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Primary causes of third-trimester bleeding
Placental abruption and placenta previa
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Classic ultrasound and gross appearance of complete hydatidiform mole
"snowstorm" on ultrasound. "Cluster-of-grapes" appearance on gross examination
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Chromosomal pattern of complete mole
46XX
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Molar pregnancy containing fetal tissue
Partial mole
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Symptoms of placental abruption
Continuous, painful vaginal bleeding
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Symptoms of placenta previa
Self-limited, painless vaginal bleeding
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When should a vaginal exam be performed with suspected placenta previa?
NEVER
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Antibiotics with teratogenic effects
Tetracyclines, fluoroquinolones, aminoglycosides, sulfonamides
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Shortest AP diameter of the pelvis
Obstetric conjugate: between sacral promontory and midpoint of symphysis pubis
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Medication given to accelerate fetal lung maturity
Betamethasone or dexamethasone x 48 hours
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Most common cause of postpartum hemorrhage
Uterine atony
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Treatment for postpartum hemmorhage
Uterine massage; if that fails, give oxytocin
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Typical antibiotics for group B streptococcus (GBS) prophylaxix
IV PCN or ampicillin
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A patient fails to lactate after an emergency C-section with marked blood loss
Sheehan's syndrome (postpartum pituitary necrosis)
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Uterine bleeding at 18 weeks' gestation; no products expelled; membranes ruptured; cervical os open
Inevitable abortion
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Uterine bleeding at 18 weeks' gestation; no products expelled; cervical os closed
Threatened abortion
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The first test to perform when a woman presents with amenorrhea
B-hCG; most common cause of amenorrhea is pregnancy
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Term for heavy bleeding during and between menstrual periods
Menometrorrhagia
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Case of amenorrhea with normal prolactin, no response to estrogen-progesterone challenge, and a history of D&C
Asherman's syndrome
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Therapy for PCOS
Weight loss and OCPs
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Medication used to induce ovulation
Clomiphene citrate
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Diagnositic step required in a postmenopausal woman who presents with vaginal bleeding
Endometrial biopsy
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Indications for medical treatment of ectopic pregnancy
Stable, unruptured ectopic pregnancy of <3.5 cm at <6 weeks gestation
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Medical options for endometriosis
OCPs, danazol, GnRH agonists
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Laparoscopic findings in endometriosis
"Chocolate cysts", powder burns
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Most common location for ectopic pregnancy
Ampulla of oviduct
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How to diagnose and follow a leiomyoma
Regresses after menopause
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A patient has increased vaginal discharge and petechial patches in upper vagina and cervix
Trichomonas vaginitis
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Treatment for bacterial vaginosis
Oral or topical metronidazole
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Most common cause of bloody nipple discharge
Intraductal papilloma
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Contraceptive methods that protect against PID
OCPs and barrier contraception
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Unopposed estrogen is contraindicated in which cancers?
Endometrial or estrogen receptor-(+) breast cancer
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A patient presents with recent PID with RUQ pain
Fitz-Huge-Curtis syndrome
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malignancy presenting as itching, burning, and erosion of the nipple
Paget's disease
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Annual screening for women with a strong family history of ovarian cancer
CA-125 and TVUS
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50-year-old woman leaks urine when laughing or coughing. Nonsurgical options?
Kegel exercises, estrogen, pessaries for stress incontinence.
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A 30 y/o woman has unpredictable urine loss. Exam is normal. Medical options?
Anticholinergics (oxybutynin) or B-adrenergics (metaproterenol) for urge incontinence
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Lab values suggestive of menopause
Increased serum FSH
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The most common cause of female infertility
Endometriosis
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Two consecutive findings of atypical squamous cells of undetermined significance (ASCUS) on Pap smear. Follow-up evaluation?
Colposcopy and endocervical curettage
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Breast cancer type that increases the future risk of invasive carcinoma in both breasts
Lobular carcinoma in situ.
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