Obgyn 201-300

Front 1

Persistent postpartum fever despite Abx, without other signs/symptoms

Back 1

Septic thrombophlebitis

Front 2

Rx for septic thrombophlebitis

Back 2

Abx + anticoagulation

Front 3

Maternal fever after vaginal repair with gray edges

Back 3

Necrotizing fasciitis

Front 4

Swollen, tender, and painful area of vaginal laceration repair that is expanding

Back 4

Hematoma

Front 5

Rx for necrotizing fasciitis

Back 5

Extensive debridement

Front 6

What category drug is sertraline?

Back 6

Category C

Front 7

2 most common side effects of fluoxetine

Back 7

Sleep and sexual disturbances

Front 8

Are SSRIs safe while breastfeeding?

Back 8

Yes!

Front 9

Depression during luteal phase but not follicular phase

Back 9

Premenstrual Dysphoric Disorder

Front 10

Vacuums have a decreased rate of ___ compared to forceps

Back 10

Maternal lacerations

Front 11

When is external cephalic version contraindicated?

Back 11

Active labor

Front 12

Management of IUGR with polyhydramnios?

Back 12

Amniocentesis to obtain fetal karyotype b/c of potential for Trisomy 18

Front 13

Risk factors for cervical insufficiency

Back 13

Prior gyne surgery (esp LEEP), prior obstetrical trauma, multiple gestation, Hx of preterm birth, 2nd trimester pregnancy loss

Front 14

How long should the cervix be at 24 wks?

Back 14

>25mm

Front 15

Rx for trichomonas

Back 15

Oral metronidazole for pt and her partner

Front 16

Amenorrhea, normally developed breasts, absent pubic/axillary hair

Back 16

Androgen insensitivity syndrome; will have internal testicles and be 46XY w/ high male-level testosterone

Front 17

Nml internal genitalia, ambiguous external genitalia, clitoral hypertrophy, high FSH/LH, low estrogen

Back 17

Aromatase deficiency

Front 18

How to differentiate aromatase deficiency from CAH

Back 18

In CAH estrogen is still synthesized (nml level) and internal genitalia are nml

Front 19

Rx for asymptomatic bacteriuria of pregnancy

Back 19

7 days of nitrofurantoin, amox, or cephalosporin (TMP contraindicated in pregnancy)

Front 20

When should gonadectomy be performed in androgen insensitivity syndrome?

Back 20

After puberty (completion of breast dev't and attainment of adult height)

Front 21

Rx for androgen insensitivity syndrome after gonadectomy/ puberty?

Back 21

Estrogen therapy (no need for progesterone as there is no uterus)

Front 22

Rx for mild pre-eclampsia in a preterm pt with immature fetal lunds

Back 22

Bed rest and frequent f/u

Front 23

Low grade fever and leukocytosis 12 hrs postpartum

Back 23

Normal!

Front 24

Rx for endometritis

Back 24

IV clinda (anaerobic coverage) and gent (G- coverage)

Front 25

Karyotype and FSH and LH in Kallman's

Back 25

46XX
Low and low

Front 26

Low-normal platelets and fibrinogen in pt with IUFD

Back 26

Worry about early consumptive coagulopathy, esp b/c fibrinogen is normally elevated in pregnancy

Front 27

Rx for consumptive coagulopathy, or concern for it, post-IUFD

Back 27

IOL

Front 28

Bleeding patterns typical on Depo

Back 28

Irregularity for first 2-3 months; amenorrhea in 50% after 1 yr

Front 29

How to avoid the nausea associated with OCPs used as emergency contraception

Back 29

Inserting second dose vaginally or taking anti-emetic 1hr beforehand

Front 30

Which type of emergency contraception requires two doses?

Back 30

OCPs; levonorgestrel can be taken in 1 or 2

Front 31

Reduced risk of what with tubal ligation?

Back 31

Ovarian cancer

Front 32

Pts with poorly controlled HTN are not a candidate for which type of contraception

Back 32

OCPs

Front 33

+ hcg, open cervix, fever

Back 33

Septic abortion

Front 34

Rx for septic abortion

Back 34

Evacuation of uterus and broad spectrum Abx

Front 35

Rx for pt wishing to get pregnant with antiphospholipid syndrome

Back 35

Aspirin + heparin

Front 36

Which has a higher blood loss, medical or surgical termination?

