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OB/GYN > U-World 2 > Flashcards

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
Q

Gold standard for evaluating cervix for cervical incompetence in pregnancy

A

Transvaginal US

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26
Q

Tamoxifen MOA

A

ER antagonist on breast tissue, agonist on endometrium and bone

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27
Q

Amenorrhea most commonly associated with significant stressors, eating disorders, and excessive exercise

A

Acquired hypogonadotropic hypogonadism

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28
Q

Preferred initial imaging for suspected gynecological tumors

A

Pelvic US

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29
Q

Chorioamnionitis is diagnosed by

A

> 1 of the following: uterine tenderness, maternal or fetal tachycardia, malodorous amniotic fluid, or purulent vaginal discharge

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30
Q

Two tx for chorioamnionitis

A

Broad spectrum Ab and delivery

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31
Q

Why does mitral stenosis often present during pregnancy

A

Physiologically increased blood volume

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32
Q

What is an incomplete abortion

A

Involved evacuation of some fetal tissues while a remained is retained in the uterine cavity

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33
Q

Standard of care for threatened abortion

A

Reassurance and outpatient follow up (US exam one week later)

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34
Q

Copious white vaginal discharge that isn’t stinky

A

Physiologic leukorrhea

Lots of squamous cells and rare leukocytes

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35
Q

Tx regimen for PID

A

Inpatient management with cefotetan and doxy

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36
Q

Inhibin-a in trisomy 18

A

Normal

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37
Q

When is a NST considered normal

A

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

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38
Q

Primary risk factor for ovarian torsion

A

Ovarian enlargement (pregnancy, tumors)

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39
Q

Examples of end organ damage in pre-e w/ severe features

A

Severe headache, persistent RUQ or epigastric pain, renal insuff, pulm edema

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40
Q

Most appropriate test to confirm IUFD

A

Real-time US

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41
Q

When does the risk of coagulopathy in IUFD go away

A

When fetus is evacuated

42
Q

What should be done after first episode of IUFD

A

Autopsy of fetus and placenta to determine cause

43
Q

2 reasons why obesity prevents osteoporosis

A

Increased weight bearing and increase estrogen from adipose tissue

44
Q

3 big placental abruption risk factors

A

Maternal hypertension, smoking, and cocaine use

45
Q

Most common cause of decreased fertility in women in their 30s who still have regular periods

A

Decreased ovarian reserve

46
Q

Hep management in pregnancy

A

Can give A and B vaccines if not already given`

47
Q

Low grade fever in immediate post part period management

A

Normal –> reassurance

Also some leukocytosis and vaginal discharge

48
Q

Failure lactate and other features of pituitary def post part likely

A

Sheehan’s syndrome

49
Q

Test before starting trastuzumab

A

Echo due to risk of cardiotoxicity

50
Q

FSH and LH in premature ovarian failure

A

FSH and LH increased

FSH/LH ratio > 1.0

51
Q

Congenital toxo triad

A

Chorioretinitis, hydrocephalus, and intracranial calcifications

52
Q

Serum BUN and creatinine in pregnancy

A

Usually decreased due to increase in renal plasma flow and GFR

53
Q

Bilateral breast tenderness and swelling in first week post-partu

A

Breast engorgement

Resolves spontaneously

54
Q

Why aren’t different blood types a problem in pregnancy

A

It only causes mild disease in the newborn

55
Q

Appearance of aromatase def

A

Affected girls will have normal internal genitalia with ambiguous external genitalia

56
Q

Labs of intrahepatic cholestasis of pregnancy

A

Elevated total bile acids and/or aminotransferases

Jaundice is uncommon

57
Q

3 clinical features of endometriosis

A
  1. Pain peaks before menses
  2. Dyspareunia
  3. Infertility
58
Q

Primary dysmenorrhea is characterized by

A

Crampy lower-abdominal pain during menses and normal physical examination

59
Q

4 first line HTN medications in pregnancy

A

Methydopa, Labetalol, Hydrazine, Nifedipine

60
Q

HTN drug classes contra in pregnancy

A

ACEi and ARBs

61
Q

Tx for fungal vaginal infection

A

Oral Azole

62
Q

Advice to newly pregnant patients on lithium

A

Wean the lithium

63
Q

3 D’s of endometriosis*

A

Dyspareunia, dysmenorrhea, dyschezia (pain w/ defecation)

