Reproductive (OBGYN) Flashcards
(150 cards)
1
Q
What is the proposed pain mechanism for women w/ primary dysmenorrhea?
A
prostaglandin
2
Q
What are the 2 MC laparascopic dxs that are made in a woman who is being evaluated for chronic pelvic pain?
A
adhesions & endometriosis
3
Q
MC type of anemia that is seen w/ pregnancy
A
iron deficieny
4
Q
MC organism causing UTI in pregnancy
A
E. coli
5
Q
What is the appropriate timing for the 1hr GTT that is given during pregnancy?
A
24 - 28 wks (if no add’nal risk factors)
6
Q
At what point in pregnancy is Grp B strep checked in the pregnant female?
A
36 wks gestation
7
Q
If a pregnant woman is found to be a carrier for grp B strep, when is tx performed?
A
during labor
8
Q
What is the TOC for a pregnant woman w/ syphillis who is allergic to PCN?
A
tx w/ PCN after desensitization
9
Q
What vaginal infxn puts a pregnant woman at risk for pre-term labor, PROM, chorioamnionitis, & postpartum endometritis?
A
bacterial vaginosis
10
Q
TOC for bacterial vaginosis
A
Metronidazole
11
Q
MCC of congenital infxn of infants in the US
A
Cytomegalovirus
12
Q
What is the method that is used to identify fetal CMV?
A
Cordocentesis for viral identification
13
Q
What is the tx of HIV/AIDS in the pregnant woman in order to decrease risk of transmission of the virus to the fetus?
A
AZT (zidovudine)
14
Q
What is the leading non-obstetrical cause of maternity mortality?
A
PE caused by thromboemolic dz
15
Q
Tx for a pregnant woman w/ a DVT?
A
Heparin
16
Q
What is the MC major neurological problem that complicated pregnancy?
A
seizure disorder
17
Q
What are the 2 MC complications of pregnant women who are treated w/ anti-seizure medications?
A
- neural tube defect
2. heart defects
18
Q
MCly employed therapy for seizure disorder during pregnancy?
A
carbamazepine (Tegretol)
19
Q
What anti-seizure medication must be avoided in pregnant pt?
A
Valproic acid (Depakote) - highly teratogenic
20
Q
What is the TOC for the vomiting that occurs w/ hyperemesis gravidarum?
A
Metochlopramide (Reglan)
21
Q
Classic findings that are seen in pre-eclampsia
A
- HTN
- edema
- proteinuria
22
Q
What part of the menstrual cycle will the pt w/ premenstrual syndrome be sx-free?
A
follicular phase
23
Q
What type of med is most effective in the tx of premenstrual syndrome/premenstrual dysmorphic disorder?
A
SSRIs or meds that suppress ovulation
24
Q
What 2 subtypes of HPV are MCly assoc. w/ cervical cancer?
A
HPV 16 & 18
25
What are the MC cell types for cervical cancer?
squamous cell (85%)
26
Name the 3 MC vasomotor sxs seen in a perimenopausal woman
1. hot flashes
2. night sweats
3. night-time awakening
27
MCC of 2ndary amenorrhea
pregnancy
| 2nd cause = endometrial polyps
28
What agents are used to tx UTI during pregnancy?
Cephalexin (Keflex)
| - other agents = sulfonamide, nitrofurantoin, & ampicillin
29
What 2 org are MCly encountered causing PNA in the pregnant pt?
1. streptococcus
| 2. Mycoplasma
30
What is the recommended therapy for acute asthma attack in the pregnant pt?
inhaled beclomethasone & bronchodilators
31
What is the MC heart valve abnormality that is encountered during pregnancy that is a serious concern for complications?
Mitral stenosis
32
What is the MCly used serum screening test used in the assessment of possible neural tube defect?
maternal serum alpha fetoprotein level at 16-18 wks
33
What is the most effective therapy for genital atrophy in the perimenopausal woman?
estrogen
34
Pt w/ ongoing pain due to endometriosis who has a TAH BSO undergoes presacral neurectomy for the pain. What is the main SE of this procedure?
Constipation & urinary urgency
35
90% of vulvar cancers are due to what cell type?
squamous cell
36
What type of vaginitis is assoc. w/ an acidic pH on testing?
Candidiasis
37
A woman presents w/ a hx of dyspareunia & worsening dysmenorrhea that often begins before menses. Examination reveals a thickened rectovaginal septum or deviation of the cervix on pelvic examination. What is the most likely dx?
Endometriosis
38
MCC of infertility in women
tubal dz (usu due to PID)
39
What endocrine disorder are pts w/ Polycystic ovary syndrome at risk for acquiring?
T2DM
40
What is the major medication of choice for pts w/ PCOS who wish to lose weight & to decrease insulin resistance?
metformin (Glucophage)
41
The definitive procedure for the dx of endometrial carcinoma
D&C
42
A young adolescent female complains of recurrent menorrhagia & irregular periods that last for 6 mths. She denies any sexual encounter. Examination reveals a neg. pelvic, pap smear, sonogram, & endometrial bx. Most likely dx is:
Dysfxnal uterine bleeding (DUB)
43
What is the leading cause of pregnancy-related death in the 1st trimester?
