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1
Q

Tx GC and Chlamydia

A 
GC = ceftriaxone
CT = azithro x1 or 10d of doxy
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2
Q

Fever 1–.4, leukocytosis, blood clots in vagina after delivery? worrisome sx?

A

NORMAL in first 24hrs post-partum

worry if high fever, foul-smelling lochia, tender uterus

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3
Q

Lupus patient develops NV, abd pain and hypotension and hypoglycemia post-op?

A

adrenal insufficiency!! 2/2 not getting steroids

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4
Q

What anti-Rh Ab titer level do you give rhogam for? what level is fetus at risk for hemolytic disease?

A
  • 1:6 - mom is already sensitized - rhogam won’t help. monitor closely for hemolytic disease.
  • > 1:8-1:32 - fetus at risk for hemolytic disease.
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5
Q

female with rash that starts on face and progresses downward + arthritis?

A

consider rubella

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6
Q

Clubbing in COPD, think…

A

MALINGNANCY (unlike other clubbing scenarios)

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7
Q

3 drugs to treat UTI in pregnancy

A

nitrofurantoin, amoxicillin, 1st gen cephalosporin

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8
Q

arm held abducted and externally rotated, which dislocation?

A

anterior (fall on outstretcehd arm)

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9
Q

arm held adducted and internally rotated, which dislocation?

A

posterior (seizure, electrocution)

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10
Q

Neonated with microcephaly, small body, hypoplastic distal phalanges, excess hair, cleft palate and developmental delay?

A

fetal hydantoin syndrome = phenytoin or carbamazepine during pregnancy

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11
Q

management of post-patum hemorrhage

A

bimanual uterine massage, IVF, uterotonic meds (oxytocin, methylergonovine, carboprost) +/- blood transfusion

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12
Q

MC age range Legg-Calve-Perthes? Tx?

A

boys 4-10 (5-7*)

Tx observation and bracing, surgery only if femoral head not contained well in acetabulum

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13
Q

boy with hip, groin, knee pain and limping gait

A

think Legg-Calve-Perthes

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14
Q

next step if amenorrheic girl has no uterus on U/S?

A

karyotype and serum test

  • 46 XX and female test level –> abnormal mullerian devel
  • 46 XY and male test level –> AIS
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15
Q

Timing for CVS vs. amniocentesis

A

CVS = 10-12wks
amnio = 16-18wks
(possible to do ~earlier amnio of CVS unavailable)

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16
Q

what do mom and baby’s blood types have to be for hemolytic disease of the newborn? what type of Ig? which can cross placenta?

A

mom = O
baby = A or B
Results in mild disease, unlike Rh incompat.
It is IgG bc only IgG can cross the placenta

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17
Q

dyschezia, dyspareunia, dysmenorrhea and difficulty conceiving? 3 tx?

A

endometriosis

Tx = OCPs (combined), leuprolide, danazol

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18
Q

6 indications for hemodialysis

A 
refractory hyperK
refractory edema/pulm edema
refractory metabolic acidosis
uremic pericarditis
uremic encephalopathy/neurophathy
coagulopathy 2/2 renal failure
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19
Q

kindey d/s a/w Hodkgkin’s lymphoma

A

Minimal Change Disease! (nephrotic syndrome –> decr alb, normal globulin)
(also can have FSGS)

20
Q

Test for cervical incompetence? Normal value?

A

transvaginal US –>funneling of cervix/cervical length which should be >25mm at 24wks

21
Q

Tx PID and when should you admit?

A

Outpt = IM cefoxitin + PO probenecid + PO doxy OR IM ceftriaxone + PO doxy
hospitalize if: high fever, N/V and cant take pill, pregnant*, teenager/low socioeconomic status
inpt = IV cefotetan or cefoxitin + doxy OR IV clinda/gent

22
Q

foul-smelling sputum, think…Tx?

A

think anaerobic pneumonia 2/2 aspiration

Tx = clindamycin

23
Q

Asian w/ epistaxis, neck swelling, sinusitis and nasal mass? RFs?

A

nasopharyngeal CA

RF = EBV!!!, smoking and nitrosamines too

24
Q

When is cephalic version indicated?

25
5 components of BPP
``` NST tone (flex/extend, extend) movement (2x/30min) breathing movement (20sec/30min) AFI (5-25) ```
26
5 indications for intubation during acute asthma exacerbation
``` normal/increased PaCO2 (should be decr. from hyperventilation) decreased breath sounds no wheezing AMS hypoxia +/- cyanosis ```
27
Early Tx of pre-eclampsia
Methyldopa 1st line = central alpha-agonist to decr symp outflow and vasodilate Labetolol for HTN
28
Pregnant lady with severe vomiting, wt loss, ketonuria and transaminitis / bili?
hyperemesis gravidarum can also have elevated lipase/amylase MCC b/w 4-10wks
29
SE niacin? MoA, Tx?
flushing + pruritis 2/2 PG-induced periph vasodilation and histamine release Tx = low dose ASA 30min before niacin
30
Acute bloody diarrhea and abd pain w/o fever? complications?
EHEC from undercooked beef | Complications = HUS, TTP
31
Tx vaginal SCCA
stage 1/2 = excise. If >2cm, radiation | Stage 3/4 or >4cm = combo chemo if healthy, otherwise radiation
32
Tx bartonella henselae
azithromycin
33
indications for treating hyperkalemia
cardiac toxicity (EKG), muscle paralysis/paresis, K >6.5
34
W/u HTN (4)
``` UA = hematuria, prot/cr ratio chemistry panel lipid panel (CAD) EKG (CAD/LVH) ```
35
MC renal d/s a/w cancers?
Membranous glomerulonephritis (except hodgkins --> MCD)
36
goal BG level in gestational DM? Tx?
75-90, low sugar diet +/- subQ insulin
37
Effect of E2 therapy on L-thyroxine requirements normally and during pregnancy?
Both require increase in L-thyroxine
38
Tx lichen sclerosis?
``` steroid cream (clabetasol) +/- bx due to risk of vulvar SCCA ```
39
Tx early syphilis if penicillin allergy
azithro or doxy
40
6 RF for placenta previa?
multiparity, adv mat age, prior CS, smoking, mult gestation, previous hx
41
COPD and asthma, respiratory alkalosis or acidosis?
``` COPD = resp acidosis (trap air?) asthma = resp alkalosis (hyperventilate) ```
42
hexagonal crystals on UA and CN nitroprusside test positive? MoA?
cystinuria --> defective AA transport by renal tubule and GI cells. Autosomal recessive
43
N/V/D then splinter hemorrhages, conjunctival hemorrhages, periorbital edema, myositis and eosinophilia?
trichinosis (trichinella roundworm) from undercooked PORK (3 stage d/s)
44
Indications for GBS prophylaxis if status unknown?
deilvery 18hrs GBS bacteruria at any time during current pregnancy prior baby with GBS sepsis
45
palpable purpura, proteinuria, hematuria, HCV?
mixed essential cryoglobinemia | +/- arthralgias, HSM and low complement
46
Tx TB?
- active dz - RIPE, then just RI for 6 mos (rifampin, INH, pyrazinamide, ethambutol) - positive PPD but asymp - INH for 9 mos * ALWAYS give B6 with INH to prevent neuropathy* get LFTs for INH

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