First Aid USMLE Step 2 CK Rapid Review – Obstetrics & Gynecology

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1° causes of 3rd trimester bleeding
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Placental abruption Placenta previa
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Classic ultrasonography and gross appearance of complete hydatidiform mole
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– Snowstorm on ultrasonography – “Cluster-of-grapes” apperance on gross examinations
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Chromosomal pattern of a complete mole
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46, XX
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Mole pregnancy containing fetal tissue
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Partial mole
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Symptoms of placental abruption
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Continuous, painful vaginal bleeding
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Symptoms of placenta previa
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Self-limited, painless vaginal bleeding
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When should a vaginal exam be performed with suspected placenta previa?
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Never
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Antibiotics with teratogenic effects
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Tetracyclines Fluoroquinolones Aminoglycosides Sulfonamides
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Medication given to accelerate fetal lung maturity
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Betamethasone or dexamethasone x 48 hours
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The most common cause of postpartum hemorrhage
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Uterine atony
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Treatment for postpartum hemorrhage
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– Uterine massage – If that fails, give oxytocin
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Typical antibiotics for group B streptococcus (GBS) prophylaxis
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IV penicillin or ampicillin
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A patient fails to lactate after an emergency C-section with marked blood loss
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Sheehan syndrome (postpartum pituitary necrosis)
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Uterine bleeding at 18 weeks gestation, no products expelled, cervical os open
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Inevitable abortion
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Uterine bleeding at 18 weeks gestation, no products expelled, cervical os closed
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Threatened abortion
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The first test to perform when a woman presents with amenorrhea
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β-hCG
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The most common cause of amenorrhea
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Pregnancy
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Term for heavy bleeding during and between menstrual periods
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Menometrorrhagia
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Cause of amenorrhea with normal prolactin, no response to estrogen-progesterone challenge, and a history of D&C
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Asherman syndrome
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Therapy for polycystic ovarian syndrome
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Weight loss, OCPs, consider metformin
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Medication used to induce ovulation
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Clomiphene citrate
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Diagnostic step required in a postmenopausal woman who presents with vaginal bleeding
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Endometrial biopsy
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Indications for medical treatment of ectopic pregnancy
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Patient stable, unruptured ectopic pregnancy of <3.5 cm at <6 weeks' gestation
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Medical options for endometriosis
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OCPs, danazol, GnRH agonists
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Laparoscopic findings in endometriosis
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Powder burns, “chocolate cysts”
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The most common location for an ectopic pregnancy
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Ampulla of the oviduct
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How to diagnose and follow a leiomyoma`
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Ultrasonography
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Natural history of a leiomyoma
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Regresses after menopause
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A patient has ↑ vaginal discharge and petechial patches in the upper vagina and cervix
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Trichomonal vaginitis
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Treatment for bacterial vaginosis
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Oral metronidazole
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The most common cause of bloody nipple discharge
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Intraductal papilloma
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Contraceptive methods that protect against PID
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OCPs and barrier contraception
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Unopposed estrogen is contraindicated in which cancers?
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Endometrial or estrogen receptor-breast cancer
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A patient presents with recent PID with RUQ pain
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Consider Fitz-Hugh-Curtis syndrome
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Breast malignancy presenting as itching, burning, and erosion of the nipple
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Paget disease
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Annual screening for women with a strong family history of ovarian cancer
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CA-125 and transvaginal ultrasonography
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A 50-year-old woman leaks urine when laughing or coughing. Nonsurgical options for stress incontinence?
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– Kegel exercises – Estrogen – Pessaries
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A 30-year-old woman has unpredictable urine loss. Examination is normal. Medical options for urge incontinence?
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– Anticholinergics (oxybutynin) – β-adrenergics (metaproterenol)
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Lab values suggestive of menopause
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↑ serum FSH
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The most common cause of female infertility
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Endometriosis
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Two consecutive findings of typical squamous cells of undetermined significance (ASCUS) on Pap smear. Follow-up evaluation?
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Colposcopy and endocervical curettage
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Breast cancer type that ↑ the future risk of invasive carcinoma in both breasts.
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Lobular carcinoma in situ

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