Ectopic pregnancy
44
A pt at 13 wks gestation presents w/ abdominal pain & vaginal bleeding for 6 hrs. The vaginal exam reveal the cervix to be dilated to 2 cm. FHT are 140. There has been no passage of any tissue. What is the correct dx?
inevitable abortion
45
What complication may be seen in pregnant woman who is given a sulfonamide for a UTI in 3rd trimester?
Kernicterus
46
What does HELLP Syndrome stand for?
Hemolyis
Elevated Liver enzymes
Low Platelets
47
What is the tx for severe pre-eclampsia?
immediate delivery of the baby
48
Causative org for Chancroid
Hemophilus ducreyi
49
2 MC tx for primary dysmenorrhea
1. OCs
| 2. NSAIDs
50
What is the predominant hormone during the follicular phase of the menstrual cycle?
estrogen
51
What is the main hormone during the luteal phase of the menstrual cycle?
progesterone
52
Primary amenorrhea is lack of menstruation at what age?
16 yoa
53
MCC of 2ndary dysmenorrhea
endometriosis
54
TOC for lymphogranuloma venereum
doxycycline (or tetracycline)
55
FSH >70 is MCly due to...
ovarian failure
56
MCC of menorrhagia in the US
uterine fibroids
57
STD that is assoc w/ a PAINLESS mucosal lesion & INGUINAL BUBOES
Lymphogranuloma venereum
58
Type of smear that is done in order to asses for HSV infxn
Tzanck smear
59
Currently approved tx for Gonorrhea
Ceftriaxone (Rocephin)
| - single IM or IV dose
60
What stage of syphilis does condyloma lata appear?
Secondary Syphillis
61
MC type of bleeding disorder that presents w/ prolonged & heavy menstrual bleeding
Von Willebrand Syndrome
62
MCC of significant post-menopausal bleeding
endometrial cancer
63
2 approved tx for Chlamydial STD:
1. Doxycycline
| 2. Azithromycin (Zithromax)
64
STD that leads to cervical dysplasia & cervical cancer most often
HPV
65
Type of ovarian cyst that may contain teeth & hair as part of the cyst;
teratoma (type of dermoid cyst)
66
when performing a cervical specimen under the Bethesda system, what area is most vital to sample?
transformation zone
67
TOC for ACUS cells being seen under Bethesda sys.
Endometrial bx & colposcopy
68
Cyst that is normal to find following ovulation
corpus luteal cyst
69
chocolate cyst that may be a palpable mass felt on the ovary
endometrioma
70
MC reason for ovarian torsion to occur
dermoid cyst
71
Midcycle pain that occurs w/ ovulation
Mittlesmertz
72
Increased ratio of LH to FSH (3:1) is MCly caused by
PCOS
73
Gold standard for making the dx of Chlamydia STD
culture
74
Tumor marker MCly used in F/U of ovarian cancer
CA-125
75
Causative organism for granuloma inguinale
Calymmatobacterium granulomatis
76
failure to induce pregnancy despite one yr of unprotected sexual intercourse
infertility
77
primary bacterium that is part of the vaginal flora
lactobacillus
78
CLUE CELLS are seen in what gynecological condition?
Bacterial vaginosis
79
Substance that must be avoided in a pt who is taking metronidazole (Flagyl)
alcohol
80
Single dose therapy indicated for treating candidal vaginitis
fluconazole (Diflucan)
81
Vaginal condition producing a STRAWBERRY CERVIX
Trichomonas
82
MC new-onset STD in US
Chlamydia
83
STD caused by a painful ulcer w/ fluctuant inguinal adenitis
Chancroid
84
Type of birth control that is CI for use in a pt w/ cervical dysplasia
cervical cap
85
TOC for Paget's dz of bone
bisphosphonates
86
defined as no menstrual cycles for 12 months or FSH >40
Menopause
87
SE that MCly occurs w/ the use of raloxifen (Evista) for the tx of osteoporosis
increased incidence of hot flashes
88
condition that results from low calcium & vitamin D intake in children resulting in poorly formed bones & bowed legs
Rickets
89
Laboratory abnormality that is seen in a pt w/ Paget's dz
increased serum alkaline phosphatase
90
MCC of solid breast mass
Fibroadenoma
91
MCC of fever after the immediate puerperium in nursing mothers
mastitis
92
type of breast cancer that is MCly assoc. w/ "P'EAU D'ORANGE" skin changes
inflammatory BRCA
93
What is the main consideration for non-lactating women who develop mastitis?
breast cancer
94
MC organism causing mastitis
S. aureus
95
MC type of breast cancer
infiltrating intraductal carcinoma
96
The fundus of the uterus is at the level of the umbilicus at how many weeks gestation?
