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Step 2 flashcards > More Ob/gyn 2 > Flashcards

More Ob/gyn 2 Flashcards

1
Q

Hypothyroidism can cause…

A

Amenorrhea
Menorrhagia
Hyperprolactinemia
spontaneous abortion

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2
Q

CI to raloxifene use for osteoporosis

A

Hx of DVT

can also cause hot flashes to get worse

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3
Q

Abx CI in pregnancy

A

Fluoroquinolones (cipro)
Tetracyclines (doxy)
Bactrim (TMP-SMX)

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4
Q

–> asymmetric IUGR

A 
Maternal HTN
preeclampsia
smoking
maternal APLS
collagen vascular disorder
uterine anomalies
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5
Q

–> symmetric IUGR

A

chromosomal anomalies
congenital anomalies
congenital infxns (TORCH)

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6
Q

PEC dx

A

> 20 weeks
140/90
0.3 gm (300 mg) protein/24 hour

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7
Q

Side effect of indomethacin as tocolytic

A
  • closure of ductus arteriosus
  • fetal bradycardia
  • Oligohydramnios*
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8
Q

surgical treatment of early endometrial cancer

A

total abdominal hysterectomy + BSO
pelvic and para-aortic lymphadenectomy
pelvic washings

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9
Q

Risk factors for PMS

A

family hx

deficiency of b6, calcium, magnesium

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10
Q

4th degree laceration

A

rectal sphincter
rectal mucosa*
internal/external anal sphincter

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11
Q

3rd degree laceration

A

rectal partial or complete sphincter tear

no mucosal involvement

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12
Q

2nd degree laceration

A

vaginal fascia

perineum

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13
Q

1st degree laceration

A

vaginal mucosa

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14
Q

protein requirements in pregnancy

A

70 g/day

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15
Q

assoc with retained placenta:

A

prior c-section
uterine fibroids
prior uterine curettage
succenturiate lobe of placenta

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16
Q

discover that baby has IUGR? then…

A

2x weekly: NST
1x weekly: AFI
1x weekly: BPP
1x/2 week: US (more frequent? not helpful)

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17
Q

baby found to be breech

A

most self-correct by 37 weeks

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18
Q

baby born to HIV mother. treat with__ for___

A

Zidovudine, for 6 weeks after birth

  • vaginal delivery: AZT during and after
  • c-section: AZT after
  • can start to check for HIV 24 hrs after delivery
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19
Q

Arrest of dilation (active phase - 1st stage)

A

no cervical dilation >2 hours for nulliparous/multiparous

add an extra hour for an epidural

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20
Q

Arrest of descent (Stage 2)

A

no descent after >2 hrs of pushing in primigravid
>1 hr of pushing for multigravid
(add an extra hr for epidural)

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21
Q

In pregnancy, CO increases by ___

A

33%

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22
Q

What stage of labor can you AROM?

A

active phase

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23
Q

Mag use in PEC delivery

A

Mag during delivery and for 24 hours PP

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24
Q

Smoking puts mom at risk for:

