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1
Q

toxic shock syndrome sx

A
  • hypotension, orthostatic syncope, macular erythoderma, fever, late skin desquaation
  • treat vanc
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2
Q

elevated markers for IUFD

risk factors

A
  • AFP

- AFP, cHTN, insulin dependent DM, FGR

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3
Q

% cHTN get PreE

A

25%

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4
Q

signs secondary HTN

A
  • family hx
  • renal disease
  • labile
  • resistant hypertension
  • high creatinine
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5
Q

necrotizing fasciitis bug

A
  • alpha hemolytic catalase neative, gram positive cooci

- strep pyrogenes

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6
Q

% uterine rupture kills the fetus

A

5%

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7
Q

EKG finding of HYPERkalemia

A

peaked T waves

  • caused by angiotensin coverting eenzyme ACE inhibitors
  • potassiume sparing diuretics
  • NSIADS
  • treat with calcium gluconate (antagonizes the K effect)
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8
Q

child labial adhesions

A
  • topical estrogen
  • steriod cream
  • afterwards need to keep apart with jelly
  • only bother with it if there are urinary symtpoms.
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9
Q

radiation effects and gestational age

A
  • post conception:
  • 0-2w: death (50-100mGy - 5-10 rads), organogensis/anomalies (200mGn-20 rads)
  • 2-8w: FGR (200mGn - 25 rads)
  • 8-15w: intellectual disability high risk (60-300 mGn)
  • 16-25w intellectual disability low risk

*pelvic/adominal CT are the worst

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10
Q

HPV vaginal cancer

A

16

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11
Q

Call exner body

A
  • granulosa cell tumor

- coffee bean nuclei

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12
Q

dysgerminoma cell marker

A
  • LDH
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13
Q

gonadoblastoma

A

malignant only if dysgerminoma elemtns

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14
Q

serous tumors

A
  • ciliated tubal epithelium, psammona bodies, tumor marker CA 125
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15
Q

lynch syndrome cancers

A
  • gastric
  • small bowel
  • hepatobiliary
  • renal pelvis
  • ureteral
  • breast
  • brain
  • colon, endo, ovarian
  • associated genes MLH1, MLH2, MSH6, PMS2
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16
Q

normal TSH level

A

0.5-3

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17
Q

RA vs OA

A
  • RA is close

- OA is outter appendage of hand

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18
Q

transobturator sling

A 
TOT = obturator (more common groin pain)
TVT = "retropubic" (more common all other inuries)
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19
Q

CAH

A
  • autosomal recessive
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20
Q

live vaccines

A
  • MMR

- rotavirus

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21
Q

contracting varicella in pregnancy

A
  • 1-2% risk get neonatal infection : skin scarring, limb hypoplasia, eye defects, neuro abnormalities
  • get varicella near dlelivery is wrose 30% death rate
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22
Q

max bone denisty

A

19 yo

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23
Q

vaginal hemotoma

A
  • caused by uterine artery

- retroperitoneal hematomas usually by iliac artery including uterine and extension of paravaginal hematoma

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24
Q

androgen insensitivity syndrome

A
  • testicular feminisation
  • 46 XY
  • x linked recessive
  • short blind vagina, no uterus or fallopian tubes, no wolffian duct structures, no pubic hair, breast devo because LH are up and increase estrogen
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25
Q

osteoperosis treatment

A
  • when 3% risk hip fracture or 20% risk of major osteoprotoc fracture (gotten from FRAX score)
  • t-score less than -2.4
  • tscore -1>-2.5 and frax >3% hip or FRAX greater than 20
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26
Q

urtheral mobility on stupid test

A
  • point Aa
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27
Q

ayptical endometrial cells on pap

A
  • endometrial/endocervical

- if those neg, then colpo

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28
Q

nerve injuries and surgery

A
  • peroneal: foot drop
  • obturator: adduction/hip rotation
  • TAH: femoral from buckwalter retractor (feels liek sciatica)
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29
Q

treatment for EIN

A
  • progesterones (includes megace) not including arm implant
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30
Q

worst contaceptive

A

spermacide – 28% failure rate

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31
Q

level of support and defect (POP)

