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U-World 2 Flashcards

1
Q

Steps to dx suspected placenta previa

A

Transabdominal US followed by transvaginal sonography

No digital vaginal exam before US

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2
Q

Lectin/sphingomyelin ratio less than what to give steroids

A

2.0

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3
Q

Most important complication of PPROM

A

Pulmonary hypoplasia

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4
Q

Cataracts, PDA and purpura in newborn likely

A

Maternal rubella infection

Also look for hearing loss

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5
Q

Steps for patient with decreased fetal movement

A

NST followed by a contraction stress test of biophysical profile if NST is non-reactive

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6
Q

What does a normal contraction stress test mean

A

Suggests a low likelihood of stillbirth within 1 week of test –> So redo in 1 week

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7
Q

Septic abortion treatment

A

Broad spectrum Ab and surgical evacuation of the uterus

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8
Q

Acid base status of hyperemesis of pregnancy

A

Primary metabolic alkalosis

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9
Q

Exercise rec for pregnant women

A

> 30 min a day for 5 days week at low or moderate intensity

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10
Q

Paget’s path description

A

large cells surrounded by halo-like areas involving the epidermis

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11
Q

Increased risk of hyperemesis garvidarum from

A

Increased placental mass (twins, molar pregnancy)

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12
Q

What causes a complete mole?

A

When 2 sperm fertilize an ovum lacking genetic material

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13
Q

What causes a partial mole

A

When 2 sperm fertilize a haploid ovum (triploid karyotype)

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14
Q

Most common risk factor for placental abruption

A

Maternal hypertension

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15
Q

When does a placental abruption not blled

A

Retroplacental location of the hemorrhage

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16
Q

Fetal hydantoin syndrome features

A

Small body size, microcephaly, digital and nail hypoplasia, hirsutism and cleft palate

