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113 Cards in this Set
- Front
- Back
Primary causes of 3rd trimester bleeding
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Placental abruption and placenta previa
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Normal or abnormal? The uterus is palpated above the pubic symphysis at 12 weeks.
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Normal
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Normal or abnormal? During pregnancy, cardiac output increases by 30-50% and heart rate is increased 10-15 bpm.
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Normal
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Normal or abnormal? A new systolic murmur is heard in a pregnant patient.
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Normal
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Normal or abnormal? A new diastolic murmur is heard in a pregnant patient
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Abnormal
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Normal or abnormal? CXR reveals cardiomegaly in a pregnant patient.
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Normal. Not actually cardiomegaly, the heart is displaced by the uterus upward and to the left
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Normal or abnormal? WBC count increases during childbirth to more than 20 million/mL.
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Normal
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What is the leading nonobstetric cause of postpartum death?
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Pulmonary embolism
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What is the most common congenital infection?
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CMV
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What parasite should pregnant women be aware of who have household cats?
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Toxoplasma gondii. Pregnant women should NOT change the litter box.
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What stage of labor? The cervix is dilated 6 cm.
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1st, active
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What stage of labor? The cervix is dilated 1 cm
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First, latent
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What stage of labor? The infant is delivered, but the placenta remains
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Stage 3
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What is the significance of late decelerations of the fetal heart rate during labor
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Uteroplacental insufficiency and fetal hypoxemia
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Persistent vomiting not related to other causes, acute starvation (large ketonuria), and weight loss (5% decrease from pre-pregnancy weight)
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Hyperemesis gravidarum
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Hyperglycemia in the first trimester suggests...
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Pre-existing diabetes
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Pregnant woman has signs of edema, polyhydramnios, and a large for gestational age fetus (>90th percentile). Diagnosis?
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Gestational diabetes
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Work-up for diagnosis of gestational diabetes
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UA reveals glycosuria, abnormal glucose challenge test (routinely performed at 24-28 weeks gestation)
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What is HELLP syndrome?
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A variant of pre-eclampsia with a poor prognosis.
Hemolysis Elevated LFTs Low Platelets (thrombocytopenia) |
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Idiopathic hypertension during pregnancy without significant proteinuria (<300mg/L) that develops at >20wks gestation
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Pregnancy-Induced Hypertension. 25% go on to develop pre-eclampsia
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New-onset grand mal seizures in patients with pre-eclampsia
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Eclampsia
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What is the definitive cure for eclampsia/pre-eclampsia?
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Delivery of the fetus
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Seizure control/prophylaxis in patients with eclampsia?
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MgSO4
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Premature separation of normally implanted placenta
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Placenta abruption
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Abnormal placental implantation
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Placenta previa
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Placenta covers the cervical os
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Total placenta previa
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Placenta extends to the margin of the os
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Marginal placenta previa
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Placenta is in close proximity to the os
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Low-lying placenta previa
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Tubal, abdominal, ovarian, or cervical pregnancy
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Ectopic
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Medical treatment of ectopic pregnancy
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Methotrexate for small unruptured tubal pregnancies, surgical options for salpingectomy
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Estimated fetal weight is less than 10th percentile for gestational age
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Intrauterine growth restriction (IUGR)
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Birth weight >90th percentile
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Fetal macrosomia
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Gestational trophoblastic disease resulting from sperm fertilization of an empty ovum
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Complete mole
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Gestational trophoblastic disease in which a normal ovum is fertilized by 2 sperm
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Incomplete (partial) mole
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Most common 1st trimester presentation of gestational trophoblastic disease (mole)
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uterine bleeding
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Slow, abnormal progression of labor
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Dystocia
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Spontaneous rupture of membranes >1hr before onset of labor
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Premature rupture of membranes (PROM)
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Spontaneous rupture of membranes that occurs at <37 weeks gestation
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Preterm premature rupture of membranes (PPROM)
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primary cause of neonatal morbidity and mortality
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premature labor
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Most common fetal malpresentation
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Breech
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Most common presentation of Sheehan's syndrome
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Failure to lactate
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Pituitary ischemia and necrosis, the primary cause of anterior pituitary insufficiency in adult females
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Sheehan's syndrome
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What is the most common cause of postpartum hemorrhage?