A
  • level 1: enterocele, vaginal prlapse
  • level 2: pravaginal
  • level 3: cystocele, rectocele
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32
Q

HPV vaccine allergy

A

yeast

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33
Q

cholesterol goals

A
  • LDL: <100

- HDL >60

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34
Q

vACccum

A

3cm anterior to the posterior fontanelle

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35
Q

normocytic anemia

A
  • acute blood loss
  • sickle cell disease
  • infection
  • bone marrow disease
  • chronic renal insufficiency
  • hypothyroidism
  • autoimmune hemolytic anemia
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36
Q

T score findings and screenign rates

A
  • -1.5 > -1.99 (5 years)

- -2 > -2.49 (1 year)

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37
Q

unilateral breast bud

A

observe. jsut delveoping

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38
Q

treatment fr nocturnal vulvar and perinala itching

A

mebendazole

- pinworms, enterobius vermicularis

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39
Q

transgender male treatment begins with

A

giving testosterone

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40
Q

transgender female treatment

A

estrogen and androgen blockers (spironolactone)

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41
Q

beneftis of delayed cord clamping

A
  • impromvent in blood count, decreased need transufusion, lower rates intrventitrucular hemorrheage, increasd iron stores, decreased nec enterocolitis
  • helps premature the most
  • at least 30-60seconds for term/preterm vigorous infants
  • UNRELATED IS SEPSIS, this is not affected.
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42
Q

which imaging is worst for the fetus

A

CT pelvis

- itravenous pyleogram is okay, lumbar spine stuff xray okay, pulmonary angigram okay

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43
Q

whole exome seuqening of fetal DNA can be obtained by XX and not by YY

A
  • can be from CVS, amnio, cord

- cannot from placenta

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44
Q

most common cause of cuff celulitis

A
  • garderella vaginalis (BV)

- treat BV with metronidazole or clindamycin

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45
Q

carpel tunel in pregnant women

A
  • treatment first line wrist splint
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46
Q

MCC duodenal ulcers in women >30 years?

A
  • h pylori, give 14d amoxicillin 1000mg BID, with clarithromyicn or metro
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47
Q

pneumococcal vaccine given to

A
  • elerly over 65 yo, or earlier if sick, sickel cell, immunosuppressed through chemo
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48
Q

least liekly lymph nodes involved in cervical cnacer

A
  • inguinal
  • spread through primary pelvic nodes (pericervical, presarcral, hypogastri/internal iliac, external iliac nodes, obturarotr ndes > paraaortic nodes
  • rarely goes as far as inginal nodes
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49
Q

hyperandrogenism test

A

total testosterone

CAH

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50
Q

unresponsive pregnant lady with known hypopituitarism shoudl be given

A
  • glucocorticoids

- thyroxine (T4/T3)

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51
Q

immature teratoma tumor markers

A

increased AFP, LDH, CA 125

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52
Q

dysgerminoma tumor markers

A

increased HCG, LDH

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53
Q

endodermal sinus tumor tumor markers

A
  • increased AFP
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54
Q

embryonoal CA tumor marker

A
  • increased HCG, AFP
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55
Q

chriocarinoma tumoar markers

A
  • icnreased HCG, AFP
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56
Q

outflow obstruction dx best with

A

MRI

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57
Q

which antitumor metbolite is administreed carefuly cause it can cause skin necrosis with extravasation?

A

Doxorubicin

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58
Q

actinomycin D

A
  • treat GTD
  • G1 phase
  • myleosuppression caused
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59
Q

bleomycin

A
  • cuases DNA breaks

- causes pulmonary fibrosis and pneumonitis

60
Q

etoposide

A
  • topoisomerase 1 and II inhibitor
  • myleosuppression
  • germ cell tumor treatment
61
Q

cisplatin/carboplatin

A

most comomon gyn malignancy treatment (ovarian, tubal, peritoneal, endometrial, cervical, vulvar cancers.

