OBGYN5

Question 1

Clinical future of MGSO4 toxicity?

Answer 1

Mild/moderate/sever

Question 2

Mild?

Answer 2

hyporeflexia, headache, nausea, and flushing

Question 3

Moderate

Answer 3

areflexia, hypocalcemia and somolecense

Question 4

Sever

Answer 4

respiratory depression

cardiac arrest

Question 5

Mechanism of toxicity?

Answer 5

block presynaptic ca entry–inhibit ca release

Question 6

Risk for toxicity?

Answer 6

renal failure/low U/O

Question 7

management of toxicity

Answer 7

Stop magnesium

Give calcium gluconate

Question 8

Normal MGSO4 mechanism of action?

Answer 8

block CNS ca channels–increase sizure threshold

Question 9

Therapeutic serum level?

Answer 9

4.8-8.4 meq/l–2-4x normal serum level

Question 10

Clinical future of benign ovarian mass?

Answer 10

in reproductive age

simple cystic lesion

Question 11

Clinical future of malignant ovarian mass?

Answer 11

In postmenopausal symptom
complex cyst
chronic pain
constipation

Question 12

Corpus lutetium cyst?

Answer 12

Unilateral
occur when follicle rupture
U/S –hypoechoic area with normal dopler

Question 13

Management?

Answer 13

Resolve by itself

Reevaluate after 6 week

Question 14

pregnancy and ulcerative colitis?

Answer 14

Px exacerbates UC because of cytokine released by the placenta.

Question 15

CM?

Answer 15

hematocasia
abdominal pain
tenesmus
toxic megacolon(rarley)

Question 16

Management?

Answer 16

continue tx(mesalamine, sulfasalazine, and TNF alpha inhibitor)in pregnancy but in breastfeeding continue except sulfasalazine.

Question 17

Complication?

Answer 17

IDA
IUGR
Preterm delivery

Question 18

Arteriovenous malformation?

Answer 18

GI bleeding
IDA
Ass. disease (CKD, VWD, and AS)

Question 19

Diverticulitis?

Answer 19

age >60

painless hematochezia, not an ass. with pregnancy

Question 20

Internal hemorrhoid?

Answer 20

painless hematochezia
constipation
itching

Question 21

Ovarian overstimulation syndrome?

Answer 21

Ovulation induction(clomiphene citrate)–execcve VEGF expression by ovaries–bilaterally enlarged ovaries with fluid third spacing(PE and Ascitis)

Question 22

rectovaginal fistula presentation?

Answer 22

leakage of flatus or feces(dark brown discharge) from the posterior vagina
Dark red valvey lesion(Due rectal mucosal overgrowth to form sinus)

Question 23

Risk factor?

Answer 23

Obstetric trauma
Pelvic radiation
pelvic surgery
Colonic ca
chrons disease
Diverticulitis

Question 24

Diagnosis?

Answer 24

PE
fistulography
MRI
Endosonography

Question 25

Uterine inversion CM?

Answer 25

PPH Round, smooth protruded mass per vagina Lower abdominal pain Unpalpable uterus

Question 26

Risk factors?

Answer 26

Macrosomia Precipitous labor Nuliparity Morbidly adherent placenta

Question 27

mechanism?

Answer 27

excessive fundal pressure | excessive cord traction

Question 28

differential?

Answer 28

protruding myoma

Question 29

how to differentiate?

Answer 29

uterus palpable at the abdomen

Question 30

management of UI?

Answer 30

Manual reversion Relaxant (nitroglycerin and terbutaline) if manual attempt faille--do then manual inversion Remove placenta and give uterotonic agent after reversion

Question 31

Remove placenta and give uterotonic agent after reversion why?

Answer 31

b/c risk of further bleeding and cervical contraction which make inversion difficult consecutively.

Question 32

Fibroid CM?

Answer 32

``` heavy prolonged menses pressure Sx (pelvic pain, constipation, and urinary frequency) Enlarged irregular uterus ```

Question 33

Obstatric complication?

Answer 33

preterm labor abortion infertility

Question 34

Management?

Answer 34

HM(preserve fertility) | hysterectomy(not want fertility)

Question 35

spontanous pregnancy decrease with increase maternal age why?

Answer 35

decrease ovarian reserve

Question 36

At which age will be a sharp decline?

Answer 36

age 35

Question 37

associated hormonal finding?

Answer 37

increase FSH due to low estrogen prdn by the ovary

Question 38

clinical importance related to infertility?

Answer 38

Infertility define > 6 month age > 35(unlike one year in age <35)

Question 39

How to D/T with primary ovarian failure?

Answer 39

in POI there will be hypoestrogenic symptoms like hot flashes, vaginal dryness...