Table II-13-1. Recommended Adjuvant Treatment for Node-Positive Breast Cancer
| Patient Group | Treatment |
| Premenopausal, ER- or PR-positive | Chemotherapy + tamoxifen |
| Ovarian ablation (or GnRH analog) ± | |
| tamoxifen | |
| Chemotherapy ± ovarian ablation (or GnRH | |
| analog) ± tamoxifen | |
| Premenopausal, ER- and PR-negative | Chemotherapy |
| Postmenopausal, ER- or PR-positive | Tamoxifen + chemotherapy |
| Postmenopausal, ER- and PR-negative | Chemotherapy |
| Elderly | Tamoxifen |
| If no ER and PR expression: chemotherapy | |
Abbreviations: ER, estrogen receptor; PR, progesterone receptor; GnRH, gonadotropin-releasing hormone.
Goldhirsch A, Glick JH, Gelber RD, Senn H-J. Meeting highlights: International Consensus Panel on the Treatment of Primary Breast Cancer. J Natl. Cancer Inst 1998;90:1604. By permission of the National Cancer Institute.
263
| S2 OB-GYN.indb 263 | 7/8/13 6:36 PM | |||
GI
| S2 OB-GYN.indb 264 | 7/8/13 6:36 PM | |||
GI
A
ABG, 100
Abnormal uterine bleeding, 231-32 Abnormal vaginal bleeding, 230-31 Abnormal vessels, 149
Abortion
first-trimester methods for, 21 induced, 21
second-trimester methods, 22 threatened, 1
Abruption placenta, 47-49 Absence type seizures, 89 Acanthosis nigricans, 246 Acceleration, 127
Accessory placental lobes, 51 Acrocentric chromosomes, 15 ACS-US, 170
Active labor, 116, 117 Acutance, 12
Acute hepatitis, 61
Acute salpingo-oophoritis, 207, 208-9 Acyclovir, 55
Adenocarcinoma, 170 Adenomyosis, 182-83, 213 Adnexal mass with ascites, 195-96
staging of, 196 Adrenal function, 246 Adrenal hyperplasia, 246 Adrenal tumor, 245 Adrenals, 5
|
|
|
Adrenarche, 239
AF-AFP and acetylcholinesterase analysis, 30 AGC-neoplastic, 170
AGC-NOS, 170
Agenesis, 177
AIDS (scquired immunodeficiency syndrome), 58 AIS (adenocarcinoma in situ), 170 Alloimmunization, 66-68
Alpha-adrenergic receptors, 157, 158 Alpha-fetoprotein (AFP), 42, 66, 194 Amenorrhea, 251
American Diabetes Association diet, 91
Index
American Fertility Society, 177 Amniocentesis, 30 Amniofusion, 129 Amnioinfusion, 75
Amniotic fluid bilirubin, 68 Amniotic fluid index, 101, 104 Anatomic lesion, 231 Anatomy
of breast, 255-56
of female reproductive, 145 Androgen insensitivity, 233, 234 Androgens, 189, 228
Android shape, 109 Anemia, 45, 93-94
Anesthesia, during labor, 123-24 Aneuploidy, 14
Angiotensin-converting enzyme (ACE) inhibitors, 82 Anomaly screening, 89, 92
Anorgasmia, 226 Anovulation, 88, 232, 249 Anovulatory bleeding, 235
Antenatal corticosteroid therapy, 70 Antenatal demise, 24
Antepartum fetal assessment, 92 Antepartum fetal testing, 103
Antepartum overt diabetes management, 92 Antepartum thrombophilias, 98-99 Anterior asynclitism, 113
Anthropoid shape, 109
Antibodies to foreign red blood cells, 66 Antibody screening, 40
Anticonvulsant metabolism, 89 Antiphospholipid syndrome (APS), 23, 99 Antithyroid medications, 88
Antiviral prophylaxis, 58 Arcuate uterus, 179 Aromatase enzyme, 228 Arousal, 223
Arterial blood pressure, 3 Ascending infection, 71 ASC-H, 170, 172 ASC-US, 172
265
| S2 OB-GYN.indb 265 | 7/8/13 6:36 PM | |||
GI
USMLE Step 2 l Obstetrics/Gynecology
|
|
|
| Asherman syndrome, 237 | Bradycardia, FHR baseline, 126 |
| Asympomatic HBV, 61 | Braxton-Hicks contractions, 36 |
| Asymptomatic bacteriuria (ASB), 41, 97 | BRCA1 gene, 193 |
| Atelectasis, 140 | Breast, 146 |
| Atypical antibody test (AAT), 40, 45, 68 | anatomy of, 7 |
| Autosomal dominant genetics, 17, 19 | benign disorders of, 257-60 |
| Autosomal recessive genetics, 18, 19 | development of, 255 |
| Azithromycin, 202 | embryology and, 6 |
| enlargement of, 37 | |
| B | hormones and, 7 |
| Backache, 36 | puberty and, 6 |
| Bacterial STDs, 201 | Breast cancer, 254 |
| Bacterial vaginosis, 161-62 | prognosis for, 260-61 |
| Bacteriuria, 97 | risk factors for, 262 |
| Balanced reciprocal translocations, 15 | Breast feeding, 58, 138 |
| Barrier-spermicidal methods, 215-16 | Breast fibroadenoma, 258-59 |
| Bartholin abscess/cyst, 204 | Breech presentation, 110, 111, 132 |
| Bartholin cyst, 166 | Brow attitude, 112 |
| Barton forceps, 131 | Bypass fistula, 160 |
