OBGYN

Question 1

significantly elevated DHEAS support the diagnosis of

Answer 1

an adrenal tumor as the etiology of hirsutism

Question 2

Hair loss in woman after baby

Answer 2

Postpartum telogen effluvium (hair loss) affects 40-50% of women postpartum.
↑ estrogen levels in pregnancy ↑ the synchrony of hair growth.
hair grows and is shed at the same time (not normal growth pattern)

Question 3

Rapid onset of hirsutism and virilizing signs are hallmarks of this disease, and include many of the findings in this patient including acne, hirsutism, amenorrhea, clitoral hypertrophy, and deepening of the voice.

Answer 3

Sertoli-Leydig cell tumors

Question 4

Possible causes of virilization include

Answer 4

PCOS
hypothyroidism,
androgen producing tumors (ovarian, adrenal, or pituitary)
anabolic steroid use.
rare cause may be late onset congenital adrenal hyperplasia.

Question 5

__________ is a more severe form of polycystic ovarian syndrome (PCOS).

Answer 5

Hyperthecosis

more difficult to treat with oral contraceptive therapy. It is also more challenging to achieve successful ovulation induction.

Question 6

_______________, can also be used in addition to the oral contraceptives for hirsutism.

Answer 6

Spironolactone, an aldosterone antagonist diuretic

Question 7

Patients with anovulatory bleeding have ?

Answer 7

predominantly proliferative endometrium from unopposed stimulation by estrogen.

Question 8

Progestins inhibit further endometrial growth via

Answer 8

converting the proliferative to secretory endometrium.

Withdrawal of the progestin then mimics the effect of the involution of the corpus luteum, creating a normal sloughing of the endometrium.

Question 9

Disorders of clotting may present with menstrual symptoms in young women, with _______ being most common.

Answer 9

Von Willeberand disease

Question 10

Leiomyomas typically present in women in their _________ age

Answer 10

30’s and 40’s

Question 11

The progestin in oral contraceptives causes ____________

Answer 11

endometrial atrophy- Dysmenorrhea should be improved.

Since prostaglandins are produced in the endometrium, there would be less produced.

Question 12

Endometriosis pathology

Answer 12

endometrial glands/stroma with hemosiderin-laden macrophages

Question 13

An endometrial biopsy should be performed on all women over age _____with irregular bleeding to rule out endometrial carcinoma.

Answer 13

40

Question 14

Hyperplastic overgrowth of endometrial glands/stroma is consistent with ?

Answer 14

endometrial polyps.

Question 15

What is physiologic leukorrhea

Answer 15

non-pathologic copious white vaginal discharge

Question 16

when do you do the quad screen

Answer 16

2nd trimester

Question 17

who is good to get cell free dna

Answer 17

women over 35 or high risk for trisomy

can be done > 10 weeks

Question 18

What cancer is pcos at risk for

Answer 18

endometrial b/c of excess estrogen

Question 19

what is peripartum cardiomyopathy

Answer 19

rapid onset heart failure > 36 weeks prego

CHF symptoms

Question 20

In order to remain in zero calcium balance, postmenopausal women require a total of ______ of elemental calcium per day.

Answer 20

1200 mg

Question 21

Begin treatment with bisphosphonates w/o a bone scan when

Answer 21

Patients who already have had an osteoporotic fracture may be treated on this basis alone.

Question 22

The World Health Organization (WHO) defines osteopenia (low bone mass) as _______

Answer 22

-1 to -2.5

Question 23

In all patients with advanced ovarian cancer, post-operative_____________ is considered standard of care in the United States.

Answer 23

chemotherapy with a combination of a taxane and platinum adjunct

Question 24

________ of the Liley curve indicate the presence of severe hemolytic disease, with hydrops and fetal death likely within 7-10 days

Answer 24

Zone 3

Question 25

Manual vacuum aspiration is more than 99% effective when?

Answer 25

in early pregnancy (less than eight weeks)

Question 26

External cephalic version and internal versions are contraindicated in ?

Answer 26

active labor.

Question 27

__________ is a common complication after vaginal delivery

Answer 27

Acute cystitis- usually e coli

Question 28

________ is used in pregnancy to treat migraine headaches.

Answer 28

. Amitriptyline

Question 29

Twin-twin transfusion syndrome most commonly occurs in ?

Answer 29

monochorionic, diamniotic twins

is the result of an intrauterine blood transfusion from one twin to the other. It

Question 30

Asthma generally worsens in 40% of pregnant patients. One of the indications for moving to the next line of treatment includes ?

Answer 30

the need to use beta agonists more than twice a week.

Question 31

One SSRI, __________ has been changed to a category D drug because of _____________

Answer 31

paroxetine (Paxil)

↑ risk of fetal cardiac malformations and persistent pulmonary hypertension.

Question 32

The following are associated with retained placenta:

Answer 32

prior Cesarean delivery, uterine leiomyomas, prior uterine curettage and succenturiate lobe of placenta.

Question 33

what does estrogen do to cholesterol

Answer 33

HDL levels increase and LDL levels decrease

Question 34

fetus requirements for methotrexate termination of ectopic

Answer 34

size of ectopic mass <4 cm without a fetal heart rate or <3.5 cm in the presence of a fetal heart rate

Question 35

Colpocleisis is one option to treat _______

Answer 35

uterine prolapse

Question 36

best treatment for stress incontinence

Answer 36

sling

aka Retropubic urethropexy

Question 37

Mifepristone can be effective up to?

Answer 37

nine weeks.

Question 38

Women with a___________ have up to a 2.5 fold increase in prolapse.

Answer 38

family history of POP

Question 39

Medical abortion is associated with ____________ vs surgical abortion

Answer 39

higher blood loss

Question 40

Primary vulvar adenocarcinomas most likely arise from the ?

Answer 40

Bartholin gland

Question 41

Bone density screening is recommended for women beginning at age ?

Answer 41

65

unless they have pre-existing risk factors which warrant earlier screening. Risk factors for osteoporosis are early menopause, glucocorticoid therapy, sedentary lifestyle, alcohol consumption, hyperthyroidism, hyperparathyroidism, anticonvulsant therapy, vitamin D deficiency, family history of early or severe osteoporosis, or chronic liver or renal disease.

Question 42

Growth of uterine fibroids is stimulated by ?

Answer 42

estrogen

Question 43

Systemic diseases such as diabetes mellitus, chronic renal disease and lupus are associated with?

Answer 43

early pregnancy loss