Ob/Gyn Blueprints & ACOG Flashcards Preview

Shelf Exams/USMLE Step 2 CK > Ob/Gyn Blueprints & ACOG > Flashcards

Flashcards in Ob/Gyn Blueprints & ACOG Deck (51)
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1
Q

What should all patients with bleeding during pregnancy receive?

A

Blood test for Rh status

If negative give RhoGAM to prevent isoimmunization

2
Q

What is terbutaline used for?

A

Beta 2 agonist

Used to relax the uterus in cases of uterine hypertonus or tachysystole (>5 contractions/10min)

3
Q

What are non-reassuring fetal signs, and how should patient be managed?

A

Repetitive late decelerations, bradycardias, and loss of variability

Face mask O2, place on left side to relieve IVC

4
Q

What are the three signs placental separation?

A

Cord lengthening, gush of blood, fundal rebound

5
Q

What does posterior succenturiate lobe? put patients at risk for?

A

Vasa previa

6
Q

What does sinusoidal pattern on continuous FHR monitoring suggest? What should be done?

A

Fetal anemia usually from vasa previa rupture

Emergent delivery

7
Q

What are classic findings of uterine rupture?

A

Severe abdominal pains with loss of station of fetal head in actively laboring patient with history of C-section

8
Q

What is the MoA of Mg in decreasing contractions? What are possible side effects?

A

Antagonizes calcium and stabilizes cell membranes

Flushing, diplopia, headache

9
Q

What are associated with increased risk for breech presentation?

A

Fetal anomalies like anencephaly and hydrocephaly

Uterine anomalies like oligo and polyhydramnios

10
Q

What are the initial steps in treating a patient presenting with eclampsia (seizing and HTN)?

A
  1. ABCs
  2. IV Mg
  3. IV labetalol or hydralazine
11
Q

HTN early in 2nd trimester?

A

Hydatidiform mole and previous chronic hypertension

12
Q

What testing should be done in women over 30-65 with negative pap and HPV?

A

Next pap HPV in 5 years

13
Q

What testing should be done in women over 30-65 with negative pap and HPV?

A

Next pap HPV in 5 years

14
Q

How do you diagnose gestational hypertension?

A
elevated BPs (> 140/90 mm Hg) after 20 weeks’
gestation
15
Q

What is the next most important step in management of a patient with HELLP?

A

This is a subtype of severe preeclampsia, must induce labor if at 32-34 weeks.

16
Q

What is true gestational diabetes and how does it arise>?

A

impairment of carbohydrate metabolism that manifests during pregnancy

human placental lactogen act as anti-insulin agents leading to increased insulin resistance

17
Q

What are signs and sx of intra amniotic infection, and what needs to be done? I

A

Fever, tender fundus, elevated WBC

Induction of labor if normal FHT

18
Q

Contraindications to using Mg sulfate?

A

Myasthenia gravis

19
Q

Side effects of terbutaline?

A

Tachycardia hypotension anxiety and chest pain

20
Q

What are the karyotypes for a partial mole? Ultrasound finding?

A

Triploid 69 xxx(y)

Marked villi swelling

21
Q

Which moles put patients at increased risk of GTD?

A

Complete moles

22
Q

What are the signs of metastatic gestational trophoblastic disease and what should be done?

A

Elevated beta HCg, no evidence of IUP,

CT c/a/p

23
Q

What is the appropriate of management of cord prolapse in a laboring patient?

A

Lift fetal head and perform emergent c section

24
Q

What is the treatment for VIN 3?

A

Wide local excision

25
Q

What should be done if patient has ASCUS but is negative for high risk HPV?

A

Resume normal screening, Pap again in 3 years

26
Q

What is most concerning finding on colposcopy?

A

Disorderly blood vessels

27
Q

What should be done for HSIL if nothing found on ECC?

A

Cervical conization

28
Q

What should be done for patients presenting with positive ECC?

A

Cervical conization

29
Q

What is Meigs syndrome?

A

Triad of ovarian tumor,ascites, and Right hydrothorax

30
Q

What is the usual ratio of FSH/LH in primary ovarian failure and why?

A

> 1 because both elevated but FSH cleared slower

31
Q

What is the best management for patient at 42 weeks with favorable cervix and no contractions?

A

admit for induction

32
Q

What is polyhydramnios with rapid decompression of intrauterine cavity put the patient at risk for?

A

placental abruption

33
Q

What is the most likely cause of vaginal bleeding and friable cervix on exam in a pregnant woman?

A

Cervicitis

34
Q

What utero-tonic agent is contraindicated in mother’s with asthma?

A

Prostaglandin F2-alpha - potent smooth muscle constrictor with effects on bronchi

35
Q

What can prostaglandin F2 alpha be used for? Prostaglandin E1?

A

F2 alpha = uterotonic agent

E1 = cervical ripening

36
Q

What are main associations with intrauterine fetal growth restriction (3rd TM)?

A

Fetal demise, perinatal demise, meconium aspiration, polycythemia, oligohydramnios

37
Q

What is the appropriate management of intrauterine growth restriction?

A

Antenatal testing of fetal well being–> NST twice weekly, weekly AFI, weekly BPP

38
Q

What are associated findings of Mitral valve prolapse, and how should it be treated in pregnancy?

A

Chest pain, palpitations, systolic ejection murmur with a click,

treat with beta-blockers

39
Q

What are the risks to the fetus in twin-twin transfusion syndrome?

A

high morbidity and mortality in both, neurological sequelae in surviving twin

40
Q

A decrease in which hormones after delivery stimulate milk production?

A

Progesterone and estrogen (relieves inhibitory influence on production of alpha-lactalbumin by the rough endoplasmic reticulum)

41
Q

What is the main abnormality caused by valproate in pregnancy?

A

Neural Tube defects

42
Q

What is the utility of the fetal fibronectin test in women with pre-term contractions?

A

99% NPV if patient is symptomatic –> thus 99% with negative result will not deliver in next 14 days

43
Q

What is the most important lab test to check with any pregnant woman with vaginal bleeding?

A

Type and screen -> to identify if RhoGAM needs to be administered

44
Q

What is the most important treatment for pregnant women in 3rd TM with newly diagnosed HIV, to prevent newborn transmission?

A

IV zidovudine at the time of delivery, along with starting HAART

45
Q

What is the goal of diastolic blood pressure reduction in a preeclamptic patient with bp 200+/100+?

A

reduce to 90-95 diastolic range, harm reduction

46
Q

What is the treatment for fetal hydrops from Rh disease in the case of severe hemolytic disease?

A

attempt intrauterine intravascular fetal transfusion

47
Q

What are associated non gyn findings in patients with lichen planus?

A

oral lesions, alopecia and extragenital rashes

48
Q

When can manual vacuum aspiration be done in pregnancy?

A

before 8 weeks to terminate

49
Q

What are the risk factors for developing pelvic organ prolapse?

A

increasing parity, increasing age, obesity, some connective tissue disorders (Ehlers-Danlos syndrome), and chronic constipation, vaginal > c section

50
Q

What should be done for HSIL, with positive acetowhite staining on colpo, but negative ECC?

A

Cold knife conization, to see specimen from within os and assess for lesions

51
Q

What should be done for a woman who presents in early first TM with heavy vaginal bleeding and severe anemia?

A

immediate D&C to remove products of conception and evaluate bleed