| Basal body temperature (BBT), 34 | Bypass incontinence, 160 |
| Basalis zone, 227 | |
| Baseline fetal heart rate, 126 | C |
| Baseline variability, 126-27 | CA-125, 194 |
| Benign cystic teratoma, 192 | Café au lait skin spots, 240 |
| Benign vulvar lesions, 166 | Calcium-channel blockers, 71 |
| Beta-adrenergic agonists, 71 | Candida vaginitis, 163 |
| Beta-adrenergic receptors, 157, 158 | Capillary injury, 79 |
| β-human chorionic gonadotropin, 189, 191 | Cardiac disease, 251 |
| test for, 187 | pregnancy and, 85 |
| titer for, 26, 27 | Cardiac output (CO), 3 |
| Bethesda system, 170 | Cardiovascular changes, during pregnancy, 3 |
| Bicornuate uterus, 178 | Carpal tunnel, 37 |
| Bilaminar germ disk, with epiblast and hypoblast layers, 8 | Cat feces, 54 |
| Bilateral sacroiliac joints, 109 | Cataracts, 56 |
| Bimanual pelvic examination, 193 | CEA (carcinoembryonic antigen), 194 |
| Biophysical profile (BPP), 104 | Cephalic presentation, 110 |
| Bishop score enlargement, 74 | Cephalohematoma, 133 |
| Bladder | Cephalopelvic disproportion, 135 |
| contraction of, 160 | Cerclage, 63 |
| relaxants for, 160 | removal of, 64 |
| residual volume of, 158 | Cervical broom, 148 |
| sensation-of-fullness volume of, 158 | Cervical cancer |
| urge-to-void volume of, 158 | invasive, 174-76 |
| Blastocyst implantation, 8 | in pregnancy, 176 |
| Bleeding, 36 | staging of, 175 |
| late pregnancy diagnosis of, 47 | Cervical change, 69 |
| Bleeding gums, 37 | Cervical cultures, 40 |
| Blood gases, 4 | Cervical dilation, 115 |
| Blood glucose monitoring, home, 91, 92 | Cervical dysplasia, 169 |
| Blood type, 40 | classification of, 171 |
| Bloody nipple discharge, 260 | histologic appearance of, 171 |
| Bloody show, 36 | histology and management of, 173, 174 |
| Bonding, 137 | satisfactory colposcopy for, 173 |
|
|
|
266
| S2 OB-GYN.indb 266 | 7/8/13 6:36 PM | |||
unsatisfactory colposcopy for, 173 vaccination for, 177
Cervical effacement, 115 Cervical insufficiency, 63-64, 149 Cervical lesions, 167
Cervical neoplasia, 169 Cervical Pap smear, 147 Cervical polyps, 167-68 Cervical stenosis, 149, 150, 172 Cervicitis, 168, 207, 208
Cesarean delivery on maternal request, 135 Cesarean hysterectomy, 50
Cesarean section, 133-35 Chadwick sign, 2 Chancroid, 201
pathophysiology of, 201 Chemoptherapy, 11, 185, 195, 196 Chest x-ray, 41, 100
|
|
|
Chlamydia, 40, 203, 207, 219 antibody for, 250
Chloasma, 2
Cholinergic receptors, 157, 158 Chorioamnionitis, 72 Choriocarcinoma, 193
Chorionic villus sampling (CVS), 30 Chorioretinitis, 54
Chromosomal aberration, 14-15
Chromosomal abnormalities, by maternal age, 14 Chronic hepatitis, 61
Chronic PID, 207, 210
Chronic salpingo-oophoritis, 209 CIN 1, 171, 173, 176
CIN 2, 171, 173
CIN 3, 171, 173 CIS, 164
Classic uterine incision, 52 Cleft lip and palate, 20 Clomiphene, 249, 250
Clostridium sordellii, 21Clue cells, 161, 162 CNS pathology, 240 Coagulation factors, 3 Coitus interruptus, 220
Cold knife cone biopsy, 149, 150 Colposcopy, 148-49, 172, 176 Combination modalities, 217
postpartum contraception, 138 Combination OCPs, 217 Combination vaginal ring, 217 Complete blood count, 39, 45
Complete isosexual precocious puberty, 240 Completed abortion, 24
Complexion changes, 37
S2 OB-GYN.indb 267
GI
Index
Compound presentation, 110
Conception dating, 33, 34
Condoms, 216
Condylmona lata, 59
Condyloma acuminatum, 203
Condylomata acuminata, 166
Cone biopsy, 172
Congenital adrenal hyperplasia, 245
Congenital deafness, 56
Congenital heart disease (CHD), 20, 56, 85
Conjoined twins, 65, 66
Constipation, 137
Contraction stress test (CST), 106-7
Cooper’s ligaments, 7, 256
Copper T-380A IUS, 219
Coronary heart disease, 85, 254
Coumadin, 12, 98
Couvelaire uterus, 49
Cramping, 137
Cryotherapy, 150
Cul-de-sac, 211
Cystectomy, 191, 192
Cystic breast mass, 257
Cystitis, acute, 97
Cystocele, 155
Cystometric studies, 158
Cyto-brush, 148
Cytology, 169
Cytomegalovirus (CMV), 56
D
Dating error, 43 D-dimer, 47
Debulking procedure, 195, 196 Deep venous thrombosis (DVT), 100
Dehydroepiandrosterone sulfate (DHEAS), 245 Depakote, 12
