OBGYN COMAT QUESTIONS & ANSWERS
Commonly occurs to the breast 3-5 days after delivery resulting in high milk productions
volumes - answer -breast engorgement
Often has flulike symptoms and unilateral breast pain with a focal area of erythema and
tenderness - answer -lactational mastitis
Focal tenderness & firmness &/or erythema; no fever - answer -plugged duct
What medication is used for prevention of seizures in patients with preeclampsia -
answer -magnesium sulfate
Estrogen containing contraceptives are contraindicated in patients with a hx of - answer
-migraines with aura
Intense constant abdominal pain and abnormal fetal heart race tracing is concerning for
- answer -uterine rupture
Fish with high levels of mercury ( swordfish, shark, bigeye, tuna) can be toxic and cause
- answer -fetal neurodevelopment issues
Postpartum patient has new-onset seizures which can cause - answer -papilledema
and recumbent headache
Prothrombic risk factors( postpartum, fam hx of dvt) should raise suspicion for - answer
-cerebral vein and venous sinus thrombosis
What is used to treat eclampsia- presents with seizures and headaches - answer -
magnesium sulfate
Solitary, firm, well-circumscribed and mobile mass, nontender in breast - answer -
fibroadenoma
Multiple, diffuse nodulocystic masses
Cyclic premenstrual tenderness - answer -fibrocystic changes
If patients are <30 with a solitary breast mass, you need - answer -further workup with
an ultrasound (to check is simple cyst or complex cyst)
What is the management for polyhydramnios - answer -expectant management
What is the clinical course for someone with primary hsv infection - answer -
spontaneous resolution of symptoms within a week
,What is given for postpartum hemorrhage to prevent the breakdown of blood clots -
answer -tranexamic acid
What are normal changes to thyroid levels during the first trimester - answer -total t4
increased
Tsh decreased
Estrogen stimulates synthesis of tbg and decreases tbg clearance, leading to an
increased pool of bound thyroid hormone
Acute cholangitis - answer -fever, ruq pain, jaundice (charcot triad)
Abdominal pain, contractions, vaginal bleeding following blunt abdominal trauma is -
answer -abruptio placentae (placenta abruption)
Tx: transfuse blood products as soon as possible
Clinical presentation:
-internal carotid artery stenosis
-recurrent headache
-pulsatile tinnitus
-renal artery stenosis - answer -fibromuscular dysplasia
What is a risk factor for pelvic organ prolapse - answer -multiple pregnancies-->
increased abdominal pressure -->weakening of the pelvic floor muscles
Patient with postpartum hemorrhage and vaginal mass is concerning for - answer -
uterine inversion
-likely occurs due to excessive fundal pressure and traction on the umbilical cord
Tx: manual replacement of the uterus
What is the treatment for uterine inversion - answer -manual replacement of the uterus
Swelling in the anteromedial knee - answer -pes anserine bursitis- related to overuse
(located over the medial tibial condyle)
Tx:nsaids, exercises
Treatment for postpartum urinary retention - answer -urethral catheterization- required
for both diagnosis and treatment
Granulosa cell tumor is due to - answer -estrogen exposure
What is a risk factor for vaginal squamous cell carcinoma - answer -smoking- vaginal
bleeding, malodorous vaginal discharge, irregular vaginal lesion
,Side effect of tamoxifen - answer -- hyperplasia of the endometrium
-due to prevention of breast cancer in high-risk patients, it is an estrogen receptor
antagonist
Meralgia parestheitica - answer -lateral femoral cutaneous nerve entrapment or injury
due to:
-compression ( tight clothing, pregnancy)
-iatrogenic injury
Most serious complication of neonatal lupus - answer -fetal atrioventricular (av) block
Treatment for postpartum endometritis - answer -clindamycin & gentamicin
Multiple intraabdominal lesions revealing endometrial glands, stroma, and hemosiderin-
laden macrophages - answer -endometriosis
Tx: reassurance and observation only
Valvular diseases are contraindications to - answer -taking pregnancy to term
Appear as a uniocular adenxal mass with homogenous - answer -endometriomas
Physiologic leukorrhea - answer -white, odorless cervical discharge composed of
cervical mucus, normal vaginal flora, and vaginal squamous epithelium
Increasing amounts of estrogen levels prior to ovulation
Presents without manifestations of infection (pruritis, erythema pain, malodorous
discharge)
Fundal tenderness and a firm, tender mass most likely has - answer -degenerating
uterine leiomyoma
Treatment for hellp syndrome - answer -magnesium sulfate for seizure prophylaxis
