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ABOG written test prep > deck 5 > Flashcards

deck 5 Flashcards

1
Q

treatment for transfusion-associated citrate toxicity?

A

Calcium chloride or gluconate

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2
Q

what is the prevelence of obesity in 20-39 year old women?

A

40%

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3
Q

why would you titrate LMWH levels in pregnancy and what is your target therapeutic level

A

altered metabolism ie from morbid obesity or renal disease

0.6-1.0 measured 4 hours after dosing.

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4
Q

recommended daily intake of iodine in pregnancy

A

220 mcg

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5
Q

criteria for dx of diabetes

A

HgbA1c > 6.5%
Fasting BS > 126
2hr after 75g glucose > 200
random > 200 w/ symptoms

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6
Q

what is the failure rate for detecting endometrial cancer in postmenopausal women using an in-office pipelle for endometrial biopsy?

what percentage of the cavity is sampled?

A

1%

5-15%

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7
Q

what is the increased risk of endometriosis with a first degree family member with the diagnosis

A

8x higher risk

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8
Q

failure rate of copper and mirena IUDs

A

copper - 0.8%
mirena - 0.2%
sterilization - 0.5%

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9
Q

absolute vs relative contraindications of cell saver

A

absolute:
- contamination with hemostatic products or bone cement (floseal, surgicel ect)
- hypotonic fluids (sterile water)
- solutions that would be toxic with IV administration (abx irrigation, hydrogen peroxide, alcohol, iodine)

Relative

  • bacterial infection in surgical wound
  • active malignancy in surgical field
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10
Q

14-methyl prostaglandin F2-alpha aka and side effects

A

carbaprost

Side effects include diarrhea, flushing, hypertension, tachycardia, nausea, or vomiting. Additionally, bronchospasm may occur, so this medication is contraindicated in patients with a history of asthma.

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11
Q

MOST COMMON complication following laparoscopic gynecologic surgery?

A

bleeding

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12
Q

rate of vertical transmission of herpes simplex virus with primary genital infection at time of vaginal delivery?

A

40-80%

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13
Q

ppx for hx of HSV infection in pregnancy

A

Beginning at 36 weeks’ gestation, either

  • acyclovir 400 mg three times daily or
  • valacyclovir 500 mg twice daily
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14
Q

odds ratio equation

A

ad/bc (cross products)

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15
Q

How is iodide transported across the placenta

A

carrier mediated process

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16
Q

Erb’s palsy involves which nerve roots

A

C5-6

waiters tip

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17
Q

Klumpke’s palsy

A

claw hand
C8-T1
may be associated with Horner’s syndrome, with ptosis, and miosis

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18
Q

treatment of thyroid storm

A
  • PTU
  • iodine 1-2hours after PTU
  • Dexamethasone or hydrocortisone (blocks peripheral conversion of T4 to T3)
  • B-blocker
  • supportive measures
  • avoid delivery during storm, fetal status should improve after maternal stabilization
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19
Q

extraintestinal manifestations of chron’s

A

Venous Thromboembolism
Renal Calculi
Osteoporosis
B12 Deficiency

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20
Q

On average, epidural analgesia prolongs the

second stage of labor by how many minutes?

A

5-10 minutes

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21
Q

The granulosa cell aromatase enzyme allows conversion of androstenedione to which hormone

A

estrone

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22
Q

In which phase of the cell cycle does protein

synthesis and RNA synthesis occure

A

G1

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23
Q

What phase of the cell cycle does DNA replication occure

A

S

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24
Q

bone formation markers

A

Osteocalcin
Bone specific alkaline phosphatase
Procollagen type I
N-terminal pro-peptide

