Ob Test 4

Front 1

Parents with X-linked dominant disorders have a ____ chance of passing it on.
A) 1:4
B) 1:2
C) 3:4
D: 100%

Back 1

B) 1:2 or 50% chance

Front 2

X-linked recessive disorders are more common in (men/women).

Back 2

Men

Front 3

What is the leading cause of infant death?

Back 3

Congenital abnormalities (20%), followed by SIDS (15%)

Front 4

Which of the following is more common in males (select all that apply)?
A) Anencephaly
B) Spina bifida
C) Congenital hip dislocation
D) Clubfoot
E) Hirschprung disease

Back 4

D, E.

Also, cleft lip alone is more common in males, and hypospadius are found in males only (obviously).
(Slide 12, Teratogenesis Genetics + Birth)

Front 5

Cleft palate alone is typically seen in (females/males).

Back 5

Females.

Cleft lip alone is typically seen in males. (Slide 17, Teratogenesis Genetics ppt.)

Front 6

What is a danger with cephalohematoma (according to Meyers' panopto)?

Back 6

Risk for hyperbilirubinemia, because "the system gets overwhelmed" in trying to break down the excess RBCs.

Front 7

Stricture in tissue, typically in the limbs, is usually associated with what genetic malformation?

Back 7

Amniotic band defect

Front 8

Which of the following statements by a new parent regarding ambiguous genitalia indicates a need for further instruction?
A) I should make sure my child is making enough wet diapers per day.
B) Aside from cosmetic issues, there is nothing wrong with my child.
C) The doctor may run a chromosomal panel to look for any other issues
D) Children with this condition usually have only one set of sex organs internally

Back 8

Answer: B

A is true, because genital abnormalities are often connected to renal and urinary abnormalities.
B is incorrect. Sometimes the cosmetic effect is a sign of a more complex problem.
C is correct, as ambiguous genitalia is linked to chromosomal and hormonal issues.
D is correct. Though the gonads may not be fully functioning, hermaphrodites typically have one sex of organs internally.

Front 9

Vitamin A deficiency is associated with what abnormality?
A) Neural tube defects
B) Neonatal hypocalcemia
C) Infantile seizures
D) Cleft lip

Back 9

D) Vitamin A deficiency can lead to eye problems, cleft lip, and facial defects.

Remember: MEGADOSES of Vitamin A can lead to craniofacial and cardiac anomalies! (Slide 5: Teratogenesis Other + Drug classes)

Front 10

Vitamin C deficiency can lead to:
A) Craniofacial and cardiac anomalies
B) Neural tube defects
C) Reduced fetal growth
D) Cleft lip

Back 10

B) Neural tube defects

(Slide 5: Teratogenesis Other + Drug Classes)

Front 11

Reduced fetal growth and neonatal hypocalcemia is associated with what deficiency?
A) Vitamin A
B) Vitamin B
C) Vitamin C
D) Vitamin D

Back 11

D) Vitamin D deficiency

(Slide 6: Teratogenesis Other + Drug Classes)

Front 12

Maternal hyperthermia is associated with what neonatal condition?

Back 12

Neural tube defects

Front 13

IUGR, congenital heart block, and low AFI are associated with what maternal disease?
A) Sjogren's syndrome
B) Myasthenia gravis
C) Rheumatic disease
D) Diabetes

Back 13

A) Sjogren's syndrome

Front 14

___ can cause PROM, hypotonia, respiratory distress, and feeding problems.
A) Rheumatic disease
B) Myasthenia gravis
C) Sjogren's syndrome
D) Diabetes

Back 14

B) Myasthenia gravis (slide 8, Teratogenesis Other + Drug classes)

Front 15

Heart, kidney, CNS, cleft palate, club foot, and cretinism is associated with (hypo/hyper)thyroidism in the mother.

Back 15

Hypothyroidism (slide 9, Teratogenesis Other + Drug Classes)

Front 16

Chorionic villus sampling done before day ___ increases risk for limb anomalies.

Back 16

Day 70 (slide 10, Teratogenesis Other + Drug classes)

Front 17

True/False. The greatest susceptibility for the fetus to teratogens occurs in the first trimester.

Back 17

True!

Front 18

PHARM REVIEW!
Remind me of the drug categories for teratogens (A, B, C, D, X).

Back 18

A: No risk to fetus, and studies say so.
B: Animal studies show no risk but no human studies exist
C: No human/animal studies or animal studies show risk but no human studies exist
D: Positive evidence of fetal risk but benefit may outweigh risk in some cases
X: Studies show fetal abnormalities/risk clearly outweighs the benefit

Front 19

True/False. Patients with known hypertension are treated with ACE inhibitors in pregnancy.

