Ob/gyn Usmle Step 3

Front 1

management for ascus

Back 1

reflex hpv testing
if high risk hpv, then colpo/bx
if low risk hpv, then repeat pap in 1 yr

Front 2

management for ASC-H, LSIL, HSIL

Back 2

do not need to do hpv testing
go straight to colpo/bx

Front 3

how is a dx of cin made

Back 3

it is the path description of the bx taken from ascus, etc

Front 4

management for cin i

Back 4

low likelihood to progress to cin ii/iii, can f/u pap q6mo x1 yr, it continues to be abnormal --> LEEP

Front 5

management for cin ii

Back 5

LEEP

Front 6

management for cin iii

Back 6

LEEP

Front 7

what does high afp mean

Back 7

ntd, ventral wall defect, inaccurate dates

Front 8

what does a low afp mean

Back 8

down syndrome, fetal demise, inaccurate dates

Front 9

what to do if afp is abnormal

Back 9

get u/s to r/o inaccurate dates or other abnormalities

Front 10

when should acyclovir be given to a woman with hsv

Back 10

4 weeks prior to delivery

Front 11

risk factors for placental abruption

Back 11

htn
trauma
polyhydramnios
cocaine

Front 12

tx of choice for htn in pregnancy

Back 12

labetolol
hydralazine

Front 13

when should rhogam be given in rh - moms

Back 13

at 28 weeks, and within 72 hrs p partum

Front 14

does an rh - mother who has rh antibodies in large titer amounts need rhogam

Back 14

no, it's too late for her.... just monitor the fetus

Front 15

how to manage a pregnant woman with anti-phospholipid syndrome who has recurrent sabs

Back 15

low dose asa and low dose heparin

Front 16

which tb medication should be avoided in pregnancy
why

Back 16

streptomhcin
--> nephrotoxic, deafness

Front 17

tx of post-partum endometritis

Back 17

gentamicin and clindamycin (both)
metronidazole can also be used for anaerobe coverage, but cannot be used in breastfeeding women

Front 18

complications of preganancy associated with adolescent mothers

Back 18

increased prenatal mortality
preterm delivery
lbw
prematurity

Front 19

should asx pts w trich be treated

Back 19

yes (they will eventually become symptomatic)

Front 20

why are sulfa drugs contraindicated in pregnancy

Back 20

they will displace bilirubin in neonate --> hyperbili

Front 21

cardiac complications associated wtih maternal dm

Back 21

fetal cardiomyopathy, chf, hypertrophic intraventricular septum

both are 2/2 increased glycogen deposits within mycoardium --> hypertrophy

Front 22

tx of fetal cardiac complications from gestational dm

Back 22

most will correct themselves without intervention

Front 23

ebstein's anomaly: what is it, what agent is implicated in it

Back 23

atrialized right ventricle) --> tr and cyanosis
lithium during pregnancy

Front 24

what % chance does a woman with CF have to get pregnant
man with cf?

Back 24

20%
5%

Front 25

management for bloody nipple d/c (unilat)

Back 25

mammography

Front 26

describe rash in herpes gestationis
tx

Back 26

plaques, papules surrounding ubilicus.
steroids (tramcinolone)

Front 27

tx of pregnancy induced pruritis

Back 27

steroids, antihistamines, oatmeal baths

Front 28

describe rash in PUPPP
tx

Back 28

pruritic red papules within striae
steroids

Front 29

how thick does endometrial stripe have to be before doing bx

Back 29

>4mm

Front 30

risks associated wtih subchorionic hematomas

Back 30

sab
bleeding

Front 31

how to manage subchorionic hematomas

Back 31

repeat u/s

Front 32

which steroids can be given to enhance fetal lung maturity

Back 32

beta methasone
dexamethasone

Front 33

which hormone is found in the morning after pill
ideally when should pill be takne

Back 33

levonorgestrol
w/i 12 hrs of intercourse

Front 34

when can copper T be used as emergency contraception

Back 34

up to 120 hrs after intercourse

Front 35

tx pf cpmdu;p,ata aci,omata

Back 35

surgical excision
chem destruction (trichloroacetic acid, internal use ok, safe in preg; podophyllin, not used in preg, only for external use)

Front 36

complications associated with retroverted uterus

Back 36

incareration in second trimester orf pregnancy can occur, so must be manually repositioned.

