OBGYN Flashcards
(304 cards)
1
Q
What is the contraindication for ergotrate in postpartum hemorrhage?
A
hypertension
2
Q
What gives a false positive syphilis test?
A
rapid plasma reagin
3
Q
What are painless fleshy papules?
A
HPV
4
Q
What malignancy is most likely following PCOS?
A
endometrial
5
Q
What type of mucous do you have during ovulation?
A
soft thin stringy
6
Q
What is -2.0 on DEXA scan?
A
osteopenia
7
Q
Why shouldn’t a woman exercise supine?
A
hypotension
8
Q
What is a hyperpigmented rash in sun exposure on a woman’s face?
A
Malar Rash
9
Q
Women is 19 and has a new breast mass, what do you do?
A
ultrasound
10
Q
A women in her 50’s, has irregular bleeding, hot flashes, menopause symptoms, what is she in?
A
perimenopasue
11
Q
Active bleeding postpartum
A
Uterine Atony
12
Q
Baby’s knees and hips flexed
A
complete breech
13
Q
Non-ruggated mass in intritus, posterior, what kind of prolapse?
A
Uterine prolapse
14
Q
16 year old has signs of premenstrual dysphoric disorder what is the treatment?
A
paroxetine
15
Q
Women has painful vesicles and ulcers and lymphadenopathy, how do you treat?
A
valacyclovir
16
Q
How much calcium should a women take?
A
1200 mg
17
Q
Women has ovarian cancer symptoms, what do you check?
A
Ca - 125
18
Q
What is the most common sign of ovarian cancer?
A
ascites
19
Q
When is the first menses after pregnancy?
A
6-12 weeks
20
Q
Women is 19 and wants to know when to go to the GYN doctor?
A
Go 21 and older every 3 years
21
Q
What causes LH surge?
A
increase in estogren
22
Q
Women is large for gestational age and something else is wrong
A
molar pregnancy
23
Q
What is the caustive agent of Chancroid?
A
H. ducreyi
24
Q
Ectopic pregnancy but stable, how do you treat?
A
methotrexate
25
pH is <4.5, what do you expect the discharge to be (candida)
curd like
26
When is the uterus not palpable?
2 weeks
27
Women need birth control postpartum, what do you give?
progesterone mini pill
28
Women has vaginal atrophy, what is the treatment?
Vaginal estrogen tablet (its estrogen cream in a tablet) all the other options are estrogen tablets that are PO to confuse you
29
What stage of labor is the placenta delivered?
third
30
Uterus larger than expected for dates and excess weight gain
multiple gestations
31
When is the fundal heights at umbilicus?
20 weeks
32
Long-term but reversible contraception?
IUD
33
Pregnant patient comes in at 19 weeks, which vaccination is given?
influenza IM
34
MC sx with preterm labor?
regular uterine contraction
35
Cough, laugh, wet
stress incontinence
36
Cough, wet, + ferning test?
ruptured membranes
37
+breast and + uterus?
outflow obstruction
38
LLQ pain?
ruptured ovarain cyst or torsion
39
contraindication of hysteroscopy?
pregnancy
40
side effects to look out for while taking aromatase inhibitors?
loss of bone density
41
What is the benefit of oral contraceptive pills?
decrease endometrial hyperplasia (combo)
42
No ovulation?
progesterone bc unopposed estrogen
43
BV treatment?
metronidazole
44
Unique to trichomoniasis
cervical punctate hemorrhages
45
Most common STD?
chlamydia
46
What is the first-line treatment for prolapse?
do kegels - first thing you do for asx prolapse
47
What is the tx for bartho cyst?
warm sitz, I&D, Bactrim, augmentin + clindamycin
48
What is the tx for a fluid-filled cyst in breast?
OCP's, danazol bromocriptine
49
What is the causative agent of mastitis?
staph aureus
50
When is fibrocystic disease pain worse?
pain worse with caffeine
51
What is the tx for breast abscess?
I&D and dicloxacillin
52
Induration with fluctuance
breast abscess
53
Pt is experiencing painful contractions for 24 hrs, 10 min apart and 3cm dilated what phase of contractions is this patient experiencing?
