Obgyn U World

Front 1

chlamydia screening

Back 1

sexually active woen <25, and at risk >25 (i.e. new partner)

Front 2

PCOS Lab

Back 2

LH/FSH > 2 or 3

Front 3

2 hour GTT

Back 3

>140 is insulin resistant >200 is DM

Front 4

finger hypoplasia, small size, excess hair, cleft lip, mid facial hypoplasia

Back 4

fetal hydatatoin sydnrome from phenytoin or carbamazapine

Front 5

new born with rhinitis, heptaosplenomegaly, and skin leisions

Back 5

syphillis

Front 6

tamoxifan risk

Back 6

partial agonist of endometrium increase risk of uterine cancer. Decreases risk of osteoperosis

Front 7

Endometroiosis treatment algorithm

Back 7

NSAID and OCPs --> progesterin and GnRH agonist --> laproscopy

Front 8

secondary ammenorhea after D&C

Back 8

likely intrauterine adhesions, normal hypo-pit axis but uterine tissue in non-responsive, hysterosalpingogram or saline or saline infusion U/S to diagnose

Front 9

progeretrone challenge 7 days followed by bleeding

Back 9

likely PCOS, if no bleeding do E,FSH, LH testing

Front 10

no bleeding on progerstone challange, normal E

Back 10

Outflow obstruction

Front 11

galactorrhea in hypothyroidism

Back 11

TRH stimulates prolactin releasing horomone receptors, prolactin inhibits GnRH

Front 12

after physician rupture of membranes, sinusoidal FHR strip

Back 12

vasa previa —> fetal vessel rupture

Front 13

transvaginal assesment of cervix

Back 13

should be 24mm at 25 weeks or greater than 10 percentile for fetal age or there is risk of cervical insufficency

Front 14

breech presentation converting

Back 14

most will self convert by 37 weeks so dont try external cep halo version until 37 weeks

Front 15

vaginal itching, atrophic vaginal wall, excoriations

Back 15

lichen sclerosis, punch biopsy, Auto immune Dx, high risk conversion SCC, Treat with topical steroids

Front 16

most likely bi lateral ovarian tumor that is not a met

Back 16

serous cystadenoma

Front 17

HGSIL and Cin 2 and 3 in prganancy

Back 17

need colposcopy, if neg then just redo at 6 weeks post partum, if suspicious leisions seen then biopsyif CIN 2 or 3 then repeat in 12 weeks

Front 18

trichomoans vs bacterial vaginosis PH, itching, inflam

Back 18

acidic, ithiy, inflamm vs basic, no itch, no inflamm

Front 19

cyst rupture treatment

Back 19

if uncomplicated (no fever, tachy, hypotension) then out patient anelgesics. Complicated need surgery

Front 20

precoscious puberty + adeneal mass w vs w/out virulization

Back 20

granulosa vs sertoli

Front 21

order of puberty

Back 21

thelarche, pubarche/adrenarche, growth spurt, menarche, breast buds, axillary and pubic hair, menses

Front 22

definition of delayed puberty

Back 22

no sexual charcteristics by age 14

Front 23

primary amenorrhea + missing kideny (or other urinary tract abnormality)

Back 23

mullareian agenesis

Front 24

placental abruption stuff

Back 24

HTn highest risk factor, uterine contractility increased, vaginal bleeding only in 80%

Front 25

pain radiating to thighs and baack hours before menstration

Back 25

priary dy dysmenorrhea, pain 2/2 prostaglandins, NSAIDs highly effective

Front 26

precocous puberty treatment

Back 26

GnRh agonist

Front 27

gold standard for diagnosing tubal dx

Back 27

laproscopy

Front 28

post menopausal bleeding requires

Back 28

endometrial biopsy if unrevealing then do hysteroscopy

Front 29

most common cause of post menopausal beeding

Back 29

thin atrophic endometrium

Front 30

normal endometrial thickness post menopause

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<4mm

Front 31

type 1 vs type 2 endometiral cancer

Back 31

type 1: pre or early moneopause, lowgrade, estrogen reponsive type 2: serous or clear cell, non estogren responsive, late monopause

Front 32

hormone risk for endometrial cancer

Back 32

estrogen without progerterone, OCPs decrease risk because of pregesterone component

Front 33

Treating Cervical cancer

Back 33

Early cervical cancer (contained within the cervix) may be treated equally well with surgery (radical hysterectomy) or radiation. However, advanced cervical cancer is best treated with radiotherapy, consisting of brachytherapy (implants) with teletherapy (whole pelvis radiation) along with chemotherapy, usually platinum-based (cis-platinum), to sensitize the tissue to the radiotherapy.