Condition for which the musculoskeletal abnormalities include webbed neck, broad
chest, micrognathia, short fourth metacarpals, cubitus valgus, & scoliosis - answer -
turner syndrome
What is a severe complication for turner's syndrome - answer -aortic dissection
Infertility and secondary amenorrhea after a procedure - answer -asherman syndrome-
the development of symptomatic intrauterine synechiae
, Ec methods that prevent pregnancy primarily by delaying ovulation - answer -although
these medications are more accessible than an iud, they are less effective at pregnancy
prevention
Patient with hematochezia, abdominal pain, and tenesmus - answer -ulcerative colitis
Patient developed tachycardia, dyspnea, generalized muscle rigidity, and dark urine
soon after anesthesia - answer -malignant hyperthermia
Presents with fever, lower abdominal pain, heavy vaginal bleeding and malodorous,
purulent vaginal discharge
And enlarged, boggy, tender uterus on pelvic exam - answer -septic abortion
Tx: suction curettage and broad-spectrum antibiotics
Treatment for septic abortion - answer -suction curettage and broad-spectrum
antibiotics
What causes anencephaly - answer -inadequate folate --> neural tube defect
High spinal anesthesia - answer -can occur if the catheter accidentally punctures the
dura and anesthetic enters the subarachnoid space
Develop ascending paralysis as the anesthetic diffuses to the upper thoracic spinal level
Composition of a mature cystic teratoma - answer -partially calcified mass with multiple
thin, echogenic bands
Encapsulated collections of old blood from ectopic endometrial implants on the ovary
that appear as homogeneous cystic masses - answer -endometriomas
An abnormal localized outpouching of the urethral mucosa into surrounding tissues
Typically arises from recurrent periurethral gland infections, which can develop into an
abscess that can eventually breach the urethral mucosa - answer -urethral diverticulum
Treatment if pregnant patient is gbs positive but allergies to penicillin - answer -
cefazolin
Normal changes during pregnancy - answer -decreased serum bun
Decreased serum creatinine
Increased renal protein excretion
Physiologic changes during pregnancy - answer -increased renal blood flow
Increased glomerular filtration rate
Commonly occurs to the breast 3-5 days after delivery resulting in high milk productions
volumes - answer -breast engorgement
Often has flulike symptoms and unilateral breast pain with a focal area of erythema and
tenderness - answer -lactational mastitis
Focal tenderness & firmness &/or erythema; no fever - answer -plugged duct
What medication is used for prevention of seizures in patients with preeclampsia -
answer -magnesium sulfate
Estrogen containing contraceptives are contraindicated in patients with a hx of - answer
-migraines with aura
Intense constant abdominal pain and abnormal fetal heart race tracing is concerning for
- answer -uterine rupture
Fish with high levels of mercury ( swordfish, shark, bigeye, tuna) can be toxic and cause
- answer -fetal neurodevelopment issues
Postpartum patient has new-onset seizures which can cause - answer -papilledema
and recumbent headache
Prothrombic risk factors( postpartum, fam hx of dvt) should raise suspicion for - answer
-cerebral vein and venous sinus thrombosis
What is used to treat eclampsia- presents with seizures and headaches - answer -
magnesium sulfate
Solitary, firm, well-circumscribed and mobile mass, nontender in breast - answer -
fibroadenoma
Multiple, diffuse nodulocystic masses
Cyclic premenstrual tenderness - answer -fibrocystic changes
If patients are <30 with a solitary breast mass, you need - answer -further workup with
an ultrasound (to check is simple cyst or complex cyst)
What is the management for polyhydramnios - answer -expectant management
What is the clinical course for someone with primary hsv infection - answer -
spontaneous resolution of symptoms within a week
,What is given for postpartum hemorrhage to prevent the breakdown of blood clots -
answer -tranexamic acid
What are normal changes to thyroid levels during the first trimester - answer -total t4
increased
Tsh decreased
Estrogen stimulates synthesis of tbg and decreases tbg clearance, leading to an
increased pool of bound thyroid hormone
Acute cholangitis - answer -fever, ruq pain, jaundice (charcot triad)
Abdominal pain, contractions, vaginal bleeding following blunt abdominal trauma is -
answer -abruptio placentae (placenta abruption)
Tx: transfuse blood products as soon as possible
Clinical presentation:
