OBGYN Practice general questions
Transvaginal US (Is the best test to seperate ectopic from intrauterine pregancy
25 year old presents with pelvic pain and uterine bleeding. Her Beta HCG was 1200 mIU/L 6 days ago. Her current Beta-HCG is 1600 mIU/L. What is the next best test in eval of this pt? a. Laparoscopy b. Culdocentesis c. Dilation and Curettage D. Transvaginal US
Endometriosis
A 25 year-old female presents with constant premenstrual pelvic pain. She also notes dysmenorrhea and dyspareunia. Which of the following is the most likely diagnosis? a. Uterine Leiomyoma b. Endometrial polyps c. Ovarian Cysts d. Endometriosis
Ectopic pregnancy. Infertility increases the risk of developing ectopic pregnancy. The onset of vaginal bleeding, pelvic pain, and formation of an adnexal mass makes this the most likely diagnosis.
A 30 year-old female presents to the emergency department with a syncopal episode. She has a history of irregular menstrual cycles and infertility. She has scanty, persistent vaginal bleeding and sharp pelvic pain. A left adnexal mass is palpated. The most likely diagnosis is A. Placenta Abruptio B. Ectopic pregnancy C. Pelvic Inflammatory Disease D. Ruptured Ovarian Cyst
Excisional biopsy.
A 35 year-old female presents with a solitary breast mass. Fine needle aspiration reveals bloody fluid with no malignant cells. What is the next best step in the care of this patient? a. Monthly follow up b. Excisional biopsy c. Hormone therapy d. Repeat fine needle aspiration
A.Magnesium sulfate is indicated in this patient with preeclampsia to reduce the risk of seizures. -Nifedipine can lead to severe hypotension and should be avoided in this case. -Diazepam may cause respiratory depression, hypotonia, and thermoregulatory problems in the newborn and should be avoided. -Captopril and other ACE inhibitors should be avoided in pregnant patients due to side effects
A 36-week pregnant patient presents to the ED with hypertension. Physical examination reveals 2+/4+ edema in the lower extremities with hyperreflexia and clonus bilaterally. A urinalysis reveals 3+ protein. Which of the following is the best treatment option for this patient? A. Magnesium sulfate B. Nifedipine. C. Diazepam D. Captopril
-Fine needle aspiration is fairly accurate, easily performed, and has minimal morbidity. -Although BRCA 1 and BRCA 2 genetic tests are used in the risk assessment for possible breast and ovarian cancer, it would not replace the need to perform a more definitive evaluation of an identified breast mass. -Serum CA-125 is a tumor marker for ovarian, not breast, cancer.
A 40 year-old female presents with a 1.5 cm well-circumscribed mass noted on mammography in the right upper, outer quadrant. Which of the following procedures is most appropriate and should be done next? A Fine needle aspiration B BRCA 1 and BRCA 2 genetic testing C Serum CA-125 D Radiation therapy
Progesterone.
A couple presents having not been able to conceive over the past 12 months. Evaluation of the male has been normal. The female has had regular menses. Ovulation can be confirmed with mid-luteal phase measurement of which of the following? A. Thyroid stimulating hormone B. Luteinizing hormone C. Progesterone D. Prolactin
B. Clomiphene citrate is the first drug of choice in patients with infertility due to anovulation with normal hormone levels. Dehydroepiandrosterone sulfate is an androgen and has no role in stimulating ovulation. Bromocriptine is used to induce ovulation in patients with pituitary tumors. Human menopausal gonadotropin is used in patients who do not respond to clomiphene or have a pituitary insufficiency.
A patient presents with infertility due to chronic anovulation. Laboratory testing reveals a normal follicle stimulating hormone, estradiol, and prolactin levels. The patient's progestin challenge test was positive. Which of the following is the drug of choice for the treatment of infertility in this patient? A.Dehydroepiandrosterone sulfate B.Clomiphene citrate C.Bromocriptine D. Human menopausal gonadotropin
Ruptured ovarian cyst
Acute pelvic pain, hemorrhagia but no adnexal mass palpable on physical exam
Wolf's syndrome
Autosomal dysorder results from deletion of short arm of chromosome 4
Cri du chat syndrome
Autosomal dysorder results from deletion of short arm of chromosome 5
Edward's syndrome
Autosomal dysorder results from trisomy 18
Edward's syndrome
Babies with the condition often born small and have heart defects. Small head, small jaw, clenched fists with overlapping fingers, severe intellectual disability. Extra chromosome 18.
wolf's syndrome
Children with condition have microcephaly, micrognathia (jaw undersized), short philtrum (grove between center lip to nose), prominent glabella, ocular hypertelorism, dysplastic ears and periauricular tags, growth restriction, intellectual disability, muscle hypotonia, seizures and congenital heart defects.
Polycystic Ovarian Syndrome
Common Sx: Hirsutism, infertility, irregular menses
Leiomyomas
Condition of uterus may present with abnormal uterine bleeding but normal do not present with any sx
Ovarian Cysts
Condition presents with adnexal mass and acute pain upon rupture. Most likely
Endometrial polyps
Condition presents with menorrhagia and intermenstrual and premenstrual bleeding, pain not typical. Most likely
Bacterial vaginosis
Condition presents with vaginal discharge with a fishy odor and clue cells (stippled epithelial cells and few WBCs) on wet mount
Pelvic inflammatory disease
Condition with Fever, Abdominal Pain, purulent vaginal discharge and cervical motion tenderness
36-40 weeks
Gestational age at which fundal height of preg woman at bottom of mother's ribs
13-14 weeks
Gestational age if fundal height of preg. woman is top of uterus, right above pubic bone
KOH prep
How do you test for vaginal candidiasis
Cervical Carcinoma
Human papilloma virus has been strongly associated with development of which type of cancer
B. Secretory luteal phase under influence of estrogen and progesterone.The endometrial changes seen in the latter half of the cycle are under the influence of both estrogen and progesterone from the corpus luteum. During this phase, the endometrium becomes more vascularized and slightly edematous.
