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CREOG Study > Truelearn review 1 > Flashcards

Truelearn review 1 Flashcards

1
Q

Most common initial presentation of DVT in pregnant women?

A

Leg pain

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2
Q

Bartholin gland cancer is most common in which group of women?

A

older women

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3
Q

Biopsy of bartholin gland is recommend in which group of women?

A
  • women age 40 and greater
  • any patient with solid components
  • persistent or worsening mass despite marsupializaton or word catheter placement
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4
Q

What kind of hysterectomy has the greatest risk of vesicovaginal fistula?

A

Radical just ( upper 1/3rd of vagina is removed. Incidence is 1/81 cases)

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5
Q

What percent of shoulder dystocia is associated with brachial plexus injury ?

A

15 - 20%

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6
Q

What is the most common cause of death following uterine artery embolization?

A

Sepsis due to a necrotic fibroid

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7
Q

If paternity can be assured, what is the next step after identifying kell antibody in a prenatal screen?

A

Test the father for paternal antigen status
( If the father is kell antigen negative, then no need for additional surveillance with sonograms etc.)

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8
Q

If paternity is uncertain, what is the next step when finding kell antibody on prenatal testing?

A

MCA Doppler to screen for fetal anemia

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9
Q

What MCA Doppler level suggests fetal anemia?

A

> 1.5 MoM

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10
Q

What gyn onc etiology should be concerned in the case of AUB for more than 6 weeks following pregnancy ?

A

Gestational trophoblastic disease

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11
Q

What is the reported sensitivity of of ultrasound for ovarian torsion?

A

92%

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12
Q

Name the layers of the bladder from inside to outside (5)

A

Transitional epithelium ( urothelium)
Laminate propia
Submucosa
Detrusor muscle (muscular is propria)
Adventitious (Serosa)

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13
Q

How to manage vaginal hematoma ?

A

Small, non expanding - expectantly manage
Large, rapidly expanding - surgical exploration

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14
Q

Most common side effect leading to urge incontinence medication (oxybutynin) discontinuation reported by patients is _____

A

Xerostomia ( dry mouth) - 34%

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15
Q

Mechanism of oxybutynin

A

Anti muscarinic - competitively inhibits acetylcholine at muscarinic receptors to decrease involuntary detrusor muscle contractions

( other meds in this group include tolteridine and fesoterodine)

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16
Q

What are the three steps of implantation ?

A

Apposition - blastocyst hatches from zona and gets ready to get sticky to endometrium
Adhesion - adhesion molecules are expressed and endometrium and embryo express proteins for cell adhesion
Invasion - trophoblasts have differentiated into syncytiotrophoblast and cytotrophoblasts and spiral arteries are being invaded and destroyed

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17
Q

Increased NT (>3 mm) is most commonly associated with

A

Fetal cardiac anomalies, the most common of which is a septal defect

18
Q

Most GYN malignancy staging systems classify invasion to adjacent structures as stage ______ and distant Mets as stage _____

What are the exceptions to this?

A

IV A

IV B

Exceptions are ovary and GTN

19
Q

Vaginal cancer staging

A

** remember there are TWO types of labia, so 2cm is the differentiator in IA vs IB and IIA vs IIB

I - in vag wall only
II - invades into paravag tissues, nothing beyond pelvic sidewalls
III - either pelvic sidewalls involved AND/OR lower 1/3rd of vagina AND/OR hydronephrosis
- spread to pelvic or groin lymph nodes
IV - spread beyond true pelvis

20
Q

Primary dysmenorrhea can be attributed to what chemicals

A

Prostaglandins ( F2 alpha and E2)

21
Q

Stillbirth work up should include what (4 )

A

Fetal autopsy
Maternal lab work
Placenta examination
Fetal karyotype/microarray

22
Q

What maternal lab work should be done in stillbirth work up

A

Screen for fetal- maternal hemorrhage with KB test
Syphilis
APLS work up - Lupus anticoagulant, anticardiolipin Ab , Beta 2 glycoprotein Abs [ performed in all cases]
Indirect Coombs test [ if not previously performed]
Glucose screening ( Oral GTT , A1C) - [ in case of LGA baby]
Toxicology screen [ in case of abruption or when drug uses suspected]

23
Q

How is advanced paternal age defined by most organizations?

A

Age > 40 yrs

24
Q

Advance paternal age is associated for what risk in a pregnancy ?

A

Increased risk of having a child with a single gene disorder

25
Q

What common meds should be continued throughout perioperative period?

A

Beta blockers
Statins
SSRIs
Thyroid hormones

26
Q

What common meds should be discontinued 24 hours before surgery?

A

ACE inhibitors, ARBs

27
Q

When should a patient discontinue NSAIDs before surgery?

A

Several days before

28
Q

Should corticosteroids be discontinued prior to surgery?

A

No!!
Continue and potentially stress dose during surgery

29
Q

What common meds should be individualized before deciding to discontinue them before surgery ?

A

Aspirin
Antiplatelets ( clopidogrel)

30
Q

What do you do about patient on oral anticoagulants like warfarin and DOACs before surgery?

A

Discontinue and bridge to short acting agents if necessary

31
Q

When to discontinue herbal supplements before surgery ?

A

1 - 2 weeks

32
Q

What is the most common karyotype of a complete mole ?

A

46 XX ( 80% of cases)
Can also be 46 XY

33
Q

What percent of twins are born prematurely ?

A

60%

34
Q

The most common site of urethral injury during gyn surgery is at ________

A

The level of the uterine arteries. Accounts for 80% of injuries

35
Q

What is the most thrombogeneic inherited thrombophilia ?

A

Antithrombin deficiency

Ppl with this and no hx of VTE = 3 - 7% of getting VTE in pregnancy
Ppl with this and a hx of VTE = 40% chance of VTE in pregnancy

36
Q

What level of antithrombin activity is abnormal ?
Is this reliable during pregnancy?

A

Anything < 60 is abnormal
Testing is reliable in pregnancy BUT

Testing is NOT reliable during acute thrombosis or with anti coagulation

37
Q

What is the uterine anomaly with the highest risk for second trimester miscarriage

A

Septate uterus

38
Q

How to diagnose adenomyosis

A

Histology via hysterectomy

39
Q

What percent of women attend the postpartum visit

A

60%

40
Q

What is the minimum time that has to pass between THERAPEUTIC LMWH and regional anesthesia

A

24 hours

41
Q

What is the minimum time that needs to pass between PROPHYLACTIC dose of LMWH and regional anesthesia

A

12 hours

42
Q

What are extrahepatic manifestations of chronic hepatitis C infxn

A

Essential mixed cryoglobulinemia ** MOST COMMON**
Porphyria cutanea Tarda
Sjogren syndrome
Membranoproliferative glomerulonephritis

CREOG Study (7 decks)

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