Front 34

pap smear guidelines

Back 34

start at 21 then every 2 years until 30, can go to every 3 yrs if last 3 normal. Stopped at 65 to 70 with h/o normal pap

Front 35

pap smear post hysterectomy

Back 35

not necessary if removed for benign condition, needed if removed for CIN etc

Front 36

hyperthyroidism + adenexal mass

Back 36

struma ovarii (cystic teratoma),

Front 37

most common tumor in women under 30

Back 37

cystic teratoma

Front 38

lychen scleoris vs lychen planus

Back 38

doesn’t involve vagina vs does

Front 39

endometreosis patients are at risk for

Back 39

infertility, usually adhesions

Front 40

trauma: uterine rupture vs placental abruption

Back 40

uterine rupture more likely to cause hypovolemic shock like picture

Front 41

RH neg testing guidelines

Back 41

RH typing and antibody test at first prenatal visit and repeat antobody test at 28 weeks

Front 42

GDM testing

Back 42

Oral GTT at 24-28 weeks, first 50g at 1 hr (if <140 no further testing) if high then 100g fasting >95, 1hr>180, 2hr>155, 3hr>140

Front 43

testing after first fetal demise

Back 43

coagulaion panel and AUTOPSY of fetus and placenta

Front 44

screening for chlamydia, syphillis, HIV, Hep B and hep C

Back 44

at first visit only at risk / all / all / all / only at risk

Front 45

BUN and Cre in Pregnancy

Back 45

both drop as GFR increases by 40-50% by mid pregnancy

Front 46

severe vomiting in preganancy weeks 4 - 10

Back 46

hyperemesis gravida, supportive treatent, mildly elevated AST ALT bili and amylase, resolves on its own. B-HCG should be done as hydatiform moles can also cause hyperemesis

Front 47

biophysical profile

Back 47

AFI, movements, heart tone, breathing, NST. (8-10 is normal) if <4 dleiver, if 4-6 then contraction stress test

Front 48

OCP effect on fibroids

Back 48

Grow

Front 49

best ultrasound estimator of size even in symmetric and asymetric fetal growth restriction

Back 49

abdominal circumference

Front 50

best birth control in nursing mother

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progesterone only pill

Front 51

normal internal genetalia, abdnomral external genetalia, primary amenorrhea

Back 51

aromotase deficeincy

Front 52

McCune albright

Back 52

café au late, polyOstotic fibrous dysplasia, endocrine hypofunction, precocious puberty (gonadotropin independent)

Front 53

Kallmann syndrome

Back 53

hypogonadotrophic hypogonadism with anosima

Front 54

endometrial biopsy with simple or complex hyperplasia w. out atypia treatment

Back 54

cyclic progestins, if w/ atypia and don’t want more kids then do hysterectomy

Front 55

intermittant vs reccurent decels

Back 55

<50% of contractions usually toleratedvs >50% of contractions needs intervention starting with maternal O2 and repositioning

Front 56

post partum endometritis treatment

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clinda and gent

Front 57

androgen insensitivity surgery

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remove gonads after puberty

Front 58

resolution of vaginal leisons with trichloracetic acid application

Back 58

HPV

Front 59

condyloma lata vs acumulata

Back 59

2ndary sypillis (lay flat) vs warts (accumulate and pile up)

Front 60

uniformly enlarged soft uterus with dysmenorrhea in 30+ woman

Back 60

adenomyosis vs endometrial cancer, if over 35 then have to get an endometrial biopsy

Front 61

adenomyosis vs leiomyomas (fibroids)

Back 61

hard to distinguish because both have dysmenorrhea and bleeding, typically adenomyosis will be uniformly enarged and leimyomas create an irregular shaped uterus

Front 62

physiologic leukorreha

Back 62

normal non-odorous white or yellow discharge without pruritis, can be signifcant

Front 63

bacterial vaginosis criterea

Back 63

ph > 4.5, thin white discahrge, + wiff test, clue cells. Treat with metronidazole

Front 64

raloxifin side effect

Back 64

SVTs, it is a SERM, unlike tamoxifen it does not increase risk of DVTs

Front 65

PH of normal amniotic fluid

Back 65

7-7.5

Front 66

management of SCUS in women >25 vs 21-24

Back 66

If ascus then do HPV DNA --> (+ then do colpsocopy) : (- repeat pap AND HPV in 3 years). Vs repeat pa in 12 months x2 if 21-24

