OB/Gyn Flashcards
(105 cards)
1
Q
Which contraceptive has greatest risk of DVT/PE?
A
patch
2
Q
pregnant –> positive for syphilis –> PCN allergy –> tx?
A
desensitize in ICU –> treat w PCN
3
Q
DEXA scan –> at what age?
A
65yo
60yo if smoker
4
Q
menopause –> what happens to FSH and anti-Mullerian hormone (increase/decrease)?
A
- increase FSH
- decrease AMH
5
Q
how confirm rupture of membranes?
A
- vaginal pooling
- nitrazine test
- fern test
6
Q
what is fetal fibronectin used for?
A
marker to assess likelihood of preterm labor bw 22-34wk pregnancy
7
Q
fetal heart tone –> late decel –> indicates what?
A
uteroplacental insufficiency
8
Q
fetal heart tone –> early decel –> indicates what?
A
fetal head compression –> increase vagal tone
9
Q
fetal heart tone –> variable decel –> indicates what?
A
umbilical cord compression
10
Q
pregnant –> DVT –> tx?
A
SQ LMWH
11
Q
PID –> inpt tx –> abx?
A
- cefoxitin + doxy
- clinda + gent
12
Q
PID –> outpt tx –> abx?
A
ceftriaxone + doxy + metro
13
Q
secondary amenorrhea –> preg test negative –> next step?
A
check FSH, TSH, prolactin
14
Q
Down synd –> quad screen results
A
- AFP decreased
- estriol decreased
- Bhcg increased
- inhibin increased
15
Q
quad screen:
- AFP decreased
- estriol decreased
- Bhcg decreased
- inhibin decreased
what condition?
A
Trisomy 18
16
Q
quad screen:
- AFP increased
- estriol normal
- Bhcg normal
- inhibin normal
what condition?
A
open neural tube defect
17
Q
quad screen:
- AFP normal
- estriol normal
- Bhcg normal
- inhibin normal
what condition?
A
- normal fetus
- trisomy 13
18
Q
quad screen:
- AFP normal
- estriol decreased
- Bhcg normal
- inhibin normal
what condition?
A
X-linked ichthyoses (steroid sulfatase deficiency)
19
Q
chorionic villous sampling –> at what gestation can be performed?
A
9-11wk gestation
20
Q
at what gestation can amniocentesis be performed?
A
15-20wk gestation
21
Q
chorionic villous sampling prior to 9wk gestation increases fetal risk of what?
A
limb abnormalities
22
Q
DEXA scan –> Tscore of what diagnoses osteoporosis?
A
< -2.5
23
Q
DEXA scan –> Tscore of what diagnoses osteopenia?
A
-1 to -2.5
24
Q
gestation diabetes –> when screen for it?
A
24-28wk gestation (2nd trimester)
25
pap --> atypical glandular cells --> next step
colposcopy w endocervical curettage
26
1st trimester --> genetic screen components
- UA nuchal translucency
- PAPP-A
- hCG
27
2nd trimester --> genetic screen components
triple screen:
- hCG
- AFP
- estriol
quad screen: inhibin-A
28
AFP --> elevated in what conditions (4)
- neural tube defect
- abdominal wall defect (gastroschisis, omphalocele)
- mult gestation
- error in gestational age
29
how dx gestational DM?
1hr gtt >140
| ```
then 3hr gtt:
- fasting >90
- 1hr >180
- 2hr >155
- 3hr >140
any 2
```
30
gestation DM --> tx
insulin (based on post-prandial sugars) <180
31
20-28wk gestation --> what conditions are screened for (3)
- gestational DM
- Rh Ag status
- maternal anemia
32
28wk gestation --> under what conditions give rhogam?