Latent Phase
54
Bone scan of -2
osteopenia
55
1st physical sign of menopause?
vasomotor instability
56
Has a breast mass got period 3 weeks ago come back?
1 week
57
Best age where there is no uterine structure path and increase prostaglandins?
20 years
58
PCOS
increased free testosterone
59
Brawny discoloration, edma?
inflammatory carcinoma
60
What do you do about a white lesion on the vagina?
bx the lesion
61
What is a symptom of late-stage ovarian cancer?
ascites
62
Patient presents with a very high Beta hCG indicating Molar pregnancy (Hydatidiform mole), what is the treatment?
D and E of the molar pregnancy followed by surveillance of serial human chorionic gonadotropin levels to confirm resolution of disease
63
How do you initially check if you suspect rupture of membranes?
speculum to see pooling
64
What trimester is the Tdap vaccine administered?
3rd
65
Mexican woman with spots on her face would make you think of what diagnosis?
chloasma
66
Why do you avoid supine position in pregnancy?
Hypoxia (compression IVC)
67
Mosaic vasculature pattern on colposcopy indicates what?
CIN (cervical intraepithelial neoplasia)
68
Symmetric face hyperpigmentation after sun exposure is called what?
Malar Rash
69
How often do you repeat pap smears in a patient with normal pap results in ages 21-24?
Every 3 yrs
70
How often do you repeat pap smears in a patient with normal pap results in ages 25-29?
Every 3 yrs
71
How often do you repeat pap smears in a patient with normal pap results with negative HPV in patients 30 years older?
Co-screening every 5 years or pap alone every 3 years
72
What medication is contraindicated in pregnancy?
isotretinoin
73
How often do you repeat pap smears in a patient with ASC-US pap results in ages 21-24?
Repeat pap in 12 month. Acceptable to also do reflex HPV testing.
74
How often do you repeat pap smears in a patient with ASC-US pap results in ages 25-29?
Preferred reflex HPV test. Acceptable to repeat pap in 12 months.
75
How often do you repeat pap smears in a patient with ASC-US pap results with negative HPV in patients 30 years older?
Repeat co-testing in 3 years
76
How often do you repeat pap smears in a patient with LSIL pap results in ages 21-24?
Repeat pap in 12 mos
77
Pregnant lady comes in for normal routine check-up and she has complains of feeling wet/water whenever she laughs but has a positive ferning test
premature rupture of membranes
78
How often do you repeat pap smears in a patient with LSIL pap results with negative HPV in patients 30 years older?
Preferred repeat pap test in 12 months. Acceptable to do Colposcopy.
79
What is the next step in a pt with LSIL pap results with postive HPV in patients 30 years older?
Colposcopy
80
What is the next step in a pt with ASC-H pap results in ages 21-24?
Colposcopy
81
What is the next step in a pt with ASC-H pap results in ages 25-29?
Colposcopy
82
What is the next step in a pt with ASC-H pap results with negative HPV in patients 30 years older?
Colposcopy
83
What is the next step in a pt with ASC-H pap results with positive HPV in patients 30 years older?
Colposcopy
84
Most likely cause of ROM
e coli for UTI
85
What is the next step in a pt with HSIL in ages 25-29?
Immediate excision treatment OR colposcopy
86
What is the next step in a pt with HSIL pap results with negative HPV in patients 30 years older?
Immediate excision treatment OR colposcopy
87
What is the next step in a pt with HSIL pap results with postive HPV in patients 30 years older?
Immediate excision treatment OR colposcopy
88
What test are performed in a pap finding of AGC?
- Follow up
- Colposcopy
- Endocervical sampling
- Endometrial sampling
89
many painless ulcers and groin LAD
lymphogranuloma venereum
90
Treatment for lymphogranuloma venereum?
doxycycline or azithromycin
| erythromycin in pregnant people
91
Cervical ripening
misoprostol or laminara
92
When do you do test for gestational diabetes mellitus?
