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EOR - Women's Health > Rosh Material #2 > Flashcards

Rosh Material #2 Flashcards

1
Q

fundal height in landmarks for gestational age

A

pubic symphysis: 12 weeks
umbilicus: 20 weeks
xiphoid process: 36 weeks
regression below 36-32 cm: 37-40 weeks

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2
Q

comorbidities associated w. preterm labor

A

T1DM
HTN
thyroid dz
asthma
kidney insufficiency
anemia
MDD

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3
Q

PCOS increases risk for what type of cancer

A

endometrial

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4
Q

first line med for ovulation induction (ex to treat infertility w. PCOS)

A

letrozole

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5
Q

rf for endometrial ca

A

ENDOMET:
elderly
nulliparity
DM
obesity
menstrual irregularity
estrogen monotherapy
tension (HTN)

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6
Q

skin condition associated w. syphilis that causes pale-brown, flat, verrucous lesions w. foul smelling mucus

A

condyloma lata

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7
Q

most specific test for syphilis when active chancre or condyloma is present

A

darkfield microscopy

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8
Q

when will VDRL and RPR be positive for syphilis

A

1-4 weeks after infxn

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9
Q

all pt’s presenting w. first episode of genital HSV should be started on what med regimen asap

A

acyclovir 400 mg tid x 7-10 days
vs
famciclovir 250 mg tid x 7-10 days
vs
valacyclovir 1,000 mg bid x 7-10 days

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10
Q

which strain of HPV is associated w. oorpharyngeal and anal cancers

A

16

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11
Q

painless genital ulcer

A

LGV
chancre

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12
Q

preferred skin surgical incision approach for c section

A

pfannenstiel

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13
Q

pyuria w. no organisms on gram stain

A

chlamydia

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14
Q

change in microbiota w.reduced concentration of lactobacilli

A

BV

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15
Q

growth on thayer martin agar

A

gonorrhea

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16
Q

3 mc complications of PID

A

tubo ovarian abscess
chronic pelvic pain
ectopic pregnancy

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17
Q

7 cardinal movements of fetal descent

A

engagement
descent
flexion
internal rotation
extension
external rotation
expulsion

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18
Q

what maneuver is used to determine fetal position

A

leopold

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19
Q

dx criteria for chorioamnionitis

A

fever >/= 39 (102.2) w.o clear source
fever 38 (100.4) to 38.9 (102.2)
PLUS
maternal leukocytosis > 15,000
fetal tachy >160
purulent or malodorous amniotic fluid

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20
Q

initial diagnostic study for evaluating suspicious breast masses in women < 40

A

core needle bx

not mammogram due to increased breast density

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21
Q

describe lesions associated w. vulvar ca

A

red and white ulcerative lesions

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22
Q

most important rf for endometritis

A

c section

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23
Q

USTFPS rec for breast ca screening for average risk women

A

starting at 50 yo q 2 years

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24
Q

mc region for breast ca to occur

A

upper outer quadrant

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25
Q

what is the T sign

A

monochorionic, diamniotic gestation

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26
Q

serious complication of monochorionic multiple gestations

A

twin-twin transfusion syndrome

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27
Q

4 contraindications to epidural

A

-preload cardiac conditions: aortic stenosis, HOCM
-coagulopathy
-infxn of lower back
-increased intracranial pressure

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28
Q

what do you think when you see a pt w. at least 2 consecutive second trimestr pregnanc losses or early premature births (<28 weeks)

A

cervical insufficiency

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29
Q

3 rf for cervical insufficiency

A

prior cervical trauma
ehlers danlos syndrome
in utero DES exposure

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30
Q

tx for chlamydia in pregnant women

A
  1. azithromycin
  2. test of cure 3-4 weeks after tx
  3. repeat testing 3 months after test of cure
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31
Q

fetal station numbers

A

-5: highest position
0: ischial spine
+3: ischial tuberosity
+5: perineum

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32
Q

what does GTPAL stand for

A

gravida: total # of pregnancies
term pregnancies (37-40 weeks)
preterm deliveries (20-36 weeks)
abortions/miscarriages: before 20 weeks
living children

