Gynecology 12th Edition by Alan H. DeCherney - Ch. 1-60,
9780071833905, with Rationales
True or False: Elective cesarean section is possible even in the setting of being afraid of the pain of
labor. - ANSWER: True. Make sure you counsel her and perform @ 39 weeks gestation.
True or False: Pharm companies can pay for doctors to get CME credit (send them to conferences) -
ANSWER: True.
What is the USPSTF reccomendation on breast cancer screening with no family history? - ANSWER:
Every two years at age 50.
What is ACOG reccomendation on breast cancer screening? - ANSWER: Yearly at age 40.
Combination of first and second degree relatives have ovarian and breast cancer. What is the initial
screening test that can be offered? - ANSWER: Mammogram.
What is the recommended screening for colon cancer? - ANSWER: Colonoscopy starting at 50 and
then every 10 years. Even if you had a grandpa that had it at 80.
Sigmoidoscopy guideline? - ANSWER: Age 50 and repeat every 5 years.
What are contraceptive methods that are <1% pregnancy rate? - ANSWER: Depo-Provera
IUD
Sterilization
Implanon
What is the risk of pregnancy with OCPs? - ANSWER: 3 to 5
What is the risk of pregnancy with a condom? - ANSWER: 12%
What method of contraception has the highest failure rate? - ANSWER: Spermicide diaphragm (18%)
What are dexa scan guidelines? - ANSWER: age 65 unless they have risk factors of osteoporosis
(chronic liver or renal disease, anticonvulsant therapy, vit D def.)
What vaccines would be contraindicated within 4 weeks of pregnancy? - ANSWER: MMR and varicella
What is an important lifestyle change for a patient who has a history of hypertension and
hypercholesterolemia? - ANSWER: Aerobic exercise.
What levels does folate lower? - ANSWER: Homosystiene
If you are trying to get pregnant or are within the first four weeks of fetal development what is
important to take? - ANSWER: 400 micrograms of Folate.
A patient has Rh hemolytic disease at 24 weeks. What should you order to monitor severity? -
ANSWER: Bilirubin. Spectroscopy of the yellow tinged amniotic fluid.
PGF2alpha has what two properties? - ANSWER: Broncho contriction (CI in asthma)
Uterine contraction
, What is an ectropion? - ANSWER: An area of columnar epithelium that has not yet undergone
squamous metaplasia.
What does acetowhite epithelium indicate? - ANSWER: Dysplasia.
Which population should stay away from methylergonovine? - ANSWER: Hypertensive or
preeclampsic moms because it is a smooth muscle constrictor.
Post partum hemmorhage management. - ANSWER: 1. Establish IV access.
2. See if there is retained placental tissue.
3. See if there is lacerations.
Which type of fibroids cause infertility? - ANSWER: Submucosal myomas
Which SSRI is contraindicated in pregnancy? - ANSWER: Paxil or Paroxetine. Causes fetal cardiac
malformations and pulmonary hypertension.
Amsel criteria for BV. - ANSWER: 1. Thin gray homogenous vaginal discharge.
2. Positive whiff test. KOH.
3. Clue Cells
4. Elevated Vaginal pH.
An adolescent, overweight mother is seeking birth control which is a possible reversible option? -
ANSWER: LARC (Long acting reversible contraceptive). IUD
Rhogam dosage in the setting of vaginal bleeding or abruption is determined by which diagnostic
study? - ANSWER: Kleihauer Betke (fetal RBCs stain dark). RhoGam neutralizes 30 cc of fetal blood.
Fever after postop day 2 on a patient that is on antibiotics and essentially has normal physical exam,
you can consider which diagnosis? - ANSWER: Septic thrombophlebitis involving thrombosis of the
venous system.
Asherman's syndrome causes amennorhea. What procedure causes this sloughing off of stratum
basalis? - ANSWER: D and C
What is the greatest risk factor to develop endometrial carcinoma? - ANSWER: 50 pounds over ideal
body weight and complex atypical hyperplasia on endometrial biopsy
If you have anemia, but a regular MCV, what should be considered? - ANSWER: Hemodilution of
pregnancy which is maximum at 34 weeks
What are risks to baby as result of gestational diabetes? - ANSWER: Shoulder dystosia
Preeclamp
Polyhydramnios
Fetal macrosomia.
What do you use in order diagnose PMS or PMDD symptoms? - ANSWER: A symptom diary for two
months.
Fever and abdominal pain in the setting of a yellow discharge separates what two etiologies? -
ANSWER: Trichomonas (yellow frothy with no fever) and PID (salpingitis w/ fever) due to gonorrohrea
If you did receive Rho-gam but are sensitized to other D antigens, what is the most likely cause? -
ANSWER: Fetal maternal hemmorhage more than expected. Remember one Rho-gam shot can only
buffer 30 cc of blood.
What is the safest method to suppress lactation? - ANSWER: Breast binding, ice packs and analgesics.