24-28 weeks
93
What are the characteristics of inevitable abortion?
open os, bleeding, no POC yet
94
pH of STDs
BV, trich, atrophic vag >4.5
| candida and cytolytic is normal
95
Pt with hx of PCOS now having vaginal bleeding, what cancer are they at risk for?
endometrial
96
What vaccine do you not give at 12 weeks?
Varicella
97
You do a fine needle biopsy in a breast - what are they at risk for developing?
cellulits
98
The woman is seeking fertility help and there were no hormone or structural imbalance - what is it most likely caused by?
ovulation problems (Primary ovarian insufficiency or savage syndrome)
99
closed os and vaginal bleeding - what is the most likely cause?
threatened abortion
100
PE showed open os and active bleeding 3 weeks postpartum
Uterine Atony
101
G1P0 15-year-old girl who has a smoking history and is pregnant with twins - how many risk factors does she have for preterm labor?
3
102
Complete breech is when the baby is in what position?
Both knees and hips flexed and buttock is down near the cervical birth canal
103
What is Cystocele?
Loss of anterior sulcus - wall between the bladder and the vagina weakens.
104
Etiology of PMDD?
Serotonin (5-HT) deficiency
105
40 year old comes in with a hx of tubal ligation and she has AUB - giving her birth control pills will do what benefit for her?
it will prevent endometrial cancer or hyperplasia
106
most commonly reported infection in the US
chlamydia
107
Mom just gave birth and a few hours later she presents with 600 cc blood loss 90/60 BP, diaphoretic, tachycardia
uterine atony
108
What drug is indicated for abnormal uterine bleeding in order to limit or restrict endometrial growth
Provera or leuprolide
109
55 yo female who feels a lump - her aunt died of breast cancer - what test do you want to do?
diagnostic mammo
110
What test would you wanna do for first OB visit?
UA
111
Bartholin cyst treatment
I&D
112
LLQ pain and vomiting?
torsion
113
many painless ulcers and groin LAD
lymphogranuloma venereum
114
Had a baby with shoulder dystocia - wants to get pregnant again within the year - what should you test?
her A1c to see if she's pre-diabetic or at risk for gestational diabetes
115
Subareolar mass treatment
I&D
116
Girl who misses 2 days every month because of period pain bloating etc.
primary dysmenorrhea
117
How do you dx PMS/PMDD?
log a journal of your symptoms
118
Average weight gain in pregnancy
25-35 pounds
119
At 12 weeks what sign would you expect to see?
Chadwicks sign- bluish coloration of the cervix and vulva and fetal heart tones.
120
When can you feel the fundal height at the umbilicus?
20 wks
121
Fetal distress indicates what?
Hypoxia
122
Patient presents with a very high Beta hCG indicating Molar pregnancy (Hydatidiform mole), what is the treatment?
D and E of the molar pregnancy followed by surveillance of serial human chorionic gonadotropin levels to confirm resolution of disease
123
White ulcerative lesion on the vagina would make you think of what diagnosis?
Vulvar carcinoma
124
What are PCOS diagnostic studies?
- Labs: Total Testosterone, Androstenedione, DHEA-S
| - US: Transvaginal
125
How do you treat PCOS?
- Lifestyle modification
- Oral contraceptives
- Metformin
126
What is Lymphogranuloma Venereum (LGV) primary infection presentation?
Genital ulcer or a mucosal inflammatory reaction at the site of inoculation
127
What is Lymphogranuloma Venereum (LGV) secondary infection presentation?
- 2 to 6 wks later
- Inflammatory reaction in the superficial and deep inguinal nodes "groove" sign
- Anorectal: proctocolitis with rectal discharge, anal pain, constipation, fever, and/or tenesmus.
128
What is Lymphogranuloma Venereum (LGV) late infection presentation?
- Fibrosis and strictures in the anogenital tract
| - Genital elephantiasis, anal fistulae and strictures, frozen pelvis, and infertility
129
What is the treatment for Lymphogranuloma Venereum (LGV)?
- Nonpregnant patients: doxycycline 100mg BID x21 days
| - Alternative: Azithromycin 1 g once weekly x21 days
130
What is the secretory phase of the menstrual cycle?
Luteal phase
131
Chancroid causative agent?
