Women's Health and OBGYN

Question 1

Discriminatory zone for + pregnancy bHCG?

Answer 1

When bHCG is >1500, you should be able to see an intrauterine pregnancy. if bHCG is >1500 and you do not see an intrauterine pregnancy on ultrasound then it is most likely ectopic

Question 2

How do you decide how to treat an ectopic pregnancy?

Answer 2

Based on the patient’s hemodynamic status.
If stable -> Methotrexate
If unstable -> surgery

Question 3

Are endometrial biopsies necessary for screening of patients on adjuvant chemo for estrogen receptor positive chemon on Tamoxifen?

Answer 3

No
An endometrial biopsy is the first step in the evaluation of postmenopausal bleeding, to exclude malignancy. Screening asymptomatic patients on tamoxifen has been shown to increase procedure rates (eg, dilation and curettage) but not increase cancer-detection rates.

Question 4

in labor Misoprostol is used for….

Answer 4

a prostaglandin E1 analog, is used for cervical ripening and labor induction (stimulation of contractions prior to spontaneous labor), not for labor augmentation.

Question 5

Indication of Caesarian delivery?

Answer 5

indicated for arrest of labor (ie, no cervical change in the active phase of labor for >4 hours with adequate contractions or >6 hours without adequate contractions)

Question 6

Treatment steps for infertility in patients with PCOS?

Answer 6

1. Weight loss
2. Clomiphen Citrate
3. Gonadotropins (FSH and LSH)
4. In-vitro fertilization (first line therapy in patients with abnormal hysterosalpingogram indicating fallopian tube obstruction

Question 7

Pregnancy screening tests at initial prenatal visit, 24-28 wks and 35-37 weeks?

Answer 7

Initial prenatal visit

Rh(D) type, antibody screen
Hemoglobin/hematocrit, MCV
HIV, VDRL/RPR, HBsAg
Rubella & varicella immunity
Pap test (if screening indicated)
Chlamydia PCR
Urine culture
Dipstick for urine protein

24-28 weeks

Hemoglobin/hematocrit
Antibody screen if Rh(D) negative
50-g 1-hour GCT

35-37 weeks

Group B Streptococcus culture

Question 8

Is Vitamin B12 anemia microcytic or macrocytic?

Answer 8

MACROcytic

Question 9

It is ok for women to receive epidural if platelets are greater than???

Answer 9

> 70,000 and are not rapidly dropping

Question 10

Sexual assault victims should be provided empiric post-exposure prophylaxis for…

Answer 10

chlamydia (azithromycin), gonorrhea (ceftriaxone), trichomoniasis (metronidazole), and HIV (tenofovir-emtricitabine with raltegravir). Post-exposure prophylaxis with the hepatitis B vaccination is dependent on vaccination status and is not indicated in this patient due to her recent vaccination.

Question 11

Sexual assault victims should be provided empiric post-exposure prophylaxis for…

Answer 11

chlamydia (azithromycin), gonorrhea (ceftriaxone), trichomoniasis (metronidazole), and HIV (tenofovir-emtricitabine with raltegravir). Post-exposure prophylaxis with the hepatitis B vaccination is dependent on vaccination status and is not indicated in this patient due to her recent vaccination.

Question 12

Estrogen promotes endometrial…

Answer 12

proliferation and increased endometrial lining

Question 13

Progesterone cues the endometrium to…

Answer 13

shed its lining