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Uterine atony
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When is breast-feeding contraindicated?
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maternal HIV infection, active hepatitis, and use of certain medications
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What is the term for "early breast milk", that contains protein, fat, secretory IgA, and minerals?
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Colostrum
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Type of spontaneous abortion in which all products of conception are expelled and pain ceases.
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Complete
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Type of spontaneous abortion in which there is mild cramping and bleeding, some products of conception are expelled. There may be visible tissue in the vagina or endocervical canal.
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Incomplete
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Type of spontaneous abortion in which no products of conception are expelled, membranes remain intact. There is uterine bleeding and abdominal pain. The fetus is still viable.
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Threatened.
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Type of abortion in which no products of conception have been expelled, but there is uterine bleeding and cramps. The os is open.
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Inevitible
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Type of abortion in which pregnancy has ceased to develop, but no products of conception have been expelled. Fetal tissue is retained. There is no uterine bleeding. The os is closed.
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Missed
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Type of abortion which is associated with infection. Maternal mortality is 10-15%
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Septic
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True or false: breast-feeding patients with mastitis should stop breast-feeding
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False. They should continue breast-feeding to prevent the accumulation of infected material.
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Unilateral breast tenderness, erythema, edema, warmth, and purulent nipple drainage.
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Mastitis
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Most common benign breast condition
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Fibrocystic change
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33 year old female presents with bilateral painful breasts and multiple masses 1 week before her period.
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fibrocystic breasts
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Most common breast lesion in women <30 years of age
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Fibroadenoma
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What diagnostic study can differentiate breast cysts from solid masses?
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Breast ultrasound
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Where is the most common area for breast cancer to occur?
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Upper outer quadrant
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What are the risk factors for breast cancer?
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Female, older age
Hx of breast cancer Breast cancer in 1st deg relative BRCA1 and BRCA2 mutations High fat, low fiber diet History of fibrocystic change with atypical cells Increased exposure to estrogen (nulliparous, early menarche, late menopause) 1st full term pregnancy after 35 |
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What are the tumor markers for recurrent breast cancer?
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CEA, CA 15-3, CA 27-29
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What chemotherapeutic agent should estrogen-receptor positive breast cancer patients receive?
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Tamoxifen
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Are estrogen-receptor and progesterone-receptor positive breast cancers associated with a favorable or nonfavorable course?
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Favorable
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What are the absolute contraindications to OCPs?
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Pregnancy
History of stroke, CAD, or DVT Breast cancer Undiagnosed abnormal vaginal bleeding Estrogen-dependent cancer A benign or malignant tumor of the liver Cigarette smoking Age >35 |
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Type of amenorrhea characterized by no menses present by age 16 with secondary sexual development present
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Primary amenorrhea
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Type of amenorrhea characterized by no sexual characteristics at the age of 14
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Primary amenorrhea
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Type of amenorrhea characterized by absence of menses for 6 consecutive months in women who have passed menarche
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Secondary amenorrhea
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Most common anatomic cause of amenorrhea
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Asherman's syndrome
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What is Asherman's syndrome?
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Type of secondary amenorrhea associated with endometritis, scarring after delivery, or D&C
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Most common cause of secondary amenorrhea
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Pregnancy
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Lab tests to obtain in a patient with secondary amenorrhea and a negative pregnancy test
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FSH, LH, prolactin, TSH, free T4, potassium, creatinine, liver enzymes, testosterone levels if hirsute or virilized, PAP smear and vaginal smear, 1-mg overnight dexamethasone suppression test (hypercortisolism)
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Highly increased prolactin in the setting of secondary amenorrhea indicates...
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prolactin-secreting pituitary adenoma
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Menstrual pain associated with ovulatory cycles in the absence of pathologic findings
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Primary dysmenorrhea
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Treatment for primary dysmenorrhea
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NSAIDs, topical heat therapy, combined OCPs
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Menstrual pain for which there is an organic cause
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Secondary dysmenorrhea
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Normal menstrual bleeding lasts an average of ___ days, and has a mean blood loss of ___mL
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4, 40
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Vaginal bleeding that occurs 6 or more months following the cessation of menstrual function
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Cancer until proven otherwise
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>80ml blood loss per cycle or prolonged bleeding (>8 days)
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Menorrhagia. May lead to anemia.