Back 19

False. ACE inhibitors are Class D-- it is best to change her to a CCB or beta-blocker.

Front 20

Most of the danger with retinoids occurs in what trimester? What about with ACE inhibitors?

Back 20

Retinoids: Most danger 1st trimester
ACE inhibitors: Most danger 2-3rd trimester

Front 21

What is the most commonly abused illegal substance in pregnancy?

Back 21

Marijuana

Front 22

Why is fetal exposure increased in mothers who use cocaine?

Back 22

Cocaine is both hydrophilic and lipophilic, meaning it dissolves in both fat and water. It persists in fetal circulation AND amniotic fluid, which increases exposure.

Front 23

Why is growth restriction increased in fetuses exposed to cocaine?

Back 23

Cocaine is a powerful vasoconstrictor, and can increase risk of miscarriage in early pregnancy, as well as preterm labor, IUGR, and increased risk of placental abruption.

Front 24

A patient in labor arrives in the ER, having had no prenatal care, and admits to using cocaine. What is the first condition you will look for?
A) Placental abruption
B) Placenta previa
C) Amniotic band defects
D) PROM

Back 24

A) Placental abruption is usually associated with cocaine use.

If a patient has a placental abruption, 9/10 times physicians will perform a urine drug screen.

Front 25

Which of the following fetal conditions is NOT associated with heroin use in pregnancy?
A) Decreased fetal lung maturity
B) Respiratory problems after birth
C) Neonatal abstinence syndrome
D) Stillbirth

Back 25

A) INCREASED fetal lung maturity is associated with heroin use in pregnancy, but "it moves things along too quickly," and can result in respiratory problems after birth. (Slide 28, Teratogenesis Other + Drug classes)

Front 26

True/False. Methadone use in neonates results in longer, but less severe withdrawal.

Back 26

True.

Front 27

True/False. Amphetamine users are safe to breastfeed.

Back 27

False. Amphetamine drugs DO pass through breast milk.

Front 28

What does TORCH stand for?

Back 28

Toxoplasmosis
Other (T. pallidum-- syphilis, varicella, Hepatitis)
Rubella
Cytomegalovirus
Herpes simplex (HSV)/HIV

Front 29

This infection is caused by contact with infected raw meat or cat feces.

Back 29

Toxoplasmosis

Front 30

A pregnant patient arrives in the ER with s/s of mono, but her test was negative. What is the next thing you suspect?

Back 30

Toxoplasmosis (Slide 4: TORCH)

Front 31

The risk of varicella issues is highest in the first ___ weeks of pregnancy.

Back 31

First 20 weeks of pregnancy (first half of pregnancy)

Front 32

Another name for Parvovirus is:

Back 32

"Fifth disease" or "slapped cheek disease"

Front 33

True/False. There is no treatment for parvovirus in pregnancy.

Back 33

True. (Slide 16: TORCH)

Front 34

True/False. It is important to ensure that a woman receives the MMR in her first trimester to ensure she does not sustain certain infections during pregnancy.

Back 34

False. MMR is a LIVE vaccine!

Front 35

True/False. Infection with rubella after the 20th week of pregnancy rarely causes defects.

Back 35

True.

Front 36

What three conditions are associated with congenital rubella (CRS)?

Back 36

Microcephaly
PDA
Cataracts

(slide 21: TORCH)

Front 37

This is the most common cause of congenital infection in the US.

Back 37

CMV

Front 38

What newborn issues are associated with CMV?

Back 38

Hepatosplenomegaly

Front 39

What is TWEAK with respect to alcohol risk assessment?

Back 39

Tolerance
Worry or concern by family or friends about drinking behavior
Eye opener
Amnesia or "blackouts" while drinking
K (Cut down) on alcohol use

(CAGE) is better!
Cut down
Annoyed
Guilty
Eye opener

Front 40

True/False. Barbiturates can be used for alcohol withdrawal in mothers.

Back 40

True, but ONLY AFTER THE FIRST TRIMESTER. (slide 9, Teratogenesis ETOH Tobacco Warnings)

Front 41

The definition of binge drinking in women is:

Back 41

4 or more drinks per occasion, or drinking more than 7 drinks per week

Front 42

What are the three diagnostic criteria of fetal alcohol syndrome (FAS)?

Back 42

Craniofacial anomalies
CNS anomalies
Pre and/or postnatal growth retardation

Front 43

Infants who exhibit some of the signs of FAS but not all three categories (CCP) in the diagnostic criteria are said to have:

Back 43

Fetal alcohol effect

Front 44

What are the five A's for smoking cessation?

Back 44

Ask about smoking habits
Advise to quit
Assess willingness to quite
Assist her in modifying her smoking behaviors
Arrange for follow-up care

Front 45

Vulvovaginal candida is usually caused by what bacteria?

