Pg 68 Flashcards
(148 cards)
1
Q
Blue Sclera
A
Osteogenesis Imperfecta
2
Q
Orange Tears
A
Rifampin
3
Q
ACE Inhibitors
A
Diabetes, chronic cough
OK for BF
Don’t give in pregnancy
4
Q
Fever in PEC mimickers
A
HUS or TTP
HUS = renal failure, oliguria, creatinine high
TTP = AMS
5
Q
Cocaine
A
Simple diffusion?
6
Q
Fe Def
A
Microcytic anemia (MCV <80)
Ferritin is most Sn/Sp marker (low)
Total Fe needed for entire pregnancy is 1g
7
Q
Facilitated diffusion
A
Sugars
8
Q
Longest diameter of the fetal head
A
Supra-occipital mentum (12.5cm)
9
Q
Most common cause of SAB
A
Trisomies/45 X (esp trisomy 16)
10
Q
Pulmonary Fibrosis
A
Bleomycin
11
Q
Most chemo is in what phase???
A
S phase
12
Q
Low AFP is associated with
A
GTN and trisomies
13
Q
Low Papp-a is associated with
A
FGR
14
Q
DVT most common side is
A
LEFT (90%)
15
Q
CMV
A
Paraventricular intracranial calcifications
do urine test to dx if sx
16
Q
Syncytiotriphoblasts produce…
A
PAPP-A and HCG
17
Q
Elevated Inhibin A
A
Bad (associated with T21)
18
Q
Listeriosis, found in ..
A
Cantaloupe
see placental abscesses
19
Q
Limiting dimension in pelvis
A
Mid pelvis (bi-spinous diameter)
20
Q
OP position most associated with this kind of pelvis
A
AnthrOPoid pelvis
21
Q
21-Hydroxylase Def (CAH) is inherited…
A
AR
elevated 17-OHP
22
Q
PCKD is inherited…
A
AD
23
Q
DMD is inherited…
A
X-linked
24
Q
Dizygous is always
A
Di-Di
Split before 4d
25
Ventilator associated infection is...
Pseudomonas Pneumonia
26
Atypical Pneumonia is usually
Mycoplasma
27
PTU
Agranulocytosis
Hepatotoxicity
Give in 1st trimester only then Methimazole after 2nd
28
Alk Phos heat stability?
Normal placenta: heat STABLE alk phos
| Cholestasis: heat labile alk phos
29
Factor V Leiden heterozygous
DO NOT TREAT
30
Most clotting seen in
AT III
31
Lewis LIVES because
IgM cant cross the placenta
32
HBV is what kind of virus?
```
DNA
Can lead to hepatocellular cancer
Vertical transmission is typically if mom has high viral load
Treat with tenofovir in 3rd trimester
OK for Vag del, BF, etc
```
33
Cardiomyopathy EF?
