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OBGYN > Uworld > Flashcards

Uworld Flashcards

1
Q

causes of oligohydraminos

A

preeclampsia, abruptio placenta, NSAIDs, uretoplacental insufficiency, renal anomalies

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2
Q

how does tocolitics like indomethacin cause oligohydraminos

A

closes ductus arteriosus which leads to vasoconstriction and under profusion of kidneys

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3
Q

complications of oligohydraminos

A

meconium aspiration, preterm delivery, umbilical cord compression

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4
Q

causes of polyhydraminos

A

esophageal/duodenal atresia, anencephaly, multiple gestations, congenital infection, DM

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5
Q

complications of polyhydraminos

A

fetal malposition, cord prolapse, preterm labor, PPROM

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6
Q

hormone levels in turners syndrome

A

low estrogen and progesterone, elevated FSH and LH

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7
Q

management of a pt with mild, asymptomatic polyhydraminos at term

A

expectant management

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8
Q

US findings of congenital CMV

A 
periventricular calcifications
ventriculomegaly
microcephaly
intrahepatic calcifications
fetal growth restrictions
hydros fatalis
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9
Q

long term effects of congenital CMV

A

sensorineural hearing loss
seizures
developmental delay

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10
Q

pathophysiology of ovarian hyper stimulation syndrome

A

increased hCG enhances ovarian vascular permeability which leads to fluid shift into extravascular space

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11
Q

clinical features of ovarian hyper stimulation syndrome

A

respiratory distress, ascites, hemoconcentration, hypercoaguable, DIC, electrolyte imbalance, multi organ failure

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12
Q

dx of ovarian hyper stimulation syndrome

A

serial CBC and electrolytes, manage fluid, serum hCG, pelvic US, CXR, echo

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13
Q

why are post menopausal women at increased risk of stress urinary incontinence

A

weakened pelvic floor muscles and decreased estrogen leading to urogenital mucosa atrophy

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14
Q

treatment of septic abortion

A

IV fluids, broad spectrum antibiotics, suction curettage

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15
Q

ABG disturbances in hyperemesis gravidarum

A

metabolic alkalosis with compensatory respiratory acidosis.

increased vomitting leads to decreased HCl which causes metabolic alkalosis

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16
Q

management of HIV + pregnant mom with viral load >1000

A

ART + zidovudine + c section

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17
Q

management of HIV + pregnant mom with viral load <1000

A

ART + vaginal delivery

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18
Q

dx of intra-amniotic infection

A 
maternal fever + at least one of following: 
fetal tachycardia (>160)
maternal leukocytosis 
maternal tachycardia 
purulent amniotic fluid
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19
Q

how can you decrease risk of preeclampsia in pts who are high risk

A

daily baby aspirin

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20
Q

high risk pts for preeclampsia

A

multiple gestations, DM, history of HTN

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21
Q

uterine aversion

A

abdominal pain, vaginal bleeding, shock

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22
Q

postmenopausal woman with endometrial cells on pap

A

must do endometrial biopsy to r/o endometrial hyperplasia

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23
Q

why does pregnancy increase risk of aspiration

A

increased progesterone leads to decreased gastric emptying and increased abdominal pressure leads to GERD

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24
Q

contraindications to contraction stress test

A

contraindications to labor: placenta previa, prior myomectomy

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25
Q

next step after a non reactive stress test

A

BPP or contraction stress test

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26
Q

BPP score of 0-4

A

fetal hypoxia due to placental insufficiency

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27
Q

normal findings of a BPP

A

> 3 fetal movements
single pocket of fluid >2 cm x1 or fluid index >5
1 episode of flexion/extension
1 breathing episode for >30 seconds

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28
Q

risk factors for active phase protraction

A

cephalopelvic disproportion, maternal obesity, nulliparity, advanced maternal age

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29
Q

presentation of choriocarcinoma

A 
AUB
pelvic pain
symptoms from metastases (lungs)
uterine mass
elevated hCG
30
Q

pathophysiology of primary dysmenorrhea

A

increased endometrial prostaglandin production which causes uterine hyper contractility