Back 45

C. albicans

Front 46

True/False. A common treatment for yeast infections during pregnancy are Diflucan or Fluconazole (antifungals).

Back 46

False. Diflucan/Fluconazole are not permitted during pregnancy. Pregnant women MUST be treated topically, with 7-day topical/vaginal cream.

Fluconazole is OK with breastfeeding!

Front 47

What is the most prevalent cause of vaginal discharge or malodor?

Back 47

Bacterial vaginosis

Front 48

What are the four clinical criteria for bacterial vaginosis?

Back 48

White, homogenous non-inflammatory discharge coating the vaginal wall
Clue cells on microscopic exam
PH of vaginal fluid >4.5
Fishy odor

Requires 3 OF 4 criteria to be met for diagnosis.

Front 49

What is the treatment for bacterial vaginosis (BV) for the NON-pregnant woman? The pregnant woman?

Back 49

NON-pregnant: Metronidazole, Clindamycin cream

Front 50

Which statement regarding Metronidazole reflects a need for further teaching?
A) This drug is indicated if I am or am planning to become pregnant
B) Alcohol is not permitted for the oral form of this drug, so I should ask my doctor for the topical form if I plan on drinking
C) I must stop breastfeeding while I am taking this drug
D) This is considered a Category B drug

Back 50

B is incorrect. NO alcohol is permitted for either PO or topical forms of Flagyl. All of the other statements are true.

Front 51

Which of the following drugs is using for suppressive therapy in pregnant women?
A) Flagyl
B) Amoxicillin
C) Bactrim
D) Macrobid

Back 51

D) Macrobid or Keflex are used in suppressive therapy. Bactrim is used in the acute stage of UTI.

Front 52

True/False. Bactrim is an effective treatment for UTI up until the last week of pregnancy.

Back 52

False. Bactrim should NOT be used after 36 weeks

Front 53

What is the biggest risk for PID?

Back 53

Untreated Gonorrhea and/or Chlamydia

Front 54

Upon examination with a speculum, you note that a patient's cervix is edematous with a "snotty" appearance. What do you suspect?
A) Chlamydia
B) Gonorrhea
C) Bacterial vaginosis
D) PID

Back 54

A) Chlamydia (Slide 33, Infections Usual Suspects)

Front 55

True/False. Tetracycline is contraindicated in pregnant women.

Back 55

True. Tetracyclines damage fetal teeth.

Front 56

Which of the following tests is a SCREENING test for syphilis?
A) Darkfield exam
B) VDRL/RPR
C) FTA-ABS
D) Western blot

Back 56

B) VDRL/RPR is a SCREENING test
(Slide 45, Infections Usual Suspects)

Front 57

Which of the following statements is FALSE regarding syphilis?
A) The Darkfield exam is routinely used for screening women at risk for syphilis
B) Positive screening results is followed up by a diagnostic test like FTA-ABS
C) False positives are not uncommon in diagnostic tests for syphilis
D) The same test must be used every time a patient is screened for syphilis

Back 57

A) The Darkfield exam is a DIAGNOSTIC test. The VDRL/RPR is a SCREENING test.

The rest of the choices are correct.

Front 58

True/False. Pregnant patients with a penicillin allergy may be prescribed doxycycline for treatment of syphilis.

Back 58

False. Pregnant patients, regardless of allergies, are treated with Penicillin G. These patients are merely given sensitization treatment beforehand.
(slide 49/52, Infections Usual Suspects)

Front 59

A mother with no prenatal care gives birth on your shift, and after delivery you note the placenta is large, heavy, pale, and yellowish-gray in color. What do you suspect?
A) Trichamoniasis
B) Syphilis
C) Gonorrhea
D) Chlamydia

Back 59

B) Syphilis

Front 60

A "strawberry cervix" is characteristic of what condition?

Back 60

Trichomoniasis

Front 61

A universal, gradual reduction in bone mass to a point where the skeleton is compromised resulting in fractures with minimal trauma.

Back 61

Osteoporosis

Front 62

Loss of bone mass.

Back 62

Osteopenia

Front 63

Which of the following is NOT considered a secondary cause of osteoporosis?
A) Rheumatoid arthritis
B) Hypothyroidism
C) Cushing's
D) Hemophilia
E) Heparin

Back 63

B) HyPER thyroidism is a secondary cause of osteoporosis. (slide 4, Osteoporosis)

Front 64

Which ethnic groups are at higher risk for osteoporosis?

Back 64

Non-Hispanic Caucasian and Asian women are at disproportionately higher risk.

Front 65

Maximum level of bone density is reached by what age?

Back 65

25-30 (slide 5, Osteoporosis)

Front 66

True/False. Alcoholism can lead to osteoporosis.