<45%
30-50% will fully recover after
If GFR after is >50%, recurrence risk is 20%
If GFR is <50%, recurrence risk is high and mortality is 16%
34
Lemon Sign
Spina Bifida (most associated with obesity)
35
Banana Sign
Chiari
36
Strawberry Cervix
Trichomonas (PO Flagyl only)
37
Blueberry muffin rash
CMV or rubella
38
Kernicterus
Sulfonamides
39
Cataracts, Cardiac defects, Deafness
Congenital Rubella
40
Microcephaly causes
Radiation (M phase)
Zika
CMV
41
#13
Trisomy 13 = Patau, midline facial defects
Highest bishop score
Chromosome for BRCA 2
42
#17
Chromosome for BRCA 1
43
Cerebral Palsy
Periventricular Leukomalacia
44
Tetracycline teratogenicity
Teeth staining
45
Avg age menarche
12.8yoa
46
BPAM
Breast (Thelarche)
Pubic hair
Axillary hair
Menarche
47
Primary amenorrhea
15yoa w/2nd sex characteristics
| 13yoa w/o 2nd sex characteristic
48
Kallman's syndrome
Primary amenorrhea
Anosmia
5'6 or taller
49
Klinefelter Syndrome
47XXY
Azoospermia
Gynecomastia
50
Precocious puberty
Get a bone age
| McCune Albright: fibrous dysplasia, precocious puberty, cafe au lait spots
51
Sheehan Syndrome
Necrosis of pituitary, 2nd amenorrhea, inability to lactate
52
Dysgerminoma
```
most common germ cell tumor (40%)
most common germ cell tumor in pregnancy
Associated with LDH elevation
See large cyst, ascites, fevers
Lymphocyte infiltrates on pathology
```
53
Cyclophosphamide
POF, hemorrhagic cystitis (give Mesna)
54
Vinblastine
Toxic to bone marrow (M phase)
55
Granulosa Cell
Sex cord stromal tumor
Call exner bodies, coffee been nuclei
Elevated inhibin B (can get high E, and concomitant endometrial cancer)
56
Krukenberg tumor
Gastric cancer
| Signet ring cells
57
Brenner tumor
Walthard Rests?
58
Nuclear Grooves
Granulosa Cell and Brenner tumors
59
Schiller Duval bodies
Endodermal Sinus/Yolk Sac tumor
| Elevated AFP, can see hemorrhagic cysts
60
Hob Nail
Clear Cell Carcinoma
61
Psammoma Bodies
Serous tumors
62
Dilated pupils
Cocaine
63
Pinpoint pupils
Heroin, morphine, opioids
64
13-18 yoa primary cause of mortality
Accidents
65
Avg blood loss per period
30-50ml
| Menorrhagia >80mL per cycle
66
TTP treatment
Plasmphoresis
67
ITP treatment
1) Steroids
2) IVIG
3) Platelet transfusion
68
BPD at term
9.3cm avg
69
Lithium
Ebstein's Anamaly
70
Inhibin A is high in what part of menstrual cycle
AFTER ovulation (with progesterone)
71
Inhibin B is high at what stage of menstrual cycle
BEFORE ovulation (with estrogen)
72
Streptomycin on fetus
Fetal high tones hearing loss
73
Chloramphenicol on fetus
Gray baby syndrome
74
Femoral Nerve root
L2-4
Quads weakness, cant climb stairs, anterior leg numbness
Cause: self-retaining retractors
75
Obturator nerve root
L2-4
| Adductor longus, inability to adduct, from direct injury in space of retzius or needle injury during TVT
76
Peroneal nerve root
L4-S2
Foot drop
Caused by dorsal lithotomy
77
Genitofemoral nerve root
L1-2
| Loss of sensation of vulva/anterior medial thigh or burning, from skin incision location
78
Side effects of Cisplatin or Carboplatin
Ototoxicity
| Nephrotoxicity
79
Doxorubicin
Cardiotoxic
80
Methotrexate and 5 FU
Myelosuppresion
81
Vinca Alkaloids
```
Peripheral Neuropathy
M phase (all other chemos are basically M phase)
```
82
Reinke Crystalloids
Lipid (Hilus) cell tumors
| hirsutism
83
CEA elevated in
Mucinous tumors
84
CRIST my nerves and BLAST my bones
Vincristine has HIGH neurotoxicity, low marrow tox
| Vinblastine has HIGH marrow toxicity, low neuro
85
Treatment of Cervical Cancer: stage IA1
<3mm stromal invasion
| Do CKC or simple hysterectomy if done with childbearing
86
Treatment of Cervical cancer IA2
```
Stromal invasion 3-5mm
Radical Hysterectomy (can do trachelectomy) but need LND
```
87
Most common GYN malignancy
Endometrial Cancer
88
Most LETHAL GYN malignancy
Ovarian Cancer
89
Most diagnosed malignancy in pregnancy
Breast cancer
90
Most common malignancy during pregnancy
Cervical cancer
91
Rarest GYN malignancy
Fallopian tube cancer
92
Most common ovarian neoplasm in reproductive aged women
Dermoids
93
Most common ovarian neoplasm is all age groups
Serous cystadenoma
94
Septic Shock, SVR is...
