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*****ObGYN > uWise > Flashcards

uWise Flashcards

1
Q

Pt with poorly controlled HTN. what method of contraception is not recommended?

A

OCPs

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2
Q

best contraception to decrease risk of ovarian cancer?

A

OCPs

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3
Q

What does levonogestrel IUD protect against?

A

endometrial cancer

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4
Q

char. of septic abortion

A

fever + bleed + dilated cervix

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5
Q

char. of threatened abortion

A

bleed + pos preg test + closed/uneffaced cervix

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6
Q

tx for APLA syndrome when pt wants to become preg?

A

ASA + heparin

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7
Q

What is 17-OH progesterone used for?

A

prevention of preterm labor in pts with recurrent pregnancy loss

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8
Q

What complication is worse with medical abortion than surgical?

A

blood loss (worse with MEDICAL abortion(

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9
Q

mifepristone MOA

A

antiprogestin used for pregnancy termination

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10
Q

misoprostol MOA

A

prostaglandin

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11
Q

Up to what gestational age can manual vacuum aspiration be used?

A

less than 8 weeks

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12
Q

what is the least invasive treatment for a missed abortion?

A

expectant management with misoprostol (PG E1)

administered orally or vaginally to induce uterine cramping with expulsion of products of conception

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13
Q

likely dx and best management for heavy bleeding after medical abortion?

A

retained products of conception. perform D&C

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14
Q

Criteria for dx of BV

A

3 out of 4:

1) thin, gray, homogenous vaginal discharge
2) positive whiff test (KOH -> amine odor)
3) clue cells on saline microscopy
4) elevated vaginal pH > 4.5

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15
Q

what can occur with severe lichen sclerosis?

A

introital stenosis, resorption of clitoris (phimosis) and labia minora

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16
Q

inflammatory mucocutaneous eruptions characterized by remissions and flares involving hair-bearing skin/scalp, nails, oral mucous membranes & vulva

A

lichen planus

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17
Q

tx options for vestibulodynia

A

TCA, pelvic floor rehab, biofeedback, topical anesthetics; last resort: vestibulectomy

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18
Q

condition results from chronic scratching and rubbing of vulva

A

lichen simplex chronicus

tx: short course topical corticosteroids and antihistamines

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19
Q

parental abx options for GC?

A

cefotetan or cefoxitin
PLUS doxy or clinda
PLUS gentamicin

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20
Q

outpt abx options for GC?

A

ceftriaxone, cefoxitin, or other 3rd gen cephalosporin PLUS doxy WITH or WITHOUT flagyl

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21
Q

what is a normal PVR?

A

50-60cc

22
Q

what PVR is seen w/ overflow incontinence

A

usually >300 cc

23
Q

risk factors for development of pelvic organ prolapse?

A

increasing parity, increasing age, obesity, Ehlers-Danlos, chronic constipation, family history

24
Q

best surgical treatment for genuine stress incontinence?

A

retropubic urethropexy (tension-free vaginal tape or other sling procedures)

25
Q

what is colpocleisis used to treat?

A

uterine prolapse; can be performed without need for general anesthesia

26
Q

what is the treatment for intrinsic sphincteric deficiency?

A

urethral bulking procedure

27
Q

what condition is repaired by fixing defects in pubocervical fascia/reattaching to sidewall?

A

cystocele

28
Q

pt has elevated serum prolactin level. next step?

A

FASTING prolactin; stimulation of breast during physical exam can give rise to elevated prolactin; if still elevated -> get TSH level and brain MRI

29
Q

what activity can worsen the pain associated with fibrocystic breast changes/cyclic mastalgia?

A

caffeine intake

30
Q

54 year old woman. mass with bloody discharge. next step?

A

excisional biopsy to rule out breast cancer

31
Q

54 year old woman. mass with clear discharge on aspiration, mass resolves. next step?

A

reexamination in 2 months to check for cyst recurrence

32
Q

pt with puerperal mastitis. still having pain with acetaminophen. started oral abx. what else to do?

A

add ibuprofen for add’l pain management

33
Q

most appropriate abx for mastitis?

A

dicloxacillin (most is caused by S. aureus); use erythromycin in PCN allergic

34
Q

42 year old woman with 2cm mass. FNA negative, mass persists. next step?

A

excisional biopsy

35
Q

why is breast ultrasound useful?

A

distinguishes between cyst and a solid mass

36
Q

what dx does uterosacral ligament nodularity suggest?

A

endometriosis

37
Q

What are the treatment options for endometriosis?

A
  • OCPS (first line. - along with NSAIDS. decreased estrogen production, decreased stim of endometrial tissue)
  • GnRH agonists (short term use only; have side effects)
  • danazol (synthetic androgen, but SE: wt gain, body hair/acne, adverse lipids)
  • laparoscopy (if failed medical tx/planning pregnancy)
38
Q

best tx of infertility of pt with known history of endometriosis and otherwise negative work up?

A

ovarian stimulation with clomiphene citrate

39
Q

imaging study for chronic pelvic pain?

A

laparoscopy

40
Q

what is interstitial cystitis?

A

chronic inflamm condition of bladder w/ recurrent urgency and frequency in absence of another cause; often have pelvic pain, may have dyspareunia

41
Q

how does danazol work?

A

testosterone derivative; suppresses the mid-cycle surges of LH and FSH

42
Q

what social factor is chronic pelvic pain often associated with?

A

physical/sexual abuse

43
Q

what is pelvic congestion syndrome?

A

pelvic veins -> chronic dilation with stasis -> vascular congestion
“pelvic fullness/heaviness”

44
Q

What nerves are at risk with a low transverse incision?

A

iliohypogastric (T12L1)

ilioinguinal (T12, L1)

45
Q

next step after diagnosis of cervical dysplasia?

A

LEEP or cold knife cone

46
Q

50 year old with onset of heavy periods. next step?

A

endometrial bx; ddx = endometritis, endometrial polyp, endometrial hyperplasia, fibroid, cancer

47
Q

complications from LEEP?

A

infxn, bleed, CERVICAL STENOSIS, persistent disease, risk preterm delivery

48
Q

CIN 1 diagnosed. benign cells on ECC. next step?

A

no tx; f/u pap in 1 year

49
Q

What are the indications for cold knife conization?

A

positive endocervical curettage; HSIL lesion too large for LEEP, pt not tolerant of exam in office; lesion extending into endocervical canal beyond vision; rule out invasive cancer

50
Q

best initial step for work up of incidental adnexal mass finding?

A

pelvic ultrasound

*****ObGYN (3 decks)

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