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OB/GYN
STEP 2 UWORLD
| Question | Answer |
|---|---|
| What are contraindications in patients with placenta previa? | No digital cervical examination and no intercourse |
| What is the possible consequence of cervical manipulation in patients with Placenta Previa? | Severe painless hemorrhage |
| What is typically the 1st manifestation of female puberty? | Breast bud development |
| How long after breast bud development is a female expected to have menarche? | 2-2.5 years |
| Menarche and puberty should be achieved by what age? | <15 years old |
| When levothyroxine should be ↑ in hypothyroid pregnant women? | Now she knows about her current preganacy |
| What is the treatment option for Vulvar Lichen Sclerosis? | Clobetasol (high potency topical steroid) |
| How is vulvar lichen sclerosis presented? | Pre-pubertal girls with intense pruritis and thin, white lesions of the vulva and peiranal region |
| At what point (weeks) are all pregnat women screened for gestational diabetes? | 24-28 weeks |
| What are R/Fs that intitle a woman to be screen earlier for gestational diabetes? | Obesity and Hispanic heritage |
| What is tocolysis? | Inhibition of contractions |
| What are risks/effects of using Indomethacin in a pregnant woman? | Oligohydramnios and premature closure of PDA |
| At what point (gestational age) does the benefits of Indomethacin use outweigh the risks? | Preterm labor at <32 weeks |
| Infertility in woman >35 years old. | Failure to conceive in 6 months of unprotected sex |
| What is used to diagnose an anatomic issue leading to infertility in a woman? | Hysterosalpingogram |
| What are the criteria for diagnosing recurrent UTI? | 2 or more infections in 6 months, or 3 more infections in 1 year |
| What are preventive measures for recurrent UTIs? | 1. Behavior modification 2. Postcoital or daily antibiotic prophylaxis 3. Topical vaginal estrogen for post-MP women |
| What is the NBSM in post-MP women with endometrial polyps? | Hysteroscopic polypectomy for adequate evaluation of endometrial hyperplasia/cancer |
| How does tobacco smoking affect endometrial cancer? | Reduces the chances of endometrial cancer |
| What is the main R/F for endometrial cancer? | Excessive uterine estrogen exposure (MC obesity, chronic anovulation) |
| Gout and which genitourinary condition are decreased by smoking? | Endometrial cancer |
| When is the antennal GBS screening done? | Rectovaginal culture at 36-38 wk. gestation |
| What are the indications for GBS intrapartum prophylaxis? | 1. GBS bacteriuria or GBS UTI in current pregnancy 2. GBS (+) rectovaginal culture in current pregnancy 3. Unknown GBS status + any of the following: a) <37 wk. gestation b) Intrapartum fever c) Rupture of membranes > or equal 18 hrs. 4. Prior infant with early-onset neonatal GBS infection |
| What antibiotic is used for GBS prophylaxis? | IV penicillin |
| What is the workup in patient with low/average risk for Ovarian cancer? | No screening necessary |
| What is the main stratification for ovarian cancer screening? | Family HX for Ovarian cancer |
| How is Pelvic Organ prolapse? | Pelvic pressure, urinary retention, incontinent, and obstructed voiding. |
| What are common R/Fs for Pelvic Organ prolapse? | Multiparity, post-MP age, hysterectomy, and obesity |
| What is the definition of labor? | Painful, regular contraction that causes cervical change |
| What is "false" labor? | Mildly painful, irregular contractions with no cervical change |
| What is the infectious cause of chorioamnionitis? | Polymicrobial |
| What is the best TX for Chorioamnionitis? | Broad-spectrum IV antibiotics and expedited delivery to ↓ neonatal and maternal morbidity |
| What is the best form to minimize risk of errors in cases of hierarchy-based barriers? | Teamwork and safety culture interventions |
| How are symptomatic fibroids clinically described? | Associated with heavy periods and an enlarged uterus with irregular contour |
| When is surgery indicated for uterine fibroids? | Only in symptomatic patients that are done having kids |
| Urinary incontinence due to pre-labor or rupture of the uterine membrane will have fluid that will test: | Nitrazine and Fern negative testing |
| What is the most accurate 1st trimester measurement for Estimated Gestational Age (EGA)? | U/S dating with fetal crown-rump measurement |
| Which trimester is the only one in which the EGA can be modified to adjust for discrepancies? | 1st trimester only |
| What is the most important risk factor for uterine rupture? | Prior uterine surgery, especially a previous C-section. |
| What are minor risk factors for Uterine rupture? | 1. Short interpregnancy interval (<6-18months) 2. Maternal age >35 |
| How is Uterine rupture clinically presented? | Sudden onset of abdominal pain, vaginal bleeding, fetal decelerations, and an irregular abdominal mass |
| What is the irregular mass(es) seen or felt in Uterine rupture? | Protruding fetal parts |
| What is the overall MCC of abruption placentae? | Vasoconstriction |
| What is abruptio placenta? | Premature placental separation from the uterus |
| What is prophylaxis TX for pre-eclampsia? | Low-dose aspirin |
| What is the time range to administer pre-eclampsia prophylaxis? | 12-28 wks., but best if given before 16wk. |
| What would be the best way to adapt and prevent errors in clinical emergencies, such as McRoberts maneuver, in a hospital setting? | Simulation-based training |
