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85 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Signs of chorioamnionitis
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1) Maternal fever
2) Uterine tenderness 3) Fetal tachycardia 4) Elevated WBC |
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What is definition of late pregnancy bleeding?
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Bleeding after 20 weeks
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What is the most common cause of late-trimester bleeding?
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Placental abruption
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Risk factors for placental abruption
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1) Previous abruption
2) Maternal trauma 3) Hypertension 4) Maternal cocaine abuse 5) Premature membrane rupture |
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Signs of mild abruption
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Moderate vaginal bleeding with no fetal monitor abnormality. Localized uterine pain and tenderness.
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Signs of moderate abruption
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Pain and bleeding can be gradual or abrupt in onset.
FHT may show tachycardia, decreased variability or mild late decels |
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Signs of severe abruption
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Abrupt pain that is continuous and knifelike. Greater than 50% separation.
FHT shows severe late decels, bradycardia or death. DIC may occur |
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Why does DIC occur with abruption?
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Release of tissue thromboplastin from placenta into maternal circulation.
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What is couvelaire uterus?
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Blood extravasating between myometrial fibers. Bruises appear on serosal surface.
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What are complications of severe abruption?
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Acute tubular necrosis from severe hypotension.
DIC from release of tissue thromboplastin. |
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What is characteristic of bleeding with abruption?
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Painful bleeding
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What is characteristic of bleeding with previa?
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Painless bleeding
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Which single dose oral regimens for gonorrhea should be avoided in pregnancy?
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Ciprofloxacin and ofloxacin.
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Single dose treatment for gonorrhea
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Intramuscular ceftriaxone
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Treatments for chlamydia
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Single dose azithromycin
1 week regimen of doxycyline or erythromycin |
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Who should be routinely screened for gonorrhea and chlamydia?
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All sexually active women who are young or have other risk factors.
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What is the most common cause of septic arthritis in sexually active young adults?
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Neisseria gonorrhea
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What is the hormone imbalance in polycystic ovarian syndrome?
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Too much LH
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What are the origins of ovarian cancers?
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Epithelial, germ cell and stromal
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What is the most common type of ovarian cancer?
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Serous cystadenocarcinoma
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What is the most common type of ovarian cancer?
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Serous cystadenocarcinoma
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What is the most common type of ovarian cancer?
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Serous cystadenocarcinoma
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What do women over 35 with abnormal bleeding need to rule out?
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Endometrial carcinoma
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What prevents gonadal malignancy in Turner's syndrome?
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Prophylactic removal of gonads.
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What congenital anomalies are associated with Turner's syndrome?
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1) Coarctation of the aorta
2) Cystic hygroma 3) Renal anomalies |
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What is the most common cause of primary amenorrhea?
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Turner's syndrome (45, X0)
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What happens if a Turner patient is given progesterone?
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Nothing, no bleeding because there was no estrogen to begin with.
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What conditions has bacterial vaginosis been linked with?
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Postpartum endometritis, pelvic infections, preterm labor.
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What are three classical presentations of endometriosis?
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Pain, abnormal bleeding and infertility
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At what ages do most women present with endometreosis?
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Between 20 and 35
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What is medical therapy for endometriosis?
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NSAIDS for pain; OCPs, danazol and GnRH agonists to induce "medical menopause" for relief of symptoms
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What is normal pH of the vagina in a premenopausal woman?
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Acidic (<4.5)
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What is characteristic of the discharge produced by bacterial vaginosis?
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Profuse, thin, foul smelling, "dirty-grey"
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What is the treatment for BV?
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Metronidazole for 7 days
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What is the alternative treatment for BV?
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Clindamycin
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What time period during pregnancy should Metronidazole be avoided?
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First trimester
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Classic findings for endometriosis on physical exam
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Fixed, retroverted uterus
Nodularity of uterosacral ligaments Fixed ovaries |
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T or F: High parity is a risk factor for cervical cancer
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True
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What can vaginal discharge of cervical cancer look like?
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Malodorous, purulent or clear
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HPV serotypes that cause cancer
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16, 18, 33, 36 and others
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Type of herpes that mostly causes genital warts
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HSV Type II (90% of cases)
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What is the treatment for herpes genitalis?
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Acyclovir, valacyclovir or famcicyclovir for 7-10 days
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In which eating disorder are severe electrolyte abnormalities and cardiac arrythmias seen?
