OB/gyn Flashcards
(141 cards)
0
Q
Admin of pgf2 (method)
A
IM
1
Q
Appropriate weight gain for preg.
If normal weight
Obese
A
Normal 25-35
Obese 11-20
2
Q
Labor warnings fetal movement
A
10 per 2 hours
3
Q
Variable decelerations mcc
A
Cord compression
4
Q
Early decelerations mcc
A
Head compressions
5
Q
Late decelerations mcc
A
Placental insufficiency (hypoxia = concerning)
6
Q
Trichomonas discharge gross
A
Yellow and frothy
7
Q
Montevideo units and cutoff
A
Sum up internal changes in 10 minutes. 200 required for adequate labor.
8
Q
Definition embryo
A
To 8 weeks
9
Q
Pre viable
A
Before 24 weeks
10
Q
Post term
A
42 weeks
11
Q
Goodell sign
A
Softening of cervix
1st sign of preg equals 4 weeks
12
Q
Time of teleangiectasias and palmar erythema
A
1st trimester
13
Q
Chloasma and time
A
Hyper pigmentation 2nd trimester
14
Q
Linea nigra
A
Line of hyper pigmentation. 2nd trimester
15
Q
Time when US can confirm gestational age
A
11 to 14 weeks
16
Q
Quickening time period
A
16 to 20
17
Q
Time period for triple or quad
A
15 to 20
18
Q
Time for gbs and chlamydia screen
A
36
19
Q
Time period for cervical checks in 3rd trimester
A
37 weeks
20
Q
Abortion def
A
Demise before 20 weeks
21
Q
Test necessary to dx type of abortion
A
US
22
Q
Complete vs incomplete abortion
A
Complete means no products of conception left
23
Q
Products of conception with intrauterine bleeding(2)
Cervix dilated or not
A
Cervix dilated is inevitable
No dilation is threatened
24
Death of fetus with all products of conception in uterus
Missed abortion
25
Abortion with infection of uterus
Septic abortion
26
First 2 clues to multip
Increased msafp and Bhcg
27
Fetal weight cutoff for underweight at delivery
2500 mg
29
2 most common tocolytics in order
Mg sulfate - neuroprotection
| CCBs
30
dosing of folic acid
| nonrisk and risk (2)
nonrisk =.4
| risk = 4
31
appropriate weight gain for obese women in pregnancy
11-20 lbs
32
apgar (5)
Include amt of p
```
appearance
pulse =>100 for 2 points
grimace
activity
respiration
```
33
acrocyanosis
blue at extremities only
| apgar score =1
34
tx fir placenta previa with bleeding or drop in hematocrit
strict pelvic rest
35
placental abruptions which are
serious
minimal complications
```
concealed = serious
external = minimal complications
```
36
cause of death in erythroblastosis fetalis (hemolytic disease of newborn)
+CO = CHF
37
test for Ab
indirect coombs
38
management if patient sensitized with > 1:16
Transcranial Doppler, if positive:
| serial amniocentesis to assess bili level
39
tx (2) high bili level in sensitized mom
percutaneous umbilical blood sample
| perform intrauterine transfusion
40
tx for HELLP
same for preeclampsia;
term = deliver
preterm = betamethasone for lungs, mg sulfate for seizures
if severe, hydralazine for BP
41
DM tests during pregnancy
32 weeks+
36 weeks+
37 weeks
38-39 weeks
32 weeks + = weekly NST
36 weeks + = NST + BPP
37 weeks = L/S ratio for lungs (if mature, deliver)
38-39 weeks = induce delivery.
42
2 timings and types of IUGR
symmetric. first 20 weeks
| asymmetric. smaller head. second 20 weeks
43
First 2 causes of IUGR
smoking
| maternal infections = #2 (immunize!)