  • cisplatin needs vigourous hydration , renal dependent
  • carboplatin: myleosuppression
62
Q

treatment STage 2B squamous cell cervical cancer

A
  • stage 1: hysterectom

- stage 11B-IVA: radiation and brachtherapy and cisplatin

63
Q

treatment for rhinosinusitis

A
  • NSAIDs
  • bacterial but doesnt’ usualyl require abx
  • abx if sx more than 10 days and include fever/pain/swelling of face
64
Q

sp svd 5 days prior, severe headache, focal neuro deficits, altered consciousness… caused by

A
  • subarachnoid hemorrhage
65
Q

pulmonary edema after hysteroscopy seen with what fluid

A
  • normal saline

pumonary edema and CHF

66
Q

down sydnrome soft markers on US

A
  • hyperechoic bowel
  • shortered femur
  • fenal lyelectasis
  • FGR
    (not renal pylectasis)
67
Q

osteoporsis casues

A
  • loss of height
68
Q

pupillary reaction to brbituates

A
  • none, (weed and barbituates)
  • amphetamines/LSD cause dilation, but reactive
  • non-reactive puplis are anticholinergic agents
69
Q

ARB fetal effects

A
  • renal tublar dysplasia
  • fetal limb contractures
  • fetal skull ossification defects
    0 hypplastic lung devo
    (not cardiac anomalies)
70
Q

blue vaginal lesion, head ache, increased blood pressure, sp NSD 5w ago…. waht do you do next?

A

CXR (GTN)

71
Q

8w preg, IUD in place, what happens if you leave it in place?

A
  • risk for spontaneous abortion, septic abortion, preterm delivery, spesis
  • no risk for fetal limb issues
  • remove prior to fetal viability, after feta viability unclear if shoudl be kept in
72
Q

vaginal itching, white discharge, ph 3.4, KOH prep and wet mount negative . next step?

A
  • culture for yeast
73
Q

donovan bodies

A
  • related to granuloma inguinale chronic ulcerative bacterial infection on vulva
  • intracelluluar gram negative non-motile encapsulated rod
  • ulcers are painless
  • given azithromycin 1gm weekly for at least 3 weeks until lesions are healed
74
Q

MCC cancer death in women

A

lung

75
Q

22 asymptomatic huge fibroid, first management optoin

A
  • observatino, leave it alone
76
Q

% cervical cancer diagnosed >65 years old

A

20%

77
Q

largest diamtere fetal head is

A
  • occiptial- mental
78
Q

MCC adverse effect copper IUD

A
  • bleeding or prolonged bleeding
79
Q

oliguria prerenal azotemia is characterized by

A
  • urine sodium excretion <20 mEq/L/24h

- urine plasma ratio greater than 40mEq/L/24h

80
Q

progesterone efects on pregnacy

A
  • increased body temp, increased nasal congestions, increased appetite, decreased esophageal tone, increased respiration
81
Q

positive tilt test sp TAH with some signs low fluids… do what

A

give crystaloids 1-2 L

  • hypovolumeic shock
  • if it were hemorrhageic shock, get IVs, transfuse, etc
82
Q

risk factors for wound dehiscence

A
  • sepsis, malignancy, HTN, pumonary disease, advnaced age

- not related is a hx of infection.

83
Q

invasive vulvar pagers disease

A
  • wide local incision for <1mm invasions

- invasive diesaese needs radial vulvectomy

84
Q

contraindications for robotic surgery

A
  • acute glaucoma
  • retinal detacment
  • increased intracranial pressure
  • ventri shunts
85
Q

ARDS is associated wtih

A
  • PCWP <12
  • PO2 < 50
  • Increased capillary permeability
  • metabolic acidosisi
  • decreased lung compliance
86
Q

give what to stop vasomoto symtpoms

A
  • gabapentin
  • clonidien
  • dang gui bu xu tang
  • paroxitine
    (not progeserones)
87
Q

what is associated with abnormal AFP

A
  • tri 18, 21, sacrococcyceal teratoma, congential hypothyroidism
    (not associated with gastrocheisis)
88
Q

caloric deficit needed to lose one pound total

A
  • 3500 calories in a pound

- 500 calories in a week to lose a pound in that week

89
Q

pod #5 with fever is most likely relate to

A
  • wound infection
90
Q

reason for POD#1 laparotomy sp LSC procedure

A

CT shwoign expanding hematmoa

91
Q

most common retro mass reatled to the urinary tract is

A

pelvic kidney

92
Q

which type of histological vulvar cacner is the most favorable prognosis

A

basal cell carcinoma

93
Q

PCOS first line fertility treatment

A

aromatase inhibitor (letrozole) which is ovulation induction

94
Q

normal seman analysis

A 
volume 2> 1.5
concentration: 20 > 15
progressive motility: 50 > 32 %
normal form: 14>4%
*concentration and motility are the most important with coitus
95
Q

