Pance Gyn

Front 1

Medication induced miscarriage/ abortion

Back 1

RU 486 &
Misoprostol

Front 2

Complications from miscarriage/abortion:

Back 2

retained products, infection, uterine scarring

Front 3

1st trimester screening for Down's syndrome?

Back 3

Nuchal translucency & PAPP-a

Front 4

Threatened AB:

Back 4

vaginal bleeding without cervical dilation prior to 20 weeks gestation

Front 5

Complete AB:

Back 5

spontaneous expulsion of all fetal and placental tissue prior to 20 weeks gestation

Front 6

Incomplete AB:

Back 6

some (but not all) of fetal/placental tissue has passed

Front 7

Inevitable AB:

Back 7

cervix is dilated and tissue may be present at cervical os

Front 8

Blighted ovum:

Back 8

gestation sac>17mm but no embryo present (embryo should be seen at 43 days)

Front 9

contributors for spontaneous abortion

Back 9

Increased age, prior miscarriage, smoking, uterine abnormalities, diabetes, progesterone deficiency, thryroid disease & genetics

Front 10

22 y/o female presents to ER with severe LLQ pain, amenorrhea, tachycardia, syncope and orthostatic hypotension. What emergent condition must be ruled out?

Back 10

Ectopic pregnancy

Front 11

Treatment of choice for STABLE ectopic pregnancies?

Back 11

Methotrexate

Front 12

Tests to confirm a viable pregnancy?

Back 12

Serial HCG, progesterone, serial transvaginal ultrasound's.

Front 13

In a viable pregnancy, Quant HCG should double within how many hours?

Back 13

48 hrs

Front 14

At what level of Quant HCG should an embryo be visible on Transvaginal US?

Back 14

1500-2000

Front 15

Gestational trophoblastic disease (GTD) benign form

Back 15

Hydatidiform moles or molar pregnancy

Front 16

Presentation on US of a complete hydatidiform moles?

Back 16

"grape-like vesicles" or a "snowstorm pattern"

Front 17

Clinical presentation of a complete or partial hydatidiform molar pregnancy?

Back 17

abnormal vaginal bleeding, uterine size greater than expected, hyperemesis, or pre-eclampsia like syndrome prior to 20 weeks gestation.

Front 18

Lab tests to confirm a molar pregnancy?

Back 18

Quant HCG >100,000

Front 19

Persistently elevated HCG in a molar pregnancy can indicate:

Back 19

Gestational trophoblastic tumor (GTD)

Front 20

Differentiate complete vs partial molar pregnancy?

Back 20

Complete: no fetal tissue, only parternal chromosome 46XX, & empty egg with only duplicate paternal chromosomes.
Partial: some fetal tissue, both maternal and paternal chrom- 69xxy and 69 xxx & egg fertilized by 2 sperm.

Front 21

Treatment of choice for STABLE ectopic pregnancies?

Back 21

Methotrexate

Front 22

Tests to confirm a viable pregnancy?

Back 22

Serial HCG, progesterone, serial transvaginal ultrasound's.

Front 23

In a viable pregnancy, Quant HCG should double within how many hours?

Back 23

48 hrs

Front 24

At what level of Quant HCG should an embryo be visible on Transvaginal US?

Back 24

1500-2000

Front 25

Gestational trophoblastic disease (GTD) benign form

Back 25

Hydatidiform moles or molar pregnancy

Front 26

Placenta previa:

Back 26

Placental covers cervical os

Front 27

Risk factors for placental abruption:

Back 27

Cocaine use, smoking, trauma, HTN, dec. folic acid, high parity, uterine anmalies, alcoholism, inc. age and thrombophilia

Front 28

Can UTI cause preterm labor?

Back 28

YES

Front 29

3 causes of vaginitis and which of the three can cause preterm labor?

Back 29

BV, trichomonas and yeast.
BV can cause preterm labor

Front 30

Complication of Abruptio placentae:

Back 30

DIC- due to activation of the extrinsic clotting mechanisms.

Front 31

Sign of molar pregnancy

Back 31

Hyperemesis gravidarum

Front 32

Define gestational diabetes

Back 32

elevated BP after 20 wks gestation which resolves by 12 wks postpartum

Front 33

Proteinuria with HTN in a pregnant woman

Back 33

Preeclampsia

Front 34

Eclampsia

Back 34

preeclampsia with seizures

Front 35

HELLP syndrome lab results

Back 35

elevated LDH, AST, ALT AND platelets<100,000

Front 36

gestational HTN: signs of increased severity

Back 36

inc. creatinine, oligohydramnios on US with growth retardation, hyperreflexia, clonus, pulmonary edema, and scrotomata

Front 37

If severe gestational HTN prior to 20 weeks, assess for what?

Back 37

GTD

Front 38

Does pre-existing DMI or DMII have higher risk for shoulder dystocia?