DES uterus, 179 Descent, 115, 117 Desire, 223
disorders of, 225 DEXA scan, 252
Diabetes mellitus, 90-91, 184 antepartum management of, 91 classification by pathophysiology, 90
Diabetic testing, 45 Diamnionic twins, 65 Diaphragm, 138
Diastolic flow, inadequate, 85 Diastolic murmurs, 3
DIC, 49
presence/absence of, 24, 25 Dichorionic twins, 65
267
7/8/13 6:36 PM
GI
USMLE Step 2 l Obstetrics/Gynecology
Dichorionic-diamnionic twins, 66 Didelphys uterus, 178 Diethylstilbestrol (DES) syndrome, 12 Diffuse cerebral vasospasm, 80 Diffuse vasospasm, 78, 79
Digital examination, 47 Dihydrotestosterone (DHT) stimulation, 9 Dilantin, 12
Dilation, rate of, 116, 117
Dilation and curettage (D&C), 21, 152 Dilation and evacuation (D&E), 22, 25 Direct Coombs test, 40
Direct scalp electrode, 126
Disseminated intravascular coagulation (DIC), 139, 140 Disulfide linkages, 115
Diuretics, 82, 243 Dizygotic twins, 64, 65 Dizziness, 37
DNA ploidy status, 261 Donovanosis, 202 Dopamine, 223 Doppler ultrasound, 29 Down syndrome, 16, 17
Drospirenone/ethinyl estradiol, 243 Ductus arteriosus, 5
Ductus venosus, 5
Dysfunctional uterine bleeding (DUB), 231-32 Dysgerminoma, 190, 193
Dysmaturity syndrome, 73 Dyspareunia, 211, 226 Dysuria, 137
E
Early deceleration, 127, 129 Eclampsia, 80
Ectocervical specimen, 147 Ectoderm, 8, 9
Ectopic pregnancy, 1, 25-27, 213, 219 Edema, 79
Edward syndrome, 16, 17, 44 Eflornithine, 247 Eisenmenger syndrome, 86 EKG, 100
Elective cesarean, 135 Electronic fetal monitoring, 125
definitions in, 126 tracings in, 105
ELISA test, 42 Embolization, 182 Embryology, 8-10, 255
breast changes and, 6 Endocervical curettage (ECC) 172, 176 Endocervix specimen, 147
Endocrine changes, during pregnancy, 5 Endoderm, 8, 9
Endometrial ablation, 232 Endometrial biopsy, 153
Endometrial carcinoma/neoplasia, 183-86 metastatic to ovaries, 194
staging of, 184 Endometrial polyp, 231 Endometrial sampling, 184 Endometrial scarring, 237 Endometriosis, 140-41, 211-12 Endometrium
layers of, 227 phases of, 227-28
End-organ perfusion, 81 Engagement, 115 Enterocele, 155 Environmental agents, 11 Epidural block, 124 Episiotomy, 121 Epithelial tumors, 193
Erythrocyte sedimentation rate (ESR), 3 Estradiol, 2
Estriol, 2, 44
Estrogen, 2, 7, 8, 194, 228, 257 alternatives to, 254 deficiency, 236
plus progestogen, 254 receptor status for, 261 replacement of, 156
Estrogen-alone therapy, 254 Estrogen-dominant endometrium, 227 Estrogen-mediated metabolic effects, 216 Estrogen-progeserone challenge test, 236 Estrone, 2
Euglycemia, 92
Excitement, 223 disorders, 225
Expulsion, 115, 219 Extension, 115
External cephalic version, 135 External rotation, 115
F
Face attitude, 112 Failure
to dissolve septum, 178 to fuse, 178
False pelvis, 109 Fatigue, 37
Fatty liver, acute, 96
FDA (Food and Drug Administration) drug categories, 11 Fecundability, 248
268
| S2 OB-GYN.indb 268 | 7/8/13 6:36 PM | |||
GI
Index
Female external genitalia, 9 Fern positive, 72
Fertility control, 215
Fetal alcohol syndrome, 12 Fetal anemia, 68
Fetal circulation, 5 Fetal demise, 24-25
Fetal fibronectin (fFN), 70 Fetal growth
sonograms of, 93 disproportionate, 101-2
Fetal heart rate (FHR) monitoring, 125 external devices for, 125
heart tones in, 33 internal devices for, 126 intrapartum, 126
3-tiered system for, 127-28 Fetal hydantoin syndrome, 12 Fetal infection, 55, 56, 57, 58, 59, 61 Fetal malpresentation, 135
Fetal monitoring tracings, approach to nonreassuring, 130 Fetal movements, absence of, 24
Fetal neuroprotection, 70
Fetal nose, pharynx suctioning, 75 Fetal pH assessment, 130
Fetal red blood cells, 67 Fetal skin biopsy, 31 Fetal surveillance, 93 Fetology, 8, 10-12 Fetoscopy, 31
Fibrocystic breast changes, 258 Flexion, 115
Fluid retention, 37
Fluorescent treponema antibody absorption (FTA), 40 Folate issues
antagonist, 27 deficiency anemia, 94 supplementation, 92
Folic acid supplementation, 20 Foramen ovale, 5 Frankenhauser’s ganglion, 123 Free T3, T4, 87
FSH, 189, 228
Functional ovarian cyst, 187 Functionalis zone, 227
G
Gap junctions, 115 Gardasil, 177
Gastrointestinal changes, during pregnancy, 4 General anesthesia, 124