If a woman has a normal 28-day menstrual cycle what tissue and hormonal phase occurs during the last 14 days? A Proliferative follicular phase under the influence of estrogen. B Secretory luteal phase under the influence of estrogen and progesterone. C Proliferative follicular phase under the influence of estrogen and progesterone. D. Secretory luteal phase under the influence of estrogen
Abruptio placentae
If pregnant woman presents with abdominal pain and vaginal bleeding it is likely
Placenta Previa
If pregnant woman presents with sudden, painless, profuse bleeding in the third trimester it is likely
Disseminated intravascular coagulation
If pregnant woman presents with systemic signs of bleeding and thrombosis. Typically presents at time of delivery. It is likely
Uterine rupture
If pregnant woman presents with vaginal bleeding or hematuria with suprabupic pain and tenderness it is likely
20 weeks
On exam a pregnant woman noted to have fundal height at level of umbilicus. This corresponds to what gestational age or how many weeks
A. Rifampin may decrease the effectiveness of the oral contraceptives. - Acetaminophen levels or effects may be decreased by oral contraceptives. -Coronary artery disease is a contraindication to the use of oral contraceptives -Progestin only oral contraceptives are less effective at inhibiting ovulation than the combination oral contraceptive.
Patient education for a 23 year-old using oral contraceptives should include which of the following? A. Rifampin may decrease the effectiveness of the oral contraceptives. B Acetaminophen may decrease the effectiveness of the oral contraceptives. C. Oral contraceptives may provide some protection from coronary artery disease. D. Changing to the "minipill" (progestin only) will inhibit ovulation more consistently than combination oral contraceptives.
Regular insulin is the drug of choice as this will maintain the mother's blood sugar but not cross the placenta.
Pharmacologic treatment of a patient with gestational diabetes should consist of which of the following? A Oral hypoglycemic agents B. Regular insulin C Oral corticosteroids D Glucagon
growth of lobules and alveolia
Progesterone influence on the breast tissue prior to menstruation causes
Endometriosis
Pt presents with premenstrual pelvic pain, dysmenorrhea, dyspareunia. Most likely
McDonald's sign
Sign of pregnancy, fundus flexes easily on the cervix, 7-8 Weeks gestation
Goodell's sign
Sign of pregnancy, softening of cervix, occurs at 4-5 weeks gestation.
Hagar's sign
Sign of pregnancy, softening of uterine isthmus. 6-8 weeks gestation
Chadwick's sign
Sign of pregnancy.Bluish or purplish discoloration of vagina, vulva and cervix. Occur 6-12 week's gestation
Permethrin 1% cream/shampoo is used to kill the louse and remove the eggs from the hair shafts
Treatment of the patient with Pediculosis pubis consists of which of the following? A Permethrin (Nix) cream B Clotrimazole (Gyne- Lotrimin) C Podofilox (Condylox) solution D Selenium sulfide (Selsun) suspension
Metronidazole
Tx of choice for bacterial vaginosis
Vaginal candidiasis
Vulvar pruritus, thick and white (curd like, cheesy) vaginal discharge - what condition?
Incision and drainage
What is primary tx of infected Bartholin duct cyst
Progesterone helps to prepare uterus for implantation and if fertilization occurs helps maintain uterine lining and pregnancy.Progesterone levels peak mid luteal (6-7 days) after ovulation. It is also best measure of ovulation. This is the best time to fertilize. After that progesterone levels drop.
What is the function of progesterone in terms of fertility and ovulation esp. for people trying to conceive
Propylthiouracil (PTU)
What is the initial treatment of choice for hyperthyroidism in a 10-week pregnant patient? A No treatment is necessary B. Propylthiouracil (PTU) C Radioiodine treatment D Subtotal thyroidectomy
Atrophic vaginitis
What vagina condition does not present with discharge but presents with vaginal dryness
Trichomoniasis
What vaginal condition presents with vulvar pruritus and a profuse, frothy, greenish, foul-smelling vaginal discharge with a PH exceeding 5.0
Bacterial Vaginosis
What vaginal infection presents with malodurous gray-white discharge. PH > 4.5 usually 5.0- 5.5
Down Syndrome
Which autosomal disorder results from the chromosomal abnormality of trisomy 21?
A. Extreme vulvar irritation. Candida infection presents with pruritus, vulvovaginal erythema, and white, cheese-like (curd) discharge that may be malodorous. - firm painless ulcer is seen in syphilis -Tender lymphadenopathy is associated with bacterial infections and is not a feature of candidal vulvovaginitis. -Purulent discharge is noted in gonorrhea
Which of the following clinical manifestations is common in candidal vulvovaginitis? A. Extreme vulvar irritation B Firm, painless ulcer C. Tender lympadenopathy D. Purulent discharge
Folic Acid
Which of the following prenatal vitamins has been shown to decrease the risk of neural tube defects? A Riboflavin B Niacin C Thiamine D Folic acid
cri du chat syndrome
children with condition have high-pitched cat like cry due to problems with larynx and nervous syt. feeding problems dysphagia and sucking, low birth weight, severe cognitive, speech and motor delays. Hyperactivity, aggression
estrogen
what hormone controls proliferation of mammary ducts
