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OB/GYN > U-World 1 > Flashcards

U-World 1 Flashcards

1
Q

Neonatal thyrotoxicosis results from

A

Transplacental passage of anti-TSH receptor antibodies during 3rd thrimester

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2
Q

Does thyroid hormone or exogenous levothyroxin cross placenta?

A

Not to significant degree

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3
Q

Tx for neonatal thyrotoxicosis

A

Methimazole + B blocker

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4
Q

When does Rh alloimmunization occur

A

When mother is Rh negative and baby is Rh positive

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5
Q

When to give two rho-gam doses

A

At 28 weeks and within 72 hours after delivery

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6
Q

What is the Kleihauer-Betke test

A

Used to determine whether higher dose of rho-gam is needed

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7
Q

If pt is on COC and has HTN, what do you do

A

d/c COC, usually causes resolution

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8
Q

Sheehan syndrome causes lack of what hormones

A

Anterior pituitary (Prolacting, GH, ACTH)

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9
Q

Epidural anesthesia effects on bladder

A

Over distention may cause loss of ability to contract causes overflow incontinence, tx short term with indwelling catheter
(don’t just observe because bladder needs to be decompressed)

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10
Q

First test on all women of childbearing age

A

Pregnancy test

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11
Q

What should be allowed to proceed in patients where fetus has been diagnosed with severe anomaly incompatible with life

A

Labor

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12
Q

Tx for pregnant woman w/ syphillis if pen allergy

A

Penicillin desensitization

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13
Q

Important AE of OCPs

A

Breakthrough bleeding, HTN, and increased risk of venous thromboembolism
Not weight gain

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14
Q

What is PMDD

A

Premenstrual dysphoric disorder - severe form of pMS with irritability and anger symptoms

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15
Q

4 rec Ab for UTI in pregnancy

A
  1. Nitrofurantoin
  2. Amoxicillin
  3. Amox-Clavulanate
  4. Cephalexin
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16
Q

TMP-SMX interferes with what in pregnancy

A

Folic acid metabolism –> contra in first trimester

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17
Q

3 things that usually cause symmetric fetal growth restriction

A

Fetal anomalies, fetal karyotype abnormality, and early maternal viral infection (MC)
Fetal factors

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18
Q

Most common fetal infection in US

A

CMV

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19
Q

Causes of asymmetric fetal growth

A

Maternal factors (Vascular disease, lupus Ab syndrome, autoimmune diseases, substance abuse)

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20
Q

When are elevated BP in pregnancy considered chronic HTN

A

> 20 weeks

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21
Q

Hyperaldosteronism causes

A

Hypernatremia and hypokalemia

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22
Q

Most common risk factor for placental abruption

A

Hypertension

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23
Q

Tx for variable compressions

A

Expectant management

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24
Q

2 recommended tx options for stress incontinence

A

Pelvic muscle exercises and urethropexy

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25
Q

Tx for BV

A

Metronidazole

same for Trich but tx patient also

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26
Q

What is pseudocyesis

A

Rare psychiatric condition in which a woman presents with nearly all signs and symptoms of pregnancy, but US reveals normal endometrial stripe and neg pregnancy test

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27
Q

US of missed abortion

A

Intrauterine collapsed gestational sac and absent fetal cardiac activity
in office preg test will still be positive

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28
Q

Tumor marker for ovarian cancer

A

CA125

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29
Q

cervical mucus in ovulatory phase

A

profuse, clear, and thin

will stretch to 6 cm

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30
Q

What is endometritis characterized by? Risk factors?

A

fever and uterine tenderness in postpartum period, often associated with foul-smelling loci
Risk factors include prolonged PROM, prolonged labor, operative vaginal delivery and C-section

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31
Q

MCC of postpartum endometritis? Tx?

A

Polymicrobial

Tx: IV clindamycin and gentamicin

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32
Q

MCC of mucupurulant cervicitis

A

Chlamydia

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33
Q

Side effects of depot shot

A

Weight gain, amenorrhea, nausea, breast tenderness

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34
Q

Contraindications to breast feeding

A

Active TB, Maternal HIV, herpetic breast lesions, varicella, chemo, active substance abuse

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35
Q

Infant contraindication to breast feeding

A

Galactosemia

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36
Q

What makes an abscess more likely than mastitis

A

Fluctuance

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37
Q

Tx for mastitis

A

Ab and breast feeding with both breasts

38
Q

What is coitus interruptus

A

Pulling out

39
Q

What causes infertility in PCOS

A

Anovulation

40
Q

3 things to check in secondary amenorrhea after pregnancy test is negative? What does an increase in each mean?