Back 36

Medical

Front 37

Concern with repeat D&C

Back 37

Increased risk of Asherman's

Front 38

After what gestational age is manual vacuum aspiration contraindicated?

Back 38

8wks

Front 39

D&E is performed in lieu of D&C in pts after how many weeks?

Back 39

16

Front 40

Drug used for induction for abortion if mom wants fetal autopsy

Back 40

Intravaginal prostaglandins

Front 41

Management of heavy bleeding post medical termination of pregnancy

Back 41

D&C

Front 42

Maternal fever two days after elective abortion

Back 42

Postop endometritis

Front 43

Management of postop endometritis

Back 43

Abx + ultrasound to look for products of conception (if found, will need repeat D&C)

Front 44

What reduces the risk of limb reduction defects with CVS?

Back 44

Gestational age (lower risk if before 9-10wks)

Front 45

Profuse, clear, thin cervical mucous indicates what stage of the menstrual cycle?

Back 45

Ovulation

Front 46

Thick, less-stretchy mucous indicates what stage of the menstrual cycle?

Back 46

Luteal

Front 47

Inability to lactate after severe PPH?

Back 47

Sheehan's Syndrome (anterior pituitary necrosis) has developed due to pituitary hypoperfusion --> decreased PRL (and TSH and FSH)

Front 48

OCPs cause a decreased rate of these two kinds of cancer

Back 48

Endometrial and ovarian

Front 49

What is the general cause of asymmetric IUGR?

Back 49

Non-ideal maternal factors (e.g. HTN) --> fetal redistribution of blood flow to vital organs (brain, heart) at the expense of other organs, e.g. abdominal viscera

Front 50

Management of unknown MMR status?

Back 50

Check to see if rubella immune; vaccinate post-partum (live vaccine, not safe in pregnancy)

Front 51

Diagnostic management of Rh-negative woman

Back 51

Test for Rh status and antibodies at 10 wks and again at 28 wks

Front 52

When is GTT screening done and which test is it?

Back 52

24-28wks
1 hr 50 gram glucose tolerance test

Front 53

What is an abnl 1hr GTT and how is it managed?

Back 53

>140 after 1hr; do a 3hr 100gram GTT

Front 54

Thin/dry/white vulva with anogenital discomfort/pruritus, dyspareuna, dysuria

Back 54

Lichen sclerosis

Front 55

Why biopsy potential lichen sclerosis?

Back 55

To rule out vulvar squamous cell carcinoma

Front 56

Rx for lichen sclerosis

Back 56

High potency topical corticosteroids

Front 57

What causes RUQ pain in pre-eclampsia?

Back 57

Distention of liver capsule

Front 58

6 aspects of severe pre-eclampsia

Back 58

HTN >160/110, proteinuria >5g on 24hr, oliguria, pulmonary edema, thrombocytopenia, elevated liver enzymes

Front 59

Cause of irregular menstrual cycles in teens (e.g. shortly after menarche?

Back 59

Inadequate LH/FSH secretion, often leading to anovulation and then breakthrough bleeding (HPG axis immaturity)

Front 60

What effect does TSH have on prolactin?

Back 60

Increases it

Front 61

Goal of colposcopy during pregnancy

Back 61

Exclusion of invasive cancer

Front 62

Management of HSIL during pegnancy

Back 62

Colpo and biopsy; if normal, second biopsy 6-8wks after delivery

Front 63

Who is raloxifene (a SERM) contraindicated in?