- mom is negative for Rh Ag and Rh Ab
| - dad is Rh Ag+ or unknown
33
gestational DM --> goal fasting glucose
<95
34
3rd trimester --> painless vaginal bleeding --> what condition?
placenta previa
35
3rd trimester --> painful vaginal bleeding --> what condition?
placental abruption
36
placenta previa --> RF (3)
- prior C/S
- multiparity
- uterine surgery
37
3rd trimester --> vaginal bleeding --> next step
fetal ultrasound
38
placental previa --> pelvic exam is contraindicated --> T/F?
T
39
hydatidiform mole --> tx
D&C
40
hydatidiform mole --> tx w D&C --> followup management
monitior hCG --> continued high level can indicate malignancy (commonly mets to lung)
41
late decel --> uteroplacental insuff --> decreased oxygen delivery to fetus
MCC
excessive uterine contraction
42
late decel --> uteroplacental insuff -- due to excessive uterine contraction
common cause of excessive uterine contraction
oxytocin administration
43
pap smear --> atypical cells of undetermined significance (ASCUS) --> next step
HPV screen
or repeat pap in 6-12mo
44
pap smear --> atypical cells of undetermined significance (ASCUS) --> HPV screen positive --> next step
colposcopy
45
pap smear --> stop at what age?
65yo
46
pap --> abnormal cells --> next step
colposcopy
47
abnormal pap --> colposcopy --> ecto positive, endo negative --> next step
local ablation:
- LEEP
- cryoablation
48
abnormal pap --> colposcopy --> ecto negative, endo positive --> next step
cone bx
49
HPV vaccine --> who?
F: 11-26
M: 11-21
50
pregnant --> BMI normal --> how much weight gain during pregnancy?
25-35 lb
51
pregnant --> BMI overweight --> how much weight gain during pregnancy?
15-25 lb
52
pregnant --> BMI underweight --> how much weight gain during pregnancy?
>35 lb
53
pregnant --> BMI obese --> how much weight gain during pregnancy?
11-20 lb
54
pregnant --> how much daily folate supplementation?
400mcg
55
pregnant --> h/o son with spina bifida --> how much daily folate supplementation?
4000mcg
56
Asherman's synd: labs
- FSH level: decreased/normal/increased?
- LH level: decreased/normal/increased?
normal ovarian fx
FSH: normal
LH: normal
57
uterine fundus --> at umbilicus
what gestational age?
20wk
58
17F pregnant --> 37wk gestation --> ER c/o vag bleed, intense pelvic pain --> VSS
dx? next step?
placental abruption
#1 step: assess maternal & fetal status
mother is stable ==> next step is begin fetal monitor
next step is NOT pelvic exam, type&screen, or ABCs
59
nurse is pregnant --> cannot take care of patients with what infections (4)?
- parvovirus B19
- measles
- varicella
- rubella
60
dysfunctional uterine bleeding --> pathophys
unopposed production of estradiol --> anovulatory cycles
61
dysfunctional uterine bleeding --> acute bleeding --> acute tx for acute bleeding
high dose estrogen for 48hr
62
dysfunctional uterine bleeding --> acute bleeding trted w high dose estrogen --> return to ER after 3 days with continued profuse vaginal bleeding
next step? why?
D&C --> rule out endometrial CA
63
>45F --> suspect anovulatory abnormal uterine bleed --> best initial diagnostic test
endometrial bx --> rule out cancer
64
endometrial bx shows endometrial CA --> check what tumor marker to evaluate for extrauterine spread?
CA-125
65
CA-125 --> extremely elevated --> indicates what condition?
ovarian CA
66
postmenopausal bleeding --> bx shows endometrial hyperplasia --> tx
progesterone
67
postmenopausal bleeding --> bx shows endometrial adenoCA --> tx
TAH+BSO
68
postmenopausal bleeding --> bx shows endometrial adenoCA --> mets --> chemotherapy regimen?
paclitaxel + doxorubicin + cisplatin
69
postmenopausal bleeding --> endometrial bx shows complex atypia
tx: progestin or surgery?
surgery
70
postmenopausal bleeding --> endometrial bx shows atypia
tx: progestin or surgery?
progestin
71
postmenopausal bleeding --> endometrial bx shows dysplasia
tx: progestin or surgery?
surgery
72
tamoxifen --> increases risk of what CA?
endometrial
73
pregnant --> vaginal bleeding
Passage of parts: no
Os: open
US: dead baby
dx?
inevitable abortion
74
pregnant --> vaginal bleeding
Passage of parts: yes
Os: open
US: retained parts
dx?
incomplete abortion
75
should be able to see fetus at what B-hCG level?
