OB GYN

Question 1

Preeclampsia

- RF

Answer 1

• > 40 yo
• nulliparity
• fam hx
• oesity
• twins
• hx HTN, DM, renal dz

Question 2

Preeclampsia

- dx

Answer 2

• new onset HTN >140/90
• proteinuria >300 mg/24 hour
• > 20 weeks gestation

Question 3

Preeclampsia

- mgmt

Answer 3

• > 37 weeks: deliver
• 34-37 weeks: induced if severe dz
• <34 weeks: steroids

Question 4

Mifepristone

- CI

Answer 4

• chronic adrenal failure
• long term steroid use
• drug is glucocorticoid receptor antagonist

Question 5

Medical abortion

- meds

Answer 5

• Mifepristone followed by misoprostol

- copper IUD

Question 6

Cyclical breast pain

- mgmt

Answer 6

• Reassurance, physical support (bra) and NSAID/tylenol

- second line: tamoxifen, danazol for 1-3 months only

Question 7

APGAR
score range
details

Answer 7

0-10
- Appearance: 
0 blue/pale 
1 body pink extremities blue
2 pink all over
- Pulse:
0 absent
1 <100
2 >100
- Grimace
0 Flaccid
1 grimace with stimulation
2 active motion - sneeze, cough, pulls away
- Activity / m tone
0 absent
1 arms/legs flexed
2 active movement
- Respiration
0 absent
1 slow, irregular
2 vigorous cry

Question 8

Fetal station

Answer 8

Position of presenting part (usu head) in centimeters relative to line across ischial spines

• superior = negative station (negative numbers 1-5)
• inferior = positive station (pos numbers 1-5)
• at the line: 0 station

Question 9

Best way to dx herpes simplex

Answer 9

PCR

- Tzanck less sensitive/specific

Question 10

Placental abruption

- biggest RF

Answer 10

prior placental abruption

also HTN, cigs, cocaine, multiparty

Question 11

Ovarian torsion

- definitive dx

Answer 11

laparoscopy

- pelvic US first line

Question 12

Labor induction

Answer 12

• ripen cervix (Bishop <6): prostaglandin E2 or E1 (dinoprostin/misoprostol)
• oxytocin

Question 13

Bishop score

Answer 13

Higher = greater chance of successful vag delivery

Question 14

Cord prolapse

- mgmt

Answer 14

• elevate presenting part of fetus
• trendelenburg position
• tocolytic

Question 15

Infertility

- dx best test

Answer 15

• anti-mullerian hormone: decline steadily with age, undetectable at menopause

Question 16

Fetal non stress test

- overview

Answer 16

measures

• fetal heart rate
• uterine contractions

Reactive (nl) if
- 2+ fetal HR accelerations 15 bpm for 15 second in 20 min

Nonreactive (abnl)
- no sig acceleration of HR, repeat in 30 min (sleeping?)

Question 17

Fetal biophysical profile

- measure what

Answer 17

1. fetal tone
2. fetal breathing
3. fetal movement
4. amniotic fluid volume

Question 18

Early vs. late decelerations

Answer 18

Early: fetal head compression
Late: fetal hypoxemia - placental insufficiency or cord compression

Question 19

Ovarian cancer

Answer 19

MCC gyn cancer death

• MC epithelial cell origin
• pelvic US to start

Question 20

Ovarian cancer tumor marker

Answer 20

CA 125

Question 21

Placenta accreta spectrum

Answer 21

• accreta: attaches to myometrium
• increta: into myometrium
• percreta: penetrates through myometrium

Question 22

Lymphogranuloma venereum

• bug
• location

Answer 22

• chlamydia trachomatis

- Africa, SE Asia, Caribbean, S. America

Question 23

Lymphogranuloma venereum

- clinical

Answer 23

• painless vesicle or ulcer, resolves spontaneously
• inguinal buboes bilaterally > multiple draining sinuses
• proctitis with tenesmus, bloody purulent drainage from anal region, scarring of perirectal tissue

Question 24

Lymphogranuloma venereum

- mgmt

Answer 24

• doxy 100 mg BID X 21 D

- I&D inguinal buboes

Question 25

Anterior fontanelle | - composed of what sutures

Answer 25

- coronal - frontal - sagittal

Question 26

Best fetal presentation

Answer 26

- longitudinal - cephalic - vertex - occiput anterior

Question 27

Adenomyosis | - overview

Answer 27

- endometrial tissue is in myometrium

Question 28

Adenomyosis | - clinical

Answer 28

- abnl uterine bleeding - painful menses - uterine enlargement - globular, boggy, symmetric uterus on palpation

Question 29

Adenomyosis | - mgmt

Answer 29

- NSAIDs - OCPs - endometrial ablation, resection if conservative fails - definitive: hysterectomy

Question 30

First line dx for dysfunctional uterine bleeding

Answer 30

- transvaginal US

Question 31

Abnormal Uterine Bleeding | - causes

Answer 31

PALM COEIN - Polyp - Adenomyosis - Leiomyoma - Malignancy/hyperplasia - Coagulopathy - Ovulatory dysfunction - Endometrial - Iatrogenic - Not yet classified

Question 32

Hypermg | - sx

Answer 32

- Loss of DTR - Decr respirations - Impaired urinary output

Question 33

Endometrial Hyperplasia | - RF

Answer 33

- increased exposure to estrogen: obesity, PCOS, exogenous E

Question 34

Endometrial Hyperplasia | - clinical

Answer 34

- abnormal uterine bleeding

Question 35

Endometrial Hyperplasia | - dx

Answer 35

- endometrial bx | - pelvic US to ro other causes of AUB

Question 36

Endometrial Hyperplasia | - mgmt

Answer 36

- no atypia: Progestins (IUD) | - atypia: Hysterectomy (keep the eggs)