16 to primary amonrrhea, +breast +pubic air, what is it and what tests

A 
mullerian agenesis (mayer rokitansky kkuster hauser syndrome
karyotype and testosterone
96
Q

Vit D defeicience leads to

A
  • hypocalcemia
  • secondary HYPERparathyroidism
  • increased bone turnover
  • increased rate of bone loss
  • decreased CA absroption
  • decreased/poor bone mineralization
97
Q

what hormone level changes the least compared pre/post menopause

A

testoserone changes barely any

98
Q

preimplantation genetic diagnostics are helpful for:

A
  • single gene disorders
  • gender
  • mutations
  • HLA typeing (minor blood typing)
    (not good for NTD)
99
Q

hwo do you manage cholelithiasis ?

A
  • fourty, fat, and fucking? these women have gallstones (cholelithiasis) and you can just ignore it if asymptomatic
  • symptomatic: can give meds: oral bile acid therapy with urodeoxycholic acid and exracorporeal shock wav lithotripsy.

(note acute cholecystitis devleops when a gallstone blocks the duct adn the gallbladder gets inflammed. = pain, n/v, leukocytosis, anorexia

100
Q

most common symptom in appendicitis in preg and outside preg

A

always RLQ pain

101
Q

BRCA1 mutation carriers increased risk for which cancers:

A
  • breast
  • ovarian
  • pancreatic
  • melanoma
102
Q

lynch syndrome cancer risk increased for

A
  • brain
103
Q

most likely neurological laparoscopic injury from a lateral trocar placement

A
  • ilioinguinal nerve
104
Q

HPV 16/18 positive serology and negaive pap smear 16 yo.

next step?

A

colposcopy

16 and 18 are hte most likely to cuase cervical cancer so maybe your screen just missed it

105
Q

MCC problem with TPN

A

catheter tip infection

106
Q

TTTS recipient twin associated with

A
  • kernicterus
  • heart failure from too much volume
  • thrombosis
  • polythycemia
  • polyhydramnios (donor has oliohydramnios, poly/oli)
107
Q

risk factor of HIT

A
  • use of unfractionated heparin
  • female gender
  • surgery
  • longer durations of heparin
  • LWMH is lower risk
108
Q

UAE has to go through which vessel

A
  • common iliac beacuse can’ maek the sharp turn
109
Q

diagnostic test for pre E oncludes:

A
  • CBC
  • liver transaminases
  • serum creatinine
  • p/c ratio
110
Q

which feature with PE increases mortality rate

- treatment

A
  • right ventriucular dysfunction

- treatment: O2, trachael intubation, mechanical intubation, need thrombolysis/filter pracelemnt/embolectomy

111
Q

what progestin in NOT derived from 19-nortestonsterone

A
  • drospirenone (unusual)
112
Q

in pregnancy what happens to facto 8 and vWF levels>

A
  • Factor 8 increases clotting
  • vWF increases clotting

— both increase (therefore both

113
Q

consanguinity increases the risk for

A

autosomoam recessive diosroders

114
Q

MCC famililal mental retardation

A

fragile X syndrom

115
Q

irregualr vaginal bleeding, first step in work up

A

b-hcg

116
Q

sudden, strong sensation to void, large volume loss, nocturia

A

urgency incontinence

- due to detrusor overactivity

117
Q

best way to examine a enterocele

A
  • standing
118
Q

amenorrhea, galactorrhea, prolactin 68

- first test

A
  • b -hcg test
119
Q

urogenital sinus gives rise to all the following structures

A
  • urinary bladder
  • hymen
  • lower vagina
  • paraurethral glands

it does NOT give rise to gartner’s duct (or upper vagina)

