Repro

Question 1

CI IUD

Answer 1

unexplained vaginal bleeding
PID/cervicitis
cervical/uterine CA, 2 atypical paps
hx heart valve or artificial joint replacement

Question 2

oligomenorrhea

Answer 2

longer time between periods

Question 3

polymenorhea

Answer 3

frequent < 21 D cycle

Question 4

menorrhagia

Answer 4

lots of flow

Question 5

metrorrhagia

Answer 5

bleeding between periods

Question 6

menometrorrhagia

Answer 6

excessive + irregular bleeding

Question 7

AUB tx

Answer 7

1) NSAID to decrease blood loss

heavy bleeding - estrogen IV, then DnC
anovulatory bleding - OCP, mirena

Question 8

21 hydroxylase deficiency

Answer 8

congenital adrenal hyperplasia
ambiguous genitals
salt wasting

Question 9

“pearl necklace sign”

Answer 9

PCOS

Question 10

dx PID

Answer 10

lower abd/pelvic pain + 1 of the following:
uterine tenderness
adenexal tenderness
CMT

Question 11

outpt tx PID

Answer 11

1) rocephin +/- doxy x 14 D

2) levofloxacin x 14D +/- flagyl

Question 12

inpt tx PID

Answer 12

1) foxy-doxy x 14D

2) clindamycine + gentamicin

Question 13

most are asx
long/heavy periods, pressure, pain
lumpy bumpy uterus

Answer 13

leiomyoma (fibroids)
estrogen/progesterone sensitive
increase in size w/ pregnancy and decrease in menopause
tx: NSAID, OCP

Question 14

tx fibroids to stop bleeding vs decrease size myomas

Answer 14

danazol - stop bleeding

Leuprolide (GnRH) - decrease size

Question 15

MCC endometrial CA

Answer 15

endometrioid
favorable prognosis
assoc w/ unopposed estrogen (tamoxifen use)

Question 16

type of endometrial CA assoc w/ p53 mutation

Answer 16

serous

poor prognosis

Question 17

HPV 16 vs 18 association w/ adeno vs squamous cervical CA

Answer 17

Sixteen = Squamous
AYE-teen = Adeno

Question 18

RF cervical CA

Answer 18

STD/HIV
smoking
lots of babies
OCP

Question 19

ssx cervical CA

Answer 19

metrorrhagia (bleeding between periods)
post-sex spotting
cervical ulceration

Question 20

CIN 1 treatment

Answer 20

after 2 neg pap at 6 and 12 mon, continue w/ Q1yr

Question 21

CIN I, II, III w/ negative margins tx

Answer 21

pap at 12 mon +/- cotest

Question 22

CIN II, III w/ positive margins

Answer 22

pap at 6 mon, consider edocervical curettage

Question 23

CIN II and III tx or persistent CIN I

Answer 23

ablation = cryotherapy or laser
excision = leep
hysterectomy if really bad

Question 24

RF vulvar CA

Answer 24

HPV 16, 18, 31
lichen sclerosus
diabetes/obesity/HTN/CAD

Question 25

what is VIN

Answer 25

vulvar interepithelial neoplasa | PRE-cancerous in PRE-menopausal F

Question 26

purritus, pain, ulceration of mass

Answer 26

vulvar ca punch bx tx: chemo, ablation, vulvectomy

Question 27

typically found in upper 1/3 vagina | sx: abnormal bleeding, d/c, or post-sex bleeding

Answer 27

vaginal CA | tx: excise

Question 28

types of pts and types of vaginal CA typical

Answer 28

postmenopause = squamous young = adeno DES exposure = clear cell

Question 29

BRCA 1 > BRCA 2 lynch syndrome CA 125

Answer 29

ovary CA 1st step: TVUS tx: TAHBSO w/ omenectomy + lymphadenectomy + chemo post-op

Question 30

tx precocious puberty

Answer 30

central - leuprolide

Question 31

``` MC of all benign breast conditions exaggerated stromal tissue 30-50y/o assoc w/ trauma and caffeine cyclical, bilateral ```

Answer 31

fibrocystic changes of breast

Question 32

MC breast lesion in women < 30 | do NOT change w/ cycle

Answer 32

fibroadenoma | cystosarcoma phyllodes = large fibroadenoma

Question 33

bx breast CA

Answer 33

FNA - initial bx | core needle - large sample to check receptor status

Question 34

tumor markers breast CA

Answer 34

CEA CA 15-3 CA 27-29

Question 35

tx breast CA

Answer 35

hormone receptor+: tamoxifen estrogen receptor-: chemo HER2/neu: trastuzumab

Question 36

complications metastatic breast CA

Answer 36

Pleural effusion, edema of arm

Question 37

CI lumpectomy

Answer 37

``` large tumor or multiples subareolar fixated to chest wall prior radiation nipple involvement ```

Question 38

bHCG levels

Answer 38

peak at 100K at 10 weeks, decreases throughout 2nd trimester, levels of in 3rd should double Q48H in early prego

Question 39

used to confirm pregnancy

Answer 39

US - gestational sac seen at 5 weeks | bHCG around 1000-1500

Question 40

physiologic changes in pregnancy

Answer 40

CO, tidal volume, respirations, blood volume, gastric emptying time - increase blood pressure, HCT, sphincter tone - decrease

Question 41

"UNDERage at 18"

Answer 41

trisomy 18 | AFP, estriol, b-hcg, inhibin A are ALL low

Question 42

"2 down, 2 up"

Answer 42

trisomy 21 AFP/estriol - down b-hcg, inhibin A - up

Question 43

when to do amniocentesis

Answer 43

> 35 gest age + abnormal quad screen

Question 44

TORCHES causes

Answer 44

``` premature delivery CNS abnormalities anemia jaundice hepatosplenomegaly growth retardation ```

Question 45

TORCHES pathogens

Answer 45

``` Toxoplasmosis Other - parvovirus, varicella, listeria, TB, malaria Rubella Cmv HSV/HIV Syphilis ```

Question 46

latent vs active 1st stage labor

Answer 46

latent: onset till 3-4cm dilated active: 4cm till 10

Question 47

fetal heart rate monitoring components

Answer 47

heart rate variability accelerations decelerations

Question 48

fetal decelerations

Answer 48

early - normal (head compression from uterine conraction) late - fetal hyoxemia, uteroplacental insufficeincy variable - umbilical cord compression

Question 49

HELLP syndrome

Answer 49

variant of preeclampsia w/ poor prognosis | hemolysis, elevated LFT, low platelet

Question 50

triad preeclampsia is not just "HyPE"

Answer 50

Htn Proteinuria Edema

Question 51

wood's screw vs mcroberts maneuvers

Answer 51

wood screw - rotation | mcroberts - leg elevation

Question 52

frank vs complete breech

Answer 52

complete knees are flexed, frank knees are extended | both have hips flexed

Question 53

immunity provided in colostrum

Answer 53

secretory IgA

Question 54

CI breast feeding

Answer 54

maternal HIV active TB drug abuse

Question 55

failure to lactate from low prolactin levels

Answer 55

Sheehan's

Question 56

tx mastitis

Answer 56

dicloxacillin keflex augmentin macrolide