OBGYN & male repro

Question 1

MC complication of PCOS

Answer 1

DM

Question 2

Fournier’s gangrene

Answer 2

scrotal edema, bullae, crepitus SURGERY

Question 3

DM in pregnancy

Answer 3

Insulin (target fasting 95, 1h pp 140, 2h pp 120)

Question 4

Spermicide/diaphragm

Answer 4

recurrent UTIs

Question 5

Blighted ovum

Answer 5

gestational sac, no ca activity

Question 6

Placenta accreta

Answer 6

Prior cs

Question 7

Turner syndrome

Answer 7

neonates: webbed neck, hand/feet edema, coarctation aorta murmur midback

Question 8

Forceps delivery

Answer 8

genital lac

Question 9

Lithium

Answer 9

Ebstein’s anomaly (enlarged RV, ASD)

Question 10

Can bilateral ureteral ligation occur during TAH?

Answer 10

YES. Anuria, AKI, hydronephrosis

Question 11

IUFD

Answer 11

> 24w induction of labor

Question 12

Chorioamnionitis

Answer 12

Labor induction

Question 13

Hyperemesis gravidarum

Answer 13

Thiamine deficiency, wernicke’s, urine ketones=severe

Question 14

HTN

Answer 14

<20w chronic, risks=IUGR, abruption, preterm del (NOT ROM), GDM

Question 15

Labor stages

Answer 15

1=latent (<6cm) active (>=6cm 1cm/2h, protracted 2h–>pit, arrest 4h/6h–>CS)
2=arrest >3h/4h (epid) OR exhaustion OR cat III OR CHF–>operative vag

Question 16

Poly/oligohydramnios

Answer 16

> 24cm, <5cm

Question 17

RFs for breech

Answer 17

submucosal fibroids, AMA, <37w, oligo/poly, plac previa

Question 18

Sertoli-Leydig tumor

Answer 18

Looks like PCOS but <1y and clitoromegaly, test–>virilization, GnRH inh–>menopause sx

Question 19

Primary amenorrhea

Answer 19

13 w/o dev, 15 w/, w/u US–>FSH (+ut) karyotype (-ut)

Question 20

Pre-eclampsia

Answer 20

> 20w!!!!!
HTN (140), +proteinuria (300 24h, p/Cr 0.3) OR end organ damage, severe fts: plt<100, LFTs, Cr>1.1, SBP 160
PULMONARY EDEMA
Del 37w, severe fts 34 induction

Question 21

Uterine inversion

Answer 21

REPLACE THE UTERUS

Question 22

Exercise in pregnancy

Answer 22

contact sports, risk of falling

Question 23

Operative vaginal delivery

Answer 23

lac

Question 24

OCPs

Answer 24

don’t cause weight gain, dec risk ov ca IN BRCA PTS

Question 25

IUGR

Answer 25

<10th, fetal prob: 1st tri, symmetric | mom prob: 2nd-3rd, bigger head

Question 26

Copper IUD

Answer 26

best emergency contraception

Question 27

Polyps

Answer 27

intermenstrual bleeding

Question 28

PPROM

Answer 28

>34w deliver, <34 hospitalize (infx, abruption, cord prolapse)

Question 29

HPV

Answer 29

condyloma accumunata, flesh-colored papules, friable, pruritic, >4yo abuse

Question 30

Pregnancy vaccinations

Answer 30

flu, Tdap (no live=varicella, inhaled flu, MMR)

Question 31

CAH

Answer 31

(21, 17 high), virilization F

Question 32

vWD

Answer 32

nl PT, plt, abnl BT, +/- PTT, DDAVP ppx or acute bleed

Question 33

Vulvar cancer

Answer 33

lichen sclerosis, plaque, itchy, bx

Question 34

Chlamydia

Answer 34

azith only (empiric OR gon azith + CTX)

Question 35

Fetal heart tracings

Answer 35

Cat I var 6-25, +/- acels, +/- early decels Cat III no var, late/var decels CS for Cat III, otherwise repositioning, amnioinfusion

Question 36

Vaginal cancer

Answer 36

posterior, superior 1/3, DES clear cell adeno, smoking squamous

Question 37

Chorioamnionitis

Answer 37

Deliver (MOC fever, WBC, fHR>160)

Question 38

Ectopic pregancy

Answer 38

rupture can have CMT, RF abnl uterine anatomy cornu rupture hemorrhage fluid in cul-de-sac