Haemophilus ducreyi
132
Presentation of Chancroid?
Painful, superficial non-indurated ulcers, often with regional lymphadenopathy.
133
Leiomyomas (uterine fibroid) symptoms?
- Abnormal uterine bleeding
- Pelvic pain/pressure.
- May also have reproductive effects (eg, infertility, adverse pregnancy outcomes).
134
How do you diagnose Syphilis?
Rapid plasma reagin (RPR) and Venereal disease research laboratory (VDRL)
135
Appearance of apgar score 0-2 indicate what?
0: blue/pale
1: pink body, blue extremities
2. pink
136
Pulse of apgar score 0-2 indicate what?
0: absent
1: Below 100 bmp
2: Over 100 bpm
137
Grimace of apgar score 0-2 indicate what?
0: absent
1: Minimal response to stimulation
2: Prompt response to stimulation
138
Activity of apgar score 0-2 indicate what?
0: Absent
1: Flexed Arms and Legs
2: Active
139
Respiration of apgar score 0-2 indicate what?
0: Absent
1: Slow and irregular
2: Vigorous cry
140
How do you calculate Naegele's rule?
Add 7 days to the first day of your LMP and then subtract three months.
141
What birth control would you use for lactating woman?
Progesterone Only or IUDs
142
What is the next step after feeling a breast lump?
- Diagnostic Mammogram
| - US
143
Baby with symptoms of fetal alcohol syndrome, what should mom have been screened with?
CAGE questionnaire
144
Side effect of anastrozole
loss of bone density
145
Presentation of Fibroadenoma?
Smooth, well-defined, mobile mass
146
How do you diagnose Fibroadeoma?
- US
| - Definitive: core biopsy or excision.
147
When is the uterus not palpable after a pregnancy?
after 2 weeks
148
What is the treatment for Chorioamnionitis?
- Induction or augmentation of labor
| - Ampicillin 2 g IV q6 hrs + Gentamicin 5 mg/kg IV daily
149
Painless bleeding after 20 weeks?
Placenta Previa
150
What week can the mother first feel the fetus move?
16-20 wks (it is called quickening)
151
When will a patient get their first menses after pregnancy?
6 to 8 weeks (if not breast feeding)
152
What is the lab test for menopause?
FSH assay
153
What is the prophylaxis antibiotic given prior to C-section?
Cefazolin 2-3g IV
| - penicillin allergy: Clindamycin 900 mg IV + Gentamicin 5 mg/kg IV.
154
Pt postpartum with fever, diaphoretic, tachycardia
uterine atony endometritis
155
What is the tx for Mastitis?
Dicloxacillin or Cephalexin 500mg 4x daily
156
Pt with A- blood type and baby is A+ what would you do?
administer Rhogam when she is at 28 weeks
157
17 yo girl describes primary dysmenorrhea ask you to diagnose
- pain with menstruation, lower abdominal, intermittent, "labor-like" on days 1-3
- nausea, vomiting, diarrhea, headache
158
How would you diagnose uterine atony?
boggy and enlarged uterus
159
What drug is responsible for stabilizing the endometrium?
leuprolide or provera
160
What is the treatment for ovarian cysts <8cms?
Cysts <8cm are functional and usually spontaneously resolve.
- Rest, NSAIDs, repeat US in 6 wks
- OCPs prevent recurrence
161
What is the treatment for ovarian cysts >8cms?
- Persistent or cysts found post menopause
| - Laparoscopy or Laparotomy
162
How do you diagnose fibrocystic breast disorder?
- US
| - FNA (straw-colored fluid - no blood)
163
How do you treat fibrocystic breast disorder?
- Most spontaneously resolve
| - FNA if symptomatic
164
Does fibrocystic breast disorder or fibroadenoma wax and wane with menstrual cycles?
Fibrocystic wax and wane, fibroadenoma do not.
165
What are s/sxs of PID?
Abdominal pain, dysuria, dyspareunia, vaginal discharge, nausea, vomiting.
166
What is the outpatient tx for PID?
Doxycycline 100mg BID x14 days. + Ceftriaxone 250mg IM x1 +/- Metronidazole
167
What type of vaginal d/c is seen in BV?