Generalized seizures, 89
Genetics
counseling for, 14 disorders of, 14 sonogram for, 29 Mendelian, 17-19 pregnancy loss and, 15-17
Germ cell tumor, 191, 193 Gestational age, 33-35, 69, 72
Gestational diabetes mellitus (GDM), 90, 92 Gestational hypertension, 77
Gestational trophoblastic neoplasia (GTN), 197, 198, 199 GI tract lesions, 193
Global Consensus Statement on Menopausal Hormonal Therapy, 253
Glomerular filtration rate (GFR), 5 Glucose tolerance, impaired, 91 Glucosuria, 5
Glycemic control, 93
Gonadal dysgenesis, 16, 233, 234 Gonadotropin-dependent precocious puberty, 240 Gonadotropin-independent precocious puberty, 240 Gonorrhea, 40, 204
Gram-negative enteric bacteria, 96 Granuloma inguinale, 202 Granulose cell tumor, 240
Graves disease, 88 Gravidas, 69
Group B β-hemolytic streptococci (GBS), 53-54 Growth spurt, 239
Gummas, 59 Gynecoid shape, 109
Gynecologic malignancy staging, 198 Gynecologic ultrasound, 147
H
HAART therapy, 58 Hair shedding, 37
“HA-IR-AN” syndrome, 247 Headaches, 37
Heart disease
classification in pregnancy, 86 in pregnancy, 87
signs of, 86 HELLP syndrome, 83 Hematocrit, 39
Hematologic changes, during pregnancy, 3 Hemoconcentration, 78, 79
Hemoglobin, 39
Hemoglobin A1C, 92
Hemolytic disease of newborn (HDN), 67 Hemorrhoids, 137
Hepatitis B virus (HBV), 40, 41, 61-62, 205
269
| S2 OB-GYN.indb 269 | 7/8/13 6:36 PM | |||
GI
USMLE Step 2 l Obstetrics/Gynecology
Herpes simplex virus (HSV), 57, 201 High-flow oxygen, administering, 129 Hirsutism, 244-47, 248
HMG, 249
Hormone replacement therapy, 252-54 Hormones, 7, 257
Hot flashes, 251
hPL (human placental lactogen), 90 HSIL, 170, 172
Human chorionic gonadotropin (hCG), 1, 44,194 Human immunodeficiency virus (HIV), 58, 205
screening for, 42
Human papilloma virus (HPV), 203 DNA testing for, 172
Human placental lactogen (hPL), 1 Human sexual response cycle, 225 Human sexual response model, 223
circular relational, 224 linear, 223
linear biologic, 224 Hydatidiform mole, 1 Hyperbilirubinemia, 93 Hyperemesis gravidarum, 66 Hyperprolactinemia, 232 Hypertension, 48, 184
chronic, 81-82
and preeclampsia, 82-83 in pregnancy, 77
Hyperthyroidism, 87 Hypertonic bladder, 159 Hypocalcemia, 93 Hypoglycemia, 93, 96 Hypoplasia, 177
Hypothalamic-pituitary failure, 233, 234 Hypothalamic-pituitary insufficiency, 236 Hypothyroidism, 88, 232
Hypotonic bladder, 137, 160 Hysterectomy, 151, 182, 232 Hysterosalpinogram (HSG), 250 Hysteroscopy, 151, 181, 184 Hysterpsalpingogram (HSG), 152
I
Idiopathic hair follicle reductase activity, 246 Idiopathic precocious puberty, 240 Immunizations
safe during pregnancy, 38 unsafe during pregnancy, 38
Imperforate hymen, 232 In vitro fertilization, 251 Incompetent cervix, 172 Incomplete abortion, 24
Incomplete isosexual precocious puberty, 240 Incontinence classification, 158-59
Indirect Coombs test, 40, 66 Indomethacin, 71 Inevitable abortion, 23 Infectious agents, 11 Infectious mastitis, 141 Infertility, 88, 247, 248-50
Infiltrating ductal carcinoma, 261 Infiltrating lobular carcinoma, 261 Inflammatory breast cancer, 261 Inherited coagulopathy, 231 Inhibin-A, 44
Insulin therapy, 91 Intermittent auscultation, 125
Internal devices, FHR monitoring, 126 Internal rotation, 115
International Menopause Society, 253 Intracranial calcifications, 54 Intracranial hemorrhage, 133 Intrahepatic cholestasis, of pregnancy, 95 Intramural leiomyoma, 179 Intrapartum issues
demise, 24
fetal scalp blood pH, 130 management, 93 thrombophilias, 99
Intrauterine, 8
Intrauterine contraception, 218-19 Intrauterine device (IUD), 138 Intrauterine growth restriction
asymmetrical, 101 symmetrical, 101
Intrauterine growth retardation (IUGR), 82, 83 Intrauterine pregnancy, 26
Intrauterine pressure catheter, 126 Intrauterine resuscitation, 129-30 Intrauterine surgery, 31 Intravenous agents, 123 Intravenous magnesium sulfate, 70 Invasive cancer, 176
Invasive cervical cancer, 174-75 Ionizing radiation, 11
Iron deficiency anemia, 94 Irregular bleeding, 248 Ischemic stroke, 254 Isotretinoin, 12
IV administration
augmenting fluid volume by, 129 hydralazine and/or labetalol, 79, 80 MgSO4, 79, 80, 82
