UWorld Questions Flashcards
Clinical features of hyperemesis gravidarum?
Severe, persistent vomiting
Fluid & electrolyte abnormalities (e.g. ketonuria)
>5% loss of pre-pregnancy weight
Clinical features of molar pregnancy?
Central heterogeneous mass with numerous cystic spaces and no fetal pole
Ovaries are enlarged with multilocular cystic appearance
Abnormal bleeding +/- passing of hydropic tissue
HG
Hyperthyroidism
Treatment of molar pregnancy?
Uterine evacuation with suction curettage
Gestational Diabetes screening?
24-28 weeks
1 hour OGTT => if >140 then 3 hour OGTT
Risk factors lactational mastitis?
Inadequate milk drainage: Replacing nursing with formula or pumped milk Weaning Pressure on duct Cracked/clogged nipple pore Poor latch
Treatment for lactational mastitis?
Analgesia
Frequent breastfeeding or pumping
Antibiotics (Staph aureus)
Characteristics of complete AIS?
Normal breast development Absent uterus and upper vagina (2/2 anti-Mullerian hormone) Cryptorchid testes Absent axillary & pubic hair Karyotype 46XY
Characteristics of Mullerian agenesis?
Normal breast development Absent or rudimentary uterus & upper vagina Normal ovaries Normal pubic hair 46XX
Characteristics of 5a-reductase deficiency?
Ambigious genitalia at birth
Male internal urogenital tract (2/2 anit-Mullerian hormone)
Ulcer difference with HSV and H.ducreyi?
HSV: shallow ulcers
H.ducreyi: deep ulcers
Sequence of antepartum fetal testing?
Non-stress test
Biophysical Profile OR Contraction Stress Test
CST => only if no contraindication to labor
Indication for umbilical artery doppler?
Growth restriction
Consequences of group ABO incompatibility?
Can get hemolytic disease of the newborn, but much less severe than Rh(D) incompatibility
Clinical presentation of Sheehan’s?
Failure of lactation Lethargy, weight gain, fatigue H/o bleeding during delivery Sparse pubic hair Dry skin Delayed tendon reflexes
Clinical presentation of placental abruption?
Constant abdominal/uterine pain
Vaginal bleeding
Increased uterine tone
Fetal distress
Clinical presentation of chorioamnionitis?
Maternal and fetal tachycardia
Maternal fever
Uterine tenderness
Main risk factor of tamoxifen?
Endometrial cancer (partial estrogen receptor agonist in endometrium)
Management of preterm labor
Tocolysis
Corticosteroids
MgSO4 (neuroprotection)
What does fetal fibronectin show?
Separation of placenta => preterm labor
Unnecessary in a patient with regular contractions
When to give progesterone supplementation?
16-36 weeks in women with singleton pregnancy and history of preterm birth
No role in ACTIVE management of preterm labor
Clinical presentation of postpartum endometritis?
Fever > 38
Uterine tenderness
Foul smelling lochia
Leukocytosis
Treatment for endometritis?
Clindamycin and gentamicin
Characteristics of ruptured ectopic pregnancy?
Abdominal, cervical, adnexal tenderness
Intrabdominal bleeding => syncope, hypotension, tachycardia
Referred shoulder pain
Urge to defecate
STI treatments?
Chlamydia: Azithromycin
Gonorrhea: Ceftriaxone
HSV: Acyclovir
Trichomonas: Metronidazole
What are the Amsel criteria?
For bacterial vaginosis (3 of 4):
- Thin, gray-white vaginal discharge
- Vaginal pH > 4.5
- Positive “whiff” test => add KOH to vaginal discharge and amine/fishy smell
- Clue cells = bacteria adhered to epithelial cells
Risk factors for chorioamnionitis?
Premature Rupture of Membranes
Intrauterine instrumentation
STIs
Prolonged labor
Clinical presentation of amniotic fluid embolism?
Cardiogenic shock
Hypoxemic respiratory failure
DIC
Coma/seizures
B-hCG cut-offs for ultrasound?
> 1500 for transvaginal US
>6500 for abdominal US
First line drugs for hypertension in pregnancy?
Methyldopa
Labetalol
Hydralazine
Nifedipine
