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Front 1

Palp of the vertex at the fundus indicates this fetus is in the ____. The majority of breech presentations will ______. ____ is best option.

Back 1

breech position, self correct by the 37th week of gestation. Therefore any attempt to convert breech into vertex is not indicated before the 37th week. Routine follow up is best option.

Front 2

External cephalic version is indicated if breech presentation is persistent after ___ wks, and if this fails, then ____ is indicated.

Back 2

37, planned cesarean delivery

Front 3

Risk factors that incr likelihood of osteoporosis include

Back 3

adv age, thin body habitus, cig smoking, excessive alcohol use, corticosteroid use, menopause, malnutrition, FH of osteo, and Azn or white ethnicity

Front 4

Infants born to pts w Graves dz treated w surg are at risk for thyrotoxicosis bc of the passage of

Back 4

passage of thyroid stimulating immunoglobulin across the placenta. In many pts w Graves, circ lvls of TSI remain as high as 500x nl for several months following thyroidectomy. They are IgG and stim fetal thyroid gland.

Front 5

Char for uterine fibroids:

Back 5

Dysmenorrhea, heavy menses, and an enlarged uterus is classic. Dull pelvic sensation. No pain on intercourse.

Front 6

Inhaled steroids ___ in pregnancy.

Back 6

Can be used. Lithium should be weened in stable bipolar preg pts and isoretnoin stopped.

Front 7

Preg is assoc w ___ in Thyroid binding globulin, and resulting in _____ total T4 and T3, a ____ free T4 and T3, and ____ TSH.

Back 7

incr, incr, normal, normal. Thyroid fxn during preg is affected by 2 things: incr in TBG conc and stim of TSH-R by hCG. An incr in circ estrogen lvls during preg leads to an incr in prod of TBG.

Front 8

Indications for GBS prophylaxis when GBS status is unknown:

Back 8

delivery at < 37wks, Duration of memb rupture >=18hrs, GBS bacteriuria in any conc during the current preg, Prior history of deliv of an infant w GBS sepsis. They get penicillin.

Front 9

Asymmetric causes Etiology of IUGR:

Back 9

Maternal factors: Maternal HTN, preeclampsia, uterine anomalies, maternal antiphos synd, collagen vasc dz, maternal cig smoking. better prog than symmetric IUGR.

Front 10

Symmetric causes Etiology of IUGR:

Back 10

Fetal factors: Chromosomal abnormalities, Congenitalanomalies, Congenital infs (TORCH)

Front 11

The most common cause of mucopurulent cervicitis, asymptomatic in more than 50% of women:

Back 11

MCC of mucopurulent cervicitis is Chlamydia trachomatis.

Front 12

Can be attempted in women w breech pregs greater than 37 wks gest age if there are no CIs to vag deliv and fetal well being has been established

Back 12

External cephalic version. This lady was at 37 weeks demonstrating a breech presentation.

Front 13

Management of placenta previa depends on severity of bleeding and age of preg. Complete placenta previa reqs deliv by c-section as the placenta covers the os cervix completely and fetus cannot be delivd vaginally.

Back 13

Conserv management at home is not done for this lady bc risk of recurrent bleeding is high. Only considered in instances where pt is stable, fetal well being, and pts house is nearby.

Front 14

In Pts w Turners they have ____ FSH.

Back 14

high, because due to lack of neg feedback.

Front 15

In preg pts, asymptomatic baceriuria incr the risk of cystitis, pyeloneph, preterm birth, and perinatal mortality. E coli accounts for more than 70% of cases. Tx in preg consists of

Back 15

7day course of nitrofurantoin, amox or a 1st gen cephalosporin.

Front 16

In premenopausal women w simple or complex hyperplasia WO atypia, the tx of choice is

Back 16

cyclic progestins. Total hysterectomy is tx of choice in premenopausal women dx w complex hyperplasia W atypia who have completed child bearing. Risk of progression to uterine cancer in Endometrial hyperplasia types: Simple 1%, Complex 3%, Simple atyp 8% Complex atyp 29% Penny, nickel dime, quarter

Front 17

14 yo girl irregular menstrual periods, menarche at 13, irregular w cycles varying from 3 to 6wks since then, no other syx, age approp 2nd sex chars, urine preg neg, nl serum prolactin and tsh, admin of micronized oral prog results in wd bleeding in 3 days. Most liekly explaination?

Back 17

Insufficient gonadotropin secretion (immaturity of HPG axis not producing adequate quantities and proportions of LH and FSH

Front 18

Kallman's syndrome presents w

Back 18

primary amenorrhea and anosmia. Nl female karyotype 46 XX and will have lab findings of GnRH def (low FSH and LH). Absent secondary sex chars such as breast dev and pubic hair.