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OB/GYN Case Files and UWorld Flashcards

1
Q

Def. of secondary amenorrhea

A

6 months of no menses in a woman with previously normal menses

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2
Q

Patient with amenorrhea s/p d&c

A

Asherman’s syndrome- dx with hysterosalpingogram

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3
Q

Elevation in prolactin is assciated with elevation in what other hormone?

A

Throid releasing hormone in hypothyroidism

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4
Q

Causes of galactorrhea

A

pituitary adenoma

pregnancy

breast stimulation

medication

chest wall trauma

hypothyroidism

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5
Q

Treatment of a prolactin secreting adenoma during pregnancy?

A

Oral bromocriptine

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6
Q

Hormone ratio that is elevated in PCOS

A

LH:FSH >2.0

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7
Q

Elevated ______ is indicative of ovarian failure

A

FSH

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8
Q

The major difference between the Dx of sheehan and intruterine adhesions

A

Withdrawl bleeding will take place in sheehan but not in intruterine adhesions

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9
Q

Treatment of post partum endometritis?

A

Clindamycin and Gentamicin

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10
Q

Insufficient tissue on endometrial biopsy of postmenopausal woman with abnormal uterine bleeding, next step?

A

D&C before ablation to ensure lack of endometrial CA

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11
Q

Diagnostic test for a patient with suspected PCOS

A

TSH, prolactin, DHEA-S, 17-hydroxyprogesterone, pelvic ultrasound

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12
Q

OCP of choice in PCOS?

A

Combination oral contraception (estrogen and progestin)

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13
Q

treatment of grade 1 endometrial adenocarcinoma in a patient the desires future pregnancy?

A

High dose progestin therapy

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14
Q

Patient in her 40s with new onset male pattern hair growth and clitoromegaly. 9cm ovarian mass palpated. Dx?

A

Sertoli-Leydig tumor. Androgen secreting.

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15
Q

6 year old girl with breast development, early menses, and an ovarian mass. Dx?

A

Granulosa-theca cell turmor– estrogen producing counterpart to the sertoli-leydig tumor

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16
Q

By what age are a lack of secondary sexual characteristics considered delayed puberty?

A

14

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17
Q

What lab test can help determine whether the cause of delayed puberty is central or ovarian?

A

Serum FSH

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18
Q

Low FSH points to a _____ cause, while high points to a _____ cause. (in delayed puberty)

A

Central (hpothalamic-pituitary axis)

Peripheral– no (-) fedback by the ovary

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19
Q

Most likely cause of primary amenorrhea in a Pt with normal breast and pubic hair development as well as urinary tract abnormalities?

A

Mullarian agenisis.

If no urnary tract abnormalities present, androgen in sensitivity is most likely

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20
Q

Testosterone level in mullarian agenisis?

A

normal

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21
Q

Five basic factors to examine in infertility:

A

ovulatory

uterine

Tubal

male factor

peritoneal factor (endometriosis)