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Bulemia
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What should be the antibiotic coverage for treatment of PID?
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Chlamydia, gonorrhea, gram negative rods and anaerobes
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What is the treatment for PID?
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Cefotetan or cefoxitin and doxycyline
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How long do you watch a tubo-ovarian abscess on antibiotics before resorting to surgery?
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72 hours
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In what type of patient is and IUD a bad idea?
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Women under 35, promiscuous women, those desiring future fertility
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Questionable correctness of this answer. Doctor dependent
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T or F: Patients with adenomyosis tend to present at a later age than patients with endometriosis
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True (35-45 years)
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Smooth symmetrically enlarged, boggy uterus that may be tender to palpation probably describes....
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Adenomyosis
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What is condyloma accuminata assiciated with?
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Genital warts or HPV
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Which conditions can cause genital warts to grow rapidly and larger?
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Pregnancy, diabetes, immunosuppresion and taking OCPs.
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What has to be included in the investigation of vaginal bleeding in postmenopausal woman?
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Pap smear, endocervical curettage, endometrial biopsy
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What is benign cystic teratoma known as?
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Mature teratoma or dermoid cyst
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What are the most common ovarian neoplasms?
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Benign cystic teratoma
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What is struma ovarii?
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Fuctioning thyroid tissue in a benign teratoma causing hyperthyroidism
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What are the screening tests for syphilis?
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VDRL and RPR
Nonspecific, false positives, become negative after treatment |
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What are confirmatory tests for syphilis?
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FTA-Abs, MHT-TP
More specific, stay positive for life |
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What is Jarish-Herxheimer?
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It is a reaction that occurs in patients with syphilis on the first day of treatment.
Fever, sweating, malaise. Not an allergic reaction! |
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What might a false positive syphilis screening test mean?
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Lupus or some collagen vascular disorder (anti-phospholipid syndrome)
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How early can pregnancy be detected by transvaginal ultrasound?
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5 weeks
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T or F: Mild glucosruia and proteinuria is normal in pregnancy
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True
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What LFT value is normally elevated in pregnancy?
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Alkaline phosphatase
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When in pregnancy is the "triple screen" done?
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16-20 weeks
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When in pregnancy is diabetes screening done?
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24-28 weeks
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What are normal pregnancy levels of beta-HCG?
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<100,000
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What is another name for molar pregnancy?
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Gestational trophoblastic neoplasia (GTN)
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What is the next step in a molar pregnancy if beta-HCG levels continue to rise after a D&C?
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Chemotherapy with methotrexate or actinomycin D
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Describe complete molar pregnancy
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46, XX; no fetal tissue present
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Describe incomplete molar pregnancy
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47, XXY; some fetal tissue present
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Date of delivery based on LMP
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subtract 3 months and add 7 days
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What is the definition of spontaneous abortion?
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Expulsion of fetus at <20 weeks or <500 grams
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In which trimester does Pregnancy Induced Hypertension classically occur?
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Third trimester
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Second trimester + signs of pre-eclampsia = ?
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Possible molar pregnancy
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What are classic complaints of PIH?
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Dec. urine output, headache, visual changes, altered mental status, RUQ pain, face, hand or leg swelling
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What defines pre-eclampsia?
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Hypertension + PROTEINURIA + edema
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What distinguishes pre-eclampsia from eclampsia?
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SEIZURES
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What is in the HELLP syndrome?
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Hemolysis, elevated liver enzymes, low platelets +/- RUQ pain
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What can occur with magnesium sulfate toxicity?
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Dec. deep tendon reflexes
Hypotension Respiratory depression |
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Which PIH is okay to treat with BP control and observation?
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Those with mild disease:
BP < 160/110, 1-2+ proteinuria and no symptoms besides edema |
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What is symmetric IUGR a result of?
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Fetal anomalies and infections
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What is asymmetric IUGR a result of?
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Maternal or placental factors
More common |
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What are the three most common presenting complaints for an ectopic pregnancy?
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Amenorrhea, abdominal pain and vaginal bleeding.
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24 year old, RLQ pain, spotting, LMP 5 weeks ago: first test?
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beta-HCG
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Name three initial lab values to check in a pre-menopausal woman presenting with amenorrhea.
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beta-HCG, TSH, prolactin
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Which metabolic disorders are women with PCOS at risk for?
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Diabetes mellitus type 2 and dyslipidemia
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