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33
Q

tx of endometritis: vaginal delivery vs c section

A

vaginal: ampicillin PLUS gentamicin
c section: clindamycin PLUS gentamicin

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34
Q

what PE test is used to monitor therapeutic levels of Mg sulfate

A

patellar reflex

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35
Q

what test is a quantitative measurement of fetal RBC in maternal blood

A

kleihauer-betke

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36
Q

when is it safe to not administer Rh IgG in an Rh negative mother

A

if the father is also Rh negative

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37
Q

tx for bloating, fluid retention, and breast tenderness for PMS

A

spironolactone

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38
Q

variable decelerations

A

compression of the umbilical cord

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39
Q

late decelerations

A

any decrease in uterine bloodflow
placental disruption

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40
Q

tx for late decelerations

A

c section

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41
Q

early decelerations

A

compression of the fetal head

normal benign finding during labor

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42
Q

earliest a molar pregnancy can be diagnosed

A

8 weeks

43
Q

mc cause of cervicitis

A

chlamydia

44
Q

IUD recommended for nulliparous women

A

13.5 levonorgestres-releasing IUD

45
Q

IUD that will stop menstrual bleeding

A

52 mg levonorgestrel-releasing IUD

46
Q

preferred type of episiotomy to minimize risk of anal sphincter laceration

A

mediolateral

47
Q

5 vaccines contraindicated in pregnancy

A

MMR
varicella
polio
BCG (TB)
live attenuated flu

48
Q

what is this showing

A

gonorrhea

49
Q

combined menopausal hormone therapy increases risk for

A

breast ca

50
Q

tx for choriocarcinoma/invasive mole

A

no metastasis: single agent chemo (MTX)
metastasis/older age/higher hCG levels: MTX PLUS uterine wedge resection vs hysterectomy

51
Q

tx for PCOS sx related to menstrual dysfxn and hyperandrogenism

A

combined OCP

52
Q

what 2 meds induce ovulation

A

clomiphene citrate
letrozole

53
Q

safest/most effective method for termination of pregnancies up to 12 weeks

A

suction curretage

54
Q

what incision is a contraindication for a trial of labor in a woman with a prev hx of c section

A

vertical uterine incision

55
Q

first line tx for non pre eclampsia HTN in pregnancy

A

methyldopa

56
Q

uterus becomes firm, there is a sudden gush of blood from the vagina, the umbilical cord moves down out of the vagina

A

normal placental separation

57
Q

best time to draw maternal alpha fetoprotein

A

15-18 weeks

58
Q

5 contraindications for cervical cerclage

A

bleeding of unknown etiology
infxn
labor
ruptured membranes
fetal anomalies

59
Q

hormones indicative of menopause:
FSH:
LH:
androstenedione:

A

FSH: increased
LH: increased
androstenedione: no change

60
Q

what do you think when you see: very firm, 8 cm ovarian mass

what is your first step in tx

A

endometrioid

surgical consult

61
Q

erythematous uticarial patches and plaques (clasically periumbilical) that progess to tense vesicles and blisters in a pregnant woman

A

herpes gestationis (pemphigoid gestationis)

62
Q

what are the four classic biometric parameters of fetal growth

A

cerebellar diameter
abdominal circumference
femur length
biparietal diameter of skull

63
Q

risk of chorionic villus sampling if performed < 10 weeks gestation

A

limb reduction defects

64
Q

t/f: gestational thrombocytopenia resolves postnatally and requires no tx

A

t!

65
Q

first line tx for pt’s who are vaginal or perianal carriers of GBS

A

intrapartum penicillin

66
Q

2 absolute contraindications for combined OCP

A

> /= 35 and smoke
/= 35 and have migraines w. aura

67
Q

in a pt w. irregular menstrual cycles, or unknown date of LMP, what should be used as a marker for repeating urine pregnancy test