20 wks
97
products of conception remain in uterus but not viable
incomplete (missed) abortion
98
What is the most likely dx in a woman who has positive BCG test, spotting & unilateral abdominal pain?
ectopic pregnancy
99
MC type of invasive breast cancer
invasive ductal carcinoma (90%)
100
What condition is assoc. w/ infiltrating intraductal cancer in the nipple & ducts of the nipple? This condition may be also assoc. w/ itching or burning of the nipple:
Paget's dz of the breast
101
Softening of the uterus that is felt early in pregnacy
Hagar's sign
102
test performed to determine the dosage for Rho-Gam to be given to a pregnant woman
Kleinhaur-Betke test
103
3 or more spontaneous abortions in succession
habitual abortion
104
MC location for tubal ectopic pregnancy
ampulla
105
MC location for metastasis from molar pregnancy
lung
106
time frame that RhoGam is given during pregnancy
28 wks
| - this will last 12-14 wks & will cover her until delivery
107
Pt presents with pregnancy, edema, HA, RUQ pain, & blurred vision. What is the most likely dz?
pre-eclampsia
108
A pregnant pt has bleeding, hyperemesis, & a uterus that is measuring large for gestational size. Lab findings include an HCG that is markedly high for pregnancy date. What is the most likely dx?
hydatiform molar pregnancy
109
What class of antihypertensive meds is strictly CI when treating pregnancy- induced HTN?
ACE inhibitors - causes renal agensis
110
TOC for seizures due to eclampsia
Magnesium, delivery
111
1st sign for magnesium toxicity
loss of reflexes
112
complications of this pregnancy-related condition includes macrosomia & shoulder dystocia
gestational diabetes
113
cocaine users are at risk for what pregnancy-related condition?
placental abruption
114
Pt has IUGR wherein the entire bay is small. What is the primary consideration for this scenario?
chromosomal abnormality in baby
115
Medication which has a famous SE of causing scalp defects in the baby
PTU
116
At how many weeks does preterm labor occur?
prior to 37 weeks gestation
117
3 MCC of 3rd trimester bleeding
1. placenta previa
2. abruption placentae
3. vasa previa
118
chronic gynecologic-related pruritus is MCly assoc. w/ what type of GYN cancer?
vulvar
119
How can fetal lung maturity be assessed?
Lecithin to Sphingomyelin ratio (L/S ratio)
| - if >2 the fetal lungs are mature
120
A breast-feeding mother presents to the office complaining of fever, chills, & a swollen red breast. What is the most likely org. causing these sxs?
Staph aureus. (Mastitis is most likely 3-4 wks post partum)
121
excessive amount of blood or duration
menorrhagia
122
bleeding between menstrual periods
metorrhagia
123
excessive amt of blood at irregular frequencies
menometorrhagia
124
Ascites & hydrothorax in the presence of an ovarian tumor
Meig's syndrome
125
The ovarian luteal phase corresponds to what phase of the uterus?
secretory phase
126
What does a biphasic curve on a basal body temperature chart of a 25 yr old woman indicate?
normal ovulation & the effect of progesterone
127
What does a monophasic curve on a basal body temperature mean?
anovulatory cycle
128
A basal body temperature graph reveals an elevated temperature that remains elevated throughout the month. What does this most likely mean?
pregnancy
129
What is the most accurate test of ovulation
endometrial bx
130
How do spontaneous abortions (miscarriages) MCly present?
pain followed by bleeding
131
Before what gestation age do most spontanous abortions occur?
8-9 weeks
132
No uterine growth, no cervical dilation, no passage of fetal tissue, & minimal cramping or bleeding. Absence of FHT & an empty sac on US. What is the dz?
missed abortion
133
Vaginal bleeding, ABDOMINAL PAIN & tetanic uterine contraction, uterine irritability, & fetal death may also be seen.
Abruptio placenta
134
When is amniocentesis commonly performed?
16-18 wks
135
A pt presents w/ pain in her eyes, canker sores in her mouth, & sores & scars in her genital areas. What is the dx?
Behcet's dz
136
What secretes beta HCG?
placenta trophoblasts
137
What is the most accurate prognostic indicator for breast cancer?
axillary node involvement
138
Where does cervical cancer most likely metastasize?
liver
139
When does an ectopic pregnancy MCly present?
6-8 wks gestation
140
For a gestational sac to be visible on US, what must the B-hCG level be?
- transabdominal US = 6500
| - transvaginal US = 2000
141
When can an intrauterine gestational sac be identified by abdominal US?
5th week
- fetal pole can be ID'd in the 6th wk
- embryonic mass w/ cardiac motion in the 7th wk
142
MC site for endometriosis
ovaries (60%)
143
DOC for treating endometriosis
Danazol
144
What 2 type of cancer that are increased in a pt w/ endometriosis?
endometrial & clear cell vaginal cancer
145
Non-invasive image method of choice for diagnosing endometriosis
Transvaginal US
146
What is the MCly regarded theory for the induction of endometriosis?
retrograde menstruation
147
3 MC sites for endometriosis
1. Ovary
2. cul de sac
3. uterosacral ligaments
148
MC finding on a pelvic examination in a woman w/ endometrosis
normal exam
149
What is considered to be the gold standard in making the dx of endometriosis?
direct visualization during laparoscopy or laparotomy
150
Definitive surgical therapy for endometriosis
TAH BSO