A 
placental abruption
placenta previa
fetal growth restriction
preeclampsia
infection
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25
CI for terbutaline
diabetes
26
Causes of cervicitis (--> post-coital bleeding)
gonorrhea chlamydia trichomonas HSV2
27
Mucopurulent cervical discharge
chlamydia >gonorrhea
28
gram-negative intracellular diplococci
gonorrhea
29
fetal complications from pregestational diabetes
``` organ defects (cardiac, renal, NTD) IUGR or macrosomia Hypocalcemia polycythemia hypoglycemia hyperbilirubinemia RDS birth injury ```
30
Hydrops fetalis
fetal hgb <7
31
signs of molar pregnancy
``` 1st trimester uterine bleeding hyperemesis gravidarum preeclampsia <24 weeks uterine size greater than dates (RF: extremes of age, diet low in folate or beta-carotene) ```
32
what to do w shoulder dystocia
``` HELPER Help reposition Episiotomy Leg elevation (McRoberts) Pressure (suprapubic) Enter the vagina and attempt rotation (Wood's screw) Reach for fetal arm ```
33
Prolonged ROM
>18 hours prior to delivery
34
Fever postpartum
``` Womb (endomyometritis) Wind (pna, atelectasis) Water (UTI) Walk (DVT, PE) Wound (incision, episiotomy) Weaning (breast engorgement, abscess, mastitis) Wonder drugs (drug fever) ```
35
Paroxetine (Paxil)
contraindicated in pregnancy | --> fetal cardiac malformation, persistent pulm HTN
36
Apt test
distinguishes maternal blood vs. fetal | e.g. use to dx vasa previa
37
before doing epidural...
must confirm Fetal Heart rate | -baby moving a lot? do an fetal scalp electrode
38
Apgars
``` heart rate: 2 respiratory rate: 2 activity: 2 reflexes: 2 color: 1 (total of 9) ```
39
CI to expectant management of severe PEC <32 weeks
thrombocytopenia (2x upper limit of normal (liver damage) unrelenting CNS sxs non-reassuring fetal signs inability to control bp w 2 meds
40
feto-maternal hemorrhage after vaginal delivery
<0.1cc
41
HTN APLS factor 5 leiden
--> IUGR + OLIGO
42
Fresh frozen plasma
fibrinogen, factors 5 and 8
43
RF for uterine inversion (things that stretch it out!)
polyhydramnios macrosomia multiple gestations multiparity (girl you got a loose uterus!)
44
RF for uterine atony
chorioamnionitis oxytocin use in labor prolonged labor (the muscle is tired!) and things that stretch it out
45
Post-term pregnancy assoc w
placental sulfatase deficiency* anencephaly* inaccurate dates fetal adrenal hypoplasia*
46
complications of post-term pregnancy
``` meconium aspiration macrosomia oligohydramnios*** dysmaturity (baby looks old!) uteroplacental insufficiency ```
47
fetal growth restriction, screws you in adulthood:
diabetes COPD HTN cardiovascular disease
48
who should not use progestin-only pills?
those who are depressed!! | they should avoid depot provera too!
49
"recurrent pregnancy loss"
>2 consecutive losses (stillbirth) | >3 spontaneous losses before 20 wks gestation
50
D&C vs D&E
D&C: <16 weeks
51
Medical abortion vs surgical
more blood less, less effective
52
Lichen planus
involves: oral membranes, vulva, hair-bearing skin -vaginal obliteration lacy, reticulated pattern of labia and perineum alopecia, oral ulcers, extragenital rashes
53
LSIL on colpo-->
repeat pap in 6 and 12 months | OR do HPV testing at 12 months
54
Indications for CKC
``` positive endocervical curettage lesion extends into the canal HSIL on pap, benign on colpo HSIL too large for LEEP to rule out invasive cancer ```
55
Pseudophedrine for SUI
has alpha-adrenergic properties | may improve urethral tone
56
Danazol
for endometriosis! prevents ovulation suppresses mid-cycle LH and FSH surge** ADE: masculinization
57
greatest risk factors for breast cancer
age | gender
58
Things that incr prolactin levels
prolactin tumor hypothyroidism chest lesions (breast implants, thoractomy scars, herpes zoster)** renal failure Imipramine (TCA - the one you use for child bedwetting)
59
See bloody nipple discharge, do -->
ductogram
60
increases fibrocystic breast changes pain
caffeine
61
Breast mammography guidelines
40 yrs+: yearly clinical breast exam, 50 yrs+: annual mammogram 35+ w pos Fhx: annual mammogram
62
Most significant impact on pts breast cancer prognosis?
Lymph node status | hormone receptor status plays some role, but not as significantly as the lymph node condition
63
Most common cause of unilateral serosanguineous nipple discharge
intraductal papilloma
64
Most common histological type of breast cancer
Infiltrating ductal carcinoma
65
Risks of forceps delivery
- Mom: perineal trauma, hematoma, pelvic floor injury | - Baby: brain and spine injury, musculoskeletal injury, corneal abration
66
Risks of vaccum extraction
-Baby: intracranial hemorrhage, scalp lacerations (if torsion is excessive), cephalohematoma
67
Non-maleficence
duty to protect the patient from harm
68
Beneficiance
duty to act for the benefit of others
69
Deliver at 34 weeks...
severe preeclampsia placenta previa PPROM HELLP
70
Deliver at 37 weeks...
preelampsia chronic HTN intrahepatic cholestasis of pregnancy IUGR

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