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Flashcards in OB GYN Deck (45)
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1
Q

placenta previa should be delivered how?

A

C section at 36-37 weeks

2
Q

when to use cerclage?

A

hx of second trimester deliveries or a short cervix (<2.5 cm)

3
Q

complications for mom due to placental abruption?

A

risk for hypovolemic shock and DIC

4
Q

HYPEREMESIS GRAVIDARUM
sx?
tx?
risks factors:

A

sx n/v persistent and severe, weight loss, and sx of dehydration

tx: IV ANTIEMETICS, fluids and electrolyte repletion
risks: multiple gestatiom, hydatidiform mole, and hx of reflux

5
Q

greatest risk factor for cerebral palsy

A

premature birth before 32 weeks

6
Q

breast feeding failure jaundice vs breast milk jaundice

A

BFFJ = decreased bilirubine elimination and inreased enterohepatic circulation (dehydrated, suboptimal feeding) –> signs of dehydration/jaundice and few diapers(red crystals), baby just needs to feed more

BMJ = high level of B-glucuronidase in milk deconjugates intestinal bilirubin –> adequate breast feeding, normal exam

7
Q

is trial of labor contraindicated in px with hx of myomectomy?

A

YESq

8
Q

primary htn vs gestational htn vs preE vs Eclampsia

A

primary = 140/90 + prior to conception or before 20 weeks gestation

gestational = after 20 weeks, no proteinuria

preE = htn after 20 weeks and proteinuria or end organ damage sx

eclampsia = preE and new onset seizures

9
Q

htn increases the risk of PPROM and preterm labor.

true or false

A

false, it only increases the risk of preterm labor, NOT PPROM

PPROM is associated with genital tract infection and hx of prior PPROM

10
Q

does levothyroxine dose stay the same, decrease or increase in pregnancy?

A

dose must increase since estrogen in pregnancy induces an increase in thyroxine binding globulin levels (more binding sites that must be saturated)

11
Q

a normal non stress test (NST) shows….

A

2 or more heart rate accelerations that are 15 + beats/min above baseline within a 20 min period
**test can last up to 40 min to account for fetal sleep

12
Q

a normal BPP…

A

score of 8-10

nonstress test, fetal movement, tone, breathing, and AFI

each get 2 max

13
Q

does chorioamnionitis require c section?

A

no

give broad spectrum abx and oxytocin to accelerate labor/delivery if 38+ weeks old

14
Q

what is the only current indication for hormone replacement therapy?

A

vasomotor symptoms in women <60 who have undergone menopause in past 10 years

**it is NO longer used to precent CAD, thromboembolism, or osteoporosis/fractures

15
Q

after breast cyst in young woman is aspirated (mass decreases size), what do you do?

A

ultrasound in 2-4 months

dont send the fluid for culture!

16
Q

most effective emergency contraceptive?

A

copper IUD inserted up to 5 days after unprotected sex

pills are less effective

17
Q

most common heart defect in edwards (tri 18)?

A

VSD

18
Q

what do the following indicate:
1 early decels
2 late decels
3 variable decels

A

1 fetal head compression (symmetric to ctx)
2 uteroplacental insufficiency / Fetal hypoxia
3 abrupt decels; cord compression or cord prolapse

19
Q

nagele rule to estimate day of delivery

A

LMP - 3 months + 7 days

20
Q

when is fetus viable?

A

after 24 weeks

21
Q

4 P categories in GP numbers

A

full pregnancies
preterm pregnancies
abortions
living children

22
Q

goodell sign

A

first sign on PE to indicate preganncy

at 4 weeks = softerning of cervix

23
Q

when is triple or quad screen done? what is added in the quad?

A

2nd trimester 15-20 weeks

AFP, estriol, bHCG, + inhibin A

24
Q

if braxton hicks ctxs become continued…

A

check cervix (true braxton hicks dont dil,ate cervix)

25
Q

chorionic villus sampling vs amniocentesis

A

CVS done at 10-13 weeks in AMA to get karyotype

Amnio done after 11-14 weeks in AMA to get karyotype

26
Q

stable patient w ectopic pregnancy can be treated with…

A

methotrexate…look for 15% decrease in hCG…second dose if bHCG doesnt decrease…if no decrease after 2nd dose –> surgery

27
Q

inevitable abortion

A

intrauterine bleeding + dilated cervix

28
Q

threatened abortion

A

intrauterine bleeding but no dilation of cervix

29
Q

missed abortion

A

fetal death but all POC are in the uterus

30
Q

what med to induce labor for an abortion?

A

misoprostol (pg e1)

31
Q

preterm labor at 24-33…..next step?

A

if stable, stop and give tocolytics(mg) and betamethasone

32
Q

placenta previa presents w

A

painless bleeding

33
Q

normal HR for fetus

A

110-160

34
Q

arrest of cervical dilation

A

no cervical change for 2 hrs

35
Q

do not perform external cephalic version until after ___ weeks

A

36

36
Q

what syndrome leaves woman unable to breast feed after delivery

A

sheehan syndrome

37
Q

tx for PMS/PMDD

A

lifestyle (exercise, stop cafferine and smoking)
or
SSRI

38
Q

horone replacement therapy is associated w what unwanted s/e

A

endometrial hyperplasia which can lead to camcer

39
Q

postcoital bleeding is ___ until proven otherwise

A

cancer

40
Q

dx step for any women >35 with abnormal bleeding

A

endometrial biopsy

41
Q

endometriosis

A

implantation of endometrial glands outside of the endometrial cavity

cyclical poelvic pain

rustry datrk brown lesions

tx ocps, danazol, leuprolide, or surgery

42
Q

LH:FSH ratio >3:1

A

polycystic ovarian syndriome

43
Q

clomiphene citrate

A

med for pcos pt who wants to get pregnant

44
Q

htn meds for pregnancy

which are contraindicated?

A

methyldopa, labetalol, hydralazine, or nifedipine

NO: ace i, arbs, spironolactone, furosemide

45
Q

which cancer does alcohol have a dose dependent effect on?

A

breast

counsel those worried about breast ca to decrease alc intake