Front 37

tx for chlamydia in pregnancy

Back 37

erythromycin base (doxycycline is contraindicated)

Front 38

complications of scuba diving during pregnancy

Back 38

gas emboli to fetus
decompression injury

Front 39

complication of hpv during pregnancy
how great is risk

Back 39

can be passed to fetus during labor passing through birth canal.
--> recurrent respiratory papillomatosis (benign laryngeal tumor)
<1% in vag deliveries, no need for c/s

Front 40

how to manage pt with uterine bleeding --> unstable hemodynamics

Back 40

give IV estrogen

Front 41

how to manage pt with dysfxnal uterine bleeding who is stable

Back 41

progesterone and estrogen (COC)

Front 42

guidelines for tetanus toxoid

Back 42

ppl with contaiminated would and last tetanus dose >5 y.a
those with clean wounds and last vaccine >10 y.a

Front 43

who gets tetanus immunoglobulin

Back 43

all with <3 doses of vaccine or unknown status

Front 44

how to eval breast mass in woman <35

Back 44

FNA or excision

Front 45

#1 cause of post-partum hemorrhage
how to manage

Back 45

uterine atony
if no evidence of retained placenta, give uterine massage, then oxytocin if persists, then uteroine artery ligation if still persists

Front 46

what must be used in combination with a pessary? why?

Back 46

estrogen cream
otherwise --> d/c, bleeding 2/2 to injury to vaginal tissue from pessary

Front 47

which antiepileptic should be used in pregnancy

Back 47

whichever one works the best, although they all have risk of teratogenicity, therefore check for NTD early

Front 48

can women on anti-epileptics breastfeed

Back 48

yes

Front 49

how to tx a pregnant woman with tb (not mdr)

Back 49

same way as non-pregnant:
INH, RIF, ethambutol

Front 50

how to tx a pregnant woman with suspected mdr-tb

Back 50

same as non-pregnant:
INH, RIF, ethambutol, pyrazinamide

Front 51

how does pregnancy affect thryoid hormone levels

Back 51

there is increased tbg, so an increased overall amt of t4 and t3, but the free amounts should be the same

Front 52

how does pregnancy affect the amount of thyroid hormone supplementation a person needs

Back 52

need more b/c increased tbg

Front 53

lab findings of gestational transient thyrotoxicosis
how long does it last

Back 53

mildly elevated fT4, and slightly lower TSH
resolves by 14 wks

Front 54

dx of true hyperthyroidism during pregnancy

Back 54

TSH <0.01
extremely elevated fT4

Front 55

why is hydrocortisone not effective in causing fetal lung maturity

Back 55

most of it is metabolized by placenta, very little actually reaches the fetus

Front 56

when can a fetus have external version to correct breech lie

Back 56

after 37 weeks if there is no contraindication to vaginal delivery and no fetal distress

Front 57

criteria for gestational thrombocytopenia

Back 57

mild and asx development of thrombocytopenia late in pregnancy
no h/o thrombocytopenia aside from pregnancy
spontaneous resolution of plt post partum

Front 58

etiology of hiv associated thrombocytopenia

Back 58

infx
malignancy
mediations
hypersplenism
ttp
dic

Front 59

plt threshold for likly itp

Back 59

<50,000

Front 60

how to handle an inadequate pap smear sample

Back 60

if from a woman with low risk factors and previously nml pap, no need to repeat.
if abnml pap and lots of risk factors, should repeat in 4-6 months

Front 61

best form of contraception in scd

Back 61

depot shot (easy compliance and may decrease # of crises)

Front 62

problems with using copper t in scd

Back 62

may cause some bleeding which can worsen scd

Front 63

absolute contraindications to ocps

Back 63

h/o stroke/thromboembolic event
liver dz
h/o estrogen dependent tumor
pregnancy
abnormal uterine bleeding
smoker >35 yo
high TG

Front 64

relative contraindications to ocps

Back 64

migraines
poorly controlled htn
anticonvulsants

Front 65

# complication of cvs, what increases its risk

Back 65

transverse limb abnormality
more likely if done <9 wks ga