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Obs og Gyn Nagy > Nagy > Flashcards

Nagy Flashcards

1
Q

Contraindications to tocolysis

A

Obstetric:
- Severe abruption
- Ruptured membranes
- Chorioamnionitis
Fetal:
- Lethal anomaly
- Fetus is already dead
- Fetal jeopardy

Maternal:
- Eclampsia
- Advanced dilation

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2
Q

Main vaginal infections

A

Bacerial vaginosis
Trichomonas
Mycosis (candida)
Condyloma

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3
Q

Gestational diabetes

A

Screen everyone at 24-28 weeks
Fasting glucose <5.6 mmol/L –> healthy
Fasting glucose 5.6 - 7.0 –> Do OGTT
Fasting glucose > 7.0 mmol/L on two separate measurements –» DM

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4
Q

OGTT

A

75 grams of glucose (fasting)
0 min: <7.0 mmol/L
120 min: < 7.8 mmol/L
If < 7.8 mmol/L –> impaired fasting glucose (IFG)
If 7.8 - 11.1 mmol/L Impaired glucose tolerance
If > 11.1 mmol/L –> DM

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5
Q

US in pregnancy

A

0 (6-7w):
- Confirm (gestational sac, HR)
- Location (intra-/extrauterine)
- Twins
I (11-13):
- Congenital malformations
- Nuchal translucency (Downs)
- Neural tube defects
- Biometrics
II (18-20):
- Congenital malformations
- Genetics
III(30-31):
I- UGR
- Late congenital malformations
IV (36-38):
- Fetal presentation
- Fetal weight
- Info for delivery

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6
Q

Placenta abruptio/placenta previa

A

Palpate uterus with hands.
Abruptio: Painfull, hard uterus –> C-cection
Previa: Painless, CTG normal

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7
Q

Post-partum hemorrhage

A

4T’s
Tissue, Trauma, Thrombin, Tone

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8
Q

Pearl Index

A

No of pregnancies in 100 females/year with chosen contraceptive.
OCP: 0.1 - 2.5
Post-coital pill: 0.5 - 2.5
IUD: 0.5 - 5
Condom: 3 - 28
Sterilization: 0.3 - 6

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9
Q

Routine exams

A

Colposcopy (using telescope to look at cervix)
Cytology
Bimanual exam
Breast exam

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10
Q

Mayer-Rokitansky-Küster-Hauser Syndrome

A

Müllarian agenesis
- congenital malformation
- Failure of Müllerian duct to develop
- Missing uterus, cervix, vagina
- Variable degree of upper vaginal hypoplasia
- Causes 15% of primary amenorrhea
- Ovaries intact, ovulation usually occurs
- Will enter puberty and have secondary sexual characteristics

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11
Q

Pap smear

A

P0: improper sample
P1: Negative, superficial cells on slide
P2: Superficial cells and WBC’s
P3: Unsure
P4: Atypical cells –> Suspect malignancy
P5: True malignancy

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12
Q

Obstetrics statistics

A

Neonatal mortality rate:
No. of neonatal deaths during 1st month/1.000 live births
- Early NMR: 1st week
- Late NMR: 2-4th weeks

Perinatal mortality rate
No. of perinatal deathts/1.000 TOTAL birhts
(22w - 7th week postpartum)

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13
Q

To exclude ectopic pregnancy

A

Measure beta-hCG
- 1.000 U/L –> Gestational sac
- 7.000 U/L –> Yolk sac
- 10.000 U/L –> Embryo
Brown spotting & abdominal pain indicates ectopic pregnancy
–> check fallopian tubes
beta-hCG doubles every 2nd day. If high but doesn’t double –> Ectopic

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14
Q

Endometriosis

A

Endometrial-like tissue outside uterine cavity
Dx: Laparoscopic visualization (Gold standard)
Tx: Surgery
Drugs: Pseudopregnancy (leuprolide?)
Pseudomenopause –> GnRH analogue

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15
Q

Urinary incontinence

A

Irritative: Urinanalysis –> Cystitis/tumor/foreign body
Stress: Loss of bladder suppord –> cough
Urge: Hypertonic –> Increased detrusor activity
Tx: Anticholinergics
Overflow/neurogenic: Hypotonic w/dribbles
Tx: Cholinergics

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16
Q

Stopping uterine bleeding

A

Young: Progesterone (preserve fertility)
Old: D&C

17
Q

History taking

A

Previous operations
Allergey to medications
Obstetrics anamnesis
Illness, drugs
First day of last menstrual period
- Naegle’s rule