120
Q

improve labido

A

testerosterone

121
Q

androgen insensitivity syndrome

A
  • female phenotype
  • short blind vagina
  • xy
  • X linked autosomal resessive
  • no ovaries or uterus or fallopian tubes
122
Q

what are the iron requremients in pregnancy daily

A
  • 1000 mg

-

123
Q

which tumor is associated with amneohrea

A
  • craniopharygniomas
124
Q

maylard incision causes whch vascualr injury

A
  • inferior epigastric (deep in the muscle bed)
125
Q

granulosa cell aromstase enzyme allows conversion of androstenedione to which of the following:

A

estrogen

(they also make inhibin)

126
Q

conidiotns that affect estrogen production in pregnancy

A
  • fetal demise
  • anencephaly
  • adreanl hypoplasia
  • trimsomy 21
  • featl ethryroblastosis

(gastrochisis does not effect estrogn)

127
Q

ovary makes the following androgens:

A

testostoerone
dihydrotestosterone
dehydroepiandrosterone
androstenedione

  • also estrogen (but it’s not an androgen)
128
Q

water transfered across the placenta

A

bulk flow (a lot)

129
Q

what cannot be assessed using “simple cystometrics”

A

intrinsic spinchter deficiency

130
Q

what phase of the cell cycles does proteins synthesis, RNA synthesis and DNA repair occur>

A

G1: protein synthesis, RNA synthesis, DNA repair
S: copies DNA two times
G2: nothing really
M: division into two cells

131
Q

VIN 3 lesions

A
  • wide local excision
  • margins clear, SSC noted in specimen, invading 0.9mm = observation
  • no risk for metasisis for invasion <1mm
132
Q

VAIN 3 management

A
  • wide local excision

(VAIN 1 obersvation after biopsy)

133
Q

tumor suppressor does HPV E6 AND E7 USE

A

E6: p53
E7: retinobastoma

134
Q

what is used for staging of cervical cnacer

A
  • cystospcy
  • proctospcy
  • intravenous pyleogram

(CT not used)

135
Q

typical findings of complete hydraform mole

A
  • abnormal uterine bleeding
  • hihg HCG
  • large uterus
  • increased thyroxine

(hyerpemesis is sometimes seen)

136
Q

26 yo secondary amenorrhea, increased hair gwroth, cliteromegaly causes by….

A

androgen secreting tumor
sertoli leygid tumor
(breast atrophy, deepening of voice)

137
Q

secondary hone loss is worked up with

A
  • CBC
  • serum chemistry
  • TSH
  • 24h urine calcium excretion

(celiac panel is second line workup)

138
Q

bone formation markers

A
  • osteocalcin
  • bone specific alk phos
  • procollagen type 1
    N-terminal pro-petide

(turn over markers: N-telopetides, c-telpetides, deoxypyridinoine)

139
Q
  • proliferative breast lesions

- non-proliferatinve breast lesions

A
  • proliferative breast lesions (increase your risk for cancer)
  • —- fibrocystic changes
  • non-proliferative breast lesions
  • —- cysts
  • —- fat necrosis
  • —- fibroadenoma
  • —- microcalicifations
140
Q

nerve injury

A

1-2 buckle my shoe (S1-2, ankle)
3-4 kick the door (L3-4 knee extension)
5-6 pick up sticks (C5-6 biceps brachialis)
7-8 lay then straight (C7-8 triceps)

141
Q

transeint causes of urinary incontinence

A 
DIAPPERS
Diabetes (DKA), infection, atrophy, Pregnancy, excess urine output, restricted mobility, stool impaction
142
Q

acute onset young child gentil itcing

A
  • mor elikely single organism – strep or shigella (repsiratory)
  • intermittent problamems then multi organism
143
Q

PE CXR findings

A
  • enlarged pulmopnary artery
  • pleural effusion possible
  • airspace opacity (lung infarcation)
  • elevated hemi-diaphragm
144
Q

pain more common with what version of sling

A

TOT (puncture muscular pelvic wall and pain over all)

145
Q

EIN treatment

medical, surgical

A

megace, progestin therapy (want retain fert or poor surgical candidate)

surgical: total hysterecomty with out other staging

(dx wth D&C hysteroscopy)

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