LOW
Caused by sepsis, anaphylaxis, etc
Tx = IVF, Pressors (Epi), Abx
95
Cardiogenic shock, CO is
LOW
96
Hypovolemic shock, SVR is?
SVR is HIGH
PCWP is low (volume down)
CO is low (volume down)
97
Aortic insufficiency, dont give...
Nifedipine
98
Myasthenia gravis, dont give...
Magnesium!
99
Most common type of myoma degeneration
Hyaline (65%)
| most common in pregnancy is Carneus
100
Most common type of fibroid degeneration IN PREGNANCY
Carneous (red, meaty, like carne asade)
101
BRCA 1 cancer risk
Breast 70%
| Ovarian 40%
102
BRCA 2 cancer risk
Breast 70%
| Ovarian 20%
103
PTEN mutation is seen in what familial cancer syndrome
Cowden
| get those facial bumps
104
TP53 is associated with which familial cancer syndrome
Li-Fraumeni
105
Genes in Lynch Syndrome
```
MLH1 (promotor methylation)
MSH2
MSH6
PMS2
Diagnosis = IMMUNOHISTOCHEMISTRY
```
106
CDKN is gene marker for what cancer?
Melanoma
2nd most common vulvar cancer
*If melanoma hx, always send placenta for path
107
CA 19-9 elevated in
Pancreatic and GI cancers
108
HE4 elevated in
Epithelial ovarian cancers
109
APC is marker for
Familial Adenomatous Polyps
110
STK 11 is cancer gene seen in...
Peutz Jeghers
| see oro-facial freckling
111
Things than can be calcified on an xray of pelvis
```
Calcified fibroid
Kidney stone
Gallstone ileus
Fetus (Lithopedian)
Dermoid (teeth)
Papillary ovarian cancer
Appendolith
Phlebolith
```
112
Most common malignant ovarian neoplasm
Dysgerminoma
113
Tx of orgasm disorder
Directed masturbation (!) - gasp
114
Lab findings in T2DM
A1c >6.5%
Microalbuminemia
Fasting >126
2hrs >200
115
Which of the following is the least likely indication for intubation in a 27wk gravida?
```
A. RR of 40
B. Respiratory fatigue
C. PCO2 of 40
D. Blood pH of 7.35
E. PO2 of 60
```
D. Blood pH of 7.35
***pCO2 >40 is indication for INTUBATION
116
```
Meiosis begins at what GA?
A. 8wks
B. 12wks
C. 16wks
D. 24wks
E. 32wks
```
B. 12 wks
117
```
During cystoscopy, you see multiple bladder contractions. What is the most likely diagnosis?
A. UTI
B. Genuine SUI
C. IC ("bladder pain syndrome"
D. Urethral syndrome
E. Urethral hypermobility
```
A. UTI (detrusor dyssynergia)
118
```
Patient has new diarrhea after going to a picnic. Most likely organism is:
A. Salmonella
B. Giardia
C. Staph A
D. Ecoli
E. Listeria
```
C. Staph - common in MAYO, tx with LR
- Salmonella is more common in chicken, eggs
- Giardia is in ponds, creeks, untreated water
- Listeria is in cantaloupes, unpasteurized cheeses (queso), processed meats
119
```
You are performing a CS and the patient is actively bleeding but hemodynamically stable. All pharmacological methods fail. What is the least likely management?
A. Hypogastric artery ligation
B. Uterine artery ligation
C. Uterine artery embolization
D. Compression stitch
E. B-lynch
```
C. UAE - would need to move to radiology and she is unstable
120
```
The least likely side-effect of MTX is:
A. irreversible alopecia
B. Pulmonary damage
C. Myelosuppression
D. Stomatitis
E. Diarrhea
```
Least likely is A) alopecia
| Most likely is GI symptoms and, from this list, D
121
```
What is the most important prognostic factor for a woman with endometrial adenocarcinoma?
