1
Q
GDM screening and confirmation test
A
1hr GTT <180 normal
confirm with
3hr GTT<140 Normal
2
Q
Recommendation and first line 4 GDM
A
Diet and exercise
insulin
3
Q
Hx of 2nd tri pregnacy loss
treatment
A
place a cerclage
4
Q
contraindication to cerclage
A
exercise
5
Q
prego + hyperglycemia dt which hormone and causes
A
hi HPL–>hi insulin resistance
polyhydromniom
large baby
hypoglycemic seizure after birth
6
Q
Chronic DM complication
A
Hypertrophic cardiomyopathy
sacral agenesis
limb fusion…
7
Q
weight gain
BMI 17 underweight
A
20-40lb
8
Q
weight gain
BMI 23 normal
A
25-35lb
9
Q
weight gain
BMI 27
A
15-25LB
10
Q
weight gain
Obesity
A
11-20lb
11
Q
39yo fm + sweating and palpatation + skin pigmentation+ levothyroxin
A
premature ovaria failure
12
Q
19yo vaginal pH 4.5, perinal discomfort, hyphae seen
A
candida
antifungal cream
oral fluconazole
13
Q
Vaginal fishy smell : BV
A
Metronidazole
no need to treat partner
14
Q
GET GAP on Metro
A
Giardia
Entermeaba hystalytica
Trich
Gardnerella
Anerobic c.diff
pylori
15
Q
greenish discharge and pontit hemorraghe
A
trichomonas vaginalis
16
Q
which hormon is low during menopause
A
Estrogen
17
Q
when to avoid estrogen and progestion for HRT post menopausal
A
Hepatic adenoma
stroke/headach
estrogen responsive maligancy
18
Q
menopausal with osteoporosis NBS
A
bisphosphonate or Reloxafen
19
Q
electrolyte and acid base
hyperemesis gravidarum causes a state of
A
hypokalemia, hypochloremia and met Alkalosis
20
Q
hyperemisis gravidarum associated with
A
gestational trophoblastic DZ
21
Q
treatment for morning sickness
A
B6
Doxilamine
eat small portion
22
Q
chronic HTN
A
HTN prior to pregancy
23
Q
HTN> 20wks with BP > 140/90
A
Gestational HTN
No proteinuria
24
Q
>
HTN+ proteinuria(>300mg/day)
endothelia dysfunction
A
pre-eclampsia
25
most important risk factor for pre-eclampsia
Prior history
26
pre-eclampsia+severe feature
| treatment
BP> 160/110
| Magnisium
27
important sign for Mag tox
low DTR
| give Ca gluconate
28
Preg+HTN+siezure
EClampsia
| Benzo and delivery
29
Preeclampsia with severe features
HELLP NBS
Immediate delivery
Hemolysis
Elevate Liver enzyme
low platelett
30
hypoplastic Rt Ventricle, downward displacement of tricuspid
| prego bipolar (menia) treatment
lithium
| Haloperidol
31
tooth discoloration
tetracycline
32
cartilage/tendon rupture/damage
floroqueolone :ceprofloxacine
33
Stappling of the epiphysis
anticoagulant contraindicated in prego w/ DVT
Warferin
34
Clear cell in next generation
causes T-shapped uterus
DES use
35
Renal problem in fetus
ACE/ARB
36
Gray baby
Chlorampheacol
37
Med causes Kernicterus
TMP-SMX- Bactrum
38
SMooth filtrum
Alcohol
39
IUGR, hypoplastic nail, microcephaly, cleft lip
Medication?
phenytoin
40
35yo +smoke+ migraine+hepatic adenoma--avoid
OCP
41
Newborn that is gittery
think withdrawal
| give methadone
42
cocain use in preg
Abroptio placente
painful 3rd tri bleeding
43
regular use of NSAID
closes dutus arteriosis
44
male pt +HRT failure +gynecomastia give?
