OB-GYN Halo-halo 2

Question 1

Preinvasive neoplastic disease of the vulva is divided into

Answer 1

SQUAMOUS:
Vulvar Intraepithelial Neoplasia

NONSQUAMOUS
Paget disease
Melanoma in situ

Question 2

______% of women with VIN have cervical neoplasia as well

Answer 2

60%

Question 3

forms of VIN

Answer 3

PREMENOPAUSAL (75%)
multifocal lesions
rapidlybecome invasive
assoc’d with HPV 75-100%

POSTMENOPAUSAL WOMEN
-focal lesions
slow to becom invasive
not typically assoc’d with HPV

*median age of VIN is 40 y/o

Question 4

____% of patients with Paget disease of the vulva will have coexistent adenocarcinoma

Answer 4

only about 20% (underlying the outward changes)

when this occurs, metastasis is common

Question 5

prognosis of vulvar Paget

Answer 5

“Without nodal met, the dse is commonly cured with local excision; however, the disease is almost invariably FATAL if it spreads to lymph nodes.” (Callahan)

Question 6

Highest region of Rh negativity

Answer 6

Basque region of Spain (30%)

Question 7

possible sequelae of Rh incompatibility

Answer 7

FETAL HYDROPS

-accumulation of fluid in the extracellular space in at least 2 body compartments

Question 8

patients with these SEVEREvalvular problems may undergo valvuloplasty

Answer 8

pulmonary stenosis (Callahan, Williams)
mitral stenosis (Williams)

*aortic stenosis: delay conception (Williams)

Question 9

most commonly performed cardiac procedure on the fetus

Answer 9

fetal aortic valvuloplasty (Williams)

Question 10

Noonan syndrome is associated with what valvulopathy

Answer 10

pulmonic stenosis

Question 11

ovaries arise from the

Answer 11

genital ridge

Question 12

lower 1/3 of vagina arise from

Answer 12

urogenital diaphragm

Question 13

most common uterine anomaly

Answer 13

1 septate uterus (35%)

2 bicornuate uterus (26%)
3 Arcuate uterus (18%)
4 unicornuate uterus (10%)
5 uterus didelphys, septate vagina (8%)

Question 14

explain septate uterus

Answer 14

failure of dissolution of the septum
25% of women with uterine septums may suffer from recurrent 1st-tri pregnancy loss (due to lack of adequate blood supply to facilitate placentation)

Question 15

explain bicornuate uterus

Answer 15

failure of fusion of the mid-mullerian ducts

more commonly complicated by the limited size of UTERINE HORN (similar to unicornuate uterus)
as such, associated with
-SECOND trimester pregnancy loss
-malpresentation
-IUGR
-PRETERM labor and delivery (deliver via CS)

Question 16

explain uterine didelphys

Answer 16

complete failure of fusion

Question 17

eponym of mullerian agenesis

Answer 17

Mayer-Rokitansky-Kuster-Hauser syndrome

Question 18

septate uterus and bicornuate uterus can be better distinguished by

Answer 18

MRI or laparoscopy (Callahan)

Question 19

Most accurate imaging tool for identifying adenomyosis

Answer 19

MRI

but pelvic ultrasound is the most common imaging modality used due to less cost

Question 20

only definitive means of diagnosing adenomyosis

Answer 20

hysterectomy [and biopsy]

Question 21

risk of spontaneous abortion

Answer 21

after 1 prior SAB: 20-25%
2 consecutive: 25-30%
3 consecutive: 30-35%

Question 22

Approach in recurrent pregnancy loss

Answer 22

1. karyotype of both parents and POC
2. hysterosalpingogram
   - if abnormal or nondiagnostic, hysteroscopic or laparoscopic exploration
3. screen for hypothyroidism, DM, APA, hypercoagulability, SLE
4. level of serum progesterone on luteal phase
5. cultures
6. endometrial biopsy during luteal phase

Question 23

treatment of APA syndrome

Answer 23

low-dose aspirin

Question 24

patients with a hx of cervical insuf should be offfered an elective prophylactic cerclage at ______

Answer 24

12-14 GA