Back 66

True. (Slide 6-- Notes-- Osteoporosis ppt)

Front 67

Loss of estrogen (increases/decreases) bone remodeling.

Back 67

Decreases (slide 7, Osteoporosis)

Front 68

What screening test for bone loss can be done in the office setting?

Back 68

Ultrasound of the forearm or calcaneal region can be used for screening of bone loss in the office setting. If this is positive then DXA screening is needed. (slide 9, Osteoporosis PPT)

Front 69

Women under age 50 are encouraged to consume how much calcium? >50?

Back 69

<50 = 1000mg
TAKING HRT >50 = 1200 mg
NOT taking HRT > 50 = 1500mg

(slide 13, Osteoporosis)

Front 70

True/False. Depo-provera has been shown to increase loss of BMD.

Back 70

True. It may affect critical bone mass development in adolescents and young adults and predispose them to osteoporosis later in life (slide 14, Osteoporosis PPT).

Front 71

What is an advantage of calcium citrate over calcium carbonate?

Back 71

While more pills are required to get the same amount of calcium as a calcium carbonate pill, calcium citrate is absorbed better in those individuals who have decreased stomach acid. (slide 16, Osteoporosis ppt).

Front 72

Which of the following statements regarding calcium intake indicates a need for further teaching?
A) I should take my calcium supplements with my meals to ensure maximal absorption
B) I should limit my alcohol consumption to fewer than 2 drinks per day to lower my risks for osteoporosis.
C) Supplements 500mg or less allow for the best absorption.
D) I should not consume more than 2500 mg/day of calcium.

Back 72

A) Patients should take their supplements 1 hour before or 2 hours after eating green leafy vegetables in order to obtain maximum absorption of calcium. (slide 17, Osteoporosis PPT)

Front 73

What is the MOA of biphosphonates?

Back 73

Reduce the number of osteoclasts/reduces osteoclast activity (slide 18, Osteoporosis PPT)

Front 74

What is a rare but potentially life-threatening side effect of biphosphanates?

Back 74

Esophageal ulceration (slide 18, Osteoporosis PPT)

Front 75

Which of the following may have protective effects against heart disease and breast cancer?
A) Ibandronate (Boniva)
B) Alendronate (Actonel)
C) Calcitonin
D) Raloxifene (Evista)

Back 75

D) Raloxifene (Evista) is used for the prevention and treatment of osteoporosis. It is similar to the breast cancer drug tamoxifen. It can reduce the risk of spinal fractures by almost 50%, though it does not appear to prevent other fractures. It may have protective effects against heart disease and breast cancer, though further studies are needed. (slide 19, Osteoporosis PPT)

Front 76

Zoledronic Acid (Zometa; Reclast) is contraindicated in what patients?

Back 76

Reclast should not be given to patients with low creatinine clearance (renal patients). This drug may cause nephrotoxicity in renal impaired patients, and should not be used with diuretic meds. (slide 20, Osteoporosis PPT).

Front 77

Which of the following statements regarding osteoporosis medications is FALSE?
A) Patients taking Alendronate (Fosomax) and Risedronate (Actonel) must not take anything else orally for 30 minutes after taking medication
B) Patients taking Ibandronate (Boniva) must take nothing else orally for 60 minutes after taking the medication
C) Zoledronic Acid (Zometa/Reclast) is administered in biannual doses for osteoporosis prevention.
D) Esophageal ulceration and erosion is a primary concern in the taking of biphosphanate drugs

Back 77

C) Zometa/Reclast is given ONCE every TWO YEARS for osteoporosis prevention (slide 20, Osteoporosis PPT)

Front 78

True/False. Breast disorders are rare in postmenopausal women not taking hormone replacement therapy.

Back 78

True. (slide 2, Breast Health PPT)

Front 79

A 35yo woman has come into your clinic for a routine checkup and tells you her breasts often feel "bumpy" and become very painful right before her menstrual period. Which of the following do you suspect?
A) Mastitis
B) Fibroadenoma
C) Intraductal papilloma
D) Fibrocystic changes

Back 79

D) Fibrocystic changes

Fibrocystic breast changes are nonpathological changes in breast tissue that occurs in response to hormone stimulation (primarily estrogen).

Front 80

Tender lumps with cobblestone consistency, most marked in the upper quadrants of the breasts are most characteristic of what disorder?
A) Mastitis
B) Fibroadenoma
C) Intraductal papilloma
D) Fibrocystic changes

Back 80

D) Fibrocystic changes (slide 3, Breast Health PPT)

Front 81

What is it called when changes to acini occur in the distal mammary lobule, and ducts become surrounded by firm, hard, plaque-like tissue?