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Increased length of time between menses (35-90 days)
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Oligomenorrhea
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Frequent menstruation (<21 day cycle), anovular
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Polymenorrhea
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Bleeding between periods
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Metrorrhagia
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Excessive irregular bleeding
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Menometrorrhagia
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most common cause of abnormal uterine bleeding
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Pregnancy
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Aberrant growth of endometrium outside the uterus
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Endometriosis
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Ovary has a characteristic "chocolate cyst"
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Endometrioma
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32 year old obese woman presents with hirsutism and inability to conceive a child. Likely diagnosis?
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Polycystic ovarian syndrome
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Lab findings in polycystic ovarian syndrome
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Increase LH/FSH ratio (>2:1), increased testosterone
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Pelvic ultrasound in a woman complaining of infertility demonstrates a "black pearl necklace" sign
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Polycystic ovarian syndrome
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Signs and symptoms of menopause (Mnemonic HAVOC)
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Hot flashes
Atrophy of the Vagina Osteoporosis Coronary artery disease |
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Lab findings in menopause
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Increased FSH and LH, increased total cholesterol, decreased HDL
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What are Amsel's criteria?
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Abnormal whitish-gray discharge, vaginal pH >4.5, positive amine ("whiff") test, clue cells.
3 out of 4 Amsel's criteria are required for the clinical diagnosis of bacterial vaginosis |
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Lab test used to screen for gestational diabetes
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1 hour glucose tolerance test
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Lab test used to confirm the diagnosis of gestational diabetes
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3 hour glucose tolerance test
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What is the most common gynecologic cancer in the United States?
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Endometrial cancer
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What is the most common type of endometrial cancer?
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Adenocarcinoma
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What are the risk factors for endometrial cancer?
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Nulliparity, late menopause, DM, obesity, unopposed estrogen therapy, and use of tamoxifen
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What hormone stimulates the release of the ovum from the follicle on day 14 of the menstrual cycle?
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Luteinizing hormone (LH)
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Uterine fibroids are also known as...
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leiomyomas
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In what type of female genital cancer do oral contraceptives have a protective effect?
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Ovarian cancer
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What tumor markers may be used to monitor ovarian cancer?
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CA-125, alphafetoprotein, and hCGs
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What types of HPV have a correlation with cervical dysplasia?
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HPV types 16, 18 and 31
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What is the most common cancer type in cervical cancer?
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Squamous cell carcinoma followed by adenocarcinoma
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What is the next step after an abnormal Pap smear?
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Colposcopy with biopsy
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What pathogen will cause the cervix to friable with prominent papillae and punctate hemorrhages (strawberry cervix)?
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Trichomonas vaginalis
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A 20 year old sexually active female presents with pelvic discomfort and dyspareunia. On exam, a thick creamy discharge is noted coming from the cervix. Culture reveals Gram-negative intracellular diplococci. Diagnosis?
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N. gonorrhea
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What antibiotic should be used to treat mastitis?
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Dicloxacillin
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What are the risk factors for pelvic inflammatory disorder?
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Nonwhite race, unmarried, cigarette smoking, use of IUD
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What is Chandelier's sign?
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Cervical motion tenderness, a sign of PID
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What are the absolute contraindications to the use of IUDs?
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Current pregnancy, abnormal vaginal bleeding, gynecologic cancer, acute cervical or uterine infection, history of PID
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What are the absolute contraindications to the use of oral contraceptive pills?
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Thromboembolism, pulmonary embolism, myocardial infarction, stroke, breast/endometrial cancer, hepatic tumor or abnormal liver function
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In what condition is preeclampsia seen before 20 weeks gestation?
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Hydatiform mole
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What is the gold standard treatment for unruptured tubal pregnancies less than 2.0 cm?
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salpingostomy
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What are the risk factors for gestational diabetes?
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Age over 25 years, obesity, positive family history, history of macrosomia, and previous miscarriage
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What is the average doubling time during the first trimester pregnancy for beta-HCG?
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48 hours
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