spironolactone
45
4wk postpartum +fever+breast tenderness +erythema
mastitis
| dicloxacillin
46
<30yo w/ multiple breast mass that response to cycle
NBS: US
fibrocystic changes
47
# >30yo
single well define painless breast mass
fibroadenoma
48
Bloody napple discharge
intraductal papiloma
49
49yo w/ large breast mass + leave like structure on histology
phyllodies tumor
50
male breast cancer inheritance
BRCA 2
51
MC location for breast cancer
upper outer quadrant
52
should breast feeding mother take estrogen OCP? Why
No: inhibition of breast milk
53
some benefits of progesterone only OCP
thickening cervical mucus
protect against endometrial cancer
54
contraindication for progesterone only OCP
progesterone receptor cancer
Lobular carcinoma insitu/invassive
55
progestione only cause
low bone mineral density
hi weight gain
prolonged returned to normal fertility
56
mastitis
first line meds
continue to breast feed
Dicloxycillin
57
Breast feeding and hi prolactin state-->
lowest HPG axis
low risk of breast cancer
low ovarian cancer (less ovalation)
low pregancy weight gain
58
infant with Galactocemia: contraindication
| enzyme involve
to breast feeding
| galactose-1-phosphate uridylyltransferase (GALT)
59
# timeline
postpartum blues
2 wks
60
# NBS
postpartum psychosis
hospitalize
antipsychotic
61
Postpartum depression
2wks
SSRI
62
Post C-section risk
fever +low abdominal pain
endometritis
63
Tx endometritis
Clindamycin/Gentamycine
64
Chorioamnonitis risk factor
prologed rupture of membrane
65
mom fever + baby tach (>160 hrt), foul amnion
| nbs
Ampicillin +Getamyci
covers listeria
| listeriosis: stillborn with abscesses
66
ruputure membrane for >18hr: NBS
GBS prophalysis
Strep agalacia
67
always watchout for no discript question asking for B-HCG or for screening
68
# recently pregnant
Blue/purple cervics ad vagina
normal sign of pregnancy
Chardwick sign
| dt increase blood flow
69
Chloasma
blotchy pigmentation of face
mask of pregnancy
| malanin surge dt hi hormone
70
# up/down
arterial BP in 1st 20 wks of pregnancy
low dt to hi progesterone
| smooth muscle relaxation
71
# pregnancy
plasma volume
hi by 50%
72
# pregnancy
RBC mass
hi by 30%
73
# pregnancy
SVR
low dt progesterone
74
# pregnancy
Oncotic pressure
low :dt low Albumin
75
# pregnancy
cardiac output
hi dt total hi Bld volume
76
# pregnancy
supine C. Output
low uterus compressing IVC
77
# pregnancy
Hematocrite physiologically
low: Anemia
78
# pregnancy
coagulation factor
hi (all protein are hi except Albumin
79
# pregnancy
gastric motility
decreases causing constipation
80
# pregnancy
Acid/base
alkalosis-->causes CO2 gradiant for baby
81
# pregnancy
ureter
dilated--> hi UTI dt urine stasis
82
# pregnancy
Bun/creatinin
low dt increase GFR
83
# pregnancy
Pituitary size
increase dt increase volume
| may result in ischemia during delivery
84
# pregnancy
thyroid size
increased
85
# pregnancy
thyroid binding globin
increased : T4 increase
Free T3 normal
86
# pregnancy
intrauterine fetal demise
NBS---> induction of vaginal delivery
87
Screen for asymptomatic UTI and treat
nitrofurantoin
Amoxicillin
fosfomycin
88
# pregnancy
Pylonephritis Tx
ceftriaxon
89
# pregnancy
pyelonephritis risk of
preterm delivery
contiune suppressive treatment during pregnancy
90
# screeninng
28 wks
Rh(D) Ig innn Rh+ female
91
# screeninng
35-37 wk
vaginal-anal swab for Strep agalactia (GBS
92
# screeninng
24-28 wk
GDM
1hr/3hr
93
# screeninng
chorionic villus sampling
10-13 wk
94
# screeninng
18-20wk
neurotube defect
95
# screeninng
Amnio quadruple screening
15wk +
96
# screeninng
10 wk
Cell free DNA
97
# screeninng
Hi AFP
neuro tube defect
hi ACH
Abdominal wall defect
98
# screeninng
mcc of hi AFP
incorrect dating
99
# screeninng
low AFP +Estriol + hi inhibin a & B-HCG
downs
100
low AFP + Estrial+ B-HCG-->
Edwards (18)
101
Positive quad screen NBS
US
102
Lobular carcinoma in situ
receptor positive breast cancers are
extrogen and progesterone positive
103
MC form of invassive breast cancer
invassive ductal carcinoma
104
peal of orange appearance of breast
Inflamatery breast
cancer
105
eczematous scaly appearance around the napple, crusty, itchy, or thickened skin
| Primary symptom is clear or bloody nipple discharge. no skin changes
paget's disease
| intraductal papiloma
106
# is there a difference
1. lumpectomy + radiation
2. Mastectomy
for early stage breast cancer survivial
107
# NBS
centinal lymphnode is positive
Axillary lymph node biopsy
108
# treatment
ER/PR pos Breast cancer
Temoxifen, Anastrozole
109
# treatment
Her2/Neu positive
Trastuzumab/Herceptin
110
JVD +EF @35% in post breast cancer treatment
Trastuzumab
| dilated cardiomyopthy reversible