Back 81

Adenosis (slide 4, Breast Health PPT)

Front 82

Which of the following components of fibrocystic changes is the cause for the cystic changes of tissue?
A) Mass develops as a result of inflammation in ducts
B) Dilation of ducts with variation of presentation
C) Layering of cells that has malignant potential
D) Changes to acini in distal mammary lobule

Back 82

B) Dilation of ducts with variation of presentation (slide 4, Breast Health PPT)

Front 83

Which of the following statements in INCORRECT regarding breast health?
A) Many women have found fibrocystic change relief with Vitamin E and B6 supplementation.
B) Fibroadenoma is typically a painless unilateral finding
C) Inflammatory breast cancer is often mistaken for mastitis
D) Intraductal papillomas are benign growths diagnosed via mammogram

Back 83

D) Intraductal papillomas often do NOT show up on mammograms, and can be A CANCER RISK!

(Slide 7, Breast Health PPT)

Front 84

The most common cause of spontaneous nipple discharge is?

Back 84

Intraductal papilloma (slide 7, Breast Health PPT)

Front 85

A small benign tumor that grows within a milk duct of the breast near the nipple.

Back 85

Intraductal papilloma

Front 86

True/False. A fibroadenoma is caused by excess formation of lobules and is benign.

Back 86

True. (slide 6, Breast Health PPT)

Front 87

Which of the following women should be referred to a physician IMMEDIATELY?
A) A 28yo complaining of constant "heaviness" and pain in her breasts several days per month.
B) A 31yo who discovered a solid, painless "lump that she can move around" during her self-exam
C) A 30 yo with nipple discharge and a painful mass in the RUQ of her left breast
D) A 40yo smoker in for her first mammogram requesting an oral contraceptive prescription

Back 87

C) These symptoms are highly indicative of an intraductal papilloma, and should be investigated immediately as this is a cancer risk.

Front 88

True/False. Breastfeeding is a risk factor for breast cancer.

Back 88

False. (slide 9, Breast Health PPT)

Front 89

True/False. It is possible for breast cancer risk to return to normal after stopping the use of OCPs.

Back 89

True. Risk decreases after stopping OCPs and returns to normal by 10 years. (slide 9, Breast Health PPT)

Front 90

When abnormal cells grow inside the lobules or milk ducts but have not spread to the surrounding tissue or beyond, the condition is called:

Back 90

Carcinoma in situ (slide 15, Breast Health PPT)

Front 91

When is it recommended for women to perform a breast self-exam?

Back 91

After the menstrual cycle/period ends. (slide 22, Breast Health PPT)

Front 92

What is another name for the "menopausal transition period"?

Back 92

Perimenopause

Front 93

Physical symptoms of hot flashes, sweating, and irregular periods are also known as:

Back 93

Vasomotor symptoms

Front 94

In perimenopause, FSH levels (increase/decrease) and estrogen (estradiol) levels (increase/decrease).

Back 94

In perimenopause, FSH levels will be increased and estradiol will be decreased.

Front 95

True/False. HTN is two time greater after menopause.

Back 95

True. (slide 13, Menopause PPT)

Front 96

After ___ years of HRT the risk of breast cancer increases.

Back 96

5 years

Front 97

Anxiety and irritability associated with menopause is termed ____.

Back 97

Climacteric syndrome

Front 98

The reproductive system is not fully functional for an average of ___ years following menarche.

Back 98

2 years. (slide 2, Menstrual disorders ppt)

Front 99

In the ___ phase of menstruation, the endometrium is edematous and vascular.
A) Menstrual
B) Prolific
C) Secretory
D) Ischemic

Back 99

C) Secretory phase (slide 7, Menstrual Disorders PPT)

Front 100

Absence of menarche beyond the age of 16.

Back 100

Primary amenorrhea (slide 9, Menstrual Disorders PPT)

Front 101

What is the primary cause of primary amenorrhea?

Back 101

PREGNANCY!!! (This will definitely be on the NCLEX!)

Front 102

Cessation of menses after menarche has occurred and periods have been successive for a period of time.

Back 102

Secondary amenorrhea (Slide 11, Menstrual Disorders PPT)

Front 103

Painful menstrual cramps without underlying pathology.

Back 103

Primary dysmenorrhea

Front 104

Which of the following is FALSE regarding primary dysmenorrhea?
A) It is nonpathological
B) It usually occurs one year or later following menarche
C) It occurs only during ovulatory cycles
D) The highest prevalence is in ages 20-24

Back 104

B) If the first incidence of dysmenorrhea occurs later than one year following menarche, SECONDARY DYSMENORRHEA is suspected. The first occurrence of primary dysmenorrhea happens WITHIN A YEAR AFTER MENARCHE.