Copious discharge, thin, homogenous watery grey-white "rotten fish" smell.
168
What type of vaginal d/c is seen in trichomoniasis?
Frothy yellow green discharge, worse w/ menses.
169
What type of vaginal d/c is seen in candida?
Thick curd-like/ cottage cheese discharge
170
What type of vaginal d/c is seen in cytolytic vaginitis?
Non-odorous discharge, white to opaque
171
Baby is tachycarda, fever, patient is achy with a fever the baby will come out?
septic
172
Most common diagnosed microorganism in the US?
chlamydia
173
What is the candidiasis discharge description?
caseous, gray, mucoseraginous, purulent
174
Most common symptom with trichomonas
cervical petechiae and pruritus
175
Uterosacral nodules in the posterior fornix
endometriosis
176
retroplacental hematoma
placental abruption
177
Pt with breast mass most common complication of needle bx
cellulitis
178
18 year old comes with Pap of ASCUS. what is the next step?
reflex HPV testing
179
Risk factor for pre-eclampsia
1st pregnancy
180
MC symptoms of chorioamnionitis
fetal Brady, uterine tenderness, vaginal bleed
181
18 year old G1P0 31EGA, % postcoital bleed for 2 days. no other sx. Dx?
placenta previa
182
What is the tx of gestational trophoblastic neoplasia?
D and C
183
9 weeks pregnant, daily n/v, what other symptoms would she have?
abdominal pain, headache, rash, weight loss
184
Routine of 1st prenatal visit
speculum exam
185
What is the tx for stable ectopic pregnancy?
Methotrexate and Leucovorin x4 doses
186
What indicated stable ectopic pregnancy?
Hemodynamically stable, early gestation <4cm, b-hCG <5,000, no fetal tones
187
Mammogram guidelines
- baseline mammogram every 2 years form age 50-74
- every 2 years beginning at age 40 if increased risk factors - 10 years prior to the age the 1'st degree relative was diagnosed
- clinical breast exam every 3 years in women age 20-39 years then annually after age 40
- breast self exam monthly beginning at age 20 - immediately after menstruation on days 5-7 of menstrual cycle
188
women has constant leakage of fluid postpartum for a few weeks that is clear - its a bladder fistula, how do you diagnose?
x-ray study with contrast - blue dye scan or something like that
189
HRT in menopause causes what?
thrombosis
190
What does progesterone do?
keeps the endometrium lining
191
Obesity causes most likely what complication?
miscarriage or fetocardioval malformation
192
What are the indications or hospitalization for PID?
- diagnosis is uncertain
- ectopic and appendicitis cannot be rule out
- pregnancy
- pelvic abscess suspected
- HIV positive
- unable to follow or tolerate outpatient regiment
- failed to respond to outpatient therapy
193
tender right inguinal lymphadenopaty + right painless labial ulcer on PE what is the dx?
primary syphilis
194
55 yo, 2 weeks of painless vaginal bleeding. LMP was 3 years ago. Last pap was also negative. PE shows small blood in the vault and an enlarged uterus. Initial dx study?
transvaginal ultrasound
195
What is the tx of a breast abscess?
I&D and anti-staph antibiotics
- regiment: nafcillin/ocacillin IV or cefazolin PLUS metronidazole
- alternative is vancomycin
- women should be encouraged to continue breast-feeding following breast infection, even in the setting of incision and drainage
196
When do you administer RhoGAM?
28 weeks and 72h of delivery.
| - OR given after any potential mixing of blood.
197
What maneuver is done with shoulder Dystocia?
- McRoberts Maneuver (increase pelvic opening with hip hyperflexion)
198
Pelvic pressure and prolonged menses x 1 year. what is expected on pe?
irregular uterus because this described leiomyoma
199
Seat belt during pregnancy
lap belt should be placed below your belly, touching your thighs, low and snug on your hip bones
-never wear above or across your belly
200
RF to PROM in 26-year-old at 32 weeks?
short cervical length, second or third trimester vaginal bleeding, uterine overdistension, nutritional deficiency of Cooper and ascorbic acid, connective tissues disorders, low body mass index, low socioeconomic status, cigarette smoking and illicit drug use
201
What is the initial treatment for nausea during pregnancy?
vitamin B6
202
How much folic acid should be consumed daily during pregnancy
400mcg, or 0.4mg, or 4g daily.
| - To prevent spina bifida and anencephaly.