111
purplish blue discoloration on arm in pt with breast recection
lymphagiosarcoma
112
# NBS
45yo + palpable breast mass
mammogram
113
# 25yo
multiple breast mass changes w/ cycle
diary menses
fibrocystic changes
114
25yo + palpable firm upper outer quadrannt solid mass on US
Biopsy
115
25yo + palpable cystic breast mass on US
FNA
| fine needle aspiration
116
25yo + palpable cystic bldly mass on FNA
core needle biopsy
117
pt w/ recurrance cystic breast mass
core needle biopsy
118
hx of classic c-section at risk for
uterine rupture
119
drug risk of placenta abroptio
cocaine
120
vasa previa NBS
no manual exam
antenatal monitory(NST)
possible hospitalization in 3rd tri
steroid
plan c-section (emergency)
121
> 500 cc bld vaginal delivery
PPH
122
>1000 cc blding during c-section
PPH
123
# PPH etiology
list
mcc: uterine atony
larceration
DIC in the obstetric setting-thrombin
Uterin inversion
124
# NBS
larceration
surgery
125
# NBS
retained placenta
D&C
126
Uterine inversion risk
Prior uterine innversion
fist the uterus back
oxytoxin
127
cause of Pituitary apoplexy
hemorraghic shock of pituitary
128
# uterine bleed
PALM-COEIN
PALM: Polyps,
Adenomyosis,
Leiomyoma,
Malignancy) and Non-structural
(COEIN: Coagulopathy,
Ovulatory dysfunction,
Endometrial,
Iatrogenic,
Not yet classified
129
usually painless, asymetrical firm uterine mass
Fibroid
130
usually painful soft symetrical bulgy uterine mass
adenomyosis
131
# NBS
Fibroid treatment
OCP/IUD /progesteron therapy
tranexamic acid
Fe
NSAID
leuprolide
132
Life threatening abnormal uterine bleed
can't tolerate oral/failure
| firstline
IV estrogen
temponnade
D&C
hysterectomy
IR embolization
133
major criteria of PCOS
polycystic ovary
hersuitism (androgen)
anovation
134
Normal Fetal Hrt rate
110-160
135
rise in hrt 15bpm 4 15sec 2x w/in 20min
positive nonstress test
NBS: BPP
| Biophysical profile
136
# hrt tracing
abrupt drop and abrupt return to baseline
| variable decelaration
cord compression
137
# hrt tracing
Late decelaration out of synch w/ contraction
uteroplacenta insufficiency
NBS
| Lt lateral decubitus position ....plan delivery
138
VEAL-CHOP
Variable------------cord compression
Early decel--------Head compression
Accelaration------normal
Late Decel--------uteroPlacenta insufficiency
139
Molar pregancy managemnt
suction curetage
140
# molar
post suction curetage NBS
OCP 4 6 month ---
HCG goes to zero
141
2-3 month post suction curetage +SOB NBS
| very high HCG (choriocarcinoma). affect thyroid with low TSH
Ches x-ray
| methotrexic & OCP 4 1yr
142
G2P1 10wk + Rh(D) -ve + Anti D Ig neg NBS
28wk give Rh(D) Ig
143
G2P1 10wk + Rh(D) pos Ig NBS
check dad if Rh(neg) no further concern
144
# NBS
3rd term pt present with painless Vaginal blding that progress to massive painful blding
| previa to uterine rupture
c-section
145
mambrane rupture > 24 hrs
GBS penecillin
146
PROM
premature rupture of membrance
147
P-PROM
preterm premature rupture of membrance
148
PP-PROM
preterm premature rupture of membrance > 24hr
149
# preterm
firbronectin pos indicate
baby will be out w/in 24hr
150
Twin-Twin = C-------A (california)
C-------------A
4 di di
5-8 mono di
8. Mono mono
13+ conjoined twin
151
PID + smoking + vaginal blding ,LMP 7days+ hcg pos
suspect ectopic
152
Prior D&C +infertility NBS
hysteroscopy
153
# NBS
Ectopic pregancy + B-HCG pos 500
| if pt has hi LFT / CKD
methetrexic
| avoid
154
threatened abortion
vaginal blding closed Os + normal fetal Hrt rate
155
Missed abortion
vaginal bldig closed Os + no viable on US
156
Partial and complete abortion
Os is open
Partial: conception product
complete: no conception product
157
NBS for spontaneous abortion
D&C
158
# NBS
Septic abortion
Antibiotic and D&C
159
NBS for 20 + wk fetal demise
Dilation and evacuation
160
Toxo
cat
difuse cerebal calcification
161
slap cheek rash
B19
SS DNA
162
Scar skin: mom had vesicular rash during pregnancy
VZV
Acyclovia
163
mom eat dairy product, baby with multiple abscess
listeriosis
164
machine-like murmur with blue berry morphen rash
missel
165
periventricular calcification
CMV
166
infection in first 20 day of life is likely
Strep Agalatia
167
# 67yo
anogenital puritis + dry paches of perineum area
lichen planus
Biopsy
168
# Tumor marker
Granulosa cell
liver cancer/York sac
choriocarcinoma
Estrogen
AFP
B-HCG
169
# 20yo
athletic + low hormone
hypogonnadotorpic hypogona
170
normal breast no uterus, hi Testosterone
Androgen insensitivity
171
breast + 46XX
Mualarian agenesis
172
amenorrhea + anosmia
Kallman sydrome
173
no breast + small uterus
Turnal syndrome
174
Uterus, no breast+ visual field defect
pituitary
shelf
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