Mccqe Obgyn Questions And Answers Graded A+

MCCQE OBGYN QUESTIONS AND ANSWERS GRADED A+ How to screen and diagnose GDM: For regular patients: Do 50g OGTT at 24-28 weeks. 7.8mmol/L -- normal 10.3 -- GDM 7.8 - 10.3mmol/L -- proceed to 2hr 75g OGTT To dx IGT or GDM do the 2hr 75g OGTT. If you only have 1 abnormality, then it's IGT, if it's two abnormalities, then they have GDM: -if fasting plasma 5.3mmol/L -if 1hr glucose 10.6mmol/lL -if 2hr glucose 8.9mmol/L Types of prenatal screening tests: 1. Triple screen: -Measures NTUS, PAPP-A, B HCG -estimates risk for trisomy 21 -85% sensitive when combine with age 2. Quad screen: -MSAFP, B hcg, unconjugated E, inhibin A -estimates risk for trisomy 21, 18, and NTD 3. IPS -Quad screen + triple screen -estimates risk for trisomy 21, 18, and NTD Previous Play Next Rewind 10 seconds Move forward 10 seconds Unmute 0:03 / 0:15 Full screen Brainpower Read More QUAD prenatal screening findings for: NTD, trisomy 21, and trisomy 18 NTD: elevated ms-AFP Trisomy 21: elevated HCG and A Trisomy 18: everything is low (AFP, HCG, A, and E) Oligohydramnios defined as: 5cm AFI, or 5th % at term Presentation of sexually transmitted urethritis Kinda presents like a UTI, and urine will have pyuria, but often no growth on culture. Frequently these patients have chlamydia, gonorrhoea, or HSV. Most common site of endometriosis outside of the pelvis? Liver Genetic make up of a complete hydatidiform mole complete moles are diploid and can be either 46XX or 46XY Partial moles are triploid 69 XXX or 69 XXY What finding is SPECIFIC for open neural tube defect? Elevated AFP acetylcholinesterase activity** note: just an elevated maternal AFP would be the result from the initial screening test that would suggest a NTD. After this, you confirm dates and etc and then do an amniocentesis which is where you can find elevated levels of AFP acetylcholinesterase that are actually specific. most common cause of post partum hemorrhage: uterine atony most common cause of jaundice in pregnancy viral hepatitis Most common sites of endometriosis: Ovaries (60%), broad ligament, cul de sac, rectosigmoid colon, and appendix. Can spread to vagina or other surgical sites. Most common hormone secreting pituitary tumor associated with amenorrhea and headaches: prolactinoma What is the point of giving tocolytics? To delay delivery by 48hrs to allow max benefit of glucocorticoids to decrease incidence of RDS. most common pelvic tumor in women Uterine leiomyomas (fibroids) What is colpitis macularis? Strawberry cervix Most common chromosomal abnormality: autosomal trisomy Best way to prevent hysteroscopic adhesions Use a balloon catheter OR Hyaluronic acid gel keeps walls of uterine cavity separated an endometrial strip of what size is concerning for endometrial cancer? 4-5mm in a woman over the age of 35 Gold standard for diagnosing endometriosis Laparoscopy Note: pelvic US is an excellent test and can show a lot but it's not the gold standard. Recommended maintenance agent for pregnant patients with mild persistent asthma? Inhaled corticosteroids What is the Jarisch-Herxheimer reaction? Resembles bacterial sepsis, can occur within first 24hrs following antimicrobial treatment (often penicillin or tetracycline). It's a transient febrile reaction that occurs in the first few hours and peaks at 6-8 hours. It's a self limited course. Single most important risk factor for developing endometritis: C section Riskiest cardiac defect to have if you're pregnant? Eisenmenger syndrome - associated with 50% mortality Tx of PID CTX + doxycyline (sometimes + metronidazole)x 14d When would you biopsy genital warts: -uncertain dx -lesions not responding to standard therapy -disease worsens during therapy -lesion is atypical -patient is immunocompromised -warts are pigmented, indurated, fixed, bleeding, or ulcerated. BV infections are commonly associated with what other microorganism that accompany that infection? Mycoplasma homonis often accompanies Gardnerella vaginalis (BV) infections. Treatment of urethral syndrome likely due to chlamydia (i.e. not responding to classic UTI tx) Doxycycline Galactorrhea is associated with which thyroid issue? Hypothyroidism - this is bc low levels of TRH result in hyperprolactinemia Most common presentation of twins vertex/vertex Tx of uncomplicated UTI in pregnancy amoxicillin Sheehan syndrome Infarction of the anterior pituitary due to large post partum hemorrhage most common cause of fetal growth restriction: #1 cause is maternal hypertension other causes: autoimmune disease, smoking, protein-calorie malnutrition, substance abuse, uterine malformation, thrombophilias, prolonged altitude exposure., hemoglobinopathies, cyanotic heart disease and pregnanty associated HTN, higher diabetes (?) and of course substance abuse. What is the ectopic pregnancy triad? Amenorrhea, adnexal tenderness, vaginal bleeding confirm; positive HCG without intrauterine gestational sac found on sonography Greatest RF for developing DM in the future after a pregnancy? Having GDM. A family hx is also a RF, but GDM is the greatest RF for future development of DM. Factors associated with decreased success of Trial of labor after cesarean (TOLAC) Factors associated w decreased success of TOLAC: -BMI 40 2 c/s without vaginal delivery prior CS for failure to descend into 2nd stage of labor maternal age 35 infant weight 4000g requirement for induction of labor non recurring causes: breech, placenta previa, active genital herpes are NOT associated with decreased success of TOLAC