OB/GYN 2

Question 1

Ca2+ supplementation in postmenopausal women

Answer 1

1200-1500mg/day (+vit d)

Question 2

3 Tx for osteoporosis

Answer 2

exercise, SERMS (no effect on hot flashes) and bisphosphonates (improve BMD and prevent frx)

Question 3

what amt of wt gain during pregnancy is recomnneded for those of:
normal wt
underwt
overwt
what is the kcal goal?

Answer 3

normal = 25-35lbs

underweight = 35-40lbs

overweight = 15lbs

i.e. 30-35kcal/kg of IDEAL body weight

Question 4

3 MC meds during pregnancy

Answer 4

prenatal vitamin, anti-emetic (Zofran), ranitidine (GERD)

Question 5

3 MC effects of maternal smoking during pregnancy

Answer 5

IUGR, preterm delivery, placental abruption

Question 6

Braxton Hicks contractions

Answer 6

false labor (no physiologic changes)

Question 7

4 stages of pregnancy

Answer 7

1. first stage: onset of labor–> full cervical dilation (10 cm)
   latent phase: cervical effacement–> early dilation
   active phase: 4 cm dilation and onward is active dilation
2. second stage: complete cervical dilation–> delivery of infant
3. third stage: delivery of infant–> delivery of placenta
4. fourth stage: 2 hrs after delivery of placenta (physiological adjustment)

Question 8

7 cardinal movements of labor

Answer 8

engagement (zero station), flexion, descent, internal rotation, extension, external rotation, expulsion

Question 9

2 causes of overestimating fetal descent/station

Answer 9

caput succedaneum, molding

Question 10

extensive blood loss after delivering the placenta? Tx?

Answer 10

Uterine atony, tx= uterine massage, oxytocin, methergine and prostaglandins

Question 11

2 meds for cervical ripening and CI, alternatives

Answer 11

Misoprostol and PGE2

CI if prior C-section, prior uterine srgy

alternatives = laminaria and 30ml foley catheter

Question 12

6 etiologies of chronic HTN in pregnancy

Answer 12

essential HTN, aortic coarctation, CT d/s, hyperthyroidism, hyperaldosteronism, Cushing’s d/s

Question 13

5 maternal complications of chronic HTN during pregnancy

Answer 13

cerebrovascular accident, placental abruption, super-imposed pre-eclampsia, renal disease, retinopathy

Question 14

3 tx for chronic HTN in pregnancy

Answer 14

methyldopa, labetolol, nifedipine

Question 15

MCC death of pregnant mom

Answer 15

Pre-eclampsia

Question 16

5 maternal complications of pre-eclampsia

Answer 16

CVA, ARF, pulmonary edema, eclampsia, death

Question 17

5 fetal complications of pre-eclampsia

Answer 17

IUGR, anemia, neutropenia, thrombocytopenia, death

Question 18

8 RF for placental abruption

Answer 18

age >35, multiparity/gestation, HTN, smoking, cocaine, uterine anomalies, prior hx

Question 19

3 tx placental abruption

Answer 19

C-section, IVF/transfusions, FFP/platelets

Question 20

MCC neonatal mortality

Answer 20

preterm delivery

Question 21

define prolonged latent phase, 1st pregnancy vs multiparous

Answer 21

1st = >20hrs

2+ = >14hrs

Question 22

arrest of dilation definition

Answer 22

no change in dilation for 2+ hrs in the ACTIVE phase of labor

Question 23

protracted desecent of labor nullipara vs multipara

Answer 23

nullipara = >2hrs of 2nd stage of labor

multipara = >1hr of 2nd phase

Question 24

3 tx for abnormal labor

Answer 24

abx if maternal infxn, amniotomy, oxytocin

Question 25

5 MC indications for C-section

Answer 25

dystocia, prior CS, fetal distress, bleeding, malpresentation

Question 26

MC complications of CS (5)

Answer 26

hemorrhage \>\> endometritis, UTI, bladder/bowel injury, wound infxn

Question 27

MCC post-op complication of CS

Answer 27

endometritis

Question 28

ml for post-partum hemorrhage vaginal vs. CS

Answer 28

vaginal = \>500ml CS = \>1000ml

Question 29

MCC post-partum hemorrhage

Answer 29

uterine atony

Question 30

MCC emergency HYSTERECTOMY

Answer 30

placenta accreta

Question 31

lacerations MC in precipitous vs. instrument delivery

Answer 31

precipitous = cervical instrument = vaginal

Question 32

4 causes of post-partum coagulopathy

Answer 32

severe pre-eclampsia, placental abruption, sepsis, amniotic fluid embolism

Question 33

Tx post-partum coagulopathy

Answer 33

platelets, FFP and croprecipitate

Question 34

3 organisms causing endometritis

Answer 34

coliforms, bacteroides, streptococcus

Question 35

post-partum fever, tachycardia, pelvic pain and tenderness but otherwise no localizing sx, dx?

Answer 35

endometritis

Question 36

Tx endometritis

Answer 36

DOC = clinda + gent OR metro+PCN OR amp+gent OR cefotetan

Question 37

Tx post-CS wound infxn

Answer 37

nafcillin and vancomycin

Question 38

4 RF for post-partum UTI

Answer 38

prior infxn, prolonged catheterization, SS disease, immunodeficiency

Question 39

Tx UTI postpartum (oral vs. IV)

Answer 39

oral = bactrim or nitrofurantion, augmentin IV = ceftriaxone, gent or aztreonam

Question 40

4 MCC post-partum UTI

Answer 40

E coli, klebsiella, proteus, gram+

Question 41

3 tx for post-partum depression

Answer 41

SSRI, venlafaxine or buproprion