OB/GYN EOR Exam

What is the most common cause of secondary amenorrhea?

Pregnancy

What is the definition of primary amenorrhea?

1. Absence of menses by age 15 with secondary sexual characteristics.

2. Absence of menses by age 13 without secondary sexual characteristics.

What is the definition of secondary amenorrhea?

Absence of menses > 6 months in a woman who previously had normal menses.

Gynecologist complaining of irritability, fatigue and spotting 1-2 weeks before her menses with symptoms ending 1-2 days after her menses begins. She has complaints of edema, weight gain and bloating. What is her diagnosis?

Premenstrual syndrome

T/F Combined hormone replacement therapy is effective for women having menopausal symptoms.

True

Note: LOWEST effective dose and SHORTEST duration.

What is the most common reason for hysterectomy?

Uterine fibroids

Name 9 risk factors for endometrial cancer.

1. Late menopause

2. Infertility

3. Obesity

4. Nulliparity

5. Tamoxifen

6. HTN

7. Unopposed estrogen

8. DM

9. Early menses

LION THUDE

Oral contraceptives and smoking are protective factors in ______ cancer.

Oral contraceptives and smoking are protective factors in ENDOMETRIAL cancer.

What is the appropriate diagnostic test for endometrial cancer?

Endometrial biopsy

What is the test of choice for endometriosis?

Laparoscopy

Dyspareunia

Dysmenorrhea

Dyschezia

Cyclical menstrual pain

Infertility

Diagnosis?

Endometriosis

Pt visits her gynecologist several weeks after delivering her baby. She complains of lower abd pain and vaginal fullness when she stands for long periods of time; relieved by lying down. Gynecologist asks her to "bear down" during pelvic exam. What is she looking for?

Uterine prolapse

What are the most common functional ovarian cysts?

Follicular cysts

How are functional ovarian cysts without torsion managed in young patients?

No treatment required, just observe.

What is the most common diagnostic test for check for cysts?

Pelvic ultrasonography

Anovulation

Hirsuitism

Virilization

Metabolic syndrome

Increased estrogen levels

Diagnosis?

PCOS

Name 4 risk factors for ovarian cancer.

1. Late menopause

2. Obesity

3. Nulliparity

4. Early menarche

What is the common symptom in early stage ovarian cancer?

A. Asymptomatic

B. Bloating

C. Pelvic/Abdominal pain

D. Early satiety

E. Urinary symptoms

A. Asymptomatic

Of the HPV types covered by Gardasil, which cause condylomata accuminate?

Types 6 and 11

Of the HPV types covered by Gardasil, which cause cervical cancer?

Types 16 and 18

Most cervical cancers occur in the

A. Endocervix

B. Transformation zone of the cervix

C. Transitional zone of the cervix

D. Ectocervix

E. Peripheral zone of the cervix

B. Transformation zone of the cervix

What is the recommendation for cervical cancer screening for patients < 21 y/o?

No screening

What is the recommendation for cervical cancer screening for patients 21-29 y/o?

Cytology q3 years

What is the recommendation for cervical cancer screening for patients 30-65 y/o?

Cytology q3 years + HPV DNA testing q5 years

What is the recommendation for cervical cancer screening for patients 65 y/o?

No screening if 3 consecutive normal paps and no history of CIN II, III

What is the next step if ASCUS?

Repeat pap q6 mos X 2

HPV DNA testing

or Colposcopy

What is the next step if HSIL?

Colposcopy or immediate LEEP

What is the next step if adolescent patient with ASCUS or LSIL?

Repeat cytology in 12 mos

Emergency contraception can be used up to ___ hours after unprotected intercourse.

Emergency contraception can be used up to 72 hours after unprotected intercourse.

What is the frequency of Depo provera injections?

q3 months

After stopping depo, when would a patient typically be ready to achieve pregnancy?

