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Emergency Medicine > Lecture 16: OB-GYN Emergencies > Flashcards

Lecture 16: OB-GYN Emergencies Flashcards

1
Q

The MCC of abnormal vaginal bleeding in a PRE-menarcheal girl is…

A

Trauma/abuse :(

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2
Q

The MCC of abnormal vaginal bleeding once you hit reproductive age is…

A

Coagulopathies

It was first on her slide so im guessing MC

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3
Q

The MCC of abnormal vaginal bleeding in a POST-menopausal woman is…

A

Exogenous hormones

That OCP MHT

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4
Q

An unstable abnormal vaginal bleed can be treated with IV (), but a stable abnormal vaginal bleed can be treated with oral ()

A
  • IV Estrogen
  • Oral short-term MHT or TXA
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5
Q

The 5 RFs for an ectopic pregnancy are:

  • Prior () pregnancy
  • Prior () surgery
  • () infections
  • () disease
  • (-osis)
A
  • Prior ectopic
  • Prior abd/pelvic/fallopian tube surgery
  • STIs
  • PID
  • Endometriosis

Also smoking + older with fertility issues

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6
Q

The classic triad of ectopic pregnancy is:

  • () pain
  • () bleeding
  • ()rrhea
A
  • Abdominal pain
  • Vaginal bleeding
  • Amenorrhea
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7
Q

Which hCG lab test is preferred and WHY

A

Quantitative is preferred, aka it gives you an actual number like 30.

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8
Q

The first US you would get of a suspect ectopic pregnancy is…

A

TransABDOMINAL (bladder full)

TVUS is empty bladder

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9
Q

A typical home pregnancy test is the equivalent of hCG being ()

A

20

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10
Q

T/F: An unstable vaginal bleed in early pregnancy (< 20 weeks) with an Rh+ mother and Rh- fetus requires Rhogam and emergent OB consult.

A

False. It is for Rh- mothers with an Rh+ fetus

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11
Q

() describes the implantation of the placenta over the cervical os

A

Placenta previa

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12
Q

A pool of fluid in the posterior fornix is diagnostic of …

A

PROM

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13
Q

() describes vaginal bleeding in the first 20 weeks of pregnancy with a closed cervical os, benign exam, and no passage of tissue.

A

Threatened abortion

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14
Q

() describes partial passage of conceptus, usually between 6-14 weeks.

A

Incomplete abortion

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15
Q

() describes fetal death at less than 20 weeks without passage of any fetal tissue for 4+ weeks after fetal death

A

Missed abortion

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16
Q

The only two abortion types that require a D&C are…

A
  • Incomplete: partial passage of products of conception
  • Missed: fetus died 4 weeks ago
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17
Q

The empiric ABX for septic abortion are () or (), along with ()

A
  • Unasyn or clinda
  • Gentamicin
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18
Q

The timeframe for chronic HTN is beginning before () gestation or lasting () weeks after delivery

A

Started before 20 weeks or lasting 12+ weeks after delivery

AKA it already existed or it existed way beyond pregnancy

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19
Q

The time frame for gestational HTN is after () weeks gestation or in the immediate () period.

A

After 20 weeks gestation or with immediate postpartum period.

20
Q

Elevated BP in pregnancy is SBP greater than () OR DBP > () on () occasions more than () hours apart.

A
  • > 140
  • > 90
  • 2 occasions more than 4 hours apart
21
Q

You should treat gestational HTN via ()

A

Lifestyle modifications

22
Q

The presence of () turns gestational HTN into pre-eclampsia.

A

Proteinuria >= 300mg in 24 hrs

Alternative criteria linked

23
Q

Besides proteinuria, HELLP syndrome is basically the equivalent to pre-eclampsia. It stands for…

A
  • Hemolysis
  • Elevated LFTs
  • Low Platelets

HELLP!!!!!!

24
Q

Severe pre-eclampsia is pre-eclampsia + ()

A

End-organ involvement

25
Q

Pre-eclampsia becomes eclampsia once () occurs.

A

Seizures

26
Q

In HELLP syndrome, () may not be present, which is always present in pre-eclampsia

A

HELLP does not always have elevated BP!!!

But it is a clinical variant of pre-eclampsia

27
Q

Besides focused US for pre-eclampsia evaluation, you can also order a…

A

CT Abdomen

28
Q

The DOC for both severe pre-eclampsia and eclampsia is…

A

IV MgSO4 4-6g

29
Q

Severe HTN in pregnancy (with a goal to reduce by (%)), is either using () or ()

A
  • 10% reduction in BP is goal
  • IV Labetalol
  • IV Hydralazine
30
Q

Overall, the definitive way to solve severe pre-eclampsia/eclampsia is…

A

Delivering the fetus!

31
Q

Pelvic pain is usually due to gynecologic pathology, but you must always get a ()

A

ALWAYS GET A PREGNANCY TEST N REPRODUCTIVE AGED WOMEN

32
Q

Primary dysmenorrhea is essentially () pain that comes () period

A

Crampy abdominal pain before or during

33
Q

Mittelschmerz is pelvic pain that occurs () period

A

DURING period (ovulation)

Mittel like Middle

34
Q

Ovarian cyst rupture causes (side) pain

A

Unilateral

35
Q

You should be concerned about an ovarian cyst if it is greater than () cm, multi(), or (consistency)

A
  • Greater than 8cm
  • Multiloculated
  • Solid

Normally just fluid filled

36
Q

() describes sudden onset of unilateral, severe adnexal pain with N/V and fever. They have a hx of chemical ovulation.

A

Ovarian torsion

37
Q

() describes chronic inflammation within the pelvis resulting from ()tissue implanting outside the uterus

A
  • Endometriosis
  • Endometrium-like tissue
38
Q

T/F: Leiomyomas are benign smooth muscle tumors in the uterus and/or GI tract.

A

Trueeee

Uterine fibroids, the big single ones

39
Q

PID encompasses 4 diseases:

  • ()itis
  • ()itis
  • () abscess
  • Pelvic ()itis
A
  • Endometritis
  • Salpingitis
  • Tubo-ovarian abscess
  • Pelvic Peritonitis
40
Q

PID has 3 groups of diagnostic criteria:

  • Group 1 (minimum criteria): () tenderness and () motion tenderness
  • Group 2 (increased specificity): (systemic), Secretions elevated ESR/CRP, positive ()
  • Group 3 (procedures based): lappy, Pelvic US/MRI, () biopsy
A
  • Group 1: Uterine/adnexal tenderness and cervical motion tenderness
  • Group 2: Fever, positive pelvic cultures
  • Group 3: Endometrial biopsy
41
Q

T/F: PID is a risk factor for ectopic pregnancy and infertility

A

TRUEEE

42
Q

Pelvic pain is initially evaluated via a (imaging)

A

TVUS

43
Q

T/F: A tubo-ovarian abscess causing pelvic pain is an indication to admit.

A

Trueee

44
Q

2 ways to treat PID via IVs:

  • () or (), with ()
  • (), plus ()
A
  • Cefotetan or cefoxitin, plus doxy
  • Clinda plus gentamicin
  • alternate: unasyn + doxy

Tin tan goes the dock, clint is a gentleman to women

45
Q

If FQ resistance is high

Oral/OP tx of PID:

  • () IM once, or () IM once with probenecid ORRRR
  • another 3rd gen cephalo with () +/- Metronidazole

I wrote more important slide?

A
  • Rocephin or Cefoxitin + probenecid
  • 3rd gen + doxy +/- metro
46
Q
A

Emergency Medicine (29 decks)

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