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Flashcards in OB/gyn Deck (141):
0

Appropriate weight gain for preg.
If normal weight
Obese

Normal 25-35
Obese 11-20

1

Admin of pgf2 (method)

IM

2

Labor warnings fetal movement

10 per 2 hours

3

Variable decelerations mcc

Cord compression

4

Early decelerations mcc

Head compressions

5

Late decelerations mcc

Placental insufficiency (hypoxia = concerning)

6

Trichomonas discharge gross

Yellow and frothy

7

Montevideo units and cutoff

Sum up internal changes in 10 minutes. 200 required for adequate labor.

8

Definition embryo

To 8 weeks

9

Pre viable

Before 24 weeks

10

Post term

42 weeks

11

Goodell sign

Softening of cervix
1st sign of preg equals 4 weeks

12

Time of teleangiectasias and palmar erythema

1st trimester

13

Chloasma and time

Hyper pigmentation 2nd trimester

14

Linea nigra

Line of hyper pigmentation. 2nd trimester

15

Time when US can confirm gestational age

11 to 14 weeks

16

Quickening time period

16 to 20

17

Time period for triple or quad

15 to 20

18

Time for gbs and chlamydia screen

36

19

Time period for cervical checks in 3rd trimester

37 weeks

20

Abortion def

Demise before 20 weeks

21

Test necessary to dx type of abortion

US

22

Complete vs incomplete abortion

Complete means no products of conception left

23

Products of conception with intrauterine bleeding(2)
Cervix dilated or not

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