Rosh Review

Question 1

MOA of acetazolamide, what does it treat

Answer 1

Carbonic anhydrase inhibitor, treats idopathic intracranial hypertension by reducing rate of CSF production

Question 2

Length of latent to active phase of labor

Answer 2

14 hours for multiparous and 20 hours for nulliparous

Question 3

Lanx incision

Answer 3

Horizontal incision at McBurney point

Question 4

Gridiron incision

Answer 4

Oblique incision performed for appy, located at McBurney point

Question 5

McEvedy incision

Answer 5

Vertical incision from femoral canal to above the inguinal ligamwnt

Question 6

Paramedian incision

Answer 6

3cm lateral to midline through the skin and subcutaneous tissue; anterior rectus sheath and rectus muscles are deflected laterally to expose the posterior rectus sheath above the arcuate line; incision involves ligation of peripheral branches of inferior epigastric vessels

Question 7

Why metformin bad peri and post op?

Answer 7

Increase risk of renal hypoperfusion, lactate acculation and tissue hypoxia

Question 8

Ilioinguinal nerve injury

Answer 8

Pain in the suprapubic area and labia, L1-L2 nerve routes, during wide transverse c-section or trochar placement; improve with hip flexion

Question 9

Pudendal nerve injury

Answer 9

Sensory deficit in perineum; presents as perineal, gluteal, vulvar pain

Question 10

Ilioinguinal/iliohypogastric injury

Answer 10

Nerves arise from T12-L1; present with burning pain to groin and pubic symphysis; sensory def to groin, symphysis, mons, lateral labia, and upper thigh

Question 11

Sciatic nerve injury

Answer 11

Peroneal: foot drop, sensory def below knee but not medial foot; motor deficit dorisiflexion of foot; nerve L4-S3

Question 12

Obturator injury

Answer 12

“Cannot ride horse”, upper medial thigh sensory deficit; thigh adduction motor deficit, L2-L4

Question 13

Femoral nerve injury

Answer 13

“Cannot climb stairs”, sensory def in anterior/medial thigh, medial calf; motor deficit hip flexion/addiction and knee extension

Question 14

Radial nerve injury

Answer 14

Presents as wrist drop; wrist and finger extension motor deficit; lateral 3.5 finger plus thumb sensory deficit; C5-T1

Question 15

Ulnar nerve injury

Answer 15

“Claw hand”; sensory deficit in medial 1.5 fingers, motor deficit in muscles of hand, C8-T1

Question 16

MOA for unfractionated heparin

Answer 16

Inhibits factor Xa and thrombin

Question 17

MOA of LMWH

Answer 17

Inhibits factor Xa

Question 18

Type II hysterectomy

Answer 18

Uterus, cervix, parametrium, and upper one-fourth of vagina

Question 19

Life of vicryl

Answer 19

Aka polyglactin 190; loses most strength by one month and dissolves by two months

Question 20

Hypogonadotropic hypogonadism anovulation

Answer 20

Decreased FSH, decreased estradiol

Ex Kallman syndrome, Sheehan syndrome, stress, intense exercise

Question 21

Normgonadotrophic normoestrogenic anovulation

Answer 21

Normal FSH, normal estradiol

Ex PCOS, congenital adrenal hyperplasia, Cushing syndrome

Question 22

Hypergonadotrophic hypogonadism anovulation

Answer 22

Decreased FSH, increased estradiol

Ex primary ovarian insufficiency, gonadal dysgenesis, fragile x permutation carriers

Question 23

Hyperprolactinemic anovulation

Answer 23

Normal FSH, increased prolactin

Ex hyperprolactinemia, lactational anemorrhea, antipsychotic drugs

Question 24

Treatment of low risk GTN

Answer 24

Methotrexate or actinomycin-D

Question 25

Treatment for high risk GTN

Answer 25

WHO criteria 5-12 EMA-CO, etoposode, methotrexate, actinomycin D, cyclophosphamide, vincristine

Question 26

Treatment of ultra high risk GTN

Answer 26

WHO 13 or greater EP-EMA, etoposide, cisplatin with etoposide, methotrexate, and actinomycin D Or TP/TE, pacilaxel, cisplatin, alternating with paciltaxel and etoposide

Question 27

Treatment of placental site trophoblastic tumor

Answer 27

Hysterectomy or fertility sparing with EP-EMA or TP/TE

Question 28

Max dose of lidocaine for an adult

Answer 28

4.5mg/kg

Question 29

MOA for increased testosterone in PCOS

Answer 29

Decreased sex hormone-binding globulin production

Question 30

Lab abnormalities in PCOS

Answer 30

Elevated luteinizing hormone and hyperinsulinemia; elevated insulin suppress hepatics production of sex hormone-binding globulin (which normally binds free testosterone)

Question 31

Meigs syndrome

Answer 31

Ovarian fibroma, pleural effusion, and ascites

Question 32

Side effects of 15-methyl-prostaglandin F2-alpha

Answer 32

Aka hemabate or carboprost Fever, bronchospasm, GI symptoms, anxiety, and chills

Question 33

Tissue layers when placing transobturator sling

Answer 33

Skin, subcutaneous fat, gracilis adductor muscle, obturator externus muscle and fascia, obturator membrane, obturator internus muscle, and periurethral endopelvic fascia

Question 34

Stage llA2 cervical cancer

Answer 34

A mass >4cm involving upper vagina

Question 35

Treatment of toxoplasmosis <18wks gestation

Answer 35

Spiramycin

Question 36

Treatment of toxoplasmosis >18weeks gestation

Answer 36

Pyrimethamine and sulfadiazine | - add folinic acid (aka leucovorin) to prevent pyrimethamine induced hematologic toxicity

Question 37

Youssef syndrome

Answer 37

Urinary continence, amenorrhea, cyclic hematuria due to vesicouterine fistula