Reproductive

Question 1

Management of breast abscess

Answer 1

Stop breastfeeding
I&D
Nafcillin, Vanc, Clinda

Question 2

Fibroadenoma

Answer 2

Mobile and rubbery without discharge
May excise if bothersome

Question 3

Fibrocystic Breast disease management

Answer 3

NSAIDs and OCPs
Decrease smoking and caffeine
Danazol for very severe

Question 4

Dx for galactorrhea

Answer 4

More concerning if unilateral
Get PRL level

Question 5

Mastitis

Answer 5

Inflammation of breast duct
Develops into abscess - no fluctuance
Dicloxacillin for staph

Question 6

Management of CIN 1-3

Answer 6

2 and 3 remove right away
Cin 1 may observe

Question 7

USPSTF HPV screening guidelines

Answer 7

21-65
CYtology every 3 years
HPV every 5 years
No screening if over 65 with no hx
If hysterectomy only needed if they had cervical cancer

Question 8

Onset of fetal movement feeling

Answer 8

16-20 weeks

Question 9

Estimated delivery date rule

Answer 9

First day of LMP plus 7 days minus 3 months

Question 10

Fundal Height benchmarks

Answer 10

Suprapubic - 12 wks
Between pubis and navel - 14 wks
Navel - 20-22 wks
Diaphragm - 38-40 wks

Question 11

Alpha fetoprotein screening

Answer 11

15-20 weeks
Increased is neural tube increased is downs
Amnicentesis for abnormal

Question 12

Non stress test

Answer 12

DOne with baby isn’t moving - look for HR, etc.
Follow up with stress test, then biophysical profile

Question 13

4 Stages of Labor

Answer 13

1 - Onset of labor to full dilation
2 - Dilation to infant delivery
3 - Delivery of infant to delivery of placenta
4 - 2 hours after delivery of placenta

Question 14

Threatened abortion

Answer 14

Bleeding without cerval dilation
Can be Saved

Question 15

Inevitable abortion

Answer 15

Cerivx is dilating without passage

Question 16

Placental abruption

Answer 16

Smoking, HTN, Cocaine, Trauma
Painful bleeding with abnormal fetal stress testing
Stabilize and deliver

Question 17

6 indications for cesarean delivery

Answer 17

Failure of labor to progress
Fetal distress
Multiple pregnancy
Placental abnormalities
Breech presentation
Maternal medical indications

Question 18

How long should labor stages 1 and 2 last?

Answer 18

1 - 14-20 hours max
2 - 2 hours

Question 19

Management of ectopic pregnancy

Answer 19

D&C or methotrexate
Rho-GAM follow up

Question 20

Positive testing for gestational diabetes5

Answer 20

BG >140 with 1 hr OGTT

Question 21

Management of gestational diabetes

Answer 21

Insulin only - no oral agents!!

Question 22

Molar pregnancy with risk of neoplasm

Answer 22

COmplete molar - two sperm fertilize an empty oocyte
Partial also has fewer symptoms

Question 23

Preeclampsia definition

Answer 23

140/90 BP
3 g in 24 hour urine or two 2+ protein dipsticks

Question 24

Management of HTN in pregnancy

Answer 24

Methyldopa - only if over 150/100
May use labetolol of nifedipine but not long term

Question 25

Management of preeclampsia

Answer 25

May use aspirin if they have a history Mag sulfate to prevent seizures Labetolol for HTN

Question 26

MCC of postpartum hemorrhage

Answer 26

Uterine atony - soft boggy uterus

Question 27

McRoberts maneuver

Answer 27

For shoulder dystocia - flex hips to deliver

Question 28

Management of missed OCP does

Answer 28

1 day - can move on as normal Several days - take it and restart but will need another form of contraception for that time

Question 29

COntraindications for hormone replacement therapy

Answer 29

Liver disease Blood clot/Thrombosis Hx of endometrial of breast cancer

Question 30

Workup for amenorrhea

Answer 30

FSH, LH and PRL Clomiphene, etc. for pituitary failure - FSH low Anovulation - High FSH, looks like menopause - estrogen deficiency

Question 31

Progesterone challenge test without withdrawal bleeding

Answer 31

Low estrogen or obstruction

Question 32

Progesterone challenge test with withdrawal bleeding

Answer 32

Anovulation

Question 33

Dysfunctional uterine bleeding

Answer 33

Estrogen levels don't cycle - contstant exposure creates irregular pattern heavier flow when gaps are longer

Question 34

Risk factors for ovarian cancer

Answer 34

BRCA-1 Fam hx Nulliparity Late menopause MC type is epithelial cell

Question 35

TUmor marker for ovarian cancer

Answer 35

Ca-125

Question 36

Presentation and MC type of cervcal cancer

Answer 36

Watery discharge and postcoital bleeding MC type is squamous cell

Question 37

Chief complaint of vulvar cancer

Answer 37

Itching

Question 38

Breast cancer screening

Answer 38

US better under 35 Every two to three 2-3 years years starting at 40 or when relative had it US for more workup

Question 39

Receptor positive breast cancer management

Answer 39

Use tamoxifen

Question 40

Hormone elevated in PCOS

Answer 40

Testosterone

Question 41

PID

Answer 41

Any pelvic infection Mostly chlamydia Chandelier sign

Question 42

Dianostic criteria for PID

Answer 42

Must Have: ABd tenderness without rebound Adnexal tenderness Cervical motion tenderness One of: Temp Gram stain pos WBC > 10,000 Pus on culdocentesis Pelvic abscess

Question 43

Management of PID

Answer 43

Cefoxitin or Cefotetan (for anaerobes not for gonorrhea) plus doxy - INpatient Rocephin and DOxy - Outpatient

Question 44

Adenomyosis

Answer 44

ENdometrial tissue in muscle of uterus manage with hysterectomy Large boggy uterus

Question 45

Aim of fibroid tx

Answer 45

Reduce uterine bleeding Firm and nontender

Question 46

Metritis

Answer 46

Infection post delivery Cefazolin for proph CLinda and Gent for C section Amp and Gent for vaginal delivery

Question 47

Bartholin gland abscess

Answer 47

Painful, usually self resolving Worry if pus or fluid filled I&D and bactrim