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Sicular > Day 9 - OBGYN > Flashcards

Day 9 - OBGYN Flashcards

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1
Q

down syndrome top causes (1-3)?

A

1) Meiotic nondisjunction
2) Inherited Robertsonian translocation
3) Mosaicism

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2
Q

Siblings w/ down syndrome+ now another kid w/ down syndrome = cause think?

A

Robertsonian translocation (Inherited)

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3
Q

MVA w/ pregnant woman - concerned for?

A

Placenta abruption

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4
Q

Mastitis + no abscess - most common cause?

A

Staph

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5
Q

Mastitis + no abscess - treat?

A

Something that covers Staph

- nafcillin, diclox

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6
Q

Mastitis + w/ abscess - treat?

A
  • incision and drainage

- abx (cover staph)

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7
Q

What should be given orally shortly before receiving an epidural?

A

Antacid

(and no meals bc concern for aspiration)

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8
Q

Release of thromboplastic substances from placental tissue can cause?

A

DIC

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9
Q

Vacuum advantage over forceps?

A

Vacuum does not occupy space next tot he fetal head

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10
Q

contraindications for vacuum?

A
  • face presentation

- breech presentation

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11
Q

Workup of syphilis?

A
  • Screening test: RPR or VDRL

- Confirmatory test: MHA-TP or Dark field microscopy

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12
Q

Treatment of syphilis?

A

Penicillin (all pts even if preggers)

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13
Q

Allergic to penicillin, preggers, but have syphilis, treatment?

A

Skin test, if true –> Desentisization –> Penicillin

not preggers could use 2nd line ones [ie doxy] but those are teratogenic

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14
Q

complete abortion, treatment?

A
  • Counseling for pt

- No remaining POCs –> nothing specific to follow

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15
Q

early decelerations caused by?

A

head compressions

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16
Q

variable deceleration caused by?

A

cord compression

(multiple causes - low amniotic fluid, cord prolapse, etc)

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17
Q

Late decelerations caused by?

A

Uteroplacental insufficiency

- (multiple causes - abruption, cocaine, etc)

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18
Q

painless vag bleeding think?

A

placenta previa

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19
Q

Painful vag bleeding think?

A

Abruption

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20
Q

lecithin to sphigomyelin ratio ideal?

A

2: 1

- below that –> give steroids to mature lungs if need to deliver

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21
Q

Nitrazine paper test is?

A

test to see if fluid is amniotic fluid (ie Premature ROM)

- blue = amniotic

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22
Q

Ferning pattern = think?

A

Amniotic fluid (ie PROM)

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23
Q

What week do you give RHoGAM and to whom?

A

@ 28 wks to Rh- mom

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24
Q

Typical treatment for GBS?

