CFP

Question 1

sterilization method with highest rate ectopic pregnancy

Answer 1

bipolar coag (17:1000)

Question 2

Mgmt if pt has IUD -> then develops PID

exceptions?

Answer 2

leave IUD in place (consider removal if no improvement in 48-72hrs of tx)

*PID sx + IUD + hx actinomyces (also add tx)

Question 3

PID Tx Abx

duration?

any exceptions?

Answer 3

ceftriaxone 500 IM nce + PO doxy 100 q12hrs + PO flagyl 500 q12hrs

duration: 14d (except ceftriaxone, one time dose)

exception: if pt >150kg, 1g ceftriaxone!)

Question 4

sepsis c/b Clostridium infxn:
1. appearance on imaging
2. mgmt

Answer 4

appearance: air w/i myometrium
mgmt: hysterectomy + bs

b/c mor esevere

Question 5

ideal GA to perform nonemergent laparoscopy? (if can’t delay until postpartum)

Answer 5

early second trimester

Question 6

ACOG rec for FH monitoring in pregnant pt nonemergent laparoscopic surgery

Answer 6

viable: NST with toco
previable: FH check

Question 7

Anesthesia during 2T pregnancy

Answer 7

no teratogenic effects, esp <3hrs

Question 8

Dx Cx post-molar GTN

Answer 8

1. hcg rise 10% (3 values in 2wks)
   or
2. hcg plateau (4 values w/i 10%, 3wks)

Question 9

WHO score for low-risk GTN

tx

Answer 9

6 or lower

MTX

Question 10

WHO score for high-risk GTN

tx

Answer 10

7 or greater

likely EMACO

Question 11

GTN WHO score higher risk components

Answer 11

1. age >40
2. abortion or term pregnancy
3. longer interval from index pregnancy
   4.higher pretreatment serum hcg
   5.GI, liver, brain mets (lung = 0 pts)
   6.more mets
   7.more previously failed chemo

Question 12

Relative CI to MTX for ectopic

Answer 12

+FH on sono
high hcg
size >4cm
refuse blood

Question 13

absolute CI to MTX for ectopic

Answer 13

-inability to fu
-active pulm, ulcer, renal, hepatic d/z
-immunodeficiency
-mod/severe anemia
-breastfeeding
-MTX hypersensitivity
-ruptured
-hemodynamic instability

Question 14

home pregnancy test timing after med AB

Answer 14

~4wks

Question 16

septic Ab Abx tx

Answer 16

triple therapy:
1. IV ampicillin = gram pos aerobes
2. IV gentamycin = gram neg aerobes
3. IV clindamycin = gram pos MRSA, MSSA; anaerobes

Question 17

sono signs DX of IUP (and what GA they are visible)

Answer 17

1. yolk sac (visible @ 5.5w)
2. embryo (visible @6w)
3. caridac activity (visible @6w)

Question 18

sono signs SUGGESTIVE of IUP (and what GA they are visible)

Answer 18

1. trilaminar endometrium (3-5w)
2. gest sac with double-decidual sign (4-9w)

Question 19

fertility rates of:
salpingectomy
salpingostomy

Answer 19

similar
salpingostomy: 60%
salpingectomy: 53%

Question 20

rate of recurrent prgnancy:
salpingostomy
salpingectomy

Answer 20

salpingostomy: 18%
salpingectomy: 7.7%

Question 21

Complete mole Karyotype

Answer 21

diploid (paternal origin)

empty egg so sperm duplicate ch

Question 22

partial mole Karyotype

Answer 22

triploid (maternal + paternal)