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MS3 > OBGYN 8 > Flashcards

OBGYN 8 Flashcards

1
Q

Tx of chorioamnionitis

A

♣ Broad spectrum IV antibiotics (e.g. ampicillin, gentamicin, clindamycin)
♣ Induction of labor

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2
Q

What are contraindications to using Indomethacin to stop preterm labor

A

3rd trimester (closure of ductus arteriosus)

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3
Q

What are contraindications to using Nifedipine to stope preterm labor

A

Hypotension

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4
Q

What are contraindications to using Mag to stop preterm labor

A

Myasthenia gravis

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5
Q

What are contraindications to using terbutaline to stop preterm labor

A

Terb is NOT used to stop preterm labor because it is ineffective and dangerous if used for long periods of time

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6
Q

Contraindications to using beta agonists (Terb and Ritodrine) as tocolytics

A

arrhythmia, HTN, seizure disorder, diabetes

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7
Q

Describe the results of amniocentesis in chorioamniotiis

A
  • Elevated IL-6
  • Low amniotic fluid glucose
  • Presence of leukocytes has low predictive value
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8
Q

When do you give steroids in PPROm

A

< 34 weeks

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9
Q

When do you give mag in PPROM

A

< 32 weeks

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10
Q

When do you augment delivery in PPROM

A

> 34 weeks

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11
Q

Adverse effects of oxytocin

A
  • Hyponatremia (Oxytocin is produced by posterior pituitary and can act similar to antidiuretic hormone)
  • Hypotension
  • Tachysystole
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12
Q

Management of woman with history of genital HSV

A

Prophylactic acyclovir or valacyclovir beginning at 36 weeks to reduce risk of outbreak during delivery

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13
Q

What are the severe features of preeclampsia

A 
♣	Thrombocytopenia (platelets <100,000)
♣	Impaired LFTs (2x normal)
♣	Renal insufficiency (Cr > 1.1)
♣	Pulmonary edema
♣	New onset cerebral disturbance, or visual impairment
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14
Q

Meds to treat severe HTN in pregnancy

A
  • Labetalol IV (do not give if bradycardic)
  • Hydralazine IV
  • Nifedipine PO
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15
Q

Diagnostic test for endometriosis

A

Laparoscopy - allows for direct visualiztaion, biopsy, and removal of endometriotic lesions

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16
Q

Common complication of endometriosis

A

Infertility - Cyclic accumulation of ectopic foci of hemorrhage and adhesions can distort pelvic anatomy and impair fertility by obstructing oocyte release or sperm entry

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17
Q

Management of spontaneous abortion without expulsion of fetal parts

A
  • Expectant or medical induction (misoprostol) if hemodynamically stable
  • Suction curettage is infection or hemodynamically unstable
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18
Q

Tx of lichen sclerosis

A

Topical steroids

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19
Q

What medication induces ovulation

A

Clomiphine

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20
Q

Tx of CAH

A

Replacement of cortisol and aldosterone

Recall that disease is caused due to defective enzyme preventing creation of cortisol/aldosterone, which leads to positive feedback to bump up the adrenal gland and all excess activity gets shunted to androgen production

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21
Q

Tx of hot flashes

A

SSRI (Venlofaxine)

22
Q

Tx of osteoporosis after menopause

A

Bisphosphonates

Vitamin D + Calcium supplements as prophylaxis

23
Q

What type of drug is Hemabate (category + MOA)

A

Prostaglandin F2-alpha

Stimulates myometrial contraction via smooth muscle constriction

24
Q

Contraindication for Hemabate

A

Asthma - also causes bronchoconstriction

25
Q

What is a B-lynch suture

A

Compression suture used to manually compress an atonic uterus in the setting of postpartum hemorrhage

26
Q

Empiric tx of postpartum endometritis

A

Ampicillin + Gentamycin

+ Clindamycin for anaerobes if delivery was C-section

27
Q

Tx of septic pelvic thrombophlebitis

A

♣ Anticoagulation

♣ Broad-spectrum antibiotics

28
Q

How do you differentiate postpartum blues from depression

A

Blues usually resolve within 10 days

Depression lasts at least 2 weeks

29
Q

What complications are associated with postterm pregnancy

A
  • Macrosomia
  • Oligohydramnios
  • Meconium aspiration
  • Uteroplacental insufficiency
  • Dysmaturity
30
Q

Management of diagnosed IUGR

A

Once- or twice-weekly NST + BPP

31
Q

On a microscopic level, what is happening that leads to cervical change

A

Breakage of disulfide bonds

32
Q

What is the most common cause of unilateral bloody nipple discharge with no associated mass

A

Intraductal papilloma

33
Q

Management of intraductal papilloma

A

Is a benign lesion

Work up = mammography US

Biopsy +/- excision

34
Q

Describe presentation of Erb Duchenne palsy

A
  • Extended elbow
  • Pronated forearm
  • Flexed wrist and fingers
35
Q

Describe what nerves are damaged and presentation of Klumpke palsy

A
  • “Claw hand”
  • Extended wrist
  • Hyperextended MCP joing
  • Flexed interphalangeal joints
  • Horner syndrome (ptosis, miosis)
36
Q

Describe Moro reflex in Erb Duchenne vs. Klumpke palsy

A 
Erb = decreased Moro 
Klumpke = intact moro

THINK: Erb is more a damage to proximal (shoulder/upper arm) vs Klumpke is distal (hand)

37
Q

Describe grasp reflex in Erb vs. Klumpke palsy

A 
Erb = intact grasp
Klumpke = absent grasp

THINK: Erb is more a damage to proximal vs. Klumpke which is distal

38
Q

What does symmetric vs. asymmetric fetal growth restriction refer to

A

Symmetric = global; proportionate growth lag between head and abd

Asymmetric = usually more restriction to abd than to head (“head-sparing” growth lag)

39
Q

Causes of symmetric IUGR

A
  • Chromosomal abnormalities (more common)

- Congenital infection

40
Q

Causes of asymmetric IUGR

A
  • Uteroplacental insufficiency

- Maternal malnutrition

41
Q

What are the two levels that are both the same (either decreased or increased) in Trisomy 21 and 18

A

AFP and estriol

Are both decreased

42
Q

Are b-hCG and Inhibin A increased or decreased in Downs

A

Increased (THINK Down is up)

43
Q

Are b-hCG and Inhibin A increased or decreased in Trisomy 18

A

Decreased b-hCG

Normal Inhibin A

44
Q

MOA of Clomiphene

A

Selective estrogen modulator

45
Q

Management of pregnant woman with HSIL (high grade squamous intraepithelial lesion) on pap smear

A

Colposcopy (safe in pregnancy)

If positive for invasive cancer, proceed with surgical excision

46
Q

Management of stable vs. unstable ectopic pregancy

A 
Stable = methotrexate
Unstable = surgery

D&C can be used to remove uterine contents for spontaneous or incomplete abortion. Not for ectopic

47
Q

Biggest risk factor for adenocarcinoma of the vagina

A

DES exposure in utero

48
Q

Diagnose: US showing adnexal mass with lack of doppler flow

A

Ovarian torsion

49
Q

Tx of ovarian torsion

A

Surgical

50
Q

How can endometriosis lead to infertility

A

Pelvic adhesions

51
Q

How does menopause affect urinary function

A

Can lead to incontinence and UTI because hypoestrogenemia results in atrophy of superficial and intermediate layers of urethral mucosal epithelium

MS3 (88 decks)

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