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Flashcards in OB/Gyn Deck (36)
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1
Q

tx of ectopic >3.5cm?

A

> 3.5cm: laproscopic

2
Q

mc tocolytic

A

MgSO4 (not just used for preeclampsia)

tocolytics slow progression of cervical dilation and contraction

3
Q

first sign of pregnancy

A

Goodell sign

cervical softening, around 4 wks

4
Q

Virchow’s triad elements occur in pregnancy. What are they?

A

Venous stasis
endothelial injury
hypercoaguability

5
Q

Term lengths

A

Preterm: 25-37 weeks
Term: 38-42
Postterm: after 42weeks

6
Q

Nagele rule for estimated day of delivery

A

LMP - 3mo + 7 days = estimated delivery day

7
Q

mc site for ectopic pregnancy specifically?

A

ampulla of the fallopian tube

8
Q

methotrexate MOA?

A

it is a folate receptor antagonist

can be used on ectopic preg

9
Q

how do you know methotrexate is knocking out that ectopic preg?

A

Want to see a 15% decrease in bHCG in 4-7d

follow every week until bHCG levels are 0

10
Q

granulosa cell tumor

A

ovarian solid tumor, malignant
produced excess estrogen
see: precocious puberty, or postmeno bleeding (bimodal age distribution)

11
Q

missed vs threatened abortion

A

missed: nonviable fetus
threatened: viable fetus

do: fetal heart tones, pelvic exam (asses cervix, fluids), then US
(i picked bHCG over US; wrong)

12
Q

HELLP syndrome

A

Hemolysis (schistocytes, etc)
Elevated Liver enzymes
Low platelets

13
Q

elevated alk phos in pregnant woman

A

normal

14
Q

preg pt with HELLP syndrome has pitting LE edema, rales , and oliguria. What is happening?

A

pulmonary edema (a rare complication of preeclampsia) (HELLP is a variant of preeclampsia)

15
Q

tx for magnesium toxicity?

A

obvi stop mag

then give calcium gluconate

16
Q

gestational HTN is when?

A

only after 20wk gestation!

17
Q

After diet and excercise, what 3 treatments are safe for gestational DM?

A

insulin
metformin
glyburide

18
Q

placenta previa vs vasa previa antepartum hemorrhage

A

both cause painless vaginal bleeding upon ROM; however, vasa previa you see rapid fetal distress

19
Q

What are the 5 elements of the Biophysical Profile?

A
Nonstress test
Fetal chest expansions (1+ in 30min)
Fetal movement (3+ in 30min)
Fetal muscle tone (1 flex)
Amniotic fluid
20
Q

Fetal tachycardia

A

> 160bpm

21
Q

What is the nonstress tests?

A

external fetal HR monitoring for ~30 min
good results: > or = 2 accelerations
bad: multiple variable or late decels

22
Q

External cephalic version

A

can be done between 37weeks - labor
to turn breech baby around
CI: placental abnormalities, oligohydramnios, multiple gestation

23
Q

Meconium aspiration syndrome looks like? assc with? at risk for?

A

see low APGARs, resp distress, and CXR with patchy b/l infiltrates

associated with advanced gestational age

at risk for persistent pulm HTN

24
Q

Testing at first prenatal visit? (8 things)

A
CBC
ABO & Rh status
Hep B 
Syphilis
Rubella 
HIV
UA 
Gonorrhea
Chlamydia
25
Q

itchy white plaques in the anogenital region

A

(vulvular) lichen sclerosis
tx: topical steroids, or tacrolimus (calcineurin inhib) if steroids aren’t enough
dx: biopsy
at risk for developing squamous cell CA

biopsy to tell this from Paget’s disease. tx for Pagets is b/l vulvectomy

26
Q

post partum hemorrhage

A

needs to be >500mL of blood (can be up to 6 wk later)

do: 1. examine the uterus for rupture, retained stuff
2. compression and massage
3. administer uterotonic agents (oxytocin, methylergonovine, caraboprost tromethamine(this is a PGF2a analog))

27
Q

Avoid these drugs in pregnancy

A

ACEi
valproic acid, carbamazepine, Li
warfarin
aminoglycosides, tetracyclines, fluoroquinolones, TMP-SMX

28
Q

Non-cancerous condition where the endometrium invades the myometrium

A

Adenomyosis

uterus feels boggy on exam

dx&tx: hysterectomy

29
Q

Drugs to tx prolactinoma

A

1.Bromocriptine 2. Cabergoline

these are dopamine receptor agonists. Dopamine inhibits prolactin release

(note: in order to treat with drugs, needs to not be causing visual disturbances)

30
Q

intraurterine adhesions

A

Asherman’s syndrome

secondary to D&C

31
Q

mc site for ureteral injury after a hysterectomy?

A

cardinal ligament
it attaches the cervix to the pelvic wall and houses the uterine arteries

The ureter run just lateral and below the uterine arteries “water under the bridge”

32
Q

assessment of amenorrhea:

A
  1. bHCG preg test
  2. TFT
  3. prolactin levels
  4. progestin challenge test
33
Q

What is a cerclage?

A

Stitches to hold in place an incompetent cervix

ex: a patient who had several abortions in their youth is now ready for a serious pregnancy

34
Q

Third trimester testing (5)

A
  1. 27wk CBC (did this at visit 1, Hg less than 11, give PO Fe)
  2. 24-28 do glucose load
    3/4. 36wk: Chlamydia, gonorrhea testing
  3. Group B strep rectovaginal swab
35
Q

motile flagellates on saline wet mount
is?
tx?

A

trichomonas

tx pt AND partner with metronidazole

36
Q

mild vs. severe preeclampsia?

A

mild: BP more than 140/90, 24H protein of more than 300mg
severe: more than 160/110, 24H protein of more than 5g