(Slide 13, Menstrual Disorders PPT)

Front 105

Which of the following is a first-line treatment for primary dysmenorrhea?
A) Birth control pills
B) Calcium channel blockers
C) Vicodin
D) NSAIDs

Back 105

D) NSAIDs block prostaglandins and abolish hypercontractility of the uterus, which lessens the discomfort associated with primary dysmenorrhea.

Front 106

True/False. Secondary dysmenorrhea is not associated with hormone levels.

Back 106

True. Secondary dysmenorrhea is not associated with hormone/prostaglandin levels. It occurs as a result of some other issue in the body. (Slide 17, Menstrual Disorders PPT)

Front 107

With this condition, tissue from the lining of the uterus is located outside of the uterus.

Back 107

Endometriosis

Front 108

Muscle tumors or growths that form on the outside, the inside, or in the walls of the uterus.

Back 108

Fibroids/leiomyomas (slide 19, Menstrual Disorders PPT)

Front 109

True/False. Anovulatory bleeding occurs when normal cycle is disrupted and may be related to another pathology.

Back 109

FALSE. Anovulatory bleeding is abnormal uterine bleeding related to hormones that direct affect the menstrual cycle. It is UNRELATED to another pathology. (slide 21, Menstrual Disorders PPT)

Front 110

This is the most common type of irregular bleeding in adolescents and in women reaching perimenopause.

Back 110

Anovulatory bleeding (Slide 21, Menstrual Disorders PPT)

Front 111

What is the basic process of anovulatory bleeding?

Back 111

Estrogen is continually secreted, but an egg never ripens in the follicle and is therefore never released. This results in progesterone never being produced from the corpus luteum to counteract uterine lining proliferation. Eventually the uterine lining outgrows its blood supply and begins to slough off at irregular intervals. (Slide 22, Menstrual Disorders PPT)

Front 112

Light uterine bleeding of variable amounts occurring between regular menstrual periods (spotting).

Back 112

Intermenstrual bleeding

Front 113

Excessive bleeding (>80cc) at REGULAR intervals. May be prolonged in duration.

Back 113

Menorrhagia

Front 114

Irregular bleeding that occurs more frequently than regular cycles.

Back 114

Metrorrhagia (Think irregular bus schedules: Metro)

Front 115

Irregular, prolonged, and excessive bleeding.

Back 115

Menometrorrhagia

Front 116

Infrequent or scant bleeding of variable duration.

Back 116

Oligomenorrhea

Front 117

Uterine bleeding occurring at regular intervals of <21 days.

Back 117

Polymenorrhea

Front 118

PMS occurs during what phase of the menstrual cycle?

Back 118

The luteal phase (slide 36, Menstrual Disorders PPT)

Front 119

This is a surgical procedure used for the treatment of anovulatory or abnormal uterine bleeding and symptomatic leiomyomas.

Back 119

Endometrial ablation.
Note: This is a SECOND-LINE TREATMENT after trying OCPs or cyclic progestins to control anovulatory bleeding. (Slide 6, MedSurg PPT)

Front 120

What are some contraindications to endometrial ablation?

Back 120

PID, current STI, and uterine perforation.
(Also uterine cancer-- process may introduce cancer cells into other parts of the body)

Front 121

What is the difference between a hysterectomy and a Total Abdominal Hysterectomy (TAH)?

Back 121

The TAH involves the complete removal of the uterus AND cervix using the abdominal surgical approach. (slide 15, MedSurg PPT)

Front 122

Which ovarian cyst occurs secondary to hormonal stimulation?

Back 122

Functional ovarian cyst (slide 21, MedSurg PPT)

Front 123

Which ovarian cyst is the most common?

Back 123

Follicular-- this occurs when the follicle fails to rupture and release the egg during ovulation. (slide 21, MedSurg PPT)

Front 124

What is the most common ovarian germ-cell tumor?

Back 124

Dermoid cyst (benign cystic teratoma)
(Slide 21, MedSurg PPT)

Front 125

True/False. Most functional ovarian cysts resolve on their own.

Back 125

True. Most cysts shrink and resolve on their own within 2-3 menstrual cycles. (slide 22, MedSurg PPT)

Front 126

What is the most common cancer of the female reproductive tract?

Back 126

Endometrial cancer (slide 31, MedSurg PPT)

Front 127

What is the "red flag" associated with endometrial cancer?

Back 127

Bleeding in post-menopausal women NOT on hormone replacement therapy. (slide 31, MedSurg PPT)

Front 128

Most cervical dysplasias occur in the ____, the region located at or near the cervical os that represents the squamous epithelium of the vagina and exocervix and the columnar epithelium of the endocervix and enodmetrium.

Back 128

Transformation zone

Front 129

This is the most causative agent of cervical cancer.