A. Age
B. Grade
C. Stage
D. +peritoneal washings
E. +aortic LN
```
C. STAGE
| - least important is D. peritoneal washings, not used in staging
122
```
An infant you just delivered has ambiguous genitalia. There are fused labio-scrotal folds as well as an enlarged clitoris. No gonads are palpable. Most likely genotype is:
A. 46 XX
B. 46 XY
C 45 X0
D. 47 XX +21
E 47 XYY
```
A. 46 XX - with CAH, 21 alpha hydroxylase def (AR)
123
```
Obesity is defined as a BMI of:
A. 25
B. 30
C. 35
D. 40
E. 45
```
B. 30
BMI 25 is overweight
30-35 Class I
35-40 Class II
40+ Class III/"morbid"
124
```
26yo G1P1 presents to ER unconscious. Medical bracelet say panhypopituitarism. What is first step in her mgmt?
A. MC
B. ACTH
C. ADH
D. GCs
E. Lasix
```
D. Glucocorticoids
| - first treat w/hydrocortisone b/c thyroxine exacerbates GC depletion
125
```
In fetal-maternal circulation, where is the highest PaO2 found?
A. Maternal uterine artery
B. Umbilical artery
C. umbilical vein
D. fetal hypogastric artery
E. maternal uterine vein
```
A. Maternal uterine artery (90-100%)
126
During gyn surgery, you dissect the broad ligament. Where is ureter found?
A. 3cm lateral to cervix
B. lateral leaf
C. 2cm superior to US ligament
D. Anterior aspect of the broad ligament
E. Medial leaf of the pelvic sidewall peritoneum
E. medial leaf
| and 1-2cm from cervix at level of internal os
127
```
Of the following malformations, which is associated with the use of lithium during pregnancy?
A. pulm
B. GI
C. CNS
D. Renal
E. Cardiac
```
E. Cardiac
| -Ebsteins anomaly
128
```
Patient with endometriosis was treated with Luprolide acetate one week ago. She now has abdominal pain. This is most likely secondary to:
A. increased progesterone level
B. ischemia of surrounding tissue
C. increase in endogenous estrogen
D. infection
E. inflammation
```
C. due to flare effect after gnRH therapy
129
```
Where would an abnormal finding be on neurological imaging after an eclamptic seizure?
A. Occipital lobe
B. Temporal love
C. Cerebellum
D. HT
E. Pituitary gland
```
A.
130
```
A 16yo Tanner stage II with hypoplastic breasts and sparse pubic hair has FSH 4 and LH 3. Most likely dx is:
A. Testicular feminization
B. Hypogonadotropic hypogonadism
C. CAH
D. Mullerian Agenesis
E. Turner syndrome
```
B. look at CNS causes
D - have normal FSH/LH usually
E - have elevated FSH
131
```
Which of the following is a late complication following a SSLF:
A. Anterior vaginal wall prolapse
B. Uterine prolapse
C. Dyspareunia
D. medial thigh pain
E. enterocele
```
A. SSLF fixes apical and then can have anterior prolapse after
132
```
Which of the following can cause IUGR prior to 26wks?
A. Cocaine
B. Tobacco
C. EtOH
D. gHTN
E. Class C DM
```
E. DM (class C = dx btw 10-19yoa)
133
```
What is the strongest sonographic sign of an ovarian malignancy?
A. multiloculations
B. Papillary excrescences
C. Neovascularization
D. Solid components
E. hyperechoic areas
```
B. nodularity and papillary shit is the worst
Refer to Onc also if PMP, CA125 >35 (>200 in pre-MP), size >10, ascites, septations >3mm (thick)
134
```
49yo with renal impairment is scheduled for pelvic CT scan w/contrast, which of the following medications should be given prior to the procedure?