oxytocin infusion, 79
270
| S2 OB-GYN.indb 270 | 7/8/13 6:36 PM | |||
K
Kallmann syndrome, 234
Karotype, 25, 43, 44
Kegel exercises, 156
Kidneys, 5
Kielland forceps, 131
Kliehauer-Betke test, 25, 68
Klinefelter syndrome (47,XXY), 16, 17
Krukenberg tumors, 193
L
Labor, 115
anesthesia options for, 123 continence and micturition, 158 induction methods for, 22 movements of, 115
nonreassuring fetal monitoring tracings and, 130 normal spontaneous, 118
prolapsed umbilical cord in, 120 prolonged or arrested active phase of, 119 prolonged latent phase of, 119 prolonged second stage of, 119-20 prolonged third stage of, 120
shoulder dystocia during, 121 stages of, 116-17, 118
Laboratory tests
first trimester, 39-42 second trimester, 42-44 third trimester, 44-45
Lacerations, 139, 140
Lactation, 7-8, 220, 257 physiology of, 6-8
Laminaria, 21
Landmarks, and positions, 112 Laparoscopy, 27, 151-52, 188, 250 Large bowel, 4
Laryngoscopic visualization, of vocal cords, 75 Late deceleration, 106, 127, 129
Latent labor, 116, 117 Latent syphilis, 59, 60 LDH, 194
Lecithin/sphingomyelin (L/S) ratio, 93 Left ventricular hypertrophy, 82
Leg cramps, 37
Leiomyoma, 179-82, 183, 219 Leukocyte count, 39
LH, 228
Lichen sclerosis, 164 Lie, 109-10 Lightening, 36 Liley graph, 67, 68 Linea nigra, 2
S2 OB-GYN.indb 271
GI
Index
Linea terminalis, 109 Lithium, 12
Liver disease, pregnancy and, 95-96 Lochia, 137
alba, 137 rubra, 137
Loop electrosurgical excision procedure (LEEP), 150 Low molecular weight heparin (LMWH), 98
Low transverse uterine incision, 134 LSIL, 170, 172
Luteoma of pregnancy, 189 Lymph node status, 260 Lymphadenectomy, 166 Lymphatic drainage, 145
Lymphogranuloma venereum (LGV), 202
M
Macrosomia, 102 Macrosomia syndrome, 73 Magnesium sulfate, 70 Male external genitalia, 9
Malignant gestational trophoblastic neoplasia, 197, 198 Malignant vulvar lesions, 164-66
Mammography, 154 microcalcifications in, 259
Marfan syndrome, 86 Marsupialization, 205 Maternal issues
age, Down syndrome and, 16 blunt trauma, 47, 48 diabetes, 121
genital lesions, 57
IM betamethasone, 70 infection, 55, 56, 57, 58, 59, 61 mortality risk, 85
PROM hazards, 73
Maternal serum alpa-fetoprotein (MS-AFP), 42-43 elevated, 43
low, 43 midpoints of, 43
Maternal-infant bonding, impaired, 137 McCune-Albright syndrome, 240 McDonald cerclage, 63
Mean corpuscular volume (MCV), 39 Meconium aspiration syndrome (MAS), 75 Meconium management, 75
Medical abortion, 21 Medications, 11 Melanoma, 165 Menarche, 227, 239
Mendelian disorders, 17-19 Menopausal hormone therapy, 253-54
271
7/8/13 6:36 PM
USMLE Step 2 l Obstetrics/Gynecology
Menopause, 2, 251 Menstrual cycle, 227, 229
hormones in, 228
length, calculated due date and, 35 Menstrual dating, 33, 34
Menstrual history, 34 Menstrual phase, 227 Menstrual physiology, 227 Mentum (chin) position, 112 Mesoderm, 8, 9 Mesonephric duct, 9 Methotrexate, 27, 198 MHA-TP assay, 40 Microinvasion, 176 Mifepristone, 21
Military attitude, 112
•
Minute ventilation (Ve), 4 Mirena, 219
Miscarriage, 15 Missed abortion, 23 Modified BPP, 104
Modified radical vulvectomy, 165, 166 Molar pregnancy, 197
Monochorionic-diamnionic twin gestation, 65, 66 Monochorionic-monoamnionic twins, 65, 66 Monosomy, 15
Monosomy X, 16 Monozygotic twins, 64, 65 “Morning after” pill, 218 Morning sickness, 37
Mortality rates, definitions of, 13 Mosaicism, 15, 149
Motor urge incontinence, 159 Mucocutaneous contact, 57 Müllerian agenesis, 233, 234 Müllerian anomalies, 177 Müllerian duct, 9
Mulluscom contagiosum, 166Multifactorial inheritance, 20 Multiple agent chemotherapy, 198 Multiple gestations, 50, 64-66 Multiple orgasms, 223
Murmurs, 3 Myomectomy, 52, 182
N
Nabothian cysts, 168
Naegele’s rule, 33-34
Nail brittleness, 37
Naloxone, 123
Narrow-deep cone, 149
National Institutes of Health, 135, 252
Natural family planning, 219-20
272
S2 OB-GYN.indb 272
GI
Neonatal issues infection and, 61 problems, 93 PROM hazards, 73
Neural tube defects (NTD), 20, 30
New York Heart Association classifications, 86 Newborn, hemolytic disease of, 67
Nitrazine positive, 72 Node-positive breast cancer, 262-63 Nondisjunction, 14
