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OBGYN Uworld Random > Week 2 UWorld and Case Files 5-8 > Flashcards

Week 2 UWorld and Case Files 5-8 Flashcards

1
Q

symptoms of ruptured ovarian cyst?

A

unilateral abdominal pain following activity

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2
Q

what is a complication of a ruptured ovarian cyst? when can this arise?

A

hemoperitoneum with patients on anti coags

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3
Q

what are signs, symptoms and way to diagnose hemoperitoneum from ovarian cyst rupture?

A

hemodynamic instability and peritoneal signs..dx with pelvic US

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4
Q

what is first line rx for dysmenorrhea in sexualy active female?

A

OCPs combined

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5
Q

what if fitz hugh curtis disease?

A

PID extension into liver capsule

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6
Q

what is classic symptom of fitz hugh curtis?

A

RUQ pleuritic pain in addition to fever and lower abdominal tenderness

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7
Q

following a c sxn a patient becomes hemodyamically unstable, what is best next step? what likely happened?

A

emergent laporotamy…likely injury to uterine artery in c sxn

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8
Q

how do you manage pregnant patient with pyelonephritis?

A

inpatient iv abx until afebrile for 24 hrs

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9
Q

complications of pyelonephritis in pregnancy 3

A

ARDS
sepsis
preterm labor

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10
Q

age cutoff for primary ovarian insufficiency

A

less than 40 years

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11
Q

what is often associated with primary ovarian insufficienc

A

autoimmune disease

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12
Q

three gyn issues that can raise ca125

A

ovarian cancer
fibroids
endometriosis

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13
Q

when is CA125 most specific for ovarian cancer?

A

in post menopausal women bc they wont have chance of fibroids and endometriosis

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14
Q

two treatment options for pelvic organ prolapse

A

surgical repair or pessary fitting

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15
Q

name the severe features of preeclampsia

A

elevated transaminases, thrombocytopenia, pulm edema, SBP over 160 or DBP over 110, increased creatinine

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16
Q

what is management of delivery with preeclampsia with severe featurs?

A

deliver at 34 weeks

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17
Q

what is management of delivery with preeclampsia without severe featurs?

A

deliver at 37 weeks

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18
Q

what is risk to fetus in preeclampsia?

A

uteroplacental insufficiency leading to fetal growth restriction and low birth weight

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19
Q

what are risks to mom in preeclampsia?

A

DIC, eclampsia and abruptio placenta

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20
Q

what is ICP? when do you get it?

A

intrahepatic cholestasis of pregnancy in 3rd tri

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21
Q

what are sx of ICP?

A

pruritis and RUQ pain

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22
Q

what are lab findings in ICP?

A

elevated liver enzymes and total bile acids

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23
Q

what is treatment for ICP?

A

ursodeoxycholic acid and antihistamine

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24
Q

what are fetal risk with ICP?

A

demise, preterm birth, neonatal RDS

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25
Q

define intrauterine fetal demis

A

no cardiac activity after 20 weeks gestation

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26
Q

what is management of intrauterine fetal demise?

A

20-23 wks can do DE

24+ need vaginal delivery induced when mom is ready

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27
Q

what causes peripheral edema in pregnancy?

A

plasma volume expansion

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28
Q

is shivering and chills and low fever common in post partum window of 24 hours?

A

yes..due to withdrawal of estrogen and progesterone

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29
Q

what trimester US is most accurate for dating? least?

A

1st is most and 3rd is least

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30
Q

what is etiology of primary dysmenorrhea?

A

increase in progesterone production

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31
Q

what is 1st and 2nd line rx of primary dysmenorrhea?

A

1st is NSAIDs to decrease progesteron

2nd is combo OCP

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32
Q

finding of androgen insensitivity syndrome

A

Xy genotypye with female phenotype…outer genitalia female with breast developed but no pubic hair…inner no female parts

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33
Q

four risks for abruptio placentae

A

HTN/preeclampsia, trauma, cocaine/smoking

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34
Q

aside from bleeding and pain, what are two other signs of abruptio placentae?

A

high frequency contractons and firm tender uterus

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35
Q

risks for having cervical insufficiency?

A

ehlers danlos, OB injury, conization

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36
Q

rx for cervical insufficincy?

A

cerclage

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37
Q

what happens with cervical insufficiency in pregnancy?

A

common to lose in 2nd tri…will have cervical dilation and increased vaginal discharge

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38
Q

what is rx of vaginosis and trichamonis?

A

metro 500mg bid 7 days

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39
Q

what are two look alikes of menopause?

A

hypothyroid and DM

40
Q

what are two signs of placenta accreta?

A

postpartum hemorrhage, difficulty delivering placenta

41
Q

how do you manage placenta accreta?

A

hysterectomy

42
Q

what are two risk factors for placenta accreta?

A

placenta previa and prior uterine surgeries

43
Q

when does septic pelvic thrombophlebitis occur?

A

post op or post partum

44
Q

why does septic pelvic thrombophlebitis occur post op and post partum?

A

because there is endothelial injury, hypercoag state and venous stasis/dilation

45
Q

what is management of septic pelvic thrombophlebitis?

A

broad spectrum abx with anticoagulation

46
Q

what are signs of septic pelvic thrombophlebitis?

A

fever that is unresponsive to abx and no infxious sx

47
Q

main symptoms of congenital Zika virus

A

microcephaly is number 1

thinned cortices and calcifications

48
Q

in exam questions, positive leukocyte esterase means what?

