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USMLE Step 2 - Top 5% > OBGYN III 👘 > Flashcards

OBGYN III 👘 Flashcards

(90 cards)

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1
Q

Screening for BRCA patients

A

6 monthly ovarian US and CA125. And annual MRI of breast. Consider prophylactic removal at 40

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2
Q

Ovulatory bleed first line Mx

A

COCP

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3
Q

Who gets DEXA scan

A

Above 65

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4
Q

Who gets HRT in menopausal

A

Less than 60 and has symptoms of flushing, vag atrophy, mood issues

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5
Q

E vs E AND P for menopause

A

E only if no uterus

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6
Q

Is liver disease a CI for HRT

A

Yes,

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7
Q

First and second line medical therapy for endometriosis

A

COCP and GnRH ag/Levo IUD

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8
Q

Severe recurrent endometriosis, and patient doesn’t want more kids

A

Can do hysterectomy

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9
Q

Patient has the endometrial hyperplasia…. Bye did the biopsy, just plain hyperplasia, no atypia

A

Just do progesterone. Then after 6mo reassess, doing biopsy. If not improvement, then send to oncology

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10
Q

What is Yasmin

A

Drospirenone + ethinyl estradiol (Yaz; Yasmin)

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11
Q

Tx for premenstrual disorder

A

SSRI if severe

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12
Q

Dx of premenstrual syndrome

A

Clinical. Get patient to take a diary and make the connection

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13
Q

Endometrial stripe size limit

A

> 4mm. Don’t forget to apply this

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14
Q

Cyst rupture but not unstable or severe

A

Reassure and observe

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15
Q

Why ovarian tumour causes precocious puberty in woman

A

Granulosa

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16
Q

<45 with AUB. Failed COCP. Do what

A

Biopsy

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17
Q

Endometrial ablations and salpingograms allowed in unknown cause of AUB

A

No…. Could spread potential cancer

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18
Q

In pregnancy why do we see an increased risk of non-compliance to medications

A

Women are often scared the medications cause harm to the baby, so decrease them

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19
Q

What affect does neuraxial epidural anaesthesia do to 2nd stage

A

Increase is it

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20
Q

Main cause of protracted active phase of labour

A

Catholic pelvic disproportion

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21
Q

Is a platelet range of 100 to 150 okay in pregnancy

A

Yes

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22
Q

Bleeding when rupture of membranes, and fetal heart tones go. Blood pressures are all okay

A

Vasa previa

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23
Q

If postpartum (few days postpartum) you have a little bit of red vaginal discharge. Patient is stable. Do we have to worry