Nonreactive NST, 103, 104, 105
Nonreassuring fetal monitoring tracings, 130, 135 Nonstress test (NST), 103-4
Normal 46,XX karyotype, 197 Nosebleeds, 37
NSAIDs, 232
Nuchal translucency (NT) measurement, 29
O
Obesity, 90, 184 Obstetric forceps 131
Obstetric lacerations, degrees of, 121 Obstetricl ultrasound, 29
Occiput anterior position, 112 Oligohydramnios, 65 Oophorectomy, 191, 192 Operative obstetrics, 131, 132 Oral contraceptives, 217-18
Oral glucose challenge test (OGTT), 91 Oral glucose tolerance tests (OGTTs), 45 Oral hypoglycemic agents, 91
Orgasm, 223 Orientation in utero, 109
Osteoporosis, 251, 252, 254 Outflow tract obstruction, 236, 237 Ovarian cancer
classification of, 193, 194 oncology overview of, 194 with peritoneal metastasis, 195 staging of, 194-95
Ovarian cyst, functional, 187 Ovarian enlargement, 247 Ovarian hyperthecosis, 189 Ovarian torsion, 192 Ovarian tumor, 245 Ovaries, 145
Overflow incontinence, 160 Oviducts, 145
Ovulation day of, 34
induction of, 249 Oxytocin, 7, 8, 115, 257
7/8/13 6:36 PM
P
Paget disease, 165
of breast/nipple, 262 Painful adnexal mass, 192 PALM-COEIN classification, 232 Palmer erythema, 2
Pap smear, 147-49, 169-70 abnormal, 169 classification of, 170 diagnostic approach to, 172 liquid based, 148
Paracervical block, 123 Paramesonephric duct, 9 Parasite, 54
Parasympathetic connections, 223 Parenteral agents, 70
Partial seizures, 89
Parturient position change, 130 Passive immunity, 257
Passive immunity, 8 Patau syndrome, 17, 17 Peau d’orange, 261
Pelvic inflammatory disease (PID), 207-9, 219 Pelvic issues
abscess, 141 diaphragm, 155 exenteration, 165 mass, 240 relaxation, 155 shapes, 109
Pelvis, anatomy of, 109
Percutaneous umbilical blood sample (PUBS), 31 Perinatal losses, terminology, 13
Perinatal mortality terminology, 13 Perinatal statistics, terminology, 12 Perineal membrane, 155
Perineal pain, 137
Periodic abstinence, 219-20 Peripartum cardiomyopathy, 86 Peripheral vascular resistance, 3 Persistent breast mass, 259-60 Pessaries, 156
Petechiae, 56 Phospatidyl glycerol, 93 Phyllodes tumor, 259
Physiologic discharge, 163 Piper forceps, 131 Pituitary, 5
Placenta accreta, 51, 120 Placenta increta, 51, 120 Placenta percreta, 51, 120 Placenta previa, 47, 49-50 Placental function, 73, 74
S2 OB-GYN.indb 273
GI
Index
Placental perfusion, decreased, 101 Plasma volume, 3
Plateau, 223
Platelet count, 3, 39, 45 Playpelloid shape, 109 Pneumonia, 53
Polycystic ovarian syndrome (PCOS), 188, 246, 247-48 Polycythemia, 93
Polyhydramnion, 65 Polyploidy, 14, 15 Pooling
positive, 72 posterior fornix, 71
Postconception week 1, 8, 10 week 2, 8, 10 week 3, 8, 11
weeks 4-8, 8-9, 11 Posterior asynclitism, 113 Postmenopausal bleeding, 183
Postmenopausal pelvic mass, 192-93 Postpartum issues
blues, 138
contraception, immunizations, 138 depression, 138
fever, 140-41
gastrointestinal tract changes, 137 hemorrhage, 93, 138-40 psychosis, 138
psychosocial problems, 137 reproductive tract changes, 137 thrombophilias, 99
umbilical artery blood pH, 130 urinary tract changes, 137
Postterm pregnancy, 73-74 PPD test, 41
Precocious puberty, 239 classifications for, 240 management of, 241
Preconception anomaly prevention, 92-93 Preeclampsia, 77
mild, 78 severe, 79
Pregnancy
abnormal bleeding during, 230 danger signs during, 38 diagnosis of, 33
endometriosis and, 212 first trimester events in, 36 induced hypertension in, 81 loss genetics of, 15-16
normal complaints during, 36-37 physiologic changes in, 2-5
273
7/8/13 6:36 PM
USMLE Step 2 l Obstetrics/Gynecology
risk factor identification for, 35 second trimester events in, 36 signs of, 33
test for, 236
third trimester events in, 36 Premalignant vulvar deratosis, 164 Premature menopause, 251, 254 Premature ovarian failure, 251
Premature rupture of membranes (PROM), 71-73 Premenarchal vaginal bleeding, 230 Premenopausal pelvic mass, 191
Premenstrual disorders, 241
Premenstrual dysmorphic disorder, 242-43 management of, 243
Premenstrual syndrome (PMS), 241-42 management of, 243
treatment, 244
Prenatal diagnostic testing, 31 Prepubertal pelvic mass, 190-91 Preterm labor, 69
