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52 Cards in this Set

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22 y.o had unprotected sex, scared she might be pregnant. Missed period today. went to CVS and bought pregnancy test, which was negative. she's still anxious and visits you. what would you suggest and why?
Ask her to come back in two weeks time. Because pregnancy test is 100% sensitive on day 11 of missed period. Plus if she's not pregnant she'll get her period at that time.
Asian woman, pregnant, CBC shows low MCV, w/ normal iron levels. What next??
r/o thalessemia, remembers that she's Asian.
a pregnant woman, comes from routine prenatal check-up. urine culture is positive. treated with antibiotics for a week. what do you do next?
Repeat culture after she finishes the antibiotic treatment
Repeat culture comes positive again, what do you do?
Treat again
What do you do next?
Start suppressive treatment, give nitrofurantion, ampicillin, or cephalaxin every night for the rest of pregnancy. She must also evacuate bladder before and after intercourse.
A pregnant lady develops pyelonephritis? What do you do?
Admit the patient and treat with IV antibiotics?
Repeat culture of the above patient is negative? What next?
Place the patient on suppressive treatment for the rest of the pregnancy.
At 22 weeks a pregnant lady comes to you with a UTI, urine culture positive for group B streptococcus. What do you do?
Treat with an antibiotic.
What next?
Repeat culture.
If repeat culture is negative, what do you do?
Give antibiotic at the time of VAGINAL delivery
at 37 weeks anorectal culture shows group b streptococci. lady decides to have C-section? What do you do?
Perform C-section. no antibiotics needed.
37 weeks, has anorectal culture positive for group b streptococci. She is in labor. membranes are ruptures she develops deep () and C-section is performed. Do you give prophylactic antibiotics?
yes, because the membranes are ruptured.
Patient with history of genital herpes in labor, on exam there is no herpetic lesion, but she is complaining of burning of vaginal and vulva. what will you do?
Do a C-section
patient 25 weeks pregnant develops genital herpes. What do you do?
Treat with acyclovir 400 mg BID
After full treatment with acyclovir what do you do next?
Treat with oral acyclovir 400 mg BID AGAIN from 36 weeks until delivery
Woman has an ectopic pregnancy and is asking for what are her chances that she will have a normal pregnancy in the future?
75% chance that she will have a uterine pregancy.
22 y.o. woman is pregnant. she wants to know how long should she have sex.
she can have sex as long as it is physically possible.
A patient had CIN II lesion in cervix and had a LEEP, she's having recurrent abortions. What is the most likely cause?
She has a short cervix as a result of the the surgicla procedure to remove her growth.
Patient has eclamptic seizure, you loaded with MgS04 and then put on a drip. The patient's breathing is shallow. you exam patient and find sluggish deep tendon reflexes. What happened?
The patient developed magnesium toxicity.
What do you do for this patient who developed magnesium toxicity?
stop the magnesium,
Patient had an episiotomy, and is now complaining of dyspareumia, what type of procedure was done
medialateral episiostomy
a young pregnant lady was recently in a car accident. she comes to the emergency room. no injury fetal monitoring is normal. she wants to go home. what will you do?
Keep the patient for at least 4 hours in the emergency room, with fetal monitoring. as placental separation can become abruption.
What do you do if you see shoulder dystocia?
Ask the mother to stop pushing, check for obstruction, do generous episiotomy, and call for assistance. anesthesiology, pediatrician, and neonatalogist
A patient is pregnant and depressed. What medication would you use?
fluoxetine (prozac)
What SSRI is contraindicated in pregnant women?
paroxetine (paxil)
The patient is pregnant and psychotic what medication do you use?
Haldol (haloperidol)
during endometrial biopsy, you perforated the uterus. How do you know you perforated? What will you do?
Withdraw the pipelle and keep the patient in hospital for 24 hours.
After hysteroscopy, the nurse reported that the patient has difficulty breathing. On chest exam the patient has basal crackles. What will you do?
The patient was fluid overloaded. hysteroscopy requires a filling fluid. treat with diuretic.
A patient comes in infertility workup, on exam the patient is revealed to have endometriosis. Found the cul de sac of the uterus. What do you do?
Endoscopic removal if she wants to get pregnant.
21 F, calls and tells you that she forgot to take her OCP. What do you tell her?
Ask her to take two pills the next day and continue the rest of the month.
A patient misses two doses of her OCP, what do you tell her?
take pil today but also take alternate method of contraception.
patient taking OCP is now pregnant. what do you tell her?
Stop the OCP and continue the pregnancy
risks of taking OCP to the fetus.
Renal agenesis.
Patient taking OCP develops HTN
Stop the OCP
A patient with sickle cell disease asks for oral contraception. What do you do?
Give a progestin only pill, because it has a lower clotting risk.
a lactating mother asks for OCP. what do you do?
Give a progesterone only pill becuase estrogen will decrease milk production.
A young patient has a miscarriage and asks for an IUD before discharge.
You can safely put it in after the delivery
Patient has copper IUD and heavy menstruaction, she is anemic, you removed copper IUD, what is the long term contraceptive method you can use.
Use levonorgestrel IUD or another hormone containing IUD because it is associated with reduced menstrual blood loss.
A patient has terrible hot flashes and is menopausal period, how will you treat her hot flashes.
low does hormone replacement therapy for a short period. Use for up to 4 years, but not much longer.
A patient who was on hormone replacement therapy watches the news and becomes worried about the side effects. what should you do
advise to stop HRT immediately.
After hormone replacement therapy was stopped, hot flashes got worst. what should you do?
SSRI, venlafaxine, neurontin
what rate do you stop the hormone relacement therapy?
can abruptly stop or slowly taper.
An old lady has recurrent candidal vaginitis, what do you do?
Check her out for diabetes or HIV.
A patient with trichomonas vaginitis comes back with another infection.
An example of reinfection, her partner was not treated.
A patient with PCOS did not get pregnant with weight reduction, clomiphene, or metformin. What do you do?
Do ovarian drilling with a laser.
A patient with ovarian tumor comes with hyperthyroidism what is the diagnosis?
Strauma Ovarii
If a patient has an ovarian cyst that contains teeth and hair what is the diagnosis?
teratoma
a patient's pap smear reports ascus
old guidelines: repeat in 6 months.
new guidelines: do reflex HPV test, if positive for HPV 16, 18, 31, or 45 then do colposcopy.
A patient with cervical cancer presents with hydronephrosis, what stage of cervical cancer does she have?
Stage III it has extended to the pelvic wall.
A patient tells you that both sisters diagnosed with breast cancer.
Refer her for genetic testing to determine if she has BRCA1 and BRCA2
antibodies to ABO antigens belong to what class of immunoglobulins? Can they cross the placenta?
They are IgM, they cannot cross the placenta.
antibodies to Rh antigens belong to which class of antibodies? Can they cross the placenta?
Belong to IgG class and they can cross the placenta