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MCCQE1 ** > OBGYN > Flashcards

OBGYN Flashcards

(58 cards)

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1
Q

Define: Secondary Amenorrhea

A

The absence of menses for three months in a woman with previously normal menstruation or nine months for women with a history of Oliogomenorrhea.

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2
Q

Patient with sweating bouts, lethargy, dyspareunia, skin hyperpigmentation, normal thyroid function, decreased cortisol levels, decreased estrogen, increased gonadotropin, + adrenal cytoplasmic antibodies.
Dx?

A

Premature ovarian failure (POF) due to an autoimmune disorder.

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3
Q

Is there an immunosuprressive therapy for POF?

A

No known therapy for POF has been proven safe and effective.

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4
Q

why shoud all women with POF recieve cyclical hormone treatement with estrogens and progestins?

A

To relieve the symptoms of estrogen deficiency and maintain bone density. BUT this wouldn’t restore patient’s ovulation.

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5
Q

What should be given to POF women who are hypothyroid?

A

Levothyroxine.

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6
Q

T/F: Surgical treatment given to all amenorrhea patients?

A

False.

It would be given if amenorrhea is caused by pituitary tumors. It isn’t necessary in patient with autoimmune oophoritis.

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7
Q

Define: primary amenorrhea?

A

absence of menstruation by age 14 in women without secondary sexual charachteristics OR absence of menstruation by age 16 in women with secondary charachteristics.

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8
Q

Patient has no secondary sexual charachteristics, FSH and LH levels were low. Dx?

A

Hypogonadotropic hypogonadism.

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9
Q

Patient has no secondary sexual charachteristics, FSH and LH levels were elevated. next step?

A

Karyotype analysis.

Hypergondatropic hypogonadism.

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10
Q

49 y/o woman: abnormal vaginal bleeding, heavy periods, intermenstrual bleeding, parous cervis w dark blood. BP is normal, hemoglobin is 115 g/L, preg test is -
next step?

A

Endometrial biopsy.

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11
Q

Initial evaluation of abnormal uterine bleeding (AUB) in reproductive age women?

A

human chorionic gonadotropin to exclude pregnancy, CBC, hemoglobin to assess anemia.

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12
Q

Evaluation for (blank) is recommended for any non pregnant reproductive age women with frequent AUB.

A

Endomentrial hyperplasia or endomentrial cancer by endometrial biopsy.

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13
Q

22 y/o woman with complaints of AUB. takes combined oral contraceptive pill.

exam shows: no lesions, no polyps, - preg test and reduced hemoglobin.
Tx?

A

NSAIDs and/or supplemental estrogen.

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14
Q

AUB between periods in women who use OCPs is known as what?

A

Breakthrough bleeding & associated with insufficient estrogens.

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15
Q

30 y/o woman: type 1 diabetic, non offensive vaginal discharge (white & curdy), itching, swollen genital area.

Test and findings?

A

Wet mount test.

Pseudohyphae and Spores.

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16
Q

31 y/o woman: vaginal discharge, odor, itching.

Examination reveals: yellow discharge, vulvar & vaginal erythema, strawberry cervix.

Dx?

A

Trichomonal vaginitis.

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17
Q

Painless bumps outside of vagina with some discomfort in sex & itching.

Tx?

A

Cryotherapy.

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18
Q

How to confirm condyloma acuminatum?

A

Acetowhitening & colposcopy.

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19
Q

T/F: treatment of genital warts may weaken condoms.

A

True

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20
Q

Ointment Tx of genital warts?

A

Sinecatechin.

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21
Q

Maximum duration of use of Sinecatechins?

A

16 weeks

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22
Q

Pelvic inflammatory disease can lead to what condition?

A

Fitz-Hugh-Curtis syndrome.

(Spreading infection to peritoneum causing inflammation & formation of scar tissue on external surface of the liver

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23
Q

T/F: Sheehan syndrome is a complication of PID

A

False.
It is characterised by decreased functioning of the pituitary gland, caused by ischemic necrosis due to blood loss & hypovolemic shock during & after childbirth.

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24
Q

Known complications of untreated PID:

Study These Flashcards
A 
Ectopic pregnancy
Tubal factor infertility
Tubo-ovarian abscesses
Pyosalpinx
Chronic pelvic pain
Peritonitis
Adhesions
Bacteremia
Septic arthritis
Fitz-Hugh-Curtis syndrome
Endocarditis
25
T/F: Cervical neoplasia is a complication of PID
False
26
40 y/o asymptomatic woman with 10 weeks sized irregular uterus. Next step?
Ultrasonography & reexamination in 6 months
27
What is CIN 1, CIN 2, CIN3?
CIN (cervical intraepithelial neoplasia) CIN1: displays dysplastic changes in appx 1/3 of the thickness of the epithelium CIN2:1/2 - 1/3 CIN: full thickness involvement
28
Next step CIN 1
Follow up without Tx by doing pap smear at 6 months or colposcopy
29
Next step CIN2
Colposcopy at 6 months & at 12 months
30
CIN3 next step
Conization of the cervix | loop electrosurgical excision
31
When is HSIL cytology is preceded with HSIL (CIN2,3), what is Tx?
Diagnostic excisional procedure
32
Women with subtotal hysterectomy OR total one for malignant cause (or benign cause but HPV positive) need what?
Routine swab of cervix or vaginal vault
33
36 y/o woman has atypical glandular cells of undetermined significance. Next step?
Colposcopy with endocervical curettage
34
When should women be tested for HPV DNA
When a pap smear shows ASCUS in women under 30 y/o
35
If ASCUS is found:
HPV test OR repeat cytology in 6 months HPV - = repeat cytology in 12 months HPV + = colpo If cytology is chosen instead of test: ASCUS = colpo - = repeat cytology again in 6 months
36
Tx for Lichen sclerosus?
Fluorinated corticosteroid
37
Ulcers in sexually active person denote one of:
``` HSV Primary syphilis Chancroid Lymphogranuloma venereum Granuloma inguinale ```
38
HSV cytology:
Multinucleated giant cells. | Epithelial cells containing nuclear inclusion bodies
39
30 y/o woman: type 1 diabetic, non offensive vaginal discharge, itching, red and swollen genital area. test and result?
Wet mount test: pseudohyphae and spores.
40
Most common species causing candidiasis?
C. albicans
41
31 y/o woman: vaginal discharge, odor, itching, yellow discharge, vulvar and vaginal erythema, strawberry cervix. Dx?
Trichomonal vaginitis.
42
Once ovarian torsion is confirmed, what should be done?
Conserve ovary via a speedy detorsion
43
Suspicions of PCOS as patient displays risks for it. What screening test to do?
Lipid levels | HbA1C
44
How to prevent congenital rubella syndrome
Ensuring a patient’s rubella antibody titre is greater than 10 IU/ml. If she is non reactive, immunization should be deferred until after delivery due to inability of rubella vaccine virus to cross placenta and infect the fetus
45
When should high risk pregnant patients be screened for DM
If they test negative in initial screening, they should be screened again towards the end of second trimester between 24th & 28th weeks
46
T/F: Amlodipine & Lisinopril are safe for HTN
False Methyldopa is safe
47
Pregnant woman with mild preeclampsia at 37 weeks gestation. Next step?
Vaginal examination and calc of Bishop score. Bishop score 6: labour should be induced Lower score: cervix should be ripened first
48
Late decelerations are consistent with what?
Uteroplacental insufficiency. Management should include intrauterine resuscitation first. If no improvement, delivery.
49
3rd stage of labour?
Delivery of placenta. If placenta isnt delivered by 30 mins, Dx of retained placenta. Mgm of Retained placenta: uterotonics + watchful waiting and/or cord traction for 15 mins. In case of hemorrhage: immediate manual removal of placenta. If it cant be removed, Dx of placenta accreta is made and hysterectomy is done.
50
Tx of women in pre term labour
1- tocolytic agent (CCB) IF they are having contractions 2- Glucocorticoid to avoid RDS in neonate 3- Antibiotics to avoid GBS
51
How is Tocolytic therapy useful?
In delaying delivery up to 48h in situations of pre term labour with contractions to allow max benefit of glucocorticoids to avoid RDS in neonates. In pts in pre term labour <30 weeks, prostaglandin synthetase inhibitors i.e. indomethacin are 1st line tocolytics
52
One major risk for Abruption?
HTN
53
Patient is breastfeeding, best contraception?
Oral progesterone pill Any contraception that includes estrogen isnt recommended since estrogen reduces breast milk production. Note: sex is to be discourages for the first 6 weeks post partum for pelvic rest.
54
Indications of CSXN:
Maternal: - Eclampsia - Prior uterine surgery - Prior classic CSXN - Cardiac Dx - Birth canal obstruction - Maternal death - Cervical cancer - Active genital herpes - HIV viral load > 1000 Fetal: - Acute fetal distress - Malpresentation - Cord prolapse - Macrosomia - Placental abruption - Placenta previa - Passenger pelvic disproportion
55
Oligohydramnios is associated with which fetal condition?
Talipes equinovarus (club foot)
56
Diagnostic test of ICP?
Elevated serum bile acids (NOT bilirubin) Note: ICP classically presents in 3rd trimester as severe pruritis
57
Define spontaneous abortion
Expulsion of an embryo or fetus weighing 500g or less. This is usually 20 to 22 weeks or less
58
Classification of spontaneous abortions?
1- Threatened: presents with vaginal bleeding +/- cramping, cervix is closed, Ultra sound shows viable fetus 2- Inevitable: Vaginal bleeding, crampy pelvic pain, cervix is dilated. 3- Incomplete: extremely heavy bleeding & cramping. Passage of tissues may have been noticed, cervix is open. 4- Complete: history of bleeding & cramping, passage of placenta & sac, resolution of Sx, cervix is closed 5- Missed: no Sx, fetus died in utero, cervix is closed. U/S shows too small fetus & no fetal heart rate 6- Habitual: > 3 consecutive spontaneous abortions 7- Septic: infection of contents of uterus

MCCQE1 ** (5 decks)

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