Primary amenorrhea, 232-35 Primary dymenorrhea, 210-11 Primary herpes, 57
Primary syphilis, 59, 60 Primiparas, 78 Progesterone, 1-2, 7, 228, 257
antagonist of, 21 challenge test for, 236 therapy of, 243
Progestin contraception, 138 Progestin management, 232
Progestin-mediated metabolic effects, 216 Progestin-only injectable, 217 Progestin-only modalities, 217 Progestin-only OCPs, 217
Progestin-only subcutaneous implant, 217 Prolactin, 7, 257
level of, 236 Proliferative phase, 227 Prolongation, 119 Prostacyclin, 78 Prostaglandin(s), 22, 78, 115
Prostaglandin synthetase inhibitors, 71 Proteinuria, 5, 79
Protozoan STDs, 201
Pseudohyphae, 163 Pseudomenopause, 212 Pseudopregnancy, 212 Puberty, 255
breast changes during, 6 overview of, 240
Pubic hair, 146 PUBS, 68
274
S2 OB-GYN.indb 274
GI
Pudental block, 123
Pulmonary angiography, 100
Pulmonary changes, during pregnancy, 4
Pulmonary embolus (PE), 100-101
Punctuation tissues, 149
Pyelonephritis, acute, 97
Pyloric stenosis, 20
Pyridoxine, 243
Q
Quadrivalent HPV recombinant vaccine, 177
Quadruple marker screen, 44
Quickening, 36
R
Radiation therapy, 165, 185
Radical hysterectomy, 151
Radical vulvectomy, 165, 166
Raloxifene, 254
Rape, 226
Rapid plasma regain (RPR), 40
Reactive NST, 103, 104, 105
Receptor status, 261
Receptors, 115
Recipient twin, 65
Recreational drugs, 11
Rectocele, 155, 156
Recurrent herpes, 57
Red blood cells (RBC), 3
Refractory phase, 223
Renal changes, during pregnancy, 5
Renal disease, 82
Renal status, 92
Reproduction, physiology of, 1-2
Residual volume (RV), 4
Resolution, 223
Respiratory alkalosis, 4
Respiratory distress syndrome, 93
Respiratory droplets, 55
Retained placenta, 139, 140
Retinal status, 92
Retinopathy, 82
Rh, 40
Rheumatic heart disease, 85
Rheumatic mitral heart disease, 86-87
RhoGAM, 23, 27, 68, 138
Robertsonian, 15
Rosette test, 68
RPR (rapid plasma regain), 59
Rubella, 55-56, 138
Rubella IgG antibody, 39-40
Ruptured ectopic pregnancy, 26
Ruptured membranes, 71
7/8/13 6:36 PM
S
Sacrococcygeal joint, 109 Sacrum position, 112 Salpingectomy, 27 Savage syndrome, 236 Scalp stimulation, 130
Secondary amenorrhea, 235 Secondary dysmenorrhea, 211-12 Secondary syphilis, 59, 60 Secretory phase, 227-28 Seizure(s), 80
disorders of, 89
Selective serotonin reuptake inhibitors (SSRIs), 243 Semen analysis, 249
Sensory irritative incontinence, 158-59 Sentinel node biopsy, 262
Sepsis, 53
Septate uterus, 178 Septic abortion, 219
Septic thrombophlebitis, 141 SERMs, 254
Serotonin, 223
Serous carcinoma, 193 Sertoli-Leydig tumor, 193, 245 Serum ammonia, increased, 96 Serum β-hCG testing, 33
17-OH progesterone, 245 Sexual activity, 225
Sexual assault, 226
Sexual dysfunction, 225-26 Sexual history-taking, 225 Sheehan syndrome, 50 Shirodkar cerclage, 64 Shoulder presentation, 110 Shunts, in utero, 5
Sickle cell anemia, 94-95 Simple hysterectomy, 151 Simpson forceps, 131
Singleton pregnancy interventions, 69 Sinusoidal pattern, 127
Skin
changes in, during pregnancy, 2 lesions in, zig-zag, 55
Snowstorm ultrasound, 198 Sonogram, 187
Sonographic visualization of fetus, 33 Sonography, 181
Spatula, 148
Spectrum, 207
Speculum examination, 47 Spermicides, 216
Spider angiomata, 2 Spinal block, 124
S2 OB-GYN.indb 275
GI
Index
Spironolactone, 247 Spontaneous abortion, 23 Spotting, 36
Squamous cell carcinoma, 170 Squamous dysplasia, 164 Squamous hyperplasia, 164
STD (sexually transmitted disease), 162 screening for, 40, 41
spectrum of, 201 with ulcers, 201-2 without ulcers, 203-4
Stein-Leventhal syndrome, 247 Sterile speculum examination, 72 Sterilization, 221
Steroid contraception, 216-17 Stomach, 4
Streptomycin, 12
Stress incontinence, 37, 159 Stretch marks, 37
Striae gravidarum, 2 Stromal tumors, 193 Structural alterations, 15 Subgalea hematoma, 133
Submucosal leiomyoma, 179, 180, 231 Subserosal leiomyoma, 179
Subtotal hysterectomy, 151 Subtotal thyroidectomy, 88 Surgical therapy, 185 Sympathetic connections, 223 Symphysis pubis, 109 Synclitism, 113
Syphilis, 40, 59-61, 201
Systemic vascular resistance (SVR), 3
T
Tachycardia, FHR baseline, 126 Tamoxifen, 254
