EM OBGYN Flashcards
(45 cards)
what defines abnormal uterine bleeding?
anything different per the patient
What is PALM COEIN
PALM: structural
- Polyps, adenoyosis, leiomyoma (fibroids), Malignancy
COEIN: non-structural
- Coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not otherwise classified
what is the treatment of abnormal uterine bleeding
will depend on severity
estrogen OCP 3 pills x 2 days or until bleeding stopped and then 2 x 3d - do not stop for next menstrual cycle
if IUD goes through uterus
What is the treatment of massive hemorrhage
may require massive transfusion
consider hormone supplementation
consider TXA
consider uterine tamponade
consult surgery
obtain US
what is the most common cause of PID
GC and chlamydia
what is PID
ascending vaginal/uterine infection
what is the presentation of PID
bilat lower abdominal pain, discharge, fever, chills, malaise, cervical motion tenderness, adnexal tenderness
what is the treatment of PID
abx for STI
admit if PG, Toxic or complicated (abscess, ectroic, fitz-hugh-curtis)
what is an inflammatory mass of the fallopian tube and ovary
tubo-ovarian abscess
what is the treatment of tubo-ovarian abscess
if < 7cm abx (cefotetan 2g IV BID + doxy 100mg PO BID)
if larger needs surgery
what is a bartholin cyst
bartholin duct that is blocked - leading to fluid accumlation
what is the treatment of bartholin cyst
drainage with word cath - stays in for 6-8 weeks
what is rotation of the ovary on the ligamentous supports
ovarian torsion
- impedes blood flow and causes necrosis
what is the presentation of ovarian torsion
severe painw ith peritonitis
N/V
fever
vaginal bleeding
what is the treatment of ovarian torsion
pain management and Zofran PRN
needs to go to the OR immediately
what is an inflammatory reaction of the vulva and vagina
vulvovaginitis
what is most common cause of vulvovaginitis
candidiasis
bacterial vaginosis
trichomoniasis
what is the presentation of breast abscess
breast pain
swelling
erythema
fever
malaise
what is the most common causative agent for breast abscess
infection arises in milk
m/c S. aureus and E.coli
what is the treatment of mastitis
breast feed
NSAIDs
Warm compress
abx if > 12-24 hours (cephalexin, augmentin or clinda)
what is the treatment of breast abscess
US to confirm
needs drainage
lido with epi
may try aspiration depending on size
larger: I&D, consult with surgery
what is the leading cause of death in women in first trimester of pregnancy
ectopic pregnancy
what is the presentation of ectopic pregnancy
POOP typically 6-8 weeks after LMP
Pain typically along one of the lower quadrants
vaginal bleeding
may be in shock
syncope
