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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
next step after a non reactive stress test
BPP or contraction stress test
26
BPP score of 0-4
fetal hypoxia due to placental insufficiency
27
normal findings of a BPP
>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
28
risk factors for active phase protraction
cephalopelvic disproportion, maternal obesity, nulliparity, advanced maternal age
29
presentation of choriocarcinoma
``` AUB pelvic pain symptoms from metastases (lungs) uterine mass elevated hCG ```
30
pathophysiology of primary dysmenorrhea
increased endometrial prostaglandin production which causes uterine hyper contractility
31
tx of primary dysmenorrhea
1st: NSAID 2nd: COC
32
clinical features of primary dysmenorrhea
pain first 2-3 days of menses, N/V, diarrhea, normal pelvic examination
33
cause of variable decelerations
cord compression, usually happens after rupture of membranes
34
first line management of recurrent variable decelerations
maternal repositioning
35
management of pts at high risk for preeclampsia
aspirin starting at 12 weeks | 24 hour urine collection at initial visit
36
clinical presentation of vasa previa
painless vaginal bleeding with ROM or contractions FHR abnormalities fetal demise
37
intraductal papilloma
unilateral bloody discharge without mass
38
invasive ductal carcinoma
unilateral bloody discharge with mass
39
tx of group B strep
PCN | if allergic: cefazolin
40
fetal hydantoin syndrome
maternal use of anti epileptics | cleft lip and palate, distal phyalnge hypoplasia, widened frontonelle, cardiac abnormalities
41
management of spontaneous abortion
medical induction expectant management suction curetage if hemodynamically unstable or if infection
42
vesicovaginal fistula clinical symptoms
painless, watery discharge from vagina after recent pelvic surgery
43
diagnosis of intraamniotic infection
maternal fever plus at least one of following: fetal tachycardia maternal leukocytosis purulent amniotic fluid
44
management of intraamniotic infection
broad spectrum antibiotics | induction of labor
45
contraindications to breast feeding
``` varicella infection HIV substance use active, untreated TB herpetic breast lesion chemo or radiation ```
46
treatment for patients with endometriosis who fail medical management
diagnostic laparoscopy
47
pregnancy related cause of wernikce encephalopathy
hyperemesis gravidarum
48
clinical features of wernickes encephalopathy
encephalopathy ocular dysfunction (nystagmus, bl abducens palsy) postural and gait ataxia
49
management of active phase arrest
C section
50
anencephaly management
fatal fetal anomally reduce risk to mother vaginal delivery best
51
preterm labor management if under 32 weeks
corticosteroids PCN for GBS mag sulfate tocolysis: indomethacin
52
preterm labor management if 32-34 weeks
PCN for GBS corticosteroids tocolysis: nifedipine
53
preterm labor management if >34 weeks
corticosteroids | PCN for GBS
54
test to definitively diagnose preeclampsia
24 hour urine protein collection
55
late decelerations
fetal hypoxia and acidemia due to urey-placental insufficiency. can be due to uterine tachysystole
56
symptomatic pubic symphysis diastasis
suprapubic pain that radiates to the back, hips, legs, made worse by walking. point tenderness to palpation over pubic symphysis
57
causes of symmetric fetal growth restriction
chromosomal anomalies, infection
58
what are fibroids
proliferation of smooth muscle within the myometrium
59
clinical features of fetal hydrops
``` polyhydraminos pericardial effusion pleural effusion ascities skin edema placental edema ```
60
diagnosis of pt with cyclic dysuria and hematuria
endometriosis
61
mature cystic teratoma US findings
complex, cystic, calcifications, hyper echoic nodules
62
management of hydatiform mole
suction D&C --> weekly B-hCG tests until undetectable --> monthly B-hCG tests for 6 months (can't get pregnant during this time)
63
complications of inadequate weight gain in pregnancy
low birth weight, preterm delivery
64
treatment for PCOS pt trying to get pregnant
letrozole
65
abnormal presentation of placental abruption
minimal bleeding bc it is contained within uterine cavity--> leads to focal pain (back pain), abnormally distended uterus, high frequency contractions
66
management of sinusoidal FHR
urgent C section
67
cause of sinusoidal FHR
fetal anemia - fetal blood loss from vasa previa
68
most serious complication of neonatal lupus
fetal AV block
69
first mutation in endometrioid endometrial carcinoma
PTEN
70
shiller-duval bodies
glomeruloid appearance, cancer cells lining up around a central capillary

OBGYN (5 decks)

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