A

UTI

49
Q

what is a urethral diverticulum? what can cause it?

A

a herniation of urethral tissue into surrounding tissue due to recurrent ant vaginal wall infxns

50
Q

what are sx of urethral diverticulum?

A

post void dribblinf, infection, and dyspareunia

51
Q

diagnosis and treatment of urethral diverticulum?

A

dx with MRI rx with surgery

52
Q

what is adequate contraction units in labor?

A

200 montevido units in 10 minutes

53
Q

2 definitions of arrest of active phase of labor

A

4 hours with no cervical change despite adequate contractions
6 hours with no cervical change and not adequate contractions

54
Q

what is difference between idiopathic hirsutism and hypertrichosis?

A

hirsutism hair is coarse and only grows in androgen dependent areas
hypertrichosis is fine hair that can grow anywhere

55
Q

what is treatment for chlamydia in pregnancy?

A

azithromycin

56
Q

until what age do you screen yearly for chlamydia and gono?

A

25

57
Q

What is interstitial cystitis?

A

chronic bladder pain not from another condition

58
Q

what are sx of interstitial cystitis?

A

pain with filling, increased frequency and urgency and dyspareunia

59
Q

what is rx for candida in vagina?

A

fluconazole

60
Q

what is discharge like in candida in vagina?

A

thick cottage cheese like

61
Q

what is the external cephalic version maneuver? when is it done?

A

at 37 weeks move transverse of breech bby to vertex

62
Q

name contraindications to an external cephalic version?

A

prior classical c sxn
prior myomectomy
prior placenta previa

63
Q

what is lichen sclerosus?

A

thin white areas on labias that can extend to rectal area

64
Q

what are symptoms of lichen sclerosus?

A

ITCHY white area

65
Q

what is rx for lichen sclerosus?

A

strong corticosteroids

66
Q

who gets lichen sclerosus?

A

prepubertal and meno women

67
Q

why do postmeno women have increased UTI risk?

A

because estrogen deficiency leads to higher vaginal pH so e coli can grow more

68
Q

what is therapy to help prvent UTI occurrence in post meno women?

A

estrogen topical cream

69
Q

6 risks to fetus with illicit drug use

A 
preterm birth
preeclampsia
diminished fetal growth
fetal demise 
spontaneous abortion
abruptio placentae
70
Q

signs of vulvar cancer?

A

pruritic vulvar plaque with AUB

71
Q

what are some risks for vulvar cancer?

A

lichen sclerosus, immunodeficiency, cervical cancer, smoking

72
Q

what is recurrence risk of preeclampsia?

A

10-20%

73
Q

what is protein cutoff for preeclampsia on 24 hour protein?

A

300 mg

74
Q

how long after delivery is magnesium continued with preeclampsia with severe features?

A

24 hours

75
Q

what is treatment for confirmed gonorrhea and negatiive chalmydia?

A

both ceftriaxone and azithromycin

76
Q

what is treatment for confirmed chlamydia and negative gono?

A

azithromycin only

77
Q

what is a biophysicsl profile?

A

non stress test of fetus with ultrasound

78
Q

what four things do you check in biophysical profile?

A 
amniotic fluid volume
fetal breathing
fetal movement 
fetal tone
non stress test result
79
Q

4 risk factors for placental dysfunction or insufficiency?

A

smoking
HTN
diabetes
advanced maternal age

80
Q

how do you score biophysical profile? what is normal?

A

2 for each category normal is 8 and up

81
Q

what score on biophysical profile means placental insufficiency?

A

less than 4

82
Q

what are three clinical signs of HELLP syndrome aside from hemolysis, elevated liver enzymes and low platelets?

A

RUQ pain, preeclampsia and N/V

83
Q

what are two urinary symptoms of menopause?

A

recurrent UTIs and incontinence

84
Q

what age should cell free DNA testing start being offered for women?

A

women over 35

85
Q

3-4 days postpartum what is expected pospartum lochia?

A

dark or red blood with similar smell to menstrual blood, can have clots

86
Q

4-14 days postpartum what is expected pospartum lochia?

A

pink or brownish old blood

87
Q

14 days to 6 weeks postpartum what is expected pospartum lochia?

A

white/yellow creamy stuff

88
Q

what is management of spontaneous abortion?

A

if hemodynamically stable without anemia give misoprostol, if not hemodynamically stable then do DC

89
Q

what is management an sign of an unstable or ruptured ectopic pregnancy?

A

hemodynamic instability…surgery

90
Q

how does a ureteral laceration present post op?

A

bloating and abdominal pain with vaginal leakage/discharge that is clear

91
Q

preterm labor prior to 34 weeks gestation age, what is management?

A

give roids, penicilliin if + or unknown GBS, tocolytics like indomethacin or nifedipine

92
Q

34+ week gestation age preterm labor what is management?

A

roids and penicillin if indicated…no tocolysis

93
Q

what is a missed abortion?

A

no vaginal bleeding or cervical dilation, but no cardiac activity

94
Q

what is an inevitable abortion?

A

vaginal bleeding and dilated cervix but fetal parts all still above internal os

95
Q

what is a threatened abortion?

A

vaginal bleeding, no cervical dilation, fetal cardiac activity still there

96
Q

what skin condition can you have in vagina?

A

vitiligo

OBGYN Uworld Random (5 decks)

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