203
How do you diagnose PID?
clinical findings suggested by direct abdominal tenderness, cervical motion tenderness, adnexal tenderness plus fever or WBC count or pelvic abscess found by manual examination or ultrasonography
204
What is the inpatient tx of PID?
- doxycycline + IV cefotetan or cefoxitin until condition improves than PO doxycycline
- clindamycin + gentamicin until condition improves than PO doxycycline
205
How do you treat condyloma accuminata in a pregnant women?
- cryotherapy
| - trichloroacetic acid
206
What is a breast abscess?
a pocket of contained infection within the breast
| -a progression from mastitis - symptoms are the same with the addition of localized mass and systemic signs of infection
207
What is the tx of a breast abscess?
I&D and anti-staph antibiotics
- regiment: nafcillin/ocacillin IV or cefazolin PLUS metronidazole
- alternative is vancomycin
- women should be encouraged to continue breast-feeding following breast infection, even in the setting of incision and drainage
208
What does it mean when fetal fibronectin is found in the cervicovag?
fFN is released into cervicovaginal fluid prior to the onset of preterm labor (20-34 wks) and during episodes of threatened preterm labor (TPL).
209
Baby is bottle feeding when would moms 1st menses postpartum occur?
6-8 wks
210
What does "VEAL CHOP" mean for fetal heart tracings?
Variable decelerations -> Cord compression.
Early deceleration -> Head compression.
Accelerations -> OK.
Late decelerations -> Placental Insufficiency.
211
ph of candida vaginitis
pH <4.5
212
Pt with DUB TSH normal, BHCG negative, no hx of abnormal paps, what is your next step?
diagnosis of exclusion, uterine dilation and curettage is the gold standard diagnosis
- progestin trial
- Pap smear
- pelvic u/s
- endometrial biopsy
213
what is a 2nd degree laceration?
in perineal area but not involving anus at all
214
What is peau d'orange?
may be a symptoms of inflammatory breast cancer
| -causes fluid to accumulate in the breast
215
Screening test for fibrocystic breasts?
US
216
What are the abnormalities of fetal alcohol syndrome?
-distinctive facial features, including small eyes, an exceptionally thin upper lip, a short, upturned nose, and a smooth skin surface between the nose and upper lip
217
What medication predispose you to vaginal vulvar, and cervical cancer?
Diethylstilbestrol (DES)
218
40 yo, 10 month amenorrhea, sleep disorder, thin vagina, narrow vagina, what is this pts greatest risk?
Premature Ovarian Failure
219
Pt with Endometrial Dysplasia biopsy and d/c are done what are the next steps?
Progestins/Estrogens/Chemotherapy
220
Preterm labor what should you rule out?
UTI - E. Coli
221
What is the tx of Gonorrhea?
Cefriaxone 250mg IM x1
| - co treat for chlamydia: Azithromycin 1g
222
Screening test for Fiboradenoma?
Screening mammogram
223
Tx for vaginal prolapse?
Pessary
224
Molar pregnancy treatment?
- Surgical uterine evacuation --> suction curettage mainstay. (hysterectomy can be an option)
- METS: chemotherapy (methotrexate)
225
Proteinuria levels in preeclampsia?
Mild: >300mg/24hrs (1+ on dipstick)
Severe: >5g/24hrs (3+ on dipstick)
226
What is the Leopold maneuver?
Maneuver consisting of 4 distinct actions to determine the position and estimate the birth weight of a fetus inside the uterus and the shape of the maternal pelvis.
- It can indicate if delivery is going to be complicated or if c-section is necessary.
227
What is threatened abortion?
Pregnancy may be viable or abortion may follow. MCC of 1st trimester bleeding.
