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OBGYN Uworld Random > Week 5 Uworld > Flashcards

Week 5 Uworld Flashcards

1
Q

what are three risk factors for late PPH?

A

prolonged labor
intraamniotic infection
macrosomia

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2
Q

what can you give to patient with incidental short cervix that is pregnant and does not have documented cervical insufficiency?

A

vaginal progesterone

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3
Q

what does vaginal progesterone do to help with short cervix in pregnancy?

A

calms uterus down to prevent preterm birth

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4
Q

2 risk factors for having hyperemesis gravidum?

A

hydatiform mole and multifetal gestation

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5
Q

what is first line treatment of migraines in pregnancy?

A

acetaminophen

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6
Q

what is a postdural puncture headache?

A

headache that onsets after an LP or epidural anaesthesia

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7
Q

what is characteristic of postdural puncture headache?

A

positional…worse when upright. can have N/V and photophobia

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8
Q

what is a physical exam finding of a postdural puncture headache?

A

neck stiffness

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9
Q

what is rx for postdural puncture headache?

A

epidural blood patch if really bad…otherwise it self resolves

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10
Q

in the periods after menarche, is there ovulation?

A

no

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11
Q

why is there no ovulation in early periods after menarche?

A

no ovulation because the hypothalamic pituitary axis is immature and not putting out right quantities of hormones

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12
Q

since no ovulation, what are early periods like?

A

often irregular and heavy bleeding

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13
Q

what is the treatment for early periods being heavy

A

progestin only or combined OCP

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14
Q

two risk factors for developing a uterine sarcoma?

A

pelvic radiation and tamoxifen therapy

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15
Q

what are symptoms of uterine sarcoma

A

uterine mass that is palpable and irregular…post meno bleeding

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16
Q

what is the workup of intraductal papilloma?

A

US or mammogram depending on if patient less or more than 30 yrsold

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17
Q

what is MC cause of bloody discharge from nipple?

A

intraductal papilloma

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18
Q

lichen sclerosus involves what skin areas?

A

labia majora/minora and the perineum/rectal area

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19
Q

what is the work up of lichen sclerosis?

A

punch biopsy

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20
Q

what are the main sx of lichen sclerosis?

A

ITCHING, excoriations, dysuria

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21
Q

what is rx for lichen sclerosis?

A

high potency steroids

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22
Q

what are abnormal labs in acute fatty liver of pregnancy?

A

high ALT/AST, hyperbilirubinemia, thrombocytopenia, leukocytosis, LOW sugar

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23
Q

what is cutoff for fetal tachycardia?

A

160bpm

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24
Q

what is a common cause of fetal tachycardia?

A

intramaniotic infection

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25
Q

what nerve can get impinged during labor?

A

femoral nerve

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26
Q

what medication used in uterine atony is contraindicated in patients with asthma?

A

carboprost

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27
Q

what medication used in uterine atony is contraindicated in patients with HTN?

A

methylergonivine

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28
Q

what is a progestin challenge test? what does it inform you about?

A

give 10 days of progestin then stop to see if will bleed …informs about estrogen levels

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29
Q

if patient does not bleed after progestin challenge test, what does it mean?

A

they dont have enough estrogen

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30
Q

what is preferred contraception pill for breastfeeders?

A

progestin only

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31
Q

bilateral gray nipple discharge is likely what?

A

galactorhhea

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32
Q

what are two endocrine causes of galactorrhea?

A

hypothyroid and prolactinemia

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33
Q

if pregnant lady has HSV history but no active lesions, what is rx?

A

start acyclovir at 36 weeks

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34
Q

fever 24+ hrs after delivery and uterine tenderness mean what?

A

postpartum endometritis

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35
Q

what are risk factors for postpartum endometritis?

A

prolonged ROM
csxn
intraamniotic infxn
GBS+

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36
Q

what are sign sof postpartum endometritis?

A

uterine tender
fever
lochia discharge

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37
Q

what is rx for postpartum endometritis?

