of ADHD in kids < and >6

A

<6 start with behavioral therapy; if >6 can start with pharmacotherapy

42
Q

EEG charact of juvenile myoclonic epilepsy

A

bilateral polyspike and slow wave activity

43
Q

What is considered delayed puberty in boys?

A

Lack of testicular enlargement (>4mL) by age 14

44
Q

Kawasaki criteria

A

> 5days of fever, + 4: conjunctivitis, mucosal changes, lymphadenopathy, rash, extremity changes

45
Q

S+S of rubeola/measles

A

Prodrome like cold, conjunctivitis, fever, Koplik spots, rash

46
Q

Treatment of measles

A

Supportive or vitamin A for hospitalized patients

47
Q

Treatment of asympotmatic moderate lead toicity

A

Oral meso-2,3-dimercaptosuccinic acid (DMSA)

48
Q

When to get tympanostomy tubes

A

If highly recurrent otitis media: >3episodes in 6 months or >4 in 12 months

49
Q

What is herpangin

A

Infection with Coxsackie A in children that results in posterior vesicles and ulcers

50
Q

Currant jelly stools in children 6mo to 3years?

A

Intussusception (also with sausage-like mass)

51
Q

Dilation of the bladder

A

Posterior urethral valve (PUV)

52
Q

Preferred abx for serious bacterial infexs in neonates

A

Ampicillin and gentamicin or cefotaxime

53
Q

Why is CTX avoided in neonates <28days

A

Risk of hyperbilirubinemia

54
Q

Bilateral calf enlargement and lower extremity weakness

A

Duchenne muscular dystrophy

55
Q

What is considered mild scoliosis?

A

Cobb angle <40

56
Q

Meconium ileus almost pathonemonic for…

A

Cystic fibrosis

57
Q

When is phototherapy initiated?

A

Ehen bili is at toxic levels (>20-25)

58
Q

Newborn diaper dermaittis vs candida

A

Contact dermatitis spares skin folds

59
Q

Apnea of premturity vs periodic breathing of newborn

A

Periodic breathing is normal and pauses last 5-10sec while apnea pauses are >20sec

60
Q

Painless abdominal mass in children (tumor)

A

Neuroblastomas

61
Q

Painful renal malignancy in kids <5

A

Wilms tumor

62
Q

Features of croup

A

Inspiratory stridor, barking cough, hoarseness

63
Q

Treatment of croup

A

corticosteroids, nebulized epinephrine if severe

64
Q

First line therapy for kids with constipation

A

Increase water and fiber and if not, osmotic laxative use (increases water and softens stool)

65
Q

Management of pediatric inguinal hernias

A

Prompt surgical correction in 1-2 weeks to prvent bowel ischemia

66
Q

Pulm complications of polymyositis

A

ILD, infection, drug-induced pneumonitis, respiratory muscle weakness

67
Q

Features of polymyositis

A

Painless, proximal muscle weakness, elevated CK and LFTs, and high inflammatory markers

68
Q

Characteristics of PCL injury?

A

Dashboard classic injury with flex knee

69
Q

Labs suggestive of pagets

A

Elevated Alkphos with normal Calcium

70
Q

CCB for Raynaud

A

Nifedipine and amlodipine

71
Q

Extraarticular manifestations of ankylosing spoindylitis

A

Acute uveitis, AR, pulm fibrosis, IgA nephropathy and restrictive lung disease

72
Q

Treatment of acute vs chronic gout

A

Actue: NSAIDs and/or colchicine; chronic: allopurinol

73
Q

Fall in outstretched arm

A

Supracondylar fracture

74
Q

How to treat HTN in scleroderma crisis?

A

ACE inhibitor and IV meds such as nitroprusside if CNS involvement or papilledema

75
Q

Treatment of mixed cryoglobulinemia

A

1) immunossuppressive therapy; 2) treat undelrying cause

76
Q

How to confirm diagnosis of sarcoid?

A

Excisional lymph node biopsy

77
Q

Triad of invasive aspergillosis

A

Cough, pleuritic chest pain, hemoptysis

78
Q

Treatment for PMR

A

low dose steroids unless GCA suspected (then high)

79
Q

Leading casue of mortality in SLE?

A

Cardiovascular events (premature coronary atherosclerosis)

80
Q

When to administer tPA in stroke?

A

<4.5hr of symptoms

81
Q

Good prognostic factors in schizophrenia

A

Acute onset (lack of prodrome), older age at onset, positive psychotic sxs

82
Q

Trreatment of Guillan Barre?

A

Plasma exchange or IVIg

83
Q

Radial nerve pathology distribution

A

Dorsal aspect of forearm and hand

84
Q

Charact of Pineal tumor

A

Parinaud syndrome: Loss of pupillary reeaction, vertical gaze paralysis, ataxia, loss of physiologic nystagmus (when looking at moving target)

85
Q

Charact of transversemyelitis

A

Rapidly progressive weakness of LE following URI

86
Q

treatment of RLS?

A

Dopamine agonists: pramipexole or ropinirole–> gabapentin if continues

87
Q

Antidepressant that does not cause sexual side effect

A

buproprion (not weight gain), mirtazapine (weight gain)

levodopa or dopamine agonists (pramipexole)

88
Q

Charact of lesions in dominant temporal lobe

A

aphasia

89
Q

Charact of lesion in nondominant parietal lobe

A

constructional and dressing apraxia (can’t du purposeful actions)

90
Q

Charact of damage in dominant parietal lobe

A

Gerstmann syndrome: acalculia, finger agnosia, agraphia, R/L confusion

91
Q

Treatment of acute mania

A

antipsychotics first (can begiven IV)

92
Q

Charact of takotsubo (parts that affects)

A

Cathecholamine surge affecting LV mid and apical hypokinesis and basilar hyperkinesis

93
Q

For which patients is CABG indicated?

A

Refractory angina despite medical therapy, Left main stenosis or multivessesl CAD along with systolic dysfunction (becuase it will improve survival in these groups)

94
Q

Treatment of HTN in patients with PCKD

A

ACE inhibitors

95
Q

Why are pts with connective tissure diseases at risk of MR?

A

Chordae tendinae rupture

96
Q

CCS abx regimen for cystitis

A

3d bactrim or FQN if allergic; if complicated 7 day bactrim

97
Q

Acute cystitis abx for pregnant patients

A

7 day course of cefpodoxime or augmentin

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