A. Diphenhydramine
B. BMZ
C. DMZ
D. Acetylcysteine
E. Observation
```
D. Mucomyst helps protect kidney and ureters from contrast dye (also given prior to cardiac cath)
- can also pre-hydrate with IVF
135
```
The most likely cause of a SBO in a 55yo female is:
A. Malignancy
B. Constipation
C. Adhesions
D. Diverticulitis
E. IBS
```
C. Adhesions - or extraluminal causes (adhesions > hernias > cancer > infection)
136
```
The most common cause of peptic ulcer disease in a reproductive age female is:
A. Infection
B. Stress
C. Anti-inflammatory medications
D. Alcohol
E. Tobacco use
```
A. Infection with H, Pylori
| - other causes do include NSAIDs, alcohol, and less common - stress
137
```
Which of the following muscles is responsible for maintaining anal continence?
A. EAS
B. IAS
C. Coccygeous
D. Bulbocavernosis
E. Levator Ani
```
B. Internal Anal Sphincter - provides resting anal tone
138
```
A patient with infertility is undergoing induction of ovulation with HMG/hcg. What is the best test to follow her progress?
A. FSH
B. LH
C. Progesterone
D. Estradiol
E. Endometrial thickness
```
D. Estradiol
| HMG is LH/FSH, so can only measure estrogen
139
```
A 19yo is dx with AIS, what is the least likely finding?
A. Breast development
B. Blind vaginal pouch
C. Clitoromegaly
D. Elevated T
E. Male pseudohermaphrodite
```
C. Clitoromegaly (think 17,20 desmolase def with this one)
140
```
Under what circumstance is giving Rhogam LEAST indicated?
A. ECV
B. Missed AB at 6wks w/o YS/FP
C. 2nd trimester amnio
D. Abd trauma
E. 1st trimester SAB
```
B.
141
```
Which of the following is a maternal physiological change associated with sPEC?
A. hemodilution
B. Occipital vasocongestion
C. increased renal blood flow
D. Placental infarction
E. Decrease in GFR
```
E. Decrease in GFR --> vasospasm (not vasocongestion), hemoconcentration (no dilution), decreased oncotic pressure, increase PCWP, pulmonary edema
142
```
Oral contraceptives are associated with an increased risk of:
A. Chlamydia
B. Endometrial Cancer
C. HSV
D. Ovarian cancer
E. uterine fibroids
```
A. Increased risk of CT, decreased risk of GC and Ov cancer
| WHY? WTF knows
143
```
if an AD disorder is transmitted from parent to child, which of the following is the recurrence risk?
A. 1
B. 25
C. 33
D. 50
E. 100
```
D. 50%
144
```
Metastases to which organ system poses the worst risk to the patient with GTD?
A. Lung
B. Spleen
C. Vagina
D. Brain
E. Bone
```
D. Brain and liver are the worst --> need EMA-CO
| Lowest risk is lung (A)
145
What are the 5 red cell antigens???
C, c, D, E, e
There is no d
Most common D > E > c > C
Titer threshold is >1:16 to do cordocentesis, etc (>1:8 in anti-Kell)
146
```
Which of the following urogyn procedures has the highest rate of bladder perforation?
A. MMK
B. Burch
C. TVT
D. TOT
E. Kelly plication
```
C. TVT (3-9% rate of bladder perf)
147
```
All of the following are seen with OHSS except:
A. ascites
B. changes in CVP
C. Tachycardia
D. HyperK
E. Hypervolemia
```
E. Hypervolemia --> actually see volume depletion, hemoconcentration
Tx is fluid hydration and electrolyte repletion, albumin, possible tap, anticoag
148
```
Which type of sexual practice is most likely to transmit the HIV virus?
A. receptive anal sex
B. Receptive vaginal sex
C. Receptive oral sex
D. insertive vaginal sex
E. insertive oral sex
```
A. its the anal