Front 67

post menopausal ovarian mass work up

Back 67

if U/S is non suspeicious and CA-125 are low then observe, but if CA-125 is high or U/S shows irregular nodular >10cm features then recc to gyn onc for investigation

Front 68

HTN before 20 weeks

Back 68

either hydatiform mole or cHTN

Front 69

threatened abortion / inevitable abortion / missed abortion

Back 69

any bvaginal bleeding before 20 weeks / vaginal bleeding and dilated ccervix with visible conception contents / fetus expires in utero but is not discharged

Front 70

post partum lochia

Back 70

lochia rubra blood clots day 1-3, lochia serosa clear serous day 3 - 4, lochia alba white or yellow

Front 71

post parutm leukocysosit, lohcia rubra, low grade fever and chills

Back 71

normal, only worry if uterus is tender or other signs of sepsis or foul smelling discharge

Front 72

testing for patients with famhx of anemia

Back 72

do CBC if normal nothing else is needed

Front 73

best test for primary syphillis

Back 73

darkfield microscopy, VDRL and RPR high false negative in primary, (recall actual diagnosis is with FTA-ABS)

Front 74

fetal station goes backwards during labor

Back 74

red flag for uterine rupture

Front 75

people who get paps before 21

Back 75

HIV, lupus, organ trasplant, etc.. Do it at age of strating sex twice in that year then annually

Front 76

GDM treatment

Back 76

first try dietray modifications goal is fasting <95, if fails diet then go to insulin

Front 77

glactorrhea color and work up

Back 77

can bemilky, gray, green, or yellow, bilateral without mass still need prolactin and TSH levels, anyone unilateral or with mass needs U/S biopsy etc

Front 78

normal AFI

Back 78

>5 but <25

Front 79

b-hcg levels

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double every 48 hrs until peak at 6-8 weeks

Front 80

main effects in pregnancy b-hcg / progesterone / estrogen

Back 80

maintain corpus leuteum / inhbit uterine contraction and prep endometrium for implantation / induction of prolactin production /

Front 81

basic labs in DIC

Back 81

low platlets and low fibrinogen

Front 82

recc anti hypertensives in pregnancy

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labetalol and methyldopa

Front 83

typical time of life for ovarian cx

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perimenopausal

Front 84

random sign of endometreosis you usually forget

Back 84

infertility

Front 85

b-hcg cutoff for visualization abdominal ultrasound vs trans vaginal ultrasound

Back 85

6500 vs 1500

Front 86

culdocentesis

Back 86

trans vaginal aspiration of cul-de-sac peritoneal fluid

Front 87

testing for down syndrome in women >35 at 10 - 12 weeks

Back 87

ultrasound nuchal trnaslucency and chroionic villous sampling w/ FISH. Cant do serum in >35 because its not accurate, 16 -18 weeks can do amniocentesis

Front 88

risks with choriovenous sampling

Back 88

fetal death as well as limb reduction defects if done at 9-10 weeks gestational age

Front 89

what to do in MgSO4 overdose during labor

Back 89

stop MgSO4 and give calcium gluconate

Front 90

irregular lower abdomen contractions in the last 4-8 weeks of pregnancy

Back 90

false labor

Front 91

most common cause of fetal non-reactive NST

Back 91

fetal sleep cycle, can wake up with vibroacoustic stimulation

Front 92

treatment of central precocious puberty

Back 92

all will need brain Ct/MRI and GnRH analog therapy

Front 93

ABX that can be used for UTI in pregnancy

Back 93

amoxicillin, nitrofuratoin, and cephalexin

Front 94

BILATERAL nodular ovarian masses in pregnacny

Back 94

usually just leoma a benign condition in pregnancy caused by Hcg, if unilateral then worry about malignancy and do laproscopy

Front 95

kallmanns syndrome enotype

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46XX

Front 96

first step in amniotic emoblsim dic

Back 96

intubate

Front 97

labs in infertiity due to aging

Back 97

FSH, inhibin B, and clomiphene challenge

Front 98

amenorrhe a in 15 y/o work up

Back 98

if 2ndary sex characteristics then wiat, if not U/S and FSH level --> if elevated FSH then do kayotype, if decreased then do brain MRI

Front 99

all the sings of pregnancy but only normal endometrial stripe on U/S and neg preg test in office

Back 99

pseudocyesis, psychiatric condition, desire for pregnancy so strong that the patient begins to have pregnancy symptoms

Front 100

treatment for teen with intense vaginal bleeding from anovulatroy cycle with neg preg test and no bleeding disorder

Back 100

high dose estrogen

Front 101

non-invasive vaginal squamous cell treatment

Back 101

<2cm do surgery >2cm do radiation