| What is the next step in management in a pregnant patient with a Pap smear demonstrating high grade squamous intraepithelial lesions? | Immediate colposcopy |
| What is Pseudocyesis? | Persistent, non-delusional belief of being pregnant |
| What are S/S seen with Pseudocyesis? | Symptoms of early pregnancy such as morning sickness and abdominal distension. |
| How is Pseudocyesis diagnosed over true pregnancy? | Pregnancy test is negative and U/S reveals and empty uterus |
| What is the finding of an empty uterus on ultrasound? | Thin endometrial stripe |
| What is MCC of 1st trimester fetal growth restriction? | Chromosomal anomalies |
| What is the 2nd MCC of 1st trimester fetal growth restriction? | Torches infections |
| How is magnesium-sulfate toxicity clinically presented? | Absent patellar reflex, respiratory depression/paralysis, and cardiac arrest. |
| What is the treatment for Magnesium-sulfate toxicity? | Calcium gluconate |
| Thin endometrial stripe indicates --> | Empty uterus |
| What is the best test to DX uterine fibroids? | Pelvic ultrasound |
| What is the most significant risk factor for breast cancer? | ↑age |
| What are minor risk factors for breast cancer? | ↑estrogen exposure, family HX (BRCA1/2) |
| What are clinical manifestations that indicate possible breast cancer? | Skin changes (peau d'orange), nipple d/c, axillary lymphadenopathy, palpable (nontender) breast mass, and abnormal mammogram |
| What is NBSM in post-MP woman with vaginal bleeding persistent despite use of OCPs? | Endometrial BX to check for hyperplasia/cancer. |
| What is the role or use for the Progesterone withdrawal test? | Evaluate secondary amenorrhea in case it is due to low estrogen. |
| How is secondary amenorrhea defined? | No menses >6 months in pts w/ previous irregular menses |
| What is another name for Mullerian Agenesis? | Mayer-Rokitansky-Kuster-Hauser syndrome |
| What test is often recommended in a patient with Mullerian agenesis? | Renal ultrasound |
| Why is a renal U/S often required in Mullerian Agenesis patient? | The urogenital development and the development of the uterus, cervix, and upper 1/3 of vagina, share a common embryologic source |
| What is a common complication of PID? | Tuboovarian abscess |
| How is tuboovarian abscess described clinically? | Fever, diffuse abdominal pain that gradually worsens on one side, and both uterine and adnexal tenderness |
| What the U/S findings in a tuboovarian abscess caused by PID? | Complex multiloculated adnexal mass with thick walls and internal debris |
| Common contraindication, related to blood pressure, for use of OCPs? | Patients with HTN, and those who develop hypertension takin OCs should discontinue the medication |
| What is an adverse effect to a Cold Knife Conization? | Deleterious effects on future pregnancy |
| What and when is Cryosurgery used in cervical cancer? | Liquid nitrogen treatment for High-grade Squamous Intraepithelial lesions in diagnosed patients |
| What is the normal menstrual cycle (according to RX and First aid)? | 21-35 days |
| How can ovulation day be calculated? | X (cycle time) - 14 |
| What histological description indicates endometrial cancer? | Small, rough, regular glands growing in confluent pattens back-to-back glandular tissue without connective tissue in btw |
| What is the main etiology for development of endometrial cancer? | Unopposed estrogen exposure over a prolonged period of time |
| What hormonal elevated levels are almost pathognomonic for premature ovarian failure? | High FSH and LH |
| How is POF and Complete insensitivity syndrome different? | Estrogen is expected elevated in Complete insensitivity syndrome |
| What is checked in a man for infertility? | Semen analysis |
| What are the labs or tests done to diagnose infertility in a woman? | Hormonal profile, pelvic ultrasound and hysterosalpingogram |
| What are protective measures for endometrial cancer development? | Combined OCPs, late menarche, early menopause, and multiparity |
| What is the surgical treatment for localized endometrial cancer? | Total hysterectomy with bilateral salpingo-oophrorectomy |
| Unilateral bloody nipple discharge with normal imaging and normal physical exam and breast size. DX? | Benign intraductal papilloma |
| What is the NBSM for intraductal papilloma? | Surgical duct excision and complete removal of any identified tumor |
| How is the discharge of candida vulvovaginitis described? | Thick, curdy, white adherent to walls of vagina |
| What is the treatment of choice for candidal vaginitis? | PO fluconazole |
| What is the best or most definitive test to DX endometriosis? | Direct visualization (±bx) of ectopic endometrial tissue via laparoscopy |
| What is a contradiction for a Copper IUD? | Setting of active infection or a HX of pelvic infection in the last 3 weeks. |
| How does Levonorgestrel prevent pregancy? | Prevents/delay ovulation by preventing egg fertilization by affecting the cervical mucus and/or ability of sperm to bind to egg. |
| What is the Yuzpe method? | cOCPs taken in doses; Progestin + Estrogen 1st dose as soon as possible, w/ 2nd dose 12 hrs. later. |
| MOA of Copper IUD: | Prevents fertilization by causing chemical change in sperm and egg before they can meet. |
| What is the cause of primary dysmenorrhea? | Excess production of prostaglandins in the endometrium |
Created by:
rakomi
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