64
Q

Goal of conservative endometriosis treatment

A

Prevention of ovulation

65
Q

2 diff dx for night sweats, insomnia,and irregular menses in middle age women

A

Hyperthyroidism and menopause

66
Q

Test of choice for suspected stone in pregnancy

A

US kidney/pelvis

67
Q

Ruptured ovarian cysts description

A

Sudden-onset severe unilateral lower abdominal pain immediately following sex or strenuous activity
Pelvis US shows free fluid near ovarian cysts

68
Q

Hypertonic uterus + bleeding

A

Placental abruption

69
Q

What is seen in false labor

A

Irregular lower abdominal contractions that are received by sedation with absent cervical changes

70
Q

Tx of fibrocystic changes after drainage of abscess

A

Observe for 4-6 weeks

71
Q

First step for any breast ass

A

Mammography and US

72
Q

Most effect emergency contraception

A

Copper insert

73
Q

Primary vaginal cancer characterized by

A

Bloody, malodorous d/c and an irregular vaginal lesion

1st step is biopsy

74
Q

Things that hemodynamically stable patient can do after sAb

A

Expectant mgmt, misoprostol, or dilation and evacuation (unstable pt’s)

75
Q

Tx for endometrial hyperplasia w/out atypia

A

Progestin therapy

76
Q

Androgen insensitivity syndrome features

A

46, Xy patients –> primary amenorrhea, normal breast development, blind vagina

77
Q

How does elevated prolactin suppress levels of LH and FSH

A

Surpasses GnRH release

78
Q

What to do to prevent hypotension with epidural? Tx if happens

A

Agressive fluids

To tx: Left uterine displacement (place pt on left side), addition IV fluid bolus, vasopressors

79
Q

When can external cephalic version be attempted

A

After 37 weeks with no contraindications to vaginal delivery and fetal well being has been established

80
Q

4 types of women whom endometrial biopsy is indicated for evaluation of abnormal uterine bleeding

A
  1. Women > 45 and all postmenopausal

2. Women age

81
Q

Low back pain in the third trimester of pregnancy comes from

A

Increased lumbar lordosis and relaxation of ligaments supporting pelvic girdle

82
Q

How does lichen sclerosis present

A

As white, think and wrinkled skin over the labia (itchy in older women)

83
Q

Trichloroacetic acid treats

A

HPV caused warts

84
Q

Painless vaginal bleeding the occurs on rupture of membranes likely to be

A

Vasa previa

85
Q

Congenital issues with lithium use in 2nd and 3rd trimesters

A

Goiter and transient neontal neuromuscular defects

86
Q

Abdominal pain in young female with the middle of her cycle with benign findings

A

Mittelschmerz (midcycle pain)

87
Q

First step to help identify PMS

A

Menstrual diary

88
Q

Injury to C8 and T1 during birth causes

A

Klumpke palsy - claw hand and extended wrist, hornet’s syndrome

89
Q

Signs/symptoms of perinatal asphyxia

A

AMS (irritability, lethargy), respiratory or feeding disorders, poor tone, seizures

90
Q

Hyperactive and tender uterus seen with

A

Placental abruption

91
Q

How does a patient with a posterior shoulder dislocation hold their arm

A

Adducted and internally rotated

92
Q

What does hGC do in early pregnancy

A

Maintains the corpus luteum

93
Q

Tx to surpasses breast milk production

A

Wear tight-fitting bra, avoid nipple manipulation and use ice packs for pain

94
Q

Amniotic fluid embolism risk factors

A

Advanced maternal age, G5 or greater, C section, previa or abruption, preeclampsia

95
Q

Only option to allow pregnancy in patients with POV? Why?

A

In vitro fertilization with donor oocytes

These patients lack viable oocytes

96
Q

What is clomiphene citrate

A

Estrogen analog that can be used to induce ovulation

97
Q

All pregnant patients get screened for what diseases

A

Syphilis, HIV, and Hep B

98
Q

5 things a BPP asseses

A

NST, amniotic fluid volume, fetal breathing movement, fetal tone, fetal movement

99
Q

Stress incontinence likely from

A

Pelvic floor muscle weakness

100
Q

Common complications of late-term pregnancies

A

Oligohydramnios, meconium aspiration, stillbirth, macrosomia, convulsions (fetal)

101
Q

Why oligohydramnios in late term births

A

Aging placenta may have decreased fetal perfusion –> decreased renal perfusion and urinary output

102
Q

Young woman with breast lump during period next step

A

Ask to return after period if no other obvious warning signs present

OB/GYN (6 decks)

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