A

14 days after last intercourse

68
Q

most sensitive pregnancy test

A

serum

69
Q

factors associated w. decreased risk of endometriosis

A

multiple births
omega 3
late menarche
extended lactation
exercise

70
Q

major difference between pms and pmdd

A

pmdd: presence of symptoms for most of the preceding year

71
Q

what 2 things must be present for dx of postpartum hemorrhage

A

blood loss >/= 1,000 mL
s/sx of hypovolemia w.in 24 hr of birth

72
Q

when is external version typically attempted

A

37 weeks

73
Q

management of suspected breech presentation before 37 weeks

A

US

74
Q

mc rf for transverse lie

A

prematurity

75
Q

what do you think when you palpate the uterus and feel the head in the LUQ

A

transverse lie

76
Q

mc cause of infant morbidity and mortality in the industrialized world

A

spontaneous preterm birth

77
Q

pathway behind spontaneous preterm birth

A
  1. increased cortisol -> increased CRH
  2. PG’s activated -> cervical ripening -> ROM
78
Q

what type of deceleration is this showing

A

variable:
onset to nadir < 20 sec
relationship to contraction is variable

79
Q

criteria for admission for labor

A

cervical dilation > 4 cm
uterine bleeding
abnormal FHR
ruptured membrane

80
Q

phases of first stage of labor based on cervical dilation:
latent phase:
active phase:

A

latent: slow cervical change to ~5 cm
active: rapid cervical change from 6-10 cm

81
Q

which shoulder is delivered first in normal labor and delivery

A

anterior

82
Q

physiologic changes in pregnancy: increases

A

fibrinogn
co
proteinuria
blood volume
wbc
gfr
rbc mass
hr
clotting

83
Q

changes in pregnancy: decreases

A

bun:cr
albumin
svr
hgb
hct
antithrombin III
gut motility
ureteral activity
pco2/hco3

84
Q

frequency of digital cervical exam to document cervical dilation, effacement, and fetal station

A

admit
first stage: q 2-4 hr
prior to anesthesia
second stage: q 1-2 hr
FHR abnormalities

85
Q

t/f: pt’s pregnant w. twins need to double up on most supplements during 2nd and third trimester

A

t!

with the exception of vit D, DHA/EPA, vit C/E

86
Q

protective factors against ovarian ca

A

hormonal contraception
tubal ligation
hysterectomy

87
Q

preferred first line chemo for ovarian ca

A

IV:
carboplatin
PLUS
paclitaxel

88
Q

factors associated w. lower external cephalic version success rates

A

nulliparity
anterior placenta
lateral/cornual placenta
decreased amniotic fluid volume
low birth weight
descent of the breech into the pelvis
obesity
posterior fetal spine
frank breech
ROM
tense uterus
fetal head not palpable thinner myometrium

89
Q

management of a patient you suspect has been abused

A

directly ask patient about specific forms of abuse when he/she is alone

90
Q

screening guidelines for abuse

A

USPSTF: all women of reproductive age
ACOG: all pregnant women at first prenatal visit, once every trimester, and postpartum checkup

91
Q

abd pain or bleeding in first 20 weeks
os closed
no passage of fetal contents

A

threatened abortion

92
Q

abd pain or bleeding in first 20 weeks
os open
no passage of fetal contents

A

inevitable abortion

93
Q

abd pain or bleeding in first 20 weeks
os open
some fetal products passed

A

incomplete abortion

94
Q

abd pain or bleeding in first 20 weeks
os closed
complete passage of fetal contents

A

complete abortion

95
Q

in utero death of embryo/fetus prior to 20 weeks
retention of fetal contents
os closed
no products passed

A

missed/delayed abortion

96
Q

cutoff for CA125 in premenopausal women that indicates need for referral (with ovarian mass)

A

> 200

97
Q

what do you think when you see: 16 weeks gestation, morning sickness that was worse than with prev 2 pregnancies, normal vitals, fundal height 18 cm, elevated Hcg and AFP

A

think multiple gestations -> ordere US

98
Q

baden-walker grading of uterine prolapse

A

1: halfway to the hymen
2: to the hymen
3: halfway past hymen
4: max descent

99
Q

management of unstable pt w. heavy AUB

A
  1. uterine curettage
  2. IV estrogen
100
Q

groove sign

A

LGV

101
Q

management of delayed emergent c-section

A

trendelenburg position
knee-chest position
bladder filling
elevation of presenting fetal part
terbutaline (tocolytic)

102
Q

women from _ have high rates of Rh(D) negative

A

basque country (northern spain/western france)

really Rosh?

103
Q

prominent fibroglandular tissue w. small cysts but no disernable mass

A

fibrocystic breast changes

104
Q

most accurate method of determining EDD

A

crown rump length

EOR - Women's Health (15 decks)

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