>1500
76
vaginal bleeding --> UPT positive --> can't see anything on TVUS --> B-hCG <1500
next step?
too early to see pregnancy on ultrasound --> repeat B-hCG quant in 48hr
77
vaginal bleeding --> UPT positive --> can't see anything on TVUS --> B-hCG <1500 --> repeat in 48hr shows B-hCG has doubled
dx?
intrauterine pregnancy
78
vaginal bleeding --> UPT positive --> can't see anything on TVUS --> B-hCG <1500 --> repeat in 48hr shows B-hCG has not doubled
dx?
ectopic pregnancy
79
Sheehan's synd (postpartum hypopituitarism) --> presentation
- failure to lactate
- amenorrhea
- other hypopituitarism
80
Sheehan's synd (postpartum hypopituitarism) --> when does it present?
days to years after delivery
81
prolactinemia --> tx
dopamine agonist:
- pramipexole
- ropinirole
82
prolactinoma --> tx
dopamine agonist:
- pramipexole
- ropinirole
NOT surgery
83
what is savage synd
resistant ovary synd --> ovaries resistant to gonadotropin --> ovarian failure --> 2ndary amenorrhea
84
blind ended vagina
what condition?
- androgen insensitivity synd (testicular feminization)
| - mullerian agenesis
85
androgen insensitivity synd (testicular feminization) --> pathophys
46XY --> X-linked recessive dz --> external genitalia --> fail to masculinize
86
androgen insensitivity synd (testicular feminization) --> risk of what complication
intra-abdominal gonads --> risk of malignancy
87
primary amenorrhea --> FSH & LH are low
what condition?
- Kallman's
| - craniopharyngioma
88
primary amenorrhea + anosmia --> dx?
Kallman's
89
Turner synd --> karyotype
XO
90
OCP can cause HTN
T/F?
T
91
what is raloxifene
SERM:
- breast cancer
- osteoporosis
92
raloxifene --> contraindication?
h/o DVT
93
hepatic adenoma --> assoc w what med?
- OCP
| - anabolic steroid
94
pregnancy --> recommended daily increase in caloric intake
300 kcal/day
95
breast: 2ndary mound
what Tanner stage? what age?
age 13-15 --> Tanner 4
96
breast: enlarge
what Tanner stage? what age?
11.5-13yo --> Tanner 3
97
endometrial bx --> endometrial adenoCA --> next step is CT imaging
T/F
F
next step is TAH/BSO
98
late decels --> uteroplacental insuff --> tx?
- L lat decubitus
- O2
- d/c oxytocin
99
what is contraindication for administering Mg sulfate in eclampsia
myasthenia gravis
100
differentiate: compete vs partial molar pregnancy
complete:
- no fetus --> only moles
partial:
- fetus/amniotic fluid/gestational sac is present
101
PCOS --> tx for oligoovulation/amenorrhea?
clomiphene --> estrogen agonist/antagonist --> increase GnRH pulse amplitude --> increase LH/FSH --> ovulation
102
pubic: adult quality --> sparse distribution
what tanner stage?
Tanner stage 3
103
breast: breast bud
what tanner stage? what age?
10-11.5yo --> Tanner stage 2
104
ovarian cancer that cause SBO --> what kind?
mucinous epithelial carcinoma
105
what constitute severe preeclampsia?
- >160/100
- 3+ proteinuria
- progressive renal fail