A

clinda and gentamicin

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38
Q

which of androgen insens syndrom and 5a reductase deficiency has breast bud development?

A

AIS does and 5a doesnt

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39
Q

what is management of intrahepatic cholestasis of pregnancy?

A

ursodeoxychoic acid and deliver at 36 weeks

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40
Q

normal female external organs, no uterus and cervix, but normal development should make you think what?

A

mullerian dysgeneis

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41
Q

what else should ppl with mullerian dysgenesis be evaluated for?

A

renal abnormalities

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42
Q

how long can discharge from vagina last after delivery?

A

8 weeks

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43
Q

what should be done for moms with gestational diabetes following delivery?

A

2hr glucose tolerance test at 6 weeks

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44
Q

what is management of placenta accreta?

A

hysterectomy

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45
Q

what med is used in PCOS to help with fertility?

A

letrozole

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46
Q

why do fibroids degenerate in pregnancy?

A

because they lose their blood

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47
Q

what are signs of fibroid degeneration?

A

leukocytosis, PAIN, tender mass, uterine contractions

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48
Q

what is rate of cervical dilation supposed to be in active phasE?

A

1cm every 2 hours

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49
Q

what is workup of fibroadenoma in adult less than 30?

A

ultrasound

50
Q

how long till someone coming off OCP should have normal periods?

A

1-3 mos

51
Q

what are three tests to workup secondary amenorrhea?

A

FSH, prolactin and TSH

52
Q

what are the requirements of latent tb to meet criteria?

A

positive test without sx and good chest x ray

53
Q

what is rx for latent tb in pregnancy?

A

isoniazid

54
Q

what is most effective emergency contraception? when do you need it by?

A

copper IUD within five days

55
Q

what age does HPV testing start

A

21

56
Q

what is polymorphic eruption of pregnancy?

A

pruritic erythematous plaques in striae

57
Q

when does polymorphic eruption of pregnancy occur

?

A

3rd trimester

58
Q

what is rx for polymorphic eruption of pregnancy?

A

steroids topical

59
Q

what is elevated in a granulosa cell tumor?

A

estradiol and inhibin

60
Q

what is special about juvenile onset granulosa cell tumor?

A

can lead to precocious puberty

61
Q

what are some signs of antiphospholipid syndrome?

A

thromboses, recurrent pregnancy losses

62
Q

what is state of someone with antiphospholipid syndrome?

A

hypercoagulable

63
Q

what can be a false positive in antiphospholipid syndrome?

A

syphilis VDRL

64
Q

what is rx for antiphospholipid syndrome?

A

LMWH

65
Q

four risk factors for preeclampsia

A

multiple gestation
T1DM
chronic HTN
SLE

66
Q

what is screening for patient with increased risk of preeclampsia?

A

24 hour urine protein at first visit

67
Q

what two bugs cause elevated vaginal pH?

A

trich and gardnerella

68
Q

aside from hot flashes, what are other SEs of tamoxifen?

A

endometrial cancer, thromboembolism

69
Q

three complications of asthma during pregnancy

A

preterm birth, low birth weight, antenatal hypoxia

70
Q

what abx for cellulitis in post partum?

A

cephalexin

71
Q

when do you give MG for CP?

A

32 weeks and less

72
Q

what should you not give in PPROM? why?

A

dont give tocolytics because contractions can be sign of maternal issues

73
Q

what is FHT seen in umbilical cord prolapse

A

bradycardia and prolonged decel

74
Q

what are the signs of acute hemolytic transfusion reaction?

A

fever chills hypotension

hemoglobinuria and flankpain

75
Q

purple mass in vagina and hemodynamic instability following delivery is what?

A

vaginal hematoma

76
Q

can you live with anencephaly?

A

no

77
Q

what is management of mom with non viable fetus who is in preterm labor?

A

allow labor to progress naturally

78
Q

what is first step in retrieving foreign body in young girls vagina? second?

A

first is irrigation with warm water and second is exam under anesthesia

79
Q

what mutation is common cause of primary ovarian insuff?