A

Prolactin: Do brain MRI
TSH: Hypothyroidism
FSH: Premature ovarian failure
3 most common cause of secondary amenorrhea after preg

41
Q

When do you give mag sulfate

A
42
Q

Pre-term labor def

A

Regular uterine contractions at

43
Q

GBS screen date

A

35-37 weeks

44
Q

partial 21-hydroxylase def in females presents with

A

late adolescence as hyperandrogegism (hirsutism, acne) and elevated 17-hydroxyprogesterone

45
Q

4 major risk factors for uterine rupture

A

Prior uterine surgery, induction of/prolonged labor, congenital uterine anomalies, fetal macrosomia

46
Q

Presentation of vasa previa

A

painless antepartum hemorrhage associated with rapid deterioration of fetal heart tracing –> fetal blood is being lost

47
Q

Why does pregnancy have mild hyponatremia

A

Hormones reset threshold to inc ADH release from pituitary

48
Q

When does adenomyosis occur

A

When endometrium grows into the myometrium

49
Q

Two drugs to induce ovulation in PCOS

A

Clomiphene citrate and metformin

50
Q

Bulky, globular and tender uterus buzzword for

A

Adenomyosis

will also have menorrhagia and pelvic pain

51
Q

Trisomy 21 quad screen

A

Low a-fp and estriol

Increased b-hCH and inhibin A

52
Q

Abdominal pain in HELLP syndrome from

A

Liver swelling with distention of hepatic (Gisson’s) capsule

53
Q

Extra-hepatic manifestations of AFLP

A

Leukocytosis, hypoglycemia, and acute kidney injury

54
Q

What causes pulmonary edema in preeclampsia

A

generalized material vasospasm leading to inc. SVR and high cardiac afterload

55
Q

Discharge in ovulation buzzword

A

“Egg white like” thickening or “spinnbarkeit”

56
Q

3 causes of variable compressions

A

Chord compression, oligohydramnios, cord prolapse

57
Q

What happens with the majority of breech presentations

A

Self-correct by 37 weeks gestation –> Don’t attempt to correct before then

58
Q

3 contraindications to external cephalic conversion

A

Placental abnormalities, fetopelvic disproportion, or hyperextended fetal head

59
Q

When should semen analysis be performed for infertility

A

Usually as initial screening test

60
Q

Why should RPR be avoided in suspected cases of primary syphillis

A

High rate of false negatives (used for screening)

61
Q

Breast mass biopsy showing foamy macrophages and fat globules is

A

Fat necrosis

62
Q

Lichen sclerosis manifestations

A

Vulvar pruritus and discomfort, exam shows porcelain-white atrophy
Biopsy to rule out vulvar SCC

63
Q

First line therapy for lichen sclerosis

A

High-potency topical steroids

64
Q

Why should you deliver immediately in patients with intrauterine fetal demise

A

To prevent coagulation abnormalities (worry about DIC)

65
Q

Elevated maternal afp could mean

A

Open neural tube defects, gastroschisis, and omphalocele

66
Q

Tx for asymptomatic patients with pos Chlamydia DNA test

A

Single dose azithromycin or 7-day course of doxy

67
Q

Neonatal drug to prevent HIV infection

A

Zidovudine

68
Q

Why is carpal tunnel increased in pregnancy

A

Secondary to estrogen mediated depolymerization of ground substance, causes interstitial edema

69
Q

What is Raloxifene? AE?

A

Estrogen antagonist in breast and vaginal tissue, agonist in bone tissue
DVT is AE

70
Q

If B-HCG is less than

A

Repeat test and transvaginal US in 48 hours

*Pos cutoff in 1,500-2,000

71
Q

Who should get Anti-D IG

A

Rh neg woman with neg Ab screen (means patient is not alloimunized)

72
Q

Tx of intrahepatic cholestasis of pregnancy

A

Ursodeoxycholic acid

73
Q

2 initial tests for asymptomatic women with pelvic mass

A

Transvaginal US and CA-125 level

74
Q

Arrest in the first stage of labor criteria

A

No cervical change for > 4 hours despite adequate contractions OR no cervical change for > 6 hours with inadequate contractions

75
Q

Gestational DM target BG levels

A
  1. Fasting > 95

2. 1 hr post prandial -

76
Q

Gestational DM screening dates

A

24-28 weeks

77
Q

Odd complication of maternal hyperglycemia

A

Hyperviscosity due to polycythemia

78
Q

How long to wait to get pregnant after MMR vacine

A

28 days (women who accidentally get in pregnancy are probs ok)

79
Q

Vaccines not recommended in pregnancy

A

HPV, MMR, Varicella, Smallpox, live flu vaccine

80
Q

Risk factors for uterine atony

A

Overdistension (twins, macrosomia) and uterine fatigue (prolonged labor)

81
Q

Endometriosis description on US

A

Homogenous cystic-appearing mass

82
Q

Hyperandrogenism during pregnancy is usually caused by

A

Ovarian masses (luteomas and theca lute cysts)

83
Q

Management for spontaneous abortion in hemodynamically unstable patients

A

Surgical (suction curattage)

84
Q

Loss of fetal station is a red flag for

A

Uterine rupture

85
Q

Next test if pap smear comes back ASC-US

A

HPV testing

86
Q

Tx for mag tox

A

Stop mag-sulfate and give Calcium-gluconate

87
Q

TSH and T4 in pregnancy

A

TSH decreased
Total t4 increased
Free T4 unchanged

88
Q

Prognosis for majority of babies born with Erbs palsy

A

Up to 80% have spontaneous recovery

89
Q

Who is at increased risk for fetal macrosomia (race)

A

African american boys

90
Q

When is laparoscopy indicated for endometriosis

A

When NSAIDS and COC have failed

91
Q

What is HER2

A

Oncogene (gets overeexpressed)

OB/GYN (6 decks)

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