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1
Q

Normal range of Amniotic fluid index (AFI)

A

5-23cm

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2
Q

Common causes of polyhydramnios

A

Maternal DM, multiple gestation and congenital abnormalities

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3
Q

What to do if at delivery patient has vaginal wart?

A

Patient can continue to deliver vaginally since cesare does not prevent vertical transmision

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4
Q

S+S of urethral diverticula

A

postvoid dribbling, dysuria, dyspareunia and anterior vaginal wall mass

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5
Q

Imaging of choice for urethral diverticula

A

MRI of the pelvis or TVUS

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6
Q

Range of transaminases in acute fatty liver of pregnancy

A

300-500 (usually occurs in third trimester

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7
Q

First line antibiotics for lactational mastitis

A

oral dicloxacillin and cephalexin

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8
Q

Treatment for breast abscess

A

Antibiotics and FNA (no I+D because of complications and poor cosmetic outcomes

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9
Q

When should pregnant women be screened for anemia and DM?

A

24-28 weeks gestation

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10
Q

Signs of uterine rupture

A

Abdominal pain, vaginal bleeding, loss of fetal station, abnormal tracing

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11
Q

Target fasting/1hr and 2hr glucoses for pregnant women

A

<95 asting, <140: 1hr, <120 2hrs

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12
Q

When should pregnant women have pelvic mass removed?

A

Early second trimester to avoid acute complications

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13
Q

What are WSW at higher risk for?

A

BV and cervical cancer

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14
Q

Ras starting in umbilicus on t2nd and 3rd trimester of pregnancy?

A

Pemphigoid gestationis

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15
Q

How to treat BV inpregnancy?

A

Same: flagyl or clinda

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16
Q

Effects of BV in pregnancy?

A

Increased risk of preterm labor but insufficient evidence so treatment mostly for symptom management

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17
Q

Management of preterm prelabor if ROM <34

A

Prophylactic antibiotics to prolong interval between ROM and delivery

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18
Q

What constitutes protracted active phase labor?

A

when dilated >6cm and rate of cervical change is <=1/2hr

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19
Q

How to prevent preeclampsia

A

Start low dose aspirin at 12 week gestation

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20
Q

When to give Anti-D immune glubulin?

A

At 28 weeks if women has negative anti-D antibody screen and repeat dose <72hours after delivery if child is Rh(D) positive

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21
Q

How to treat liscchen sclerosus

A

High dose topical corticosteroids

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22
Q

How to charact lichen sclerosus?

A

Vulvar pruritus and thinned skin with some thin white areas

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23
Q

Who gets endometrial biopsy for bleeding in menopausal transition?

A

> 45 with suspected anovulatory bleeding or <45 with risk factors for unopposed estrogen, persistent bleeding of failed medical management

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24
Q

What to do with specific BHCG quantification

A

a) >1500 and IUP, treat for abnormal IUP. B) if >1500 and EP unconfirmed, repeat BHCG in 48hrs, 3) <1500 and no IUP, repeat in 2 days, d) >1500 and TVS with adnexal mass, EP confirmed