44
definition macrosomia
>4500 g
45
AFI normal
8-18
46
AFI normal
8-18
47
5 components of BPP
```
TB-MAN
tone
breathing (30 in 30 minutes)
movement (3 in 30 minutes)
AFI
NST (2 accelerations in 20 minutes)
```
48
definition accelerations
more than 15
49
definition variable decel
decrease in HR with no relation to contractions
50
significance variable decel
umbilical cord compression
51
late decels significance
fetal hypoxia (very concerning; often uteroplacental insufficiency)
52
lightening
fetal descent into pelvic brim (before labor)
53
2 signs of placental separation besides blood, cord lengthening
uterus fundus rising
| uterus becoming firm
54
contraindication for PGE2 for cervical ripening
asthma
55
definition of protraction of cervix of prime
| arrest
if no more than 1.2 cm in hour
| arrest = no cervical change for 2 hours
56
prolonged latent stage cutoffs of prime and multipara
```
prime = 20 hours
multi = 14 hours
```
57
tx (2) for prolonged latent stage
rest and hydration
58
frank vs complete breech
```
frank = hips flexed with extended knees
complete = hips and knees flexed.
```
59
time period where you can do cephalic version
after 36 weeks
60
PROM vs PPROM
```
prom = before labor
PPROM = before labor and before term
```
61
tx PPROM
abx
62
2 indicators of fetal lung maturity (1 is a gestational age)
positive phosphatidylglycerol or 34 weeks gestational age
63
evidence of chorioamniotis on amniocentesis
glucose less than 20
64
moderate variability def
6-25
65
admin of PGF2a
IM or uterine injection
66
tx for unresponsive uterine atony
B lynch suture
67
placental enzyme deficiency that can lead to postterm
sulfatase
68
S/D ratio abnormality in umbilical arteries in IUGR
increase in the S/D ratio reflects increased vascular resistance.
69
metrorrhagia
intermenstrual bleeding
70
oligomenorrhea
mentrual cycle >35 days
71
lichen sclerosis vs lichen planus
```
sclerosis = cancer risk if postmenopausal
planus = violet, flat papules
```
tx both with topical steroids.
72
marsupialization
I&D where you keep lesion (bartholin gland, for ex) with sutures.
73
vaginal discharge with a fishy odor
vaginosis
74
profuse, green, frothy vaginal discharge
trichomonas
75
clue cells on KOH
| dz and pathogen
bacterial vaginosis
| gardnerella
76
tx trichomonas
metronidazole for patient AND partner
77
vulvar soreness and pruritis
| red lesion with superficial white coating
paget dz
78
paget dz of vulva dx and tx
```
dx = bx
tx= vulvectomy
```
79
squamous cell carcinoma stage 0 vs I vs II of vagina
O= in situ
| 1=2 cm vulva o perineum
80
SCC of vagina stage III vs IV vs IVa
```
III = urethra or anus. unilateral nodes
IV = bladder, rectum or bilateral nodes
IVa = distant metastasis
```
81
2 med tx for severe endometriosis (vs OCPs for mild)
```
danazole = androgen
leuprolide = GnRH agonist constant admin
```
82
LH: FSH ratio in PCOS
greater than 3:1
83
GSI vs ISD
both types of stress continence
GSI = bladder instability (genuine stress incontinence)
ISD = sphincter probs (idiopathic sphincter deficiency, less common)
84
cause of urge incontinence
detrusor instability
85
2 tx for urge incontinence in a post menopausal female (categories)
vaginal estrogens
| anticholinergics
86
fixed, drain pipe urethra and incontinence
| name and tx
intrinsic sphincteric deficiency ( a more rare form of stress continence).
urethral bulking procedure
87
q tip test with angle greater than 30
hypermobile urethra
| stress urinary incontinence
88
nerve cutaneous sensation to the groin and the skin overlying the pubis
iliohypogastric
89
nerve cutaneous sensation to the groin, symphysis, labium and upper inner thigh
ilioinguinal
90
inability to adduct thigh = what nerve
obturator
91
type of pregnancy assoc. w/placental sulfatase deficiency, fetal adrenal hypoplasia
postterm
92
obese woman should gain how many pounds in pregnancy?
