UWorld 4 Flashcards
How does the uterus feel when there is uterine atony?
Large and boggy
Which medication do you use to treat trich?
Metronidazole
Which antibiotic is used to treat Chlamydia?
Doxycycline
“Clams at the docks”
What’s the most effective emergency contraception method?
Copper IUD
Can you use a copper IUD 3-5 days after unprotected sex for emergency contraception?
Yes
Where does the uterine fundus appear if the uterus is well contracted?
At the level of the umbilicus
What condition might cause heavy menses, pelvic pain, constipation, and infertility?
Leiomyomas (fibroids)
What condition causes painful bumps that leave acneiform scars in the groin?
Hidradenitis suppurativa
What is Hidradenitis Suppurativa?
An inflammatory condition in intertrigenous areas due to occluded follicles
What heart disease can worsen during pregnancy?
Rheumatic mitral stenosis
What heart condition during pregnancy can cause rapid onset heart failure at >36 weeks?
Peripartum cardiomyopathy
Can you have a vaginal birth with placenta previa?
No, it requires a C-section
Which vaginal infection doesn’t relate to vaginal pH?
Candida
What condition causes painful periods, sporadic pelvic pain, and pain during bowel movement?
Endometriosis
What’s the best treatment for endometriosis?
OCPs
What’s the best treatment for endometriosis with h/o infertility, need for definitive therapy, contraindications to hormonal birth control?
Laparoscopy
Can endometriosis cause a fixed, mobile uterus?
Yes
What’s the definition of uterine tachysystole?
> 5 contractions/10 minutes
What’s the management of uterine tachysystole?
Discontinue uterotonic agents
What’s the etiology of early decelerations?
Fetal head compression (normal)
“You’re early, that’s good”
What’s the etiology of variable decelerations (4)?
- Cord compression
- Oligohydramnios
- Cord prolapse
- Uterine rupture
What’s the etiology of late decelerations?
Uteroplacental insufficiency
“You’re late, thats bad”
What’s the best initial treatment for recurrent variable decelerations?
Maternal repositioning
Which category of FHR tracings only includes early decelerations (no late or variables)?
Category I
Does a category III tracing require a c-section?
Yes
How do women with Sheehan Syndrome typically present?
With the inability to breastfeed
Which STI has small and shallow ulcers, large, painful inguinal lymph nodes (buboes), and inclusion bodies?
Lymphogranuloma venereum (Chlamydia)
Does syphilis have a single, indurated, well-circumscribed ulcer?
Yes
Which STI has multinucleated giant cells and intranuclear inclusions?
Herpes
Which STI has deep ulcers with a gray/yellow base?
Chancroid (H. ducreyi)
What do you treat asymptomatic bacteriuria with in pregnancy (4)?
- Cephalexin
- Amoxicillin-clav
- Nitrofurantoin
- Fosfomycin
When is TMP-SMX contraindicated?
During the 1st trimester (interferes with folic acid synthesis)
What dx is painless vaginal bleeding >20 weeks gestation?
Placenta previa
What’s the management of placenta previa?
No intercourse, no digital cervical exam, admit for bleeding episodes
Dx for irregular uterine contour that may be palpable as a globular mass?
Leiomyoma (fibroid)
What’s the biggest risk of maternal hypertension?
Preterm labor
How do you differentiate between gestational vs chronic hypertension?
Chronic is prior to 20 weeks
What’s the best way to position the patient and maneuver to prevent shoulder dystocia?
Lower the head of the bed, flex the hips against the abdomen
What are the first and second line treatments for GDM?
- Lifestyle
2. Insulin
Patients under age 45 who have failed medical management require what?
Endometrial biopsy
What are the 2 main risk factors for intrauterine adhesions?
- Infection (septic abortion)
2. Intrauterine surgery
How do you evaluate for intrauterine adhesions?
Hysteroscopy
Is a c-section for a breech baby for the baby or mom’s benefit?
The baby’s, so if a baby is nonviable, regular vaginal delivery is indicated even if baby is in breech position
Which maternal virus causes fetal brain calcifications and microcephaly?
CMV
What’s the definition of eclampsia?
New onset HTN (140+/90+) plus proteinuria (300+, or protein:creatinine 0.3+, or dipstick 1+), or signs of end-organ damage
What’s the difference between preeclampsia vs. preeclampsia with severe features?
Severe features form has end-organ damage
What’s the treatment for a septic abortion?
Broad spectrum abx and suction curettage
When is screening mammography initiated?
50+
What’s the best tx for a short cervix with no history of preterm labor?
Vaginal progesterone
What’s the best tx for a short cervix with a history of preterm labor?
Cerclage & serial TVUS
How do you measure cervical length?
Transvaginal US
How do you diagnose chorioamnionitis?
Maternal fever plus 1+ of the following:
Fetal tachycardia >160
Maternal leukocytosis
Purulent amniotic fluid
What diagnosis has the following quad screen results?: AFP: down hCG: down estriol: down inhibin: normal
Trisomy 18
“Prince Edward was 18 and very down”
What diagnosis has the following quad screen results?: AFP: down estriol: down hCG: up inhibin: up
Trisomy 21
“In Down’s, hCG is up”
What diagnosis has the following quad screen results?:
AFP: up
everything else: normal
Neural tube or abdominal wall defect
Do twins have a higher risk of preterm labor?
Yes
Don’t forget to look at what things during the exam?
BMI
Imaging findings
BP
Labs
What’s the most common cause of asymmetric fetal growth restriction (big head, small abdomen)
HTN
What’s the most common cause of symmetric fetal growth restriction (small head, small abdomen)?
Congenital disorders or first trimester infections
What color discharge does BV have?
Grey
What’s the treatment for intrahepatic cholestasis of pregnancy?
Ursodeoxycholic acid & antihistamines
What antibiotic do you use to treat pyelonephritis or gonorrhoeae in pregnancy ?
Ceftriaxone
“Ax the py so it’s gone”
What’s the best tx for PID?
Ceftriaxone + Azithromycin
“Zith up the clam”
What’s the best tx for lactational mastitis?
Dicloxacillin
What’s the best tx for GBS prophylaxis and syphilis?
Penicillin
What’s the best tx for breast abscesses?
Vancomycin
What’s the best tx for postpartum endometritis?
Clindamycin + Gentamicin
“Now that the baby’s out and it’s infected, get the mice in there”
What’s the best tx for PROM?
Ampicillin + Erythromycin
“I’m amped up for PROM cuz I got rhythm”
What’s the best tx for HPV genital warts?
Trichloroacetic acid
What’s the best tx for premies prior to 32 weeks for neural protection?
Magnesium sulfate
What’s the best tx for up to 36w6d for fetal lung development?
Corticosteroids
When do you check for Down syndrome and how?
10 weeks with fetal free DNA
When can you check chorionic villus?
10-12 weeks
“Villains go first”
When can you check amniocentesis?
15-20 weeks
Which type of incontinence?:
Impaired detrusor muscles
“Oh no my juicer won’t work so it’s overflowing! We need to give Bethane a chol!”
Overflow
Which type of incontinence?: Hypermobility of the urethra and bladder neck Pelvic floor muscles Urethra Bladder neck Tx: kegels, pessary, clamp
Stress incontinence
Which type of incontinence?:
Overactivity of detrusor the juicer
Tx: oxybutynin
Urge
“I have the urge to try oxy”