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25
Management of ectopic pregnancy
MTX if HDS no fetal cardiac act and BHCG <5K; laparoscopy if >5000, mass >3.5cm of fetal heart. If RH - get RH immunoglobulin
26
Highest risk factor for recurrent PID?
Multiple sexual partners
27
First line therapy for patient w/ PCOS wanting pregnancy?
Weight loss since it can restore ovulation, then letrozole if no effect
28
Other medications for hot flashes
SSRI
29
Preferred tx for trich
Single dose oral metronidazole
30
When to give steroids before delivery?
If preterm <37 weeks or <34 if DM (but can cause hyperglycemia
31
PID regimen inpatient
IV cefoxitin/cefotetan + doxy; IV clinda + gentmycin, IV unasyn+ doxy
32
PID regimen oral
CTXx1+ doxy x14; cefoxitin + probenecid PO + doxy
33
First division point in primary amenorrhea
Uterus abscent or present
34
What is considered primary amenorrhea
abscent of menses by 15 if breast present; or by 13 I fno breasts
35
A clue for androgen insensitivity syndrome
No hair
36
Treatment of pneumonia in kids
High dose Amox (if lobar) vs azithro if bilateral
37
S/S of congenital rubella
SNHL, patent DA, cataracts, low birth weight and purpuric lesions
38
Characteristics of mastoiditis
fever and otalgia, protrusion of the auricle, opacification of mastoid cells on CT/MRI
39
Treatment of mastoiditis
IV abx and drainage of purulent material
40
Virus causing hand-foot-mouth disease
Coxsackievirus
41
Treatmend of ADHD in kids < and >6
<6 start with behavioral therapy; if >6 can start with pharmacotherapy
42
EEG charact of juvenile myoclonic epilepsy
bilateral polyspike and slow wave activity
43
What is considered delayed puberty in boys?
Lack of testicular enlargement (>4mL) by age 14
44
Kawasaki criteria
>5days of fever, + 4: conjunctivitis, mucosal changes, lymphadenopathy, rash, extremity changes
45
S+S of rubeola/measles
Prodrome like cold, conjunctivitis, fever, Koplik spots, rash
46
Treatment of measles
Supportive or vitamin A for hospitalized patients
47
Treatment of asympotmatic moderate lead toicity
Oral meso-2,3-dimercaptosuccinic acid (DMSA)
48
When to get tympanostomy tubes
If highly recurrent otitis media: >3episodes in 6 months or >4 in 12 months
49
What is herpangin
Infection with Coxsackie A in children that results in posterior vesicles and ulcers
50
Currant jelly stools in children 6mo to 3years?
Intussusception (also with sausage-like mass)
51
Dilation of the bladder
Posterior urethral valve (PUV)
52
Preferred abx for serious bacterial infexs in neonates
Ampicillin and gentamicin or cefotaxime
53
Why is CTX avoided in neonates <28days
Risk of hyperbilirubinemia
54
Bilateral calf enlargement and lower extremity weakness
Duchenne muscular dystrophy
55
What is considered mild scoliosis?
Cobb angle <40
56
Meconium ileus almost pathonemonic for…
Cystic fibrosis
57
When is phototherapy initiated?
Ehen bili is at toxic levels (>20-25)
58
Newborn diaper dermaittis vs candida
Contact dermatitis spares skin folds
59
Apnea of premturity vs periodic breathing of newborn
Periodic breathing is normal and pauses last 5-10sec while apnea pauses are >20sec
60
Painless abdominal mass in children (tumor)
Neuroblastomas
61
Painful renal malignancy in kids <5
Wilms tumor
62
Features of croup
Inspiratory stridor, barking cough, hoarseness
63
Treatment of croup
corticosteroids, nebulized epinephrine if severe
64
First line therapy for kids with constipation
Increase water and fiber and if not, osmotic laxative use (increases water and softens stool)
65
Management of pediatric inguinal hernias
Prompt surgical correction in 1-2 weeks to prvent bowel ischemia
66
Pulm complications of polymyositis
ILD, infection, drug-induced pneumonitis, respiratory muscle weakness
67
Features of polymyositis
Painless, proximal muscle weakness, elevated CK and LFTs, and high inflammatory markers
68
Characteristics of PCL injury?
Dashboard classic injury with flex knee
69
Labs suggestive of pagets
Elevated Alkphos with normal Calcium
70
CCB for Raynaud
Nifedipine and amlodipine
71
Extraarticular manifestations of ankylosing spoindylitis
Acute uveitis, AR, pulm fibrosis, IgA nephropathy and restrictive lung disease
72
Treatment of acute vs chronic gout
Actue: NSAIDs and/or colchicine; chronic: allopurinol
73
Fall in outstretched arm
Supracondylar fracture
74
How to treat HTN in scleroderma crisis?
ACE inhibitor and IV meds such as nitroprusside if CNS involvement or papilledema
75
Treatment of mixed cryoglobulinemia
1) immunossuppressive therapy; 2) treat undelrying cause
76
How to confirm diagnosis of sarcoid?
Excisional lymph node biopsy
77
Triad of invasive aspergillosis
Cough, pleuritic chest pain, hemoptysis
78
Treatment for PMR
low dose steroids unless GCA suspected (then high)
79
Leading casue of mortality in SLE?
Cardiovascular events (premature coronary atherosclerosis)
80
When to administer tPA in stroke?
<4.5hr of symptoms
81
Good prognostic factors in schizophrenia
Acute onset (lack of prodrome), older age at onset, positive psychotic sxs
82
Trreatment of Guillan Barre?
Plasma exchange or IVIg
83
Radial nerve pathology distribution
Dorsal aspect of forearm and hand
84
Charact of Pineal tumor
Parinaud syndrome: Loss of pupillary reeaction, vertical gaze paralysis, ataxia, loss of physiologic nystagmus (when looking at moving target)
85
Charact of transversemyelitis
Rapidly progressive weakness of LE following URI
86
treatment of RLS?
Dopamine agonists: pramipexole or ropinirole--> gabapentin if continues
87
Antidepressant that does not cause sexual side effect
buproprion (not weight gain), mirtazapine (weight gain) | levodopa or dopamine agonists (pramipexole)
88
Charact of lesions in dominant temporal lobe
aphasia
89
Charact of lesion in nondominant parietal lobe
constructional and dressing apraxia (can't du purposeful actions)
90
Charact of damage in dominant parietal lobe
Gerstmann syndrome: acalculia, finger agnosia, agraphia, R/L confusion
91
Treatment of acute mania
antipsychotics first (can begiven IV)
92
Charact of takotsubo (parts that affects)
Cathecholamine surge affecting LV mid and apical hypokinesis and basilar hyperkinesis
93
For which patients is CABG indicated?
Refractory angina despite medical therapy, Left main stenosis or multivessesl CAD along with systolic dysfunction (becuase it will improve survival in these groups)
94
Treatment of HTN in patients with PCKD
ACE inhibitors
95
Why are pts with connective tissure diseases at risk of MR?
Chordae tendinae rupture
96
CCS abx regimen for cystitis
3d bactrim or FQN if allergic; if complicated 7 day bactrim
97
Acute cystitis abx for pregnant patients
7 day course of cefpodoxime or augmentin

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