Office Practice
Per ACOG, more than ___ mL of blood loss per menses is abnormal.
80
(Fun fact - Regular tampons and regular daytime pads absorb about 5 mL per each!)
30 yo G1 @ 39w0d delivers a 3500g infant over a second degree perineal laceration. 30 minutes after leaving, you're called back for patient reporting intense rectal pressure. You note a 5 x 7 mm swelling of the left labium majus. Next best step?
Warm compresses and serial labs
First line treatment of chlamydia infection in pregnancy?
Azithro 1 g x1 and TOC
Doxy 100 mg BID x 7 days
Patient has HSIL on vulvar biopsy. Final path from wide local shows VINIII and negative margins. Follow up exam intervals for surveillance?
6 mo
12 mo
Then annually
Doctor.
Szymanksi
(Per ACOG) Pt presents with inter-menstrual bleeding. TVUS suggestive of a polyp. Next best imaging modality to evaluate?
Saline-infusion sonohysterography
3 cm; posterior
Patient is not able to have/consume pork products. What hemostatic agent is contraindicated?
Gel-foam
(Pork-derived hemostatic agent)
Most common ovarian cancer in pregnancy?
Dysgerminoma
Rupture and put in an IUPC
Chow
56 yo post menopausal pt with 2x episodes spotting. TVUS shows a thin, uniform endometrial stripe of 3 mm. An endometrial stripe <4 mm confers a 99% ________ for endometrial cancer.
[Options- Sensitivity, Specificity, Negative Predictive Value, Liklihood ratio]
NPV
(Organogenesis)
Chorionic villi have formed by ______ in relation to LMP.
4 weeks from i.e., by the time of missed menses
1st line treatment for labial adhesions not resolved with observation?
Topical estrogen +/- manual separation x2-6 weeks
Burning lower leg pain POD0 evening after TLH for endo. What is the EARLY manifestation of acute compartment syndrome?
Pain with passive stretch
(Pain, pallor, paresthesia, pulselessness all late manifestations)
Langstraat
30 yo with a 3 cm firm, mobile lesion in the upper outer quadrant of the breast. Mammogram is BIRADS-3. Follow up?
Clinical breast examination and repeat breast imaging every 6–12 months for 1–2 years to assess stability. (2% chance malignancy)
Most likely trisomy with holoprosencephaly, clenched hands, cleft lip, early onset FGR?
Trisomy 13
Give at least five (5) Absolute Contraindications to Methotrexate Therapy.
- Porphyria, acute peptic ulcer disease, acute pulmonary disease, clinically significant liver disease, clinically significant renal disease, Ruptured Ectopic Pregnancy, Breastfeeding, Hemodynamic Instability, Sensitivity to MTX, Inability to Follow up
Which herbal supplement can increase operative bleeding?
Gingko bilboa
inhibits platelet activating factor and has the potential to increase bleeding risk during surgery.
What number baby is this for you?
Traynor
If brother with colon cancer @ 35 yo, your pt should begin colonoscopy screening at ____.
25 years (10 years prior to disease dx in 1st degree relative)
New age to start colonoscopy screening?
Name of the manuver to acheive appropriate axis of traction on fetal head during forceps delivery.
Pajot–Saxtorph
Pt undergoes abd myomectomy via pfannenstiel. She has burning pain from the inferior edge of pannenstiel incision spanning to over the ipsilateral labium majus. Which nerves and nerve roots are likely impacted?
T12-L1
ilioinguinal and iliohypogastric nerves, which are the ones most likely to be involved with fascial closure from a transverse incision.
48-year-old woman recently diagnosed with cervical cancer is receiving cisplatin and tandem and ovoid brachytherapy. What is the best way to prevent vaginal stricture in this patient?
Resume dilation or intercourse immediately AFTER radiation
Just something to consider
Rose