1 year

A 29 y/o sexually active nulliparous female smoker with a past medical history of DVT x2 is seeking contraception. She desires to have future pregnancies. Which of the following would you recommend?

A. Coitus interruptus

B. Combined OCPs

C. Progestin only pill

D. Essure

C. Progestin only pill

What is the definition of infertility?

Failure to conceive after 1 year of unprotected intercourse.

What is the inpatient treatment for PID?

Cefoxitin + Doxy

OR

Clinda + Gent

What is the outpatient treatment for PID?

Ceftriaxone + Doxy +/- Flagyl

Fetal heart tones can be measured starting at ____ wks gestation.

Fetal heart tones can be measured starting at 10 wks gestation.

What are the 5 parameters of BPP?

1. NST

2. Fetal tone

3. Fetal movement

4. Fetal breathing

5. AFI

What part of the fallopian tube is the most common location for ectopic pregnancies?

Ampulla

What is the diagnostic tool of preference for ectopic pregnancy?

Transvaginal ultrasound

Gestational diabetes is screened at __-__ weeks.

Gestational diabetes is screened at 24-28weeks.

What is the treatment of choice for pregnancy induced hypertension?

Labetalol

In a patient with preeclampsia, how long after delivery should magnesium sulfate be continued?

Until 24 hours after delivery

What does HELLP stand for?

Hemolysis

Elevated LFTs

Low platelets

Describe the Rhogam administration schedule for Rh-negative mothers.

300 mg at 28-29 weeks and after delivery if baby is Rh Positive, then the mother receives Rhogam within 72 hours.

What is the normal cut off value for 1 hour GCT?

<140

What are the abnormal cut off values for 3 hour GTT?

Fasting >95

1 hour >180

2 hour > 155

3 hour > 140

Latent phase

What stage of labor?

First stage

Active phase

What stage of labor?

First stage

Onset of labor to full cervical dilation and effacement.

What stage of labor?

First stage

Full dilation to delivery of baby.

What stage of labor?

Second stage

Delivery of baby to delivery of placenta.

What stage of labor?

Third stage

Causes behavior/attention problems, heart defects, facial changes, prow growth, and MR when used during pregnancy.

A. Alcohol

B. Bactrim

C. Cocaine

D. Methotrexate

E. Nitrofurantoin

A. Alcohol

Causes hypertonia, attention problems, delays in growth/language, low birth weight, placental abruption, RDS, SIDS when used during pregnancy.

A. Alcohol

B. Bactrim

C. Cocaine

D. Methotrexate

E. Nitrofurantoin

C. Cocaine

Causes hyperbilirubinemia when used in 3rd trimester.

A. Alcohol

B. Bactrim

C. Cocaine

D. Methotrexate

E. Nitrofurantoin

B. Bactrim

Causes IUFD if given less than 40 days gestation.

A. Alcohol

B. Bactrim

C. Cocaine

D. Methotrexate

E. Nitrofurantoin

D. Methotrexate

What is the most common cause of poistcoital bleeding?

Cervical polyp

What is the initial treatment of endometriosis?

NSAIDs

What are the 4 most common indications for cesarean section?

1. Previous c/s

2. Breech presentation

3. Dystocia

4. Fetal distress

What color discharge seen in trichomoniasis?

Yellow green

Pregnant patient has not been sensitized for rubella. When do you immunize her?

Postpartum

What is the most common cause of first trimester abortion?

Chromosomal abnormalities (i.e. aneuploidy)

What is the recommended weight gain for patients with BMI 19-25?

25-35 lbs.

What is the most likely etiology in a patient with amenorrhea and galactorrhea?

Prolactinoma

What serum progesterone level is viable for pregnancy?

>25

Methotrexate can be used on ectopic pregnancies that are ___ cm in diameter with hCG levels of ____-____ mIU/L.

Methotrexate can be used on ectopic pregnancies that are <3.5 cm in diameter with hCG levels of <5,000-15,000 mIU/L.