Question 39

Placental abruption

Answer 39

low-vol cont, +/- bleeding, non-reassuring FHT, give IVfluid

Question 40

SERMs

Answer 40

both DVT, hot flashes, tamoxifen endometrial ca, raloxifene used for osteoporosis

Question 41

Varicocele

Answer 41

L > b/l, R ca or thrombus get US, infertility

Question 42

Syphilis

Answer 42

RPR/VLDR may be negative primary dz, give penG anyway

Question 43

Vaginal pH

Answer 43

3.8-4.5

Question 44

Osteogenesis imperfecta Type II

Answer 44

fatal

Question 45

Fibroadenoma DIAGNOSIS

Answer 45

bx

Question 46

Endometrial bx indications

Answer 46

abnormal bleeding OR atypical glandular cells

Question 47

Placenta previa

Answer 47

>20w, transabd-->transvag US, nl FHT painless bleeding, give fluids

Question 48

Mammo guidelines

Answer 48

50-74 q2y

Question 49

Obesity anovulation

Answer 49

fat pt--> inc androstendione + estrone, LH/FSH messed up

Question 50

Ovarian ca

Answer 50

Epithelial ovarian carcinoma MC postmen, urinary sx, constipation, rectovag=met, pulm eff met, ovary fallopian tube peritoneum, US thick septations solid CT CA-125

Question 51

When to get a UPT

Answer 51

Reproductive age before any radiation imaging

Question 52

Atrophic vaginitis - can you have petechiae?

Answer 52

YES, Lichen sclerosis sx but no plaques, +vag involvement, pH high >4.5 2/2 low lactate production

Question 53

Ureteroplacental insufficiency

Answer 53

BPP-->30 min Nonstress test (reactive), amnio (>5 index, >2 pocket), mvmt (>3), tone (>1 flex/ext limbs or spine), breathing (1), 8nl, <4 deliver

Question 54

Anti-epilleptics

Answer 54

Phenytoin, carbamazepine, depakote wide fontanelle, cleft palate, tiny hands/feet, microcephaly TAPER PRIOR TO PREG if sz free >2y

Question 55

Vulvar lichen sclerosis

Answer 55

Pre-menarche postmen, vag architecture (labia, anal fissures), NO VAGINA

Question 56

Copper IUD

Answer 56

Don't give if anemia or h/o heavy menstrual bleeding

Question 57

Penile fracture

Answer 57

uro emergency tunica albuginea if they can't pee uretherography

Question 58

Early decels

Answer 58

Symm w/ contractions, head compression, benign

Question 59

Late decels

Answer 59

Fetal hypoxia, abruption, uteroplacental insuff

Question 60

Variable decels

Answer 60

Umb cord compression

Question 61

Endometriosis

Answer 61

Starts 2 days before

Question 62

Breast cancer prognosis

Answer 62

TNM staging

Question 63

Breast cancer birth control

Answer 63

Copper IUD, ABSOLUTELY NO HORMONAL INCLUDING PROG IUD

Question 64

Breast mass eval

Answer 64

<30 US, >30 mammo, dx bx

Question 65

BPH

Answer 65

a-1 inh tamsulosin, finasteride 5-a-reductase inh adjunct or hypotension

Question 66

Surgical site infx

Answer 66

>24h after surg, induration, erythema, obesity, emergency

Question 67

Short interpregnancy interval

Answer 67

<18mo, inc risk of preterm, PPROM, anemia, low birth wt

Question 68

Chronic bacterial prostatitis

Answer 68

UTIs that get better w/ short course abx (NO URETHRAL DISCHARGE=urethritis), tx cipro x6w

Question 69

Indications for endometrial bx

Answer 69

postmen AUB, endometrial cells on pap, atypical glandular cells on pap

Question 70

Androgen insensitivity syndrome

Answer 70

46XY no internal sex organs test-->estrogen periphery have some secondary F sexual characteristics

Question 71

Mammary paget's disease

Answer 71

85% ca, adeno

Question 72

Simple breast cyst

Answer 72

Clear fluid, f/u 2-4mo then q1y

Question 73

Oxytocin toxicity

Answer 73

ADH, hypoNa

Question 74

Endometrial hyperplasia

Answer 74

RF inc estrogen=obesity, early menarche, nulliparity

Question 75

hCG function

Answer 75

corpus luteum-->prog until placenta does it

Question 76

Urethral diverticulum

Answer 76

Pain, discharge from meatus

Question 77

Uterine tachysystole

Answer 77

>5 contractions in 10 min, reposition, tocolysis, stop pit

Question 78

Superficial dehiscience

Answer 78

Wound dressing, don't need abx or anything

Question 79

Tubo-ovarian abscess

Answer 79

Comp of PID, complex multi-loculated thick walls internal debris

Question 80

Hyperprolactinemia

Answer 80

Pit tumor or hypothyroid (other s/s, inc hypothalamic upreg)