31
Q

tx of primary dysmenorrhea

A

1st: NSAID
2nd: COC

32
Q

clinical features of primary dysmenorrhea

A

pain first 2-3 days of menses, N/V, diarrhea, normal pelvic examination

33
Q

cause of variable decelerations

A

cord compression, usually happens after rupture of membranes

34
Q

first line management of recurrent variable decelerations

A

maternal repositioning

35
Q

management of pts at high risk for preeclampsia

A

aspirin starting at 12 weeks

24 hour urine collection at initial visit

36
Q

clinical presentation of vasa previa

A

painless vaginal bleeding with ROM or contractions
FHR abnormalities
fetal demise

37
Q

intraductal papilloma

A

unilateral bloody discharge without mass

38
Q

invasive ductal carcinoma

A

unilateral bloody discharge with mass

39
Q

tx of group B strep

A

PCN

if allergic: cefazolin

40
Q

fetal hydantoin syndrome

A

maternal use of anti epileptics

cleft lip and palate, distal phyalnge hypoplasia, widened frontonelle, cardiac abnormalities

41
Q

management of spontaneous abortion

A

medical induction
expectant management
suction curetage if hemodynamically unstable or if infection

42
Q

vesicovaginal fistula clinical symptoms

A

painless, watery discharge from vagina after recent pelvic surgery

43
Q

diagnosis of intraamniotic infection

A

maternal fever plus at least one of following:
fetal tachycardia
maternal leukocytosis
purulent amniotic fluid

44
Q

management of intraamniotic infection

A

broad spectrum antibiotics

induction of labor

45
Q

contraindications to breast feeding

A 
varicella infection
HIV
substance use
active, untreated TB
herpetic breast lesion
chemo or radiation
46
Q

treatment for patients with endometriosis who fail medical management

A

diagnostic laparoscopy

47
Q

pregnancy related cause of wernikce encephalopathy

A

hyperemesis gravidarum

48
Q

clinical features of wernickes encephalopathy

A

encephalopathy
ocular dysfunction (nystagmus, bl abducens palsy)
postural and gait ataxia

49
Q

management of active phase arrest

A

C section

50
Q

anencephaly management

A

fatal fetal anomally
reduce risk to mother
vaginal delivery best

51
Q

preterm labor management if under 32 weeks

A

corticosteroids
PCN for GBS
mag sulfate
tocolysis: indomethacin

52
Q

preterm labor management if 32-34 weeks

A

PCN for GBS
corticosteroids
tocolysis: nifedipine

53
Q

preterm labor management if >34 weeks

A

corticosteroids

PCN for GBS

54
Q

test to definitively diagnose preeclampsia

A

24 hour urine protein collection

55
Q

late decelerations

A

fetal hypoxia and acidemia
due to urey-placental insufficiency.
can be due to uterine tachysystole

56
Q

symptomatic pubic symphysis diastasis

A

suprapubic pain that radiates to the back, hips, legs, made worse by walking. point tenderness to palpation over pubic symphysis

57
Q

causes of symmetric fetal growth restriction

A

chromosomal anomalies, infection

58
Q

what are fibroids

A

proliferation of smooth muscle within the myometrium

59
Q

clinical features of fetal hydrops

A 
polyhydraminos
pericardial effusion
pleural effusion
ascities
skin edema
placental edema
60
Q

diagnosis of pt with cyclic dysuria and hematuria

A

endometriosis

61
Q

mature cystic teratoma US findings

A

complex, cystic, calcifications, hyper echoic nodules

62
Q

management of hydatiform mole

A

suction D&C –> weekly B-hCG tests until undetectable –> monthly B-hCG tests for 6 months (can’t get pregnant during this time)

63
Q

complications of inadequate weight gain in pregnancy

A

low birth weight, preterm delivery

64
Q

treatment for PCOS pt trying to get pregnant

A

letrozole

65
Q

abnormal presentation of placental abruption

A

minimal bleeding bc it is contained within uterine cavity–> leads to focal pain (back pain), abnormally distended uterus, high frequency contractions

66
Q

management of sinusoidal FHR

A

urgent C section

67
Q

cause of sinusoidal FHR

A

fetal anemia - fetal blood loss from vasa previa

68
Q

most serious complication of neonatal lupus

A

fetal AV block

69
Q

first mutation in endometrioid endometrial carcinoma

A

PTEN

70
Q

shiller-duval bodies

A

glomeruloid appearance, cancer cells lining up around a central capillary

OBGYN (5 decks)

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