11-20
93
dx tool for appendicitis during pregnancy
graded compression ultrasonography
94
Normal age range for menarche
9-17
95
Mullerian agenesis
| Associated prob
Renal anomalies.
96
Gartner's cyst
Mesonephric cyst of upper vagina
97
Nabothian vs mesonephric cysts
Cysts of cervix. Nabothian is superficial.
98
Hyperthecosis
Severe PCOS
99
time period where vacuum aspiration is OK for elective abortion
embryos only! (< 8 weeks)
100
method of obtaining PRL level
fasting
101
score for osteopenia
T score between -1 and -2.5
102
making dx of urge incontinence on cystometrogram
uninhibited contraction of the bladder with filling
103
3 factors necessary to develop 2ndary sexual characteristics
adequate body weight, sleep and optic exposure to sunlight
104
Colpocleisis
surgical closure of vagina- used to tx prolapse
105
3 vitamin deficiencies assoc. w/PMS
ABE has 6 dates of PMS
| A, E and B6
106
tx for anti-phospholipid antibody syndrome (2)
aspirin plus heparin
107
complete mole
karyotype?
fetal parts?
risk od post-molar GTD?
diploid (XX or XY) - empty egg
no fetus
+risk of post-molar GTD
108
definition of microinvasive cervical cancer
invasion <3 mm below basement
109
relationship between OCPs and ovarian cancer
OCPs are protective
110
ectropion of cervix
outward turning edge of cervix
111
lyonization of genes
X inactivation
112
tx for cholestasis of pregnancy (2)
ursodeoxycholic acid
| naltrexone
113
use of clomiphene challenge test
to test for ovarian reserve in old patient
114
way to suppress lactation if patient does not want to breast feed (3, 2 would be a reasonable answer)
breast binders
ice packs
analgesics
115
bloody show during labor. etiology of blood
friable cervix
116
BV risk in pregnancy
PPROM
117
polymenorhea
cycle length <21 days
| normal flow
118
malignant trophoblastic gestational dz
vs
choriocarcinoma
choriocarcinoma has metastasis
119
time of division of mono-di twins
4-8 days
120
primary amenorrhea (2)
no menses by:
age 16
OR
4 years post-thelarche
121
secondary amenorrhea (2)
no menses in previous menstrual patient:
missed 3 cycles
OR
none for 6 mos.
122
reactive NST
2 accelerations greater than 15 bpm/over 15 seconds within 20 minute window
123
normal variability of FHT
6-25
124
acceleration
+15 bpm over 15 seconds
125
failure to progress during active labor
no change in 2 hours
126
4 causes of postpartum hemorrhage
Tone (uterine atony leading to continued bleeding)
Trauma (perineal or cervical lacerations, uterine inversion)
Tissue (retained or invasive placental tissue in the uterus)
Thrombin (a bleeding disorder-much less common that the other three causes)
127
general rule of thumb for neonatal weight gain once milk is in
1 oz gain/day
128
nonstress test pass
2 or more accels in 20-40 minutes
129
risk of trastuzumab (herceptin)
cardiotoxicity
130
most common complication of postterm
oligohydramnios
131
B-HCG is + how long after mab
4-6 weeks
132
etiology of symmetric (head and body) vs asymmetric IUGR
symmetric tends to be fetal origin
| asymmetric tends to be maternal vascular dz
133
if dilation is 6 or greater arrest is considered (2)
no change for 4 hours despite adequate contractions
| no change for 6 hours with inadequate contractions
134
when in gestation can you dx gestational htn or preeclampsia?
after 20 weeks
135
corticosteroids necessary at what gestation
less than 34 weeks
136
cutoff for Hg for anemia in pregnancy
11
137
normal contraction stress test (equivalent of BPP)
no variable or late decels
138
tx (2) of postpartum endometritis
IV clinda and gent
139
tx for bacterial vaginosis
metronidazole
140
reason for Mg admin during preterm labor
neuroprotection (prevents CP)
141
approach to recurrent late decels
indication for C/S