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22
Q

Female with dymenorrhea, dyspareunia, and dyschezia

A

endometriosis

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23
Q

Most common cause of postmenopausal bleeding

A

atrophic endometritis

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24
Q

Age of initial pap smear

A

21 regardless of sexual practices

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25
benign cystic ovarian tumor that can cuase hyperthyroidism
Struma Ovarii
26
Treatment for struma ovarii
exploratory laporotomy with ovarian cystectomy
27
Patient \<30 with complex cyst, differential dx?
Dermoid or cystic teratoma
28
Thin white and puritic vulvar tissue
lichen sclerosis
29
Diagnostic test and treatment of lichen sclerosis
vulvar biopsy showing thinned epidermis, hyperkeratosis, and elongation of rete ridges -Tx Corticosteroids
30
Patient reports symptoms of being pregnant and a +home preg test but her US is non-preg and the office test is negative
pseudocyesis
31
itchy palms and soles
intrahepatic cholestasis of pregnancy increased bile salts
32
Abx of choice for lactation mastitis
Dicloxacillin and cefalexin
33
Bright red painless bleeding
placenta previa
34
risk factors for placenta previa
- previous c section - smoking - advanced maternal age - prior placenta previa
35
length of a variable deceleration
\<30s
36
patient with a LEEP or a cone biopsy of the cervix is at greatest risk for...
cervical incopetence/insufficiency
37
Gold standard method to diagnose cervical incompetence
transvaginal ultrasound
38
Threashold B-hCG level
1500-2000
39
this 2 hour glucose tolerance level is associated with insulin resistance
\>140
40
A patient with PCOS and insuline resistance should be perscribed what medication
Metformin
41
BUN and sCr have this change during pregnancy
both decrease
42
At how many weeks are fetal lungs mature?
34
43
Best contraception for once ovulation has occured?
Copper IUD Effective 99% up to 5 days
44
Most important side effect of raloxifene
DVT
45
Abx used in pregnant woman with asymtomatic bacturia
Amoxicillin Nitrofurantoin Amoxicillin-clavinulate Cefalexin
46
What STD should all pregnant women be screened for regardless of risk factors?
Syphillis
47
Most common cause of mucopurulent cervicitis in reprodutive age females
Chlamydia
48
Clitoromegaly with high concentrations of gonadotropins and maternal masculinization during pregnancy
Aromatase deficiency
49
Next dx test in a patient who has period pain refractory to OCPs and ibuprophen
laproscopy (endometriosis)
50
Endometriosis carries a high risk for this future complication
infertility
51
WHen to remove testes in ovarin insensitivity syndrome
after putberty to ensure proper breast development
52
after rupture fetal heart tones assume a sinusoidal, tachycardia-bradycardia rhythm. There is profuse uterine bleeding. Dx?
Vasa previa leading to rupture of uterine vessels
53
Best Dx test for acute appendacitis of pregnancy
Ultrasound
54
Dx test of choice for renal colic in pregnancy
Ultrasound of the kidney and ureter
55
Angle of cotton swap that indicates urethral hypermobility
\>30 degrees
56
Treatment for stress incontinence
Kegal exercises followed by urethorpexy (restoration of the vesicourethreal angle)
57
When should Rho-Gam be administered, why?
28-32 weeks and again within 72hrs of birth -because the half life of anti-d is about 6 weeks which will cover most of the third trimester
58
Measurement of this is the most reliable index for fetal growth restriction
abdominal circumference
59
causes of symmetric IUGR
Chromosomal abnormalities TORCH infections Maternal substance abuse anemia
60
Causes of assymtric IUGR
HTN, malnutrition and genetic abnormalities
61
Appropriate management of incomplete abortion in a stable woman
Misoprostol OR Observation and Expectant management
62
Bilateral solid cystic ovarian tumors in pregnant woman with hirsutism
luteoma --expectant management
63
Management of a female with intrauterine fetal demise and borderline coagulation studies
Induction of labor-- suspicious for DIC
64
Cause of DIC in an intrauterine fetal demise
release of tissue factor (thromboplastin) from the placenta into maternal circulation
65
Tx of Trichomonas
Metronidazole for female and husband
66
Biopsy shows hyperplasia without atypia in a woman who does no desire fertility- Tx?
Progestin therapy
67
Ovarian torsion more common on this side
right
68
B-hCg is produced in the _______ and functions to \_\_\_\_\_\_\_\_.
Produced by syncitiotrophoblast and maintains the corpus luteum
69
Prolactin production is induced by
TRH and Serotonin
70
Which two hormones are decreased in a quad screen indicative of down syndrome?
msAFP and Estriol
71
What is mittleschmerz
mid cycle pain caused by ovulation
72
Who are the only patients to get a CA-125 level?
Postmenopausal women with mass
73
Combined OCPs cause worsened \_\_\_\_\_\_
HTN
74
What is the genotype in Kallman syndrome?
Normal
75
Trichomonas pH
\>4.5
76
Tx of high post void residuals in a patient with epidural anesthesia
intermittant catheterization
77
Turner syndrome causes FSH to be \_\_\_\_\_\_\_
High
78
Classic triad for hydatidiform mole
Hyperemisis Gravid uterus beyond gestational dates B-hCG \>100,000
79
Hyperemisis gravidum is associated with increased levels of what enzymes
LFT
80
Goddell Sign
Softening of the cervix Apparent at 4 weeks gestation
81
Chadwick sign
blue discoloration of vagina and cervix
82
elements in tripple screen? quad screen? Performed when?
MS AFP B-HCG Estriol Quad screen= above + inhibin A 15-20wks
83
Time when chorionic villus sampling is performed
10-13 wks
84
Pregnanacy that ends before 20wks gestation
abortion
85
Critical mass for delivery of fetus
\>2500g
86
To be considered gestational HTN, it must occur after this point
20wks

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