Back 129

HPV (slide 36, MedSurg PPT)

Front 130

Which Pap result is most likely to progress to cancer?

Back 130

High-grade squamous intraepithelial lesion (CIN II or III and carcinoma in situ) (slide 44, MedSurg PPT)

Front 131

Which Hepatitis is transmitted via the fecal-oral route?

Back 131

Hepatitis A

Front 132

Which Hepatitis is spread through direct contact with blood or blood contaminated items (and can be spread sexually)?

Back 132

Hepatitis B

Front 133

True/False. Hepatitis A is chronic.

Back 133

False.

Front 134

True/False. Hepatitic B is rarely spread sexually.

Back 134

False. Hepatitis C is rarely spread sexually, but is spread by direct contact with blood or blood contaminated items.

Front 135

A mother traveling to San Antonio has come down with Hepatitis A after eating raw oysters, and asks you if breastfeeding is still okay. What do you tell her?

Back 135

Yes, breastfeeding is fine with Hep A.

Front 136

Which of the following is NOT true regarding Hepatitis B vaccine?
A) It is not recommended for acute patients in the NICU
B) It is a three-dose series, with the latter doses at one and six months later
C) If exposed to Hep B, patients may be given IgG
D) It is recommended for health care workers

Back 136

A) It is recommended for ALL children aged 0-18 years old

Front 137

True/False. In testing a neonate for Hepatitis B, the baby MUST be bathed first.

Back 137

True! The baby must be bathed prior to invasive tests to decrease percutaneous exposure to mom’s blood. (slide 6, Infections Hep, HIV, HSV)

Front 138

What is the leading indication for a liver transplant?

Back 138

Hepatitis C

Front 139

A mother with Hepatitis C asks you if it is okay to breastfeed. What is your response?
A) Breastfeeding is perfectly fine in patients with Hepatitis C
B) Breastfeeding is not recommended in patients with Hepatitis C, as it can be transmitted to the baby through a mother’s milk
C) Breastfeeding is fine as long as the nipples are intact
D) Breastfeeding is not recommended in patients with Hepatitis C, as these patients are usually co-infected with HIV

Back 139

C) Breastfeeding is fine in HCV-positive mothers. They should only consider abstaining from breast-feeding if their nipples are cracked or bleeding. (slide 8, HIV/HPV/HSV)

Front 140

If mom is Hep C positive, newborns should not be tested for Hep C prior to ___ months of age, because the baby is still carrying mom’s antibodies.

Back 140

18 months (slide 8, HIV/HPV/HSV)

Front 141

In HIV, the ___ test screens, and the ___ test confirms.

Back 141

ELISA screens, Western Blot confirms

Front 142

True/False. HIV therapy is considered “single-drug” therapy.

Back 142

False. HIV therapy is considered combination therapy.

Front 143

True/False. Pregnant women are tested in both the first and third trimester for HIV.

Back 143

True! (slide 10, HIV/HPV/HSV)

Front 144

If antibody testing is not helpful until a child is 18 months of age or older, how can infants or young siblings be tested for HIV?

Back 144

Infants and young siblings can be tested using HIV DNA probes or HIV RNA tests as early as 48 hours after birth. (slide 11, HIV/HPV/HSV)

Front 145

If a pregnant woman’s viral load is greater than ____, the infant will be delivered by C-section at 38 weeks.

Back 145

Viral load > 1,000 copies = C-section at 38 weeks (Zidovudine IV 4 hours prior)
Viral load < 1,000 copies may be delivered vaginally, but it is important to counsel the patient that it can increase the risk of transmission (Zidovudine IV during labor and PO antivirals will be continued)
(Slide 12, Hep/HIV/HPV/HSV)

Front 146

AZT is usually continued for how long in treating a baby with an HIV positive mom after birth?

Back 146

Baby is treated with AZT (Zidovudine) after delivery and tx is continued for 6 weeks (slide 13, Hep/HIV/HPV/HSV)

Front 147

Acyclovir is considered what pregnancy class drug?

Back 147

Pregnancy Class B drug. This drug is used to treat Herpes Simplex in the last 4-6 weeks of pregnancy to suppress the disease. (slide 27, Hep/HIV/HPV/HSV)

Front 148

The quadrivalent HPV vaccine Gardasil treats what types of HPV?

Back 148

6, 11, and 18 (technically 16 also, but Meyers said we didn’t have to know that) (slide 30, Hep/HIV/HPV/HSV)

Front 149

HPV vaginal warts are usually caused by which types?