A

FMR1 fragile X

80
Q

a thin intertwin membrane means what?

A

diamniotic

81
Q

indomethacin can cause what in fetus if given to mom?

A

oligohydramnios

82
Q

if you have bloody nipple discharge and a breast mass then what is most likely cause?

A

invasive ductal carcinoma

83
Q

what lab abnormality can occur in amphetamine intox?

A

hyponatremia

84
Q

what happens to pupils with amphetamine?

A

dilation

85
Q

fetal heart block causes what issue on FHT?

A

bradycardia

86
Q

dysuria and sterile pyuria should make you think what?

A

chlamydia infection

87
Q

what is urethral hypermobility?

A

urethra abnormally moves with stress/valsalva and is not able to fully close

88
Q

what type of incontinence with urethral hypermobility?

A

stress

89
Q

what is rx for urethral hypermobility?

A

pelvic floor exercises

90
Q

irregular menstrual bleeding and RUQ pain should make you think what?

A

fitz hugh curtis syndrome

91
Q

a maculopapular rash in pregnancy that is on trunk and includes the palms and soles should make you think what?

A

secondary syphillis

92
Q

patient with IUD in and found to have actinomyces and are symptomatic, what should you do?

A

further evaluation including IUD removal and penicillin

93
Q

patient with IUD in and found to have actinomyces and are asymptomatic, what should you do?

A

nothing

94
Q

can you have cervical motion tenderness in endometriosis?

A

yes

95
Q

what is ideal head position for fetus?

A

occiput anterior

96
Q

what should you evaluate if baby has fetal growth restriction?

A

placental function

97
Q

how do you evaluate placental function in baby who has fetal growth restriction?

A

umbilical artery ultrasound

98
Q

what is a contrindication to IUD placement that is related to menses?

A

irregular unexplained menstrual bleeding

99
Q

what is management of patient with intra amniotic infection?

A

abx and labor augmentation

100
Q

what is imaging modality for fecal incontinence after a laceration ?

A

endoanal US

101
Q

define missed abortion

A

no bleeding, closed os, no cardiac activity or fetal pole

102
Q

define threatened abortion

A

vaginal bleeding, closed os,positive fetal cardiac activity

103
Q

define inevitable abortion

A

open os, bleeding, fetal parts still there

104
Q

define incomplete abortion

A

bleeding, open os, some parts still there

105
Q

define complete abortin

A

closed os, bleeding, no parts left

106
Q

two tests to diagnose a vesicovaginal fistula

A

dye test and cystourethroscopy

107
Q

patient under 45 yrs old with AUB intermenstrual bleeding should be treated how?

A

start on OCPs

108
Q

patient under 45 yrs old with AUB intermenstrual bleeding who tried OCPs and didnt work, should be treated how?

A

endo biopsy

109
Q

a persistent rise in hcg after a d/c is diagnostic for what?

A

ectopic pregnancy

110
Q

what med is contrindicated with myasthenia gravis patients in pregnancy?

A

Mg

111
Q

what is rectus abdominis stasis?

A

linea alba weakens and gut can protrude with vlsalve

112
Q

what are risks for rectus abdominis stasis?

A

pregnancy and surgical weakening

113
Q

what is a SE of epidural anasethesia?

A

hypotension

114
Q

what is cause of hypotension in epidural?

A

leads to venodilation and venous pooling so low cardiac return

115
Q

what is risk with hypotension from epidural?

A

fetal acidosis

116
Q

what is management of hypotension from epidural?

A

left uterine displacement, fluids and pressors

117
Q

which antiHTN should you not give to a mom with severe range pressures and bradycardia?

A

labetalol

118
Q

name three antiHTN for severe range pressures in pregnancy

A

labetalol
hydralazine
nifedipine

119
Q

cause of RUQ pain in HELLP?

A

distension of the liver capsule

120
Q

what lung finding can occur in preeclampsia?

A

pulmonary edema

OBGYN Uworld Random (5 decks)

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