Tanner stages of development, 146 Telogen effluvium, 37 Teratogenesis
agents resulting in, 11 stages of, 10-11
Teratology, 10-12 Terminal hair, 244 Tertiary syphilis, 59-60 Testicular function, 9
Testosterone, 194, 223, 245, 247 stimulation of, 9
Tetracycline, 12
Tetraploidy, 14
Thalidomide, 12 Theca lutein cysts, 189 Thelarche, 239
275
7/8/13 6:36 PM
USMLE Step 2 l Obstetrics/Gynecology
Threatened abortion, 23 Thromboembolism, 100 Thrombophilias, 97-99 Thrombophlebitis, superficial, 100 Thyroid, 5
ablation of, 88 disease of, 87
disorders of, in pregnancy, 88 storm in, 87
Thyrotropin (TSH) level, 236 Tidal volume (Vt), 4
Tine test, 41
Tocolytic agents, 70-71 Tocolytic contraindications, 70 Tonic-clonic seizures, 89
Total body x-ray, 25 Total hysterectomy, 151 Toxoplasmosis, 54 Tranexamic acid, 232
Transabdominal sonogram, 29 Transabdominal ultrasound, 147 Transdermal skin patch, 217 Transitory fetal bradycardia, 123 Translocations, 15
Transvaginal sonogram, 29 Transvaginal ultrasound, 147 Trichomonas vaginitis, 162-63, 203
Trilaminar germ disk, with ectoderm, mesoderm, endoderm layers, 8
Trimethadione, 12 Triple-marker screen, 92 Triploid 69,XXY karyotype, 197 Trisomy, 14, 15
13, 17 18, 16, 17, 44 16, 44
screening, 44 True pelvis, 109 Tubal disease, 250 Tubal ligation, 221
Tuberculosis (TC) screening 41 Tubo-ovarian abscess (TOA), 207, 209-10 Tubular necrosis, 49, 50
Tumor size, 261
Turner syndrome (45,X), 16, 17 21-hydroxyolase deficiency, 245
Twin pregnancy, 1 complications, 64 interventions, 69
Twin pregnancy, 1 Twin-twin transfusion, 65 Type 1 diabetes mellitus, 90 Type 2 diabetes mellitus, 90 T-zone, development of, 147
276
S2 OB-GYN.indb 276
GI
U
Ultrasonography, 184
Ultrasound Doppler, 68 Umbilical artery Doppler, 107
absent diastolic flow, 108 normal diastolic flow, 108 reversed diastolic flow, 108 waveform patterns, 107
Umbilical cord compression of, 127 entanglement of, 65
Unexplained infertility, 250-51 Unexplained uterine hemorrhage, 140 Unfractionated heparin (UFH), 98 Unicornuate uterus, 177-78 Universal precautions, body fluids, 58 Unruptured ectopic pregnancy, 27 Ureters, 5
Urinalysis, 41
Urinary incontinence, 157 Urinary tract, 251
infection of, 96, 140 lesions in, 193
Urine
culture, 41
screening, first trimester, 41 Uterine atony, 138-39, 140 Uterine contractions, 22, 69, 72
decreasing, 129
Uterosacral ligament nodularity, 211 Uterus, 145
enlarged, 33, 179 incisions in, 133-34 inversion of, 139, 140 perforation of, 219 prolapse of, 155, 156 rupture of, 52 support for, 155
V
Vacuum curettage, 21
Vacuum extractor, 132-33
Vagina, 145
Vaginal birth after cesarean (VBAC), 135
Vaginal colonization, 53
Vaginal diaphragm, 216
Vaginal discharge, 161
Vaginal douche, 220
Vaginal dryness, 254
Vaginal examination, 130
Vaginal prolapse, 156
Vaginismus, 226
Valproic acid, 188
7/8/13 6:36 PM
GI
Index
Vaniqa, 247 Vaproic acid, 12
Variable deceleration, 127, 129 Varicella (VZV), 55
Varicella pneumonia, 55 Varicose veins, 37
Vasa previa, 51
Vascular engorgement, 223 Vasectomy, 221 Vasomotor symptoms, 253 Vasospasm, 81 Velamentous insertion, 51 Vellus hair, 244
Venereal disease research laboratory (VDRL), 40 Venous blood pressure, 3
Venous thromboembolism, 254 Vertex attitude, 112
Vesical neck contraction, 160 relaxants, 160
Viral STDs, 201
Virilization, 244
Von Willebrand disease, 231 Vulvar biopsy, 154
Vulvar diseases, 164-65
Vulvar lesion with pruritus/neoplasia, 164 Vulvular carcinoma, 164-66
W
Warfarin, 12, 98 Western blot test, 42 “Whiff” test, 161
White blood cells (WBC), 3
White diabetes classification, in pregnancy, 90 White epithelium, 149
Wide-shallow cone, 149 Wolffian duct, 9
Women’s Health Initiative, 252, 253 Word catheter, 204
Wound infection, 141
X
X-linked dominant genetics, 19
X-linked recessive genetics, 18, 19
Y
Yaz, 243
Yeast vaginitis, 163
Z
Zidovudine (ZDV), 58
277
| S2 OB-GYN.indb 277 | 7/8/13 6:36 PM | |||
GI
| S2 OB-GYN.indb 278 | 7/8/13 6:36 PM | |||
GI
| S2 OB-GYN.indb 279 | 7/8/13 6:36 PM | |||
Дата добавления: 2018-11-24; просмотров: 238; Мы поможем в написании вашей работы! |
Мы поможем в написании ваших работ!