- No POC expelled form uterus
- Cervical OS closed
- Bloody vaginal d/c
- Supportive therapy and serial B-hCG
228
What is inevitable abortion?
Pregnancy is not salvageable
- No POC expelled
- Progressive
- Progressive cervix dilation >3cm effaced +/- rupture of membranes
- Moderate bleeding >7 days
- Dilation and Evacuation
229
First trimester screening test?
- Maternal blood screening test: free B-hCG, PAPP-A, Nuchal translucency.
- Uterine size and gestation
- US
- Chorionic villus sampling
230
What blood test is elevated in PCOS
Testosterone
231
The diagnosis of Dysfunctional Uterine Bleeding is known as what?
Dx of exclusion
232
PMDD occurs during what phase?
Luteal
233
Treatment of Condyloma acuminatum?
Cryotherapy, trichloroacetic acid, surgical excision, electrosurgery, and laser therapy.
234
Treatment of Endometriosis?
OCPs, Leuprolide, Danazol, Depo Provera
235
Estrogen contraceptives possible SEs?
Thromboembolism
236
Initial test for postmenopausal bleeding?
Endometrial bx
US
Hysterscopy
237
What do you feel for to diagnose retained products of conception postpartum?
Firm Uterus
238
What age do you not give contraceptive pills to?
Smokers older than 35
239
How do you treat endometrial hyperplasia?
Progestin (PO or IUD-Mirena)
240
What is cystocele?
Bladder to drop or sag into the vagina
241
Pregnant woman starts having seizures mid-exam, how do you treat?
Magnesium sulfate
242
What position is best to have the pt in to observe for rectocele?
standing position
243
S/Sxs of cervical cancer?
- Post coital bleeding/spotting
- Metrorrhagia
- Pelvic pain
- +/- watery vaginal d/c
244
What test is used to monitor treatment progress in Ovarian cancer?
CA-125
245
How do you diagnose lymphogranuloma venereum (LGV)?
PCR to detect for C. trachomatis.
246
How do you diagnose for vulvar cancer?
Bx
247
High risk cancerous strains of HPV?
16 and 18
248
Genital Wart strains of HPV?
6 and 11
249
Treatment of stage IIA Cervical cancer
- TAH-BSO
| - Radiation + Chemo tx (Cisplatin)
250
How do you treat cervical insufficiency?
Cerclage
251
Vaginal atrophy treatment?
Topical estrogens
252
S/Sx of inflammatory breast cancer?
- Red, swollen, warm, itchy breast, nipple retraction, peau d'orange (d/t lymphatic destruction)
253
How do you diagnose inflammatory breast cancer?
Bx
254
How do you diagnose Gardnerella vaginalis (BV) microscopically?
- Clue cells
| - Few WBC
255
Regular period every 26 days what day does she ovulate?
Days 12-14 (LH surge causes ovulation)
256
What is the treatment for choriocarcinoma?
Methotrexate (chemo) and Hysterectomy
257
Best test for detecting abnormalities first trimester?
Chorionic villus sampling
258
Trisomy 18 screening results?
- a-FP: Low
- B-hCG: Low
- Estradiol: Low
259
What is the treatment for gestational diabetes?
- Insulin
- Glyburide or metformin
- Labor induction (@ 38 wks if uncontrolled/macrosomia)
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When do you do the 50g oral glucose challenge test?
24-28 wks
| - if >140mg/dL after 1 hr then perform 3 hour oral GTT.
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When do you perform the 3 hr 100g oral glucose tolerance test?
Perform in the AM after overnight fasting
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Fetal early decelerations is a sign of what?
Head compression
263
Fetal late decelerations is a sign of what?
Uteroplacental insufficiency
264
When checking for cervical dilation, you note a pulsating structure what does that mean?
Prolapsed umbilical cord
265
How do you diagnose infertility?
Hysterosalpingography
266
S/Sxs of incomplete abortion?
- Pregnancy not salvageable
- Some POC expelled some still retained
- Cervical Os is dilated
- Heavy bleeding, mod-severe cramping, retained tissue, boggy uterus
- D and E and 1st trimester
- Pictocin
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S/Sxs of complete abortion?