Back 149

6 or 11 (slide 32, Hep/HIV/HSV/HPV)

Front 150

Which of the following statements is FALSE regarding HPV?
A) HPV can be cleared completely by the body without medical intervention
B) Most HPV is asymptomatic and subclinical
C) The HPV vaccine is not required for women already exposed to the virus
D) Visible genital warts for HPV are usually caused by types 6 or 11

Back 150

C) The HPV vaccine is indicated regardless of exposure, as it vaccinates against MULTIPLE STRAINS OF HPV. (slide 32, Hep/HIV/HPV/HSV)

Front 151

True/False. Only TCA (trichloroacetic acid) and BCA (bichloroacetic acid) are considered safe for treatment of HPV in pregnancy.

Back 151

True! (slide 38, Hep/HIV/HPV/HSV)

Front 152

You have been alerted to the presence of a condyloma on a newborn baby. Which of the following is INCORRECT?
A) This is often caused by HPV or syphilis
B) The physician must be notified ASAP as infants with this have increased risk for laryngeal papillomatosis
C) A C-section may eliminate certain risks associated with sequalae to this disorder
D) The warts associated with this condition are very friable and can bleed in excess if torn

Back 152

C) A C-section does NOT eliminate the risk for laryngeal papillomatosis. (slide 39, Hep/HIV/HPV/HSV)

Front 153

What is the primary indication for PID (pelvic inflammatory disease) as compared with other conditions?

Back 153

Cervical Motion Tenderness (CMT)

Front 154

True/False. An IUD must be removed prior to treatment of PID.

Back 154

FALSE! (slide 43, Hep/HIV/HPV/HSV)

Front 155

A breastfeeding new mom just gave birth and has developed a UTI. Which of the following prescriptions is contraindicated?
A) Amoxicillin
B) Keflex
C) Macrobid
D) Ampicillin

Back 155

C) Macrobid. Do NOT give Macrobid (Nitrofurantoin) to nursing mothers of babies <1 month, as it displaces bilirubin from albumin binding sites

Front 156

What is the most frequently reported bacterial STI in the US?

Back 156

Chlamydia

Front 157

True/False. Chalmydial opthalmia neonatorum is treated prophylactically in all newborns with erythromycin ointment.

Back 157

False. Opthalmia neonatorum caused by syphilis is NOT reliably prevented with ophthalmic erythromycin. Gonorrheal O.N. is prophylactically treated with erythromycin ointment (slide 37, Infections Usual Suspects).

Front 158

Frothy, malodorous, copious discharge with pruritis is associated with what disorder?

Back 158

Trichomoniasis (slide 56, Infections Usual Suspects)

Front 159

Congenital hip dislocation occurs primarily in (girls/boys).

Back 159

Girls! (slide 12, Teratogenesis Genetics + Birth)

Front 160

Which of the following occurs primarily in GIRLS (select all that apply)?
A) Spina bifida
B) Hirschprung disease
C) Clubfoot
D) Pyloric stenosis
E) Congenital hip dislocation

Back 160

A, D, E. (slide 12, Teratogenesis Genetics + Birth)

Front 161

Remember, most sobriety drugs (Antabuse, Campral, Naltrexone) are Pregnancy Class ____.

Back 161

C!

Front 162

Which of the following is NOT associated with Fetal Alcohol Syndrome (FAS)?
A) Mild to moderate mental retardation
B) Pectus carinatum
C) Microcephaly
D) Hemangiomas
E) Ventricular septal defects

Back 162

B) Pectus EXCAVATUM is associated with FAS. (slide 21, Teratogenesis ETOH)

Front 163

Which of the following statements regarding tobacco use in pregnancy is FALSE?
A) Smoking, like alcohol consumption, interferes with calcium absorption.
B) Babies of smokers are more likely to appear lethargic and difficult to stimulate/resuscitate than babies of non-smokers.
C) Babies of smokers have increased risk for ear infections
D) Mothers who smoke have increased risk of placental abruption than women who do not

Back 163

B is incorrect. Babies of smokers appear to be more jittery and more difficult to soothe than babies of non-smokers

Front 164

True/False. Vitamin E deficiency is not associated with teratogenicity.

Back 164

True. Neither deficiency or excess of Vitamin E is associated with teratogenicity.

Front 165

Which of the following teratogens is NOT associated with neural tube defects?
A) Maternal hyperthermia
B) Folic acid deficiency
C) Vitamin C deficiency
D) Myasthenia gravis

Back 165

D) Myasthenia gravis is NOT associated with neural tube defects

Front 166

Which of the following is FALSE regarding Hepatitis?
A) The Hep A vaccine should be avoided in pregnancy, as this is a live vaccine
B) Women with Hepatitis A are safe to breastfeed
C) Hepatitis B is spread primarily through contact with blood
D) Pregnant women are routinely tested for Hep B

Back 166

A) The Hep A vaccine is fine to give in pregnancy (slide 3, Hep/HIV/HSV)