A

Normal lochia rubra

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24
Q

After salpingectomy for ectopic pregnancy, what injection shall I give

A

RhoGAM

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25
If I have ectopic pregnancy and do salpingectomy, do I need methotrexate
No
26
Obvs gravidity is number of preg. What is parity
Number of live births beyond 20 weeks
27
Foods to avoid in preg
Fish with mercury, moderate caffeine only, undercooked meat and fish. Delicaneyby
28
We give folate, calcium, iron to patients!. But what extra for vegans
D and B12
29
Obvs give IV penciclin for GBS prophlx. If allergy? Or if risk of anaphylaxis
Ceph Clinda or vanco resp
30
When to do the A test in preg
10-14 weeks. So do PAPPA and HCG and nuchal trans. Then do the quad screen not long after
31
When to do the gest DM screen if no risk factors
End of second trim or beginning of third
32
Obvs in first visit we test lots of infx. In high risks, what do we check again at end
Chlamydia gonorrhea hiv syphilis
33
High AFP can be seen on NTD or abdominal wall defect. Where else?
Twins, incorrect dating, fetal death, placental A
34
When does all the aneuploidy stuff start
10 weeks onward
35
SE if amniocentesis
PROM, chorioamn, hemorrhage
36
10-12 weeks gest, or 15-20 weeks gest. Which is CVS and which amnio
That ordet t
37
Mercury affect of fetus
Cerebral atrophy. Microcephalic etc
38
Safest testracine in preg
Doxy
39
Feta warfarin syndrome
Nasal hypo, stippled bone epiphysis, and more
40
Vit A tox to preg
Thymic agenesis, CV defect, craniofascial issue, CL/CP etc
41
Infant from HIV mum…. Her titre was less than 1000, do I give Tx?
Yes.
42
CMV vs Rubella cong infx?
Rubella: Blueberry muffin, cataracts, PDA, hearing loss CMV: perivent calcification. Petechia rash.
43
Methylene TDF reductase def
Same as saying homocysteinuria
44
If spont abortion early (<12 weeks) likely what cause
Chromosomal
45
If spont abortion later (12-20weeks) likely what cause
Coag, C insuff.
46
How to prevent spont abortion in APLS
LMWH and aspirin
47
Spontaneous abortion order
, threatened, inevitable, incomplete, complete, missed. All os closed and POC still there, but bleeding. Then Os opens but POC kept. Then POC half gone. Then POS gone and Os closed
48
Spontaneous abortion. Incomplete, or inevitable. If <12 weeks or after
Manual aspiration. Or DandC if after
49
Stillbirth Mx If < or > 24 weeks
DandE Induce labour Autopsy to see cause
50
If sus spont abortion. See no fetal pole, no cardiac activity on US… do what?
HCG
51
Medical abortion: If < or > 10 weeks gest
Misoprostol and mifepristone DandC with vaccum aspiration
52
Complications of abortion
Retained POC (causing DIC of endometritis or septic abortion)
53
Way to remember Os open and spont abortion
If begins with I…. Then it’s open Os (inevitable and incomplete)
54
First invx in hyperemesis G
Usually US to check for twins or molar or chorio
55
Main step approach to Tx for hyperemesis G
Diet, anti H, metaclo, ondansteorn
56
Reasons for doing early GTC I’m first trim
Fat mum, PCOS, previous macrosomic, previous test of insulin resistance (HbA1c above 5.7), previous gest DM, first degree relative with DM, CVD.
57
Reasons to do early GTC in preg (first trim)
Fat mum, PCOS, previous macrosomic, previous test of insulin resistance (HbA1c above 5.7), previous gest DM, first degree relative with DM, CVD.
58
Greater than 8, invegstiagte. In terms of Gest DM
If HBAC1 large that 8 in preg… check for congetsinal issues
59
What is considered macrosomic
>4000g. If EFW is above 4500 do C-section
60
Gestational DM. In labour what do we do
Infuse insulin and dextrose to keep steady glucose
61
We all know chronic HTN is Dx before 20 weeks. How else can we Dx retrospectively
If persists >3mo post partum
62
List all the elements that make preeclampsia severe
TCP, Cr high, LFT *2 high, pulmonary edema, Neuro issues and headache unresponsive to meds, eye issues
63
General Mx on delivery for: Preeclampsia not severe Severe features Eclampsia
37 34 Immediate
64
Some preeclampsia stuff to Mx 37 weeks Far from terms (before 34) Severe features If Mg tox 24 hr postpartum
Deliver Expectant, with BP control, Mg drip, Same as above Calcium gluconate Continue seizure prophlx
65
Patient with preeclampsia has headache and RUQ pain. Is this severe
Yes severe features
66
RF for preeclampsia
Renal disease (SLE DM), nulliparoty and twin, fam Hx, HTN, extremes of age. Molar preg
67
If eclampsia seizure recurs, give what
Diazepam
68
Do you need routine monitoring of Mg levels when giving Mg in eclampsia/preeclampsia with severe features
No
69
Intrahep cholestasis vs AFLP quick facts
Pruritus, like pain mild elevated LFT. Best to measure bile acids (sens and spec). Give Urso and deliver at 36 RUQ pain, low glucose, jaundiced, only 200-300 LFT. TCP and DIC Deliver!
70
Does ectopic preg cause vag spotting
Yes
71
Risk factors for molar preg
Extreme age, folate def or carotene def
72
Stable abruption can be Mxd expectantly. What about more severe
Bag deliver if mother and fetus ok C sec if not
73
Risk factors for acreta
Low lying placenta, downs, prior Sx to endemtrium
74
Baby with EFW of >5000, or 4500 with DM
C-SECTION
75
Main thing to rule out at first in Oligohydramnios
ROM
76
Does all women get RhoGAM
Only Rh neg women with positive or unknown man. Then if baby positive for Rh, give after birth. Not for all!
77
when do we actually do fetal movement assessment and NST in preg
For pregnancies at high risk of fetal demise… around 30 weeks can start
78
What is a reactive stress test?
2 accel over 20 mins.
79
Causes for non reactive stress test
Less than 32 week, sleeping (wake up with vibration), CNS issue, narcotic mum. Do follow up with CST or BPPP
80
When not to do contraction stress test
If risk of premature/Previa/ Hx of urge time Sx
81
What is a positive CST
Worry some (unlike NST). Deliver. Is when late decals usually
82
What are the abnormal umbilical artery dipole findings
Decrease, absent, reverse end diastolic flow. High velocity diastolic flow is good
83
BPP Test the Baby MAN
Tone, Breathing, movement, amniotic FI, Non stress
84
When do we use umbilical Doppler velocity
If sus FGR
85
When do we use umbilical Doppler velocity
FGFR
86
List of CI to breast feed
HIV in US, Tb unTx, varicella, herpes on boob. Chemo, radioTx, cocaine PCP, cannabis. TETRACYCLINE CHLORAMPHENICOL m, galactosemia
87
Mx for those not wanting to breastfeed
Supportive bra, avoid nipple stun, apply ice and NSAID.
88
If no improvement in breast mastitis in 48 hours… do what
US to see if abcess
89
Breastfeeding and get painful tender lump…. No fever or chills. No leuko
Localised plugged duct
90
Breast engorment Mx
Frequent breast feed, or suppress lactation if not feeding. Warm compress before and cold between feed.

USMLE Step 2 - Top 5% (34 decks)

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