Back 38

DM type 2 has higher risk for shoulder dystocia presentation.
DM type 1 has higher risk for growth restriction.

Front 39

RH incompatibility

Back 39

When mother is Rh negative and babe is Rh positive.

Front 40

Rh factor is also known as?

Back 40

rhesus D factor

Front 41

When should Rho-Gam be administered?

Back 41

28-29 weeks and again after delivery if baby is Rh+.
Also, any time there is a possibility of mother/fetus blood mix (ectopic pregnancy, miscarriage, CVS, amniocentesis or trauma).

Front 42

Rh incompatibility risk to infant?

Back 42

Can cause severe fetal anemia (hemolysis) and death (fetal hydrops).

Front 43

When do you screen for grp B strep?

Back 43

35-37 weeks

Front 44

Treatment for group B strep if patient is + or if status is unknown in a laboring patient

Back 44

PCN

Front 45

80% of Premature rupture of membranes is caused by?

Back 45

Infection

Front 46

gestational HTN: signs of increased severity

Back 46

inc. creatinine, oligohydramnios on US with growth retardation, hyperreflexia, clonus, pulmonary edema, and scrotomata

Front 47

If severe gestational HTN prior to 20 weeks, assess for what?

Back 47

GTD

Front 48

Does pre-existing DMI or DMII have higher risk for shoulder dystocia?

Back 48

DM type 2 has higher risk for shoulder dystocia presentation.
DM type 1 has higher risk for growth restriction.

Front 49

RH incompatibility

Back 49

When mother is Rh negative and babe is Rh positive.

Front 50

Rh factor is also known as?

Back 50

rhesus D factor

Front 51

Most common cause of secondary amenorrhea

Back 51

Pregnancy

Front 52

What hormone signal is needed for follicle maturation and production of estradiol?

Back 52

FSH

Front 53

Which hormone release is part of the secretory phase?

Back 53

Progesterone

Front 54

it causes follicular rupture, ovulation and establishes the corpus luteum?

Back 54

LH

Front 55

Estrogen

Back 55

Causes grow of the endometrium

Front 56

GnRH is released from?

Back 56

Hypothalamus

Front 57

LH and FSH are released from where?

Back 57

Pituitary

Front 58

Ovaries release which hormones?

Back 58

Progesterone and estrogen

Front 59

Luteal phase= ?

Back 59

secretory phase

Front 60

Monophasic basal body temperature indicates what?

Back 60

anovulatory cycle

Front 61

mid cycle spotting indiactes what?

Back 61

decline in estrogen that occurs immediately prior to the LH surge

Front 62

Progesterone withdrawal signals what?

Back 62

onset of menses

Front 63

post-Menopausal woman not on HRT would have ? level of FSH and LH

Back 63

HIGH on both

Front 64

function of prolactin

Back 64

Lactation. Plus synthesis & release of progesterone by ovaries and testosterone by the testes.

Front 65

Menorrhagia

Back 65

excessive amount of vaginal bleeding or duration of bleeding

Front 66

metorrhagia

Back 66

bleeding between menstrual periods

Front 67

menometrorrhagia

Back 67

excessive amount of blood at irregular frequencies

Front 68

define secondary amenorrhea

Back 68

No menstruation for 6 months or more in a woman who was previously menstruating regularly

Front 69

Second most common reason for secondary amenorrhea

Back 69

Hypothalamic hypoganadism

Front 70

Premature menopause cause

Back 70

smoking, chem, radiation or anything that limits the ovarian blood supply.

Front 71

Progesterone challenge yields a bleed.. what does that mean?

Back 71

Pt is producing at least 40 pg/ml of estrogen and has a functioning endometrium.

Front 72

Progesterone challenge fails .. what do you check next?

Back 72

FSH

Front 73

Progesterone challenge fails, FSH is high in a secondary amenorrhea- Diagnosis?

Back 73

Gonadal failure.....

Front 74

Progesterone challenge fails, FSH is low in a secondary amenorrhea- Diagnosis?

Back 74

Hypothalamic dysfunction

Front 75

Dysfunctional uterine bleeding in teenagers- Cause?

Back 75

anovulation

Front 76

Galactorrhea and no menstration

Back 76

Hyperprolactinemia

Front 77

Median age for menopause

Back 77

51

Front 78

Halban's syndrome

Back 78

persistence of a corpus luteum with delayed menses, pelvic mass and (-) HCG

Front 79

an anti-estrogen

Back 79

Progestin

Front 80

Initial work up for 25 y/o with secondary amenorrhea >6 months

Back 80

Pelvic, PAP, HCG, Prolactin and a progesterone challenge

Front 81

Menopause causes decline in which hormones?

Back 81

estrogen and androstenedione.
Progesterone is absent.

Front 82

Which hormone increases in circulation with menopause

Back 82

testosterone

Front 83

Cause of mild hirsutism in menopause?