-internal carotid artery stenosis
-recurrent headache
-pulsatile tinnitus
-renal artery stenosis - answer -fibromuscular dysplasia
What is a risk factor for pelvic organ prolapse - answer -multiple pregnancies-->
increased abdominal pressure -->weakening of the pelvic floor muscles
Patient with postpartum hemorrhage and vaginal mass is concerning for - answer -
uterine inversion
-likely occurs due to excessive fundal pressure and traction on the umbilical cord
Tx: manual replacement of the uterus
What is the treatment for uterine inversion - answer -manual replacement of the uterus
Swelling in the anteromedial knee - answer -pes anserine bursitis- related to overuse
(located over the medial tibial condyle)
Tx:nsaids, exercises
Treatment for postpartum urinary retention - answer -urethral catheterization- required
for both diagnosis and treatment
Granulosa cell tumor is due to - answer -estrogen exposure
What is a risk factor for vaginal squamous cell carcinoma - answer -smoking- vaginal
bleeding, malodorous vaginal discharge, irregular vaginal lesion
,Side effect of tamoxifen - answer -- hyperplasia of the endometrium
-due to prevention of breast cancer in high-risk patients, it is an estrogen receptor
antagonist
Meralgia parestheitica - answer -lateral femoral cutaneous nerve entrapment or injury
due to:
-compression ( tight clothing, pregnancy)
-iatrogenic injury
Most serious complication of neonatal lupus - answer -fetal atrioventricular (av) block
Treatment for postpartum endometritis - answer -clindamycin & gentamicin
Multiple intraabdominal lesions revealing endometrial glands, stroma, and hemosiderin-
laden macrophages - answer -endometriosis
Tx: reassurance and observation only
Valvular diseases are contraindications to - answer -taking pregnancy to term
Appear as a uniocular adenxal mass with homogenous - answer -endometriomas
Physiologic leukorrhea - answer -white, odorless cervical discharge composed of
cervical mucus, normal vaginal flora, and vaginal squamous epithelium
Increasing amounts of estrogen levels prior to ovulation
Presents without manifestations of infection (pruritis, erythema pain, malodorous
discharge)
Fundal tenderness and a firm, tender mass most likely has - answer -degenerating
uterine leiomyoma
Treatment for hellp syndrome - answer -magnesium sulfate for seizure prophylaxis
Condition for which the musculoskeletal abnormalities include webbed neck, broad
chest, micrognathia, short fourth metacarpals, cubitus valgus, & scoliosis - answer -
turner syndrome
What is a severe complication for turner's syndrome - answer -aortic dissection
Infertility and secondary amenorrhea after a procedure - answer -asherman syndrome-
the development of symptomatic intrauterine synechiae
, Ec methods that prevent pregnancy primarily by delaying ovulation - answer -although
these medications are more accessible than an iud, they are less effective at pregnancy
prevention
Patient with hematochezia, abdominal pain, and tenesmus - answer -ulcerative colitis
Patient developed tachycardia, dyspnea, generalized muscle rigidity, and dark urine
soon after anesthesia - answer -malignant hyperthermia
Presents with fever, lower abdominal pain, heavy vaginal bleeding and malodorous,
purulent vaginal discharge
And enlarged, boggy, tender uterus on pelvic exam - answer -septic abortion
Tx: suction curettage and broad-spectrum antibiotics
Treatment for septic abortion - answer -suction curettage and broad-spectrum
antibiotics
What causes anencephaly - answer -inadequate folate --> neural tube defect
High spinal anesthesia - answer -can occur if the catheter accidentally punctures the
dura and anesthetic enters the subarachnoid space
Develop ascending paralysis as the anesthetic diffuses to the upper thoracic spinal level
Composition of a mature cystic teratoma - answer -partially calcified mass with multiple
thin, echogenic bands
Encapsulated collections of old blood from ectopic endometrial implants on the ovary
that appear as homogeneous cystic masses - answer -endometriomas
An abnormal localized outpouching of the urethral mucosa into surrounding tissues
Typically arises from recurrent periurethral gland infections, which can develop into an
abscess that can eventually breach the urethral mucosa - answer -urethral diverticulum
Treatment if pregnant patient is gbs positive but allergies to penicillin - answer -
cefazolin
Normal changes during pregnancy - answer -decreased serum bun
Decreased serum creatinine
Increased renal protein excretion
Physiologic changes during pregnancy - answer -increased renal blood flow
Increased glomerular filtration rate
