OBGYN 3

Question 1

indication for cerclage

Answer 1

h/o incompetent cervix

h/o preterm delivery and short cervix found on US in 2nd trimester

Question 2

reasons why TMP-SMX CI in pregnancy

Answer 2

1st trimester: interferes w/ folic acid metabolism

3rd trimester: kernicterus

Question 3

most accurate dating gestational age

Answer 3

first trimester US with crown rump length

Question 4

when estimated gestational age with LMP differs from ultrasound by ____, change to ultrasound date

Answer 4

more than 7 days in 1st trimester US

more than 10 days in 2nd trimester US

Question 5

DIC in pregnancy associated with

Answer 5

amniotic fluid embolism
preeclampsia
sepsis

Question 6

risk factors for postpartum uterine atony

Answer 6

prolonged labor
chorioamnionitis
uterine over distention (mult gestations, polyhydram)
retained placenta

Question 7

list 3 uterotonics and their contraindications

Answer 7

oxytocin
methylergonovine (incr BP)
carboprost (asthma)

Question 8

reasons why pregnant are screened for asymptomatic bacteriuria

Answer 8

low birth weight

incr risk pyelonephritis

Question 9

what happens to BUN and Cr in pregnancy, and why?

Answer 9

decrease

increase renal plasma flow and GFR

Question 10

isotretinoin birth defects

Answer 10

craniofacial
heart
deafness

Question 11

type of wrist pain in new mothers, and what tendon

Answer 11

de quervain tenosynovitis

abductor pollicis longus and extensor pollicis brevis

Question 12

when to screen for asymptomatic bacteriuria

Answer 12

1st trimester

Question 13

3 tumors that cause maternal virilization

Answer 13

luteoma
theca luteum cyst
Krukenberg tumor

Question 14

indications for NST

Answer 14

high risk pregnancies starting at 32-34 weeks

loss of perception of fetal movements

Question 15

causes of fetal tachycardia

Answer 15

maternal fever
maternal hyperthyroidism
meds (terbutaline)
abrupio placentae

Question 16

sinusoidal fetal heart tracing

Answer 16

fetal anemia

Question 17

causes of variable decels

Answer 17

cord compression

Question 18

cell free DNA can detect

Answer 18

trisomy 13, 18, 21

Question 19

gestational DM screen

Answer 19

24-28 weeks with OGTT

OR if high risk / sxs, can do A1c in first trimester

Question 20

ATBs for UTI

Answer 20

nitrofurantoin
PCN
amox-clav
fosfomycin

Question 21

persistent bacteriuria (after at least 2 courses of therapy)… management?

Answer 21

daily prophylactic therapy for rest of pregnancy

Question 22

preferred OCP in lactating women and why

Answer 22

progesterone only pill

• doesn’t affect milk
• no risk of VTE

Question 23

patient does not want to breastfeed anymore. what to do

Answer 23

tight fitting bra

ice packs

Question 24

DES female and male babies

Answer 24

female: hooded cervix, T shaped uterus, small uterine cavity, vaginal septae
male: hypospadias, cryptorchidism, microphallus, testicular hypoplasia

Question 25

foamy macrophages and fat globules on breast biopsy is

and calcifications on mammo, and fixed irregular mass

Answer 25

fat necrosis

Question 26

fetal anemia associated with

Answer 26

vasa previa

Question 27

suspect endometrial cancer… workup

Answer 27

premenopausal: endometrial biopsy
postmenopausal: transvaginal ultrasound

Question 28

timing of pain in endometriosis

Answer 28

2 weeks up to right before menses

Question 29

woman 25+, ASCUS.. and HPV +, next step

Answer 29

colposcopy

Question 30

woman 25+, ASCUS.. and HPV neg, next step

Answer 30

Pap and HPV in 3 years

Question 31

woman 21-24 and ASCUS or HSIL, next step

Answer 31

repeat in 1 year

Question 32

cervical cancer screening for immunocompromised (including SLE)

Answer 32

start at onset of sexual activity
Q 6 months x 2
then annually