Back 63

Pts with a history of thromboembolism

Front 64

Risk for endometrial cancer: tamoxifen vs. raloxifene

Back 64

Increased with tamoxifen, not with raloxifene

Front 65

Raloxifene is a first-line agent for prevention of

Back 65

Osteoporosis (possibly also breast cancer)

Front 66

Rx for lactation suppression

Back 66

No meds! Tight bras, no nipple manipulation, ice packs, analgesics

Front 67

Urinary urgency, urinary frequency, chronic pelvic pain

Back 67

Interstitial cystitis

Front 68

Causes and relief of pain in interstitial cystitis

Back 68

Sex, full bladder, exercise, spicy foods

Relieved by voiding

Front 69

Rx for young woman with a breast mass

Back 69

Re-examine just after menstrual period; if no smaller, FNA or excisional biopsy (no role for mammography b/c of high density of breast tissue in young women)

Front 70

3 potential causes of variable decels

Back 70

Cord compression, low amniotic fluid, fetal hypoxia

Front 71

Multi-step management of non-reassuring fetal heart tones

Back 71

Maternal oxygenation and repositioning --> fetal scalp pH to assess for hypoxia --> amnioinfusion --> C-section

Front 72

Affect of pregnancy on thyroid hormones

Back 72

Increased TBG and stimulation of TSH receptor by hCG -->
Increased total T3/T4, normal free T3/T4, low-normal TSH

Front 73

Rx for yeast infection

Back 73

Oral fluconazole

Front 74

Chronic pelvic pain, worse premenstrually; dysmenorrhea; pain with defection' rectovaginal tenderness; tenderness with movement of the uterus

Back 74

Endometriosis

Front 75

Management of suspected endometriosis

Back 75

Laparoscopy

Front 76

Pts with endometriosis are at risk for developing

Back 76

Infertility

Front 77

Management of repetitive late decels

Back 77

Emergent C-section

Front 78

Most common risk factor for placental abruption

Back 78

Maternal HTN

Front 79

Respiratory failure and cardiac shock during amniocentesis or labor

Back 79

Amniotic fluid embolism

Front 80

What is Stein-Levanthal syndrome?

Back 80

PCOS

Front 81

Fertility option for patients with premature ovarian failure

Back 81

IVF

Front 82

Premature ovarian failure is associated with what class of diseases?

Back 82

Autoimmune diseases

Front 83

What is a luteal phase defect?

Back 83

Failure of corpus luteum to produce sufficient progesterone to maintain endometrium and allow implantation

Front 84

Rx for luteal phase defect

Back 84

Progesterone supplement

Front 85

How to distinguish btwn leiomyomas and adenomyosis?

Back 85

Fibroid uterus is usually irregularly shaped, rather than symmetrically enlarged

Front 86

Endometrial glands in the uterine muscle is called

Back 86

Adenomyosis

Front 87

Hyperventilation, agitation, and tachy in pt with prior C-section

Back 87

Imminent uterine rupture

Front 88

Maternal symptoms in vasa previa

Back 88

None! Only fetal exsanguination

Front 89

How to distinguish btwn uterine rupture and abruptio placenta?

Back 89

Uterine rupture has abdominal exam with irregular contours (fetal limbs), more likely to cause hypovolemia/shock

Front 90

Most common cause of increased MSAFP

Back 90

Dating error

Front 91

3 other causes of increased MSAFP

Back 91

NTDs, abdominal wall defects, multiple gestation

Front 92

Management of increased MSAFP

Back 92

Ultrasound to look for multiple gestation/ fetal size for dating/ identifiable anomalies

Front 93

Quad screen with low MSAFP, low estriol, high beta-hCG, high inhibin A

Back 93

Down syndrome

Front 94

Quad screen with low MSAFP, low estriol, low beta-hCG, normal inhibin A

Back 94

Edward

Front 95

Protein excretion in preeclampsia is >?

Back 95

300mg/24hr

Front 96

Rx for mild pre-eclampsia with pre-term fetus

Back 96

Methyldopa and bed rest

Front 97

Amsel criteria are used to diagnose

Back 97

BV

Front 98

Waht are the 4 Amsel criteria?

Back 98

Thin, gray-white vaginal discharge
Vaginal pH > 4.5
Positive whiff test w/ KOH
Clue cells

Front 99

When is IOL used for a missed abortion?

Back 99

After the 16th week of gestation

Front 100

Management of inevitable abortion

Back 100

Hospitalization, analgesics, observation (same as for incomplete abortion to monitor for sepsis, DIC, hemorrhage) + suction curettage