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17
Q

AE of COC

A

VTE, HTN, hepatic adenoma, rarely strokes and MI

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18
Q

How does hypothyroidism cause hyperprolactinemia

A

TRH stimulates prolactin production

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19
Q

Biggest risk factor for vaginal clear cell carcinoma

A

In utero DES exposure

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20
Q

HTN is a risk factor for what type of fetal growth restriction

A

Asymmetric 2/2 uteroplacental insufficiency

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21
Q

Who is the HPV vaccine recommended for

A

All women 9-26 regardless of HPV status or sexual activity

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22
Q

LH and FSH levels in anovulation

A

Normal

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23
Q

Women >35 should be offered what chromosomal abnormality screening test

A

Cell-free fetal DNA testing

Can be done in first trimester, quad screen not until 2nd

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24
Q

Most accurate way to determine gestational age

A

US dating w/ fetal crown-rump measurement in the first trimester

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25
Gold standard for evaluating cervix for cervical incompetence in pregnancy
Transvaginal US
26
Tamoxifen MOA
ER antagonist on breast tissue, agonist on endometrium and bone
27
Amenorrhea most commonly associated with significant stressors, eating disorders, and excessive exercise
Acquired hypogonadotropic hypogonadism
28
Preferred initial imaging for suspected gynecological tumors
Pelvic US
29
Chorioamnionitis is diagnosed by
>1 of the following: uterine tenderness, maternal or fetal tachycardia, malodorous amniotic fluid, or purulent vaginal discharge
30
Two tx for chorioamnionitis
Broad spectrum Ab and delivery
31
Why does mitral stenosis often present during pregnancy
Physiologically increased blood volume
32
What is an incomplete abortion
Involved evacuation of some fetal tissues while a remained is retained in the uterine cavity
33
Standard of care for threatened abortion
Reassurance and outpatient follow up (US exam one week later)
34
Copious white vaginal discharge that isn't stinky
Physiologic leukorrhea | *Lots of squamous cells and rare leukocytes*
35
Tx regimen for PID
Inpatient management with cefotetan and doxy
36
Inhibin-a in trisomy 18
Normal
37
When is a NST considered normal
If in 20 min there are at least 2 accelerations of the fetal heart rate of at least 15 bpm above baseline lasting at least 15 seconds each
38
Primary risk factor for ovarian torsion
Ovarian enlargement (pregnancy, tumors)
39
Examples of end organ damage in pre-e w/ severe features
Severe headache, persistent RUQ or epigastric pain, renal insuff, pulm edema
40
Most appropriate test to confirm IUFD
Real-time US
41
When does the risk of coagulopathy in IUFD go away
When fetus is evacuated
42
What should be done after first episode of IUFD
Autopsy of fetus and placenta to determine cause
43
2 reasons why obesity prevents osteoporosis
Increased weight bearing and increase estrogen from adipose tissue
44
3 big placental abruption risk factors
Maternal hypertension, smoking, and cocaine use
45
Most common cause of decreased fertility in women in their 30s who still have regular periods
Decreased ovarian reserve
46
Hep management in pregnancy
Can give A and B vaccines if not already given`
47
Low grade fever in immediate post part period management
Normal --> reassurance | Also some leukocytosis and vaginal discharge
48
Failure lactate and other features of pituitary def post part likely
Sheehan's syndrome
49
Test before starting trastuzumab
Echo due to risk of cardiotoxicity
50
FSH and LH in premature ovarian failure
FSH and LH increased | FSH/LH ratio > 1.0
51
Congenital toxo triad
Chorioretinitis, hydrocephalus, and intracranial calcifications
52
Serum BUN and creatinine in pregnancy
Usually decreased due to increase in renal plasma flow and GFR
53
Bilateral breast tenderness and swelling in first week post-partu
Breast engorgement | Resolves spontaneously
54
Why aren't different blood types a problem in pregnancy
It only causes mild disease in the newborn
55
Appearance of aromatase def
Affected girls will have normal internal genitalia with ambiguous external genitalia
56
Labs of intrahepatic cholestasis of pregnancy
Elevated total bile acids and/or aminotransferases | *Jaundice is uncommon*
57
3 clinical features of endometriosis
1. Pain peaks before menses 2. Dyspareunia 3. Infertility
58
Primary dysmenorrhea is characterized by
Crampy lower-abdominal pain during menses and normal physical examination
59
4 first line HTN medications in pregnancy
Methydopa, Labetalol, Hydrazine, Nifedipine
60
HTN drug classes contra in pregnancy
ACEi and ARBs
61
Tx for fungal vaginal infection
Oral Azole
62
Advice to newly pregnant patients on lithium
Wean the lithium
63
3 D's of endometriosis*
Dyspareunia, dysmenorrhea, dyschezia (pain w/ defecation)
64
Goal of conservative endometriosis treatment
Prevention of ovulation
65
2 diff dx for night sweats, insomnia,and irregular menses in middle age women
Hyperthyroidism and menopause
66
Test of choice for suspected stone in pregnancy
US kidney/pelvis
67
Ruptured ovarian cysts description
Sudden-onset severe unilateral lower abdominal pain immediately following sex or strenuous activity Pelvis US shows free fluid near ovarian cysts
68
Hypertonic uterus + bleeding
Placental abruption
69
What is seen in false labor
Irregular lower abdominal contractions that are received by sedation with absent cervical changes
70
Tx of fibrocystic changes after drainage of abscess
Observe for 4-6 weeks
71
First step for any breast ass
Mammography and US
72
Most effect emergency contraception
Copper insert
73
Primary vaginal cancer characterized by
Bloody, malodorous d/c and an irregular vaginal lesion | *1st step is biopsy*
74
Things that hemodynamically stable patient can do after sAb
Expectant mgmt, misoprostol, or dilation and evacuation (unstable pt's)
75
Tx for endometrial hyperplasia w/out atypia
Progestin therapy
76
Androgen insensitivity syndrome features
46, Xy patients --> primary amenorrhea, normal breast development, blind vagina
77
How does elevated prolactin suppress levels of LH and FSH
Surpasses GnRH release
78
What to do to prevent hypotension with epidural? Tx if happens
Agressive fluids | To tx: Left uterine displacement (place pt on left side), addition IV fluid bolus, vasopressors
79
When can external cephalic version be attempted
After 37 weeks with no contraindications to vaginal delivery and fetal well being has been established
80
4 types of women whom endometrial biopsy is indicated for evaluation of abnormal uterine bleeding
1. Women > 45 and all postmenopausal | 2. Women age
81
Low back pain in the third trimester of pregnancy comes from
Increased lumbar lordosis and relaxation of ligaments supporting pelvic girdle
82
How does lichen sclerosis present
As white, think and wrinkled skin over the labia (itchy in older women)
83
Trichloroacetic acid treats
HPV caused warts
84
Painless vaginal bleeding the occurs on rupture of membranes likely to be
Vasa previa
85
Congenital issues with lithium use in 2nd and 3rd trimesters
Goiter and transient neontal neuromuscular defects
86
Abdominal pain in young female with the middle of her cycle with benign findings
Mittelschmerz (midcycle pain)
87
First step to help identify PMS
Menstrual diary
88
Injury to C8 and T1 during birth causes
Klumpke palsy - claw hand and extended wrist, hornet's syndrome
89
Signs/symptoms of perinatal asphyxia
AMS (irritability, lethargy), respiratory or feeding disorders, poor tone, seizures
90
Hyperactive and tender uterus seen with
Placental abruption
91
How does a patient with a posterior shoulder dislocation hold their arm
Adducted and internally rotated
92
What does hGC do in early pregnancy
Maintains the corpus luteum
93
Tx to surpasses breast milk production
Wear tight-fitting bra, avoid nipple manipulation and use ice packs for pain
94
Amniotic fluid embolism risk factors
Advanced maternal age, G5 or greater, C section, previa or abruption, preeclampsia
95
Only option to allow pregnancy in patients with POV? Why?
In vitro fertilization with donor oocytes | These patients lack viable oocytes
96
What is clomiphene citrate
Estrogen analog that can be used to induce ovulation
97
All pregnant patients get screened for what diseases
Syphilis, HIV, and Hep B
98
5 things a BPP asseses
NST, amniotic fluid volume, fetal breathing movement, fetal tone, fetal movement
99
Stress incontinence likely from
Pelvic floor muscle weakness
100
Common complications of late-term pregnancies
Oligohydramnios, meconium aspiration, stillbirth, macrosomia, convulsions (fetal)
101
Why oligohydramnios in late term births
Aging placenta may have decreased fetal perfusion --> decreased renal perfusion and urinary output
102
Young woman with breast lump during period next step
Ask to return after period if no other obvious warning signs present

OB/GYN (6 decks)

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