- Complete passage of all products
- All POC expelled from uterus
- Cervical os closed
- Loss of pregnancy sx +/- brown discharge
- D and E
- Misoprostol
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How do you treat chronic HTN?
Methyldopa, Labetalol, or Hydralazine
269
How do you treat preeclampsia?
Delivery
270
What B/P readings of mild and severe preeclampsia?
Mild: >140/90
Severe: >160/110
271
MC symptom of severe preeclampsia?
Scotoma (vision loss)
272
MC severe symptom of severe preeclampsia?
Hyperreflexia
273
How do you diagnose Placenta Previa?
TVUS
274
Treatment of abruptio placentae?
C-section
275
Diagnostic criteria for postpartum depression?
- Onset: 2 wks - 2 mo postpartum
- Duration: 3-14 mos
- Clinical manifestations: irritability sleep and mood disturbances, hearing changes, anxiety.
- May have thoughts of harming baby
- May need antidepressants
276
Multiple gestations is a risk factor for
Preterm labor
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How do you diagnose Molar pregnancy?
B-hCG and snow storm on TVUS
278
Treatment for GERD in pregancy?
Lifestyle and dietary modification (eg, elevation of the head end of the bed, avoidance of dietary triggers).
- Antacids followed by sucralfate.
- H2RAs then PPIs
279
How do you diagnose PROM?
- Sterile speculum exam: visual inspection-pooling of secretions
- Nitrazine paper rest: turns blue if pH >6.5
- Fern test: amniotic fluid - fern pattern
- US
280
Sign of Latent phase of labor?
Cervix effacement with gradual cervical dilation
281
Discontinuation of breastfeeding postpartum menses returns when?
~ 6 weeks after d/c breastfeeding
282
What medication induces labor?
Oxytocin
283
Treatment for Ovarian Torsion?
Emergency
284
MCC of mastitis?
Staph aureus
285
Most important thing to do to prosecute a rapist?
Immediately perform rape kit
286
Signs of bladder (vesicovaginal) fistula, constant leakage of fluid what test do you do?
Indigo dye and tampon test
287
Symptoms of chorioamnionitis?
- Fever.
- Fast heart rate in mother and baby.
- Sore or painful uterus.
- A bad smell from the amniotic fluid.
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What innocent murmur of pregnancy is heard and where?
Systolic murmur on left side
289
Physiology of pregnancy?
BP lowers, physiologic anemia, etc
290
Placenta previa presentation → transabdominal US vs. speculum exam?
- Pelvic US: transverse line
| - avoid speculum and pelvic exam if possible
291
Strawberry cervix → cervical “hemorrhages is a sign of what?
Trichomonas
292
(-) progesterone challenge test, what’s the problem?
Ashermans or outflow obstruction
293
Amine odor on exam is a sign of what vaginal infection?
Bacterial vaginosis
294
Tamoxifen increases risk for what cancer?
Endometrial cancer and uterine sarcoma
295
Laxative used for a rectocele?
Osmotic and stimulant (bisacodyl) were options
296
Causes of PPROM?
- Infection: amniotis
- Hx of PPROM
- Cigarette smoking
- Cord prolapse
- Multiple pregnancy
- Low weight
297
What other dx. is fibrocystic breast related to?
Fibroadenoma --> both noncancerous conditions
298
Two fetuses produced by the splitting of a single zygote would be considered what?
Monozygotic (Identical)
299
Two fetuses produced by two zygotes would be considered what?
Dizygotic (Fraternal)
300
Multiple fetuses produced by two or more zygotes would be considered what?
Polyzygotic
301
Hypogonadism in a perimenopausal woman?
Yes
302
What gene do you give radiation to breast cancer?
HER 2 negative
303
Women present with AUB for 6 months and they ruled out organic causes. What do you do next?
if the patient is at risk for endometrial cancer (chronic anovulatory cycles, obesity, multiparty, age >35, Dm or on tamoxifen therapy) then do an endometrial biopsy
304
38 wk induction of labor. Pt has chorioamnionitis diagnosis and is put on abx. Delivers the twins. Most likely complication she will have?
uterine atony