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25
when do you repeat dexa scan for a patient with osteopenia
5 years (could do sooner if T score < -2)
26
organism for ear infection in adult
H. flu
27
Why use a b-blocker in a pregnant pt with mitral stenosis
prevents tachycardia leading to pulmonary edema
28
After an exposure and infection with Hepatitis B, | what is the first detectable serological marker?
HBsAg
29
In cases of endometrial cancer, levels of which | tumor associated antigen are most elevated?
CA 125
30
why do pts with spinal cord injuries require early epidural
to prevent autonomic dysrelexia (aka autonomic hyperreflexia) found in 85% of pts with lesion at or above T6. the large, unopposed sympathetic outflow causes sudden elevation in blood pressure, piloerection, skin pallor, and severe vasoconstriction below the neurologic level. Goal of a T10 level
31
non surgical options for tx of EIN
``` Medroxyprogesterone acetate Depot medroxyprogesterone Micronized vaginal progesterone megestrol acetate Levonorgesterel IUD ```
32
A female fetus has 6-7 million oocytes present during the 20th week of gestation. Approximately how many oocytes are present at birth? at puberty?
1.5 million 300,000
33
Which POP-Q point represents the level of uterosacral | ligament attachment to the proximal posterior cervix?
D (not assessed s/p hyst)
34
at unicornuate uterus can be associated with what other gyne pathology
endometriosis
35
WHI risks for estrogen only HRT
Among women receiving estrogen only, there was an increased risk of thromboembolic events, but not an increased risk of cardiovascular events or breast cancer
36
WHI findings for combined HRT
slightly increased risk of breast cancer, coronary heart disease, stroke, and venous thromboembolic events Decreased risk of fractures and colon cancer
37
changes to the renin-angiotensin-aldosterone system during pregnancy
all are increased. which helps to maintain BP particularly in first trimester renin is produced in the maternal kidneys and placenta
38
Isotrentinoin affects on pregnancy
include external ear malformations, cleft palate, micrognathia, conotruncal heart defects, ventricular septal defects, aortic-arch malformations, and certain brain malformations.
39
CT scan with fibromuscular dysplasia
rental artery stenosis
40
FENa < 1
pre-renal
41
treatment for varicella exposure in pregnancy? illness? pneumonia?
exp - VZIG if nonimmune Illness - oral acyclovir pneumonia - IV acyclovir
42
#1 risk factor for dysparunia postpartum
3rd-4th degree lacs
43
preferred suture for cerclage
uncoated polyester (permanent and low inflammation)
44
among women with recurrent genital herpes how many will have recurrence in pregnancy? at time of delivery?
75% | 14%
45
diagnostic test for pelvic congestion syndrome
pelvic venography (can dx and tx) or pelvic CT
46
what risk is associated with a prosthetic heart valve and how should it be prevented
infectious endocarditis single dose of abx 30-60 minutes prior to delivery ppx abx for invasive dental procedures
47
what gestational age do you begin screen for TTTS
16 wks
48
what is the best regimen for stress dose steroids in laobr
hydrocortisone 25 mg IV every 6 hours.
49
who does NOT require stress dose steriods
- taking steroids for < 3wks - <5mg/day prednisone for any length of time - < 10 mg prednisone every other day
50
risk of HIV and HepB with blood transfusion
1: 2 million HIV 1: 200,000 hep B
51
gestational age for vacuum delivery
> 34 wks due to increased risk of neonatal complications, including neonatal cephalohematoma, retinal hemorrhage, and intracranial hemorrhage. forceps acceptable < 34wks
52
most reliable sign of placental seporation
cord lengthening
53
most common type of epithelial ovarian cancer
serous
54
most likely form of fibroid degeneration in pregnancy
carneous/red
55
where are the inferior epigastric vessels located at the level of the ASIS
inferior epigastric vessels typically lie 3.7 cm from the midline at the level of the anterior superior iliac spine
56
At the level of the ASIS where should trochars be placed to avoid injuries
Most injuries to either nerves or vessels can be avoided if placement is >6 cm from the midline at this level 2cm medial to and at or superior to the ASIS, lateral to the rectus border
57
what angle should the umbilical trochar be placed
45 degrees (up to 60 in an obese patient)
58
sensitivity of dx torsion by US
75-90%
59
what is the most common classification of neonatal HSV infection
disease limited to the skin, eyes, or mouth | disseminated disease #2, CNS disease #3
60
At what GA do red blood cells appear
7-8 weeks
61
A "increased awareness to breath" in pregnancy is caused by
decreased PCO2 (respiratory alkalosis)
62
cardiopulmonary changes in pregnancy CO, HR, SVR, Pulm vascular resistance
increased cardiac output (+45%) increased heart rate (+17%) decreased systemic vascular resistance (-21%) decreased pulmonary vascular resistance (-34%)
63
Changes in respiratory system in pregnancy FRC, Lung cap, residual volumen, expiratory reserve V, inspiratory capacity, tital volume
``` decreased functional residual capacity (responsible for more shallow breathing) decreased total lung capacity decreased residual volume decreased expiratory reserve volume increased inspiratory capacity increased tidal volume ```
64
what are increased when both forceps and vacuums are used for a vaginal delivery compared with either method alone
anal sphincter injuries | intracranial injuries
65
who is a candidate for a presacral neurectomy?
pts with refractory, midline, pelvic pain, who is young and desires future fertility and has already undergone multiple laparoscopies resection of the sympathetic nerves over the sacral promontory to block visceral afferent signals from the pelvic organs
66
among women who are high risk for neural tube defect how much can folic acid reduce the risk
In a high-risk population, neural tube defects can be prevented in up to 70% of cases with appropriate folic acid supplementation of 4 mg daily, beginning at least 3 months prior to pregnancy
67
4 parts to pathogenesis of endometriosis
- retrograde menstruation - increased COX-2 > overproduction of prostoglandins - increased aromatase > increased local estrogen - Progesterone resistance > amplifies estrogenic effect
68
hydral pathway for severe BPs
give 5 or 10 mg wait 20 minutes if still severe give 10 mg wait 20 minutes > switch to labetalol
69
how does pregnancy affect HIV disease course
no change
70
for AIS when do you removed testes
after puberty | risk of malignancy prior to 20 y/o is very low
71
layers of the abdominal wall
``` skin campers scarpas anterior rectus sheath rectus abdominis muscle transversalis fascia peritoneum ```
72
anion gap calc
sodium - (chloride+bicarb)
73
first trimester screen
HCG, PAPP-A, NT
74
polydioxanone
PDS | initially same strength as vicryl but maintains 50% strength at 4 weeks and less inflammation
75
affects of TXA when used for PPH
reduction in maternal MORTALITY | benefits occurred when received within 3 hours from delivery
76
how much does a BSO reduce the risk of ovarian cancer in patients with BRAC
80%
77
pagets disease of the breast is associated with which cancer
Ductal or DCIS
78
other than breast and ovarian Ca BRCA1 &2 are associated with
1- prostate | 2- pancreas, prostate, melanoma
79
In patients with perianal extramammary Paget's disease, | up to 90% of cases may also have what other type of cancer?
colorectal
80
sacral agenesis occurs at what gestationa
3-7 wks
81
VACTERL
``` V - Vertebral anomalies A - Anorectal malformations C - Cardiovascular anomalies T - Tracheoesophageal fistula E - Esophageal atresia R - Renal (Kidney) and/or radial anomalies L - Limb defects ```
82
most common cause of necrotising fascitis
Group A strep

ABOG written test prep (7 decks)

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