Question 81

Tocolytics

Answer 81

<32w indomethacin, 32-34 nifedipine (flushing, HA, tachycardia, palp), in the hosp terbutaline (NOT IF DIABETIC, arrhythmia, pulm edema)

Question 82

Sildenafil

Answer 82

Contraindicated nitro, a blockers

Question 83

Bacterial vaginosis

Answer 83

NO CERV INVOLVEMENT

Question 84

Nl postpartum

Answer 84

Low grade fever <24h, lochia, perineal edema

Question 85

Primary dysmenorrhea

Answer 85

(Physiologic), not endometriosis (+dysparaeunia, pain w/ defecation)

Question 86

Sterile pyuria

Answer 86

Chlamydia or HSV

Question 87

Inflammatory breast carcinoma

Answer 87

Looks infected, PEAU D'ORANGE, LN

Question 88

TOL contraindications

Answer 88

Classic CS, myomectomy w/ uterine cav entry

Question 89

Prenatal screening

Answer 89

10w cfDNA, 10-13 CVS, 15-20 amniocentesis

Question 90

Testicular torsion

Answer 90

pain w/ elev, 1 higher than other, no cremasteric reflex +/- hematoma

Question 91

Shoulder dystocia

Answer 91

C8 T1 = "claw hand" +/- Horner's, C5 C6 = "waiter tip" no moro

Question 92

HSV in preg

Answer 92

ACYCLOVIR @36W REGARDLESS | AT DELIVERY --> no lesions vag, active lesions CS

Question 93

Exogenous steroids

Answer 93

Test labs can look nl

Question 94

Hyperandrogenism in preg

Answer 94

NO MASS (placental aromatase def, vir) VS MASS Malig=Sertoli-Leydig vir u/l resection 2nd tri or PP, benign=b/l luteoma solid vir, theca cyst (low risk vir in fetus)

Question 95

Fat necrosis

Answer 95

trauma/surg, dimpling nipple retraction calcifications c/f malig but is benign foamy mac fat globules bx no inc risk

Question 96

Hypertensive crisis

Answer 96

>160/110, IV labetalol (HR), hydral, nifedipine (PO)

Question 97

Spinal epidural abscess

Answer 97

Epidural sequelia, IVDU, FEVER + back pain + neuro, dx MRI tx abx + surgical decomp

Question 98

Postpartum fever

Answer 98

>24h MC endometritis vag flora clinda + genta | No imp 48h septic pelvic thrombophlebitis, pelvic abscess

Question 99

Cerebral palsy

Answer 99

Prematurity

Question 100

TAH

Answer 100

Ureteral injury e’rrrry damn time

Question 101

Cephalohematoma

Answer 101

Forceps vacuum DOES NOT CROSS MIDLINE (caput common nbd crosses midline)

Question 102

Hypogonadism (male)

Answer 102

PRIMARY not making test LH FSH high, SECONDARY LH FSH low/nl, get prolactin +/- MRI

Question 103

Galactokinase deficiency

Answer 103

Cataracts ONLY | G-1-P uridyl transferase cataracts + a lot of other bad shit hypotonia jaundice baby looks fucked up

Question 104

Down Syndrome

Answer 104

hypotonia

Question 105

External cephalic version

Answer 105

offer at 37w

Question 106

Ovarian hyperstimulation syndrome

Answer 106

B/l cysts, 1-2w, VEGF (ascites, pulm effusion), hemoconcentration, tx

Question 107

Disseminated gonorrhea

Answer 107

Arthritis + pustular rash extremities torso, blood clx negative, tx IV CTX + PO azithro

Question 108

GBS ppx

Answer 108

<37w, ROM >18h, fever (hx prior neonatal infx, pos any time during preg even if tx) penicillin

Question 109

Fetal fibronectin

Answer 109

<34w, ROM >18h, fever, 1w delivery, betamethasone

Question 110

Retained placenta

Answer 110

>30m, hemorrhage (uterus doesn't contract)

Question 111

PID

Answer 111

can still have pharyngeal erythema