A

Pencillin G

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25
Treatment for GBS to severe penicillin allergic pt?
Vancomycin | - Can't give cefazolin b/c cross reactivity w/ pencillin
26
Pregnant woman has lower hematocrit, why?
Decreased ratio of RBC to plasma (bc vol goes up)
27
Prolapsed cord, treat?
Perform an emergency C section | - DON"T TOUCH THE CORD
28
Treat hypermagnesemia?
Calcium gluconate
29
Breech position, when do you do what?
``` expectant management (still has time to rotate) >36wk --> External cephalic version ```
30
Indications for GBS treatment during labor?
- Previous child w/ GBS sepsis - Previous GBS in earlier point in this pregnancy - Positive cx at 34-36 wks
31
Causes of abortions by trimester
1st - genetic abnormalities in fetus | 2nd & 3rd - maternal issues
32
asymptomatic U/A w/ E.coli treat?
Oral Abx
33
preggers, 2 time asymptomatic E.Coli on urine cx, treatment?
- Oral Abx | - Start prophylactic Abx for remainder of the pregnancy
34
Asymmetric IGUR?
Maternal issue | - HTN, later start
35
Symmetric IGUR
- Fetal issue | - infx, earlier start
36
Most common cause of post-partum hemorrhage?
Uterine atony | "spongy soft uterus"
37
Management of post-partum hemorrhage?
1) fundal massage | 2) med to contract uterus (oxytocin, prostaglandin, etc)
38
Low Transverse has highest risk of predisposing pt to?
Placenta Accreta | - not associated w/ uterine rupture
39
deceleration w/ no relation to uterine contractions means?
umbilical cord compression | variable decels
40
Painless serous discharge - think?
Chlamydia
41
calymmatobacterium granulomatous has no what?
Lymphadenopathy
42
creamy purulent discharge = think?
gonorrhea
43
DVT treatment
Firstline: LMWH - -> treat for a long time: bridge to warfarin, INR of 2-3 - -> only, if only treating for a short time
44
Greatest risk from having ovarian teratoma?
Torsion
45
acute-angle glaucoma + urge incontinence, can't give?
- oxybutynin (anticholinergic, antimuscerinic) | - Imipramine (TCA)
46
Neonatal conjuntivitis 2-4 days post birth, cause?
Gonorrhea
47
Urge incontinence, good test?
Cystometry (checks strength of muscle)
48
unscheduled bleeding contraceptive most commonly?
Depo
49
w/in 3 mo of STD, shouldn't use what contraception?
IUD "w/in 3 mo of STD, can't put in an IUD"
50
First sign of puberty in female?
Thelarche (boobs)
51
First sign of puberty in boys?
Growth of testicles
52
KOH pos test = think?
Gardnerella
53
Contraception effects malignancy risks how?
INC cancers w/ CONsonant (ie HCC, Bone cancer, Breast, cervical) DEC cancers that start w/ vowels (ie Ovarian, Endometrial)
54
Vulvar itching + white plaque + excoriations = think?
Lichen sclerosis
55
Treat lichen sclerosis w/?
Clobetasol cream (high dose steroid)
56
Most common cause of heavy menstrual bleeding?
Anovulation (dysfunctional ovulation due to unopposed estrogen) - Estrogen too high in that cycle
57
Treat anovulation?
mild - expectant management mod - oral cyclic progestins severe - fluids, IV progesterone
58
Dysfunctional uterine bleeding (DUB)
Unopposed estrogen (too high compared to progesterone) --> too much endometrium made --> heavy periods
59
Most common cause of heavy menstrual bleeding if everything appear normal (ie nL H&P, labs, etc)
Dysfunctional uterine bleeding (DUB)
60
Only thing you might find on abl w/ dysfunctional uterine bleeding?
Maybe thickened endometrium on imaging
61
Neonatal conjunctivitis 1-2wks post birth = think?
Chlamydia | - treat w/ oral macrolide
62
differentiate androgen insensitivity syndrome from mullerian agenesis?
AIS - no pubic or axillary hair, testes on imaging MA - hair, ovaries on imaging
63
biopsy + complex fluid collection posterior to the uterus - think?
Uterine perforation
64
Q-tip test dx what?
Stress Incontinence
65
Tamoxifen inc risk for?
Endometrial changes --> endometrial CA
66
Treatment of dysfunctional
mild - nothing or OCP mod - Oral High dose progesterone (+/- estrogen) severe - fluids + IV hormones
67
cervical motion tenderness think?
Pelvic Inflammatory Disease
68
fertility treatment + ovarian problem = think?
ovarian hyperstimulation syndrome
69
febrile + sore throat + cervical tenderness = think?
PID
70
most common PMS symptom?
Abdominal bloating
71
older woman w/ breast problem + no discrete mass + skin changes - think?
Inflammatory cancer
72
Paget's disease effects where?
Nipple
73
Ulcerative lesion at nipple think?
Paget's disease
74
Treatment of uncomplicated UTI?
Oral TMP-SMX for 3 days
75
Pain on menses + pain on BM + infertility - think?
Endometreosis
76
Most likely location of endometriosis?
Fallopian tubes (b/c retrograde endometrial sloughing --> backward from uterus --> fallopian tubes --> ovaries --> uterine ligaments --> etc)
77
enlarged uterus in reproductive age female - think? (2)
- Leiomyosis (fibroids, irregular) | - Adenomyosis (symmetrical, cystic findings)
78
hypothyroidism can predispose females to what?
anovulation --> DUB --> heavy menstrual bleeding
79
prolactinoma workup?
1) prolactin levels 2) MRI of brain 3) if there --> bromocriptine 4) if meds don't solve, surgery
80
1st step in fertility workup?
Semen analysis

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