Back 83

inc. in free androgen to estrogen ratio

Front 84

Reason for increase in vaginitis with postmenopause

Back 84

vaginal ph rises allowing increase in bacteria

Front 85

"strawberry cervix"

Back 85

Trichomonas

Front 86

"Clue cells"

Back 86

Gardnerella vaginitis

Front 87

Normal vaginal ph

Back 87

3.8 - 4.4

Front 88

Venereal warts are caused by

Back 88

HPV types 6 & 11

Front 89

HPV type associated with cervical cancer

Back 89

16, 18, 31

Front 90

When can't a woman take Flagyl?

Back 90

During her first trimester.

Front 91

Vulvular ulcer with vague border and gray base?

Back 91

chancroid caused by Haemophilus ducreyi

Front 92

;Condylomata is often seen with which other STD?

Back 92

Trichomonas Vaginitis

Front 93

Disseminated gonococcal infection can cause what?

Back 93

Septic arthritis

Front 94

Treatment for gonorrhea

Back 94

Ceftriaxone and doxy

Front 95

maculopapular rash on palms and soles

Back 95

Secondary syphilis

Front 96

PID is most often caused by?

Back 96

N. gonorrhea and C.trachomatis

Front 97

adnexal tenderness, cervical & uterine tenderness and abdominal tenderness..

Back 97

PID

Front 98

common site of implantation in ectopic pregnancy

Back 98

ampulla of fallopian tube

Front 99

Is the HCG lower or higher in ectopic pregancy vs intrauterine pregnancy?

Back 99

HCG is lower in ectopic pregnancy than intrauterine pregancy.

Front 100

Anterior pituitary necrosis following post partum hemorrhage and hypotension.

Back 100

Sheehan's syndrome

Front 101

exotoxin of Staph aureus

Back 101

Toxic Shock Syndrome

Front 102

Toxic shock syndrome critieria

Back 102

T> 38.9 C, rahs, hypotension, involvement of 3 organs and neg tests for RMSF, Hep B, measles, leptospirosis and VDRL

Front 103

Treatment for TSS?

Back 103

Fluids, FFP, vaginal irrigation, and either nafcillin or oxacillin.

Front 104

uterine synechiae" or intrauterine adhesions

Back 104

Asherman's syndrome

Front 105

How to you diagnose dysfunction uterine bleeding?

Back 105

Exclusion of pathologic cause for abnormal uterine bleeding makes the diagnosis

Front 106

Treatment for DUB?

Back 106

Converting proliferative (estrogent) to secretory (progesterone) endometrium corrects most acute DUB-
Provera 10 mg x 10 days
High dose estrogen to stabilize followed by progesterone

Front 107

DX for DUB?

Back 107

HX, low progesterone levels, absence ovulatory temp rise

Front 108

progesterone inhibits what?

Back 108

pituitary gonadotropins

Front 109

Diagnosis of chronic pelvic pain?

Back 109

by exclusion but usually from exacerbation of dysmenorrhea pain from baseline during CPP episode

Front 110

Primary dysmenorrhea

Back 110

no organic cause, pain with menses due to production of prostaglandins

Front 111

Secondary dysmenorrhea etiology

Back 111

Pathologic cause such as endometriosis, fibroids, muscle tumors, ovarian cysts, PID, or IUD.

Front 112

Pain with menstruation

Back 112

Mittleschmerz

Front 113

Dysmenorrhea tenderness is more ______ than ________

Back 113

uterine than adnexal

Front 114

cervical motion tenderness, pelvic pain, purulent discharge

Back 114

PID

Front 115

Relative contraindications for IUD

Back 115

Nulliparity, previous ectopic pregnancy, STD, severe dysmenorrhea, uterine abnormalities, anemia and young age

Front 116

Stein-Leventhal syndrome

Back 116

PCOS

Front 117

String of Pearls presentation within ovaries

Back 117

PCOS

Front 118

why are patients with PCOS are at higher risk for endometrial hyperplasia and carcinoma?

Back 118

Unopposed estrogen

Front 119

Presentation of PCOS

Back 119

Infertility, male hair pattern, truncal obesity, intractable acne and either oligomenorrhea or amenorrhea

Front 120

treatment for hirsutism

Back 120

Weight loss and androgen lowering agents- OCP.

Front 121

Clinical features of Endometriosis

Back 121

deep thrust dypareunia,dyschezia, intermittent spotting and pelvic pain. As well as tender nodularity of the cul-de-sac and uterine ligaments

Front 122

Treatment for endometriosis

Back 122

Depends upon severity of symptoms, location and severity of disease as well as whether or not patient has desire for childbearing

Front 123

treatment for DUB

Back 123

Cyclic progesterone and progestin OCP

Front 124

If fertilization does not occur:

Back 124

Corpus luteum deteriorates. Estrogen and progesterone levels drop. The blood vessel lining sloughs off, and menstruation