18
Q

Marsupialization of Bartholin’s cyst

A

Cyst opened at edges + sutured, forming an open pocket

19
Q

Endometrial cancer (Staging)

A

0: CIS
I: Limited to uterus
Ia: <50% of myometrium
Ib: >50% of myometrium
II: Cervical involvement
III: Local spread
IIIa: Adnexa/uterine serosa
IIIb: Vagina/parametrium
IIIc1: Pelvic nodes
IIIc2: Paraaortic nodes
IV: Metastasis
IVa: bladder/rectal mucosa
IVb: Distant metastasis, ascites, peritoneum

20
Q

Vulvar cancer (Staging)

A

0: VIN
I: Limited to vulva/perineum < 2 cm
Ia: <1mm stromal invasion
Ib: >1mm stromal invasion
II: Extension to adjacent perineum
III: Any size + extension to perineal structures with positive inguinofemoral LN
IV: Metastasis
IVa: Bladder, uerthra, rectum, bone
IVb: Distant metastasis (pelvic LN)

21
Q

Vaginal cancer (Staging)

A

0: VAIN
I: Limited to vagina
II: Paravaginal invasion without extension beyond pelvic side walls
III: Invasion of pelvic side wall
IV: Metastasis beyond pelvis
IVa: Bladder, rectum
IVb: Distant metastasis

22
Q

Breast cancer (TNM)

A

Tis: DCIS, LCIS
T1: 2 cm
T2: 2-5 cm
T3: >5cm
T4: Metastasis
T4a: chest wall:
b: Skin
c: Chest wall + skin
d: Inflammatory carcinoma
N: Lymphnodes
Nx: LN cannot be assessed
N0: No cancer cells
N1: Cancer cells in armpit LN but not stuck to surrounding tissues
N2: Stuck to surrounding tissues
N3: Cancer cells in LN below collar bone, behind breast bone, above collarbone
M: Metastasis
M0: No metastasis
M1: Metastasis

23
Q

Breast cancer TNM

A

Tis: DCIS, LCIS
T1: 2cm
T2: 2-5 cm
T3: >5cm
T4: Metastasis
Chest wall
Skin
Chestwall and skin
Inflammatory carcinoma

N0: No cancer cells
N1: Cancer cells in armpit
N2: Stuck to surrounding tissue
N3: Cancer cells around clavicle

M0: No metastasis
M1: Metastasis; bones, lungs, brain

24
Q

Cervical cancer (Staging)

A

0: CIN
I: Limited to cervix
Ia: Microscopically visible
Ia1: Stromal invasion <3mm depth, <7 mm extension (microinvasive)
Ia2: Stromal invasion 3-5mm depth, >7 mm extension
Ib: clinically visible lesion
Ib1: < 4cm
Ib2: > 4cm
II: beyond cervix, not pelvic side walls, not lower 1/3 of vagina
IIa: upper 2/3 of vagina. No parametrial involvment
IIa1: <4cm
IIa2: >4cm
IIb: Parametrial invasion
III:
a. lower 1/3 of vagina. No pelvic wall extension
b. Pelvic side wall extension, obstructive uropathy
IV: Metastasis
a. Bladder, rectum
b. Distant organs

25
Q

LSIL/HSIL

A

LSIL: Condyloma. CIN I.
HSIL: CIN II. CIN III –> in situ –> invasive carcinoma.

LSIL and HSIL based on Cytology
CIN I-III based on histology

26
Q

Cervical carcinoma (staging, simple)

A

0: CIN
I: Limited to cervix
Ia: Microscopic
Ib: Macroscopically visible

II: beyond cervix
IIa: Uterus, upper 2/3 vagina
IIb: Parametrial invasion

III:
IIIa: Lower 1/3 vagina.
IIIb: Pelvic side wall.

IV: Bladder, rectum, distant.

27
Q

Ovarian cancer (Staging)

A

I: Ovary/fallopian tube
Ia: 1 ovary/fallopian tube
Ib: 2 ovaries/fallopian tubes

II: Pelvic extension/primary peritoneal cancer
IIa: Uterus/fallopian tubes
IIb: Other pelvic tissues

III: Cytologically/histologically confirmed spread to peritoneum and retroperitoneal LN
(IIa-c)

IV: Metastasis
IVa:: Pleural effusion with positive cytology
IVb: Distant metastasis

Obs og Gyn Nagy (1 decks)

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