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Third Year > Ob/Gyn > Flashcards

Ob/Gyn Flashcards

1
Q

uterine fundal tenderness

A

endometritis

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2
Q

most common cause of PPH

A

uterine atony

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3
Q

what bugs cause endometritis

A

polymicrobial involving strep and staph overall

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4
Q

most significant risk for post partum depression

A

previous depression

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5
Q

breast feeding decreases the risk of what kind of cancer

A

ovarian

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6
Q

best way to stop breast feeding

A

breast binding, ice packs, and avoidance and stimulation, NSAIds

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7
Q

what are the risks of trying to stop breast feeding with medications

A

increased thromboembolic events

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8
Q

what hormone causes milk production

A

prolactin

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9
Q

what hormones inhibit milk production in the breast

A

estrogen and progesterone. Progesterone withdrawal leads to the prolactin rising in the breast

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10
Q

intense nipple pain is caused by what organism

A

candida

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11
Q

how many poopy diapers in a day

A

3-4 per day

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12
Q

how many wet diapers per dau

A

6 per day

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13
Q

what hormone is stimulated by suckling

A

oxytocin is released because of the sckling response which helps with milk let down and ejection

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14
Q

how long do you wait for repeat beta HCG with ectopic pregnancy

A

48 hours

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15
Q

what is the biggest risk factor for ectopic pregnancy

A

prior ectopic pregnancy

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16
Q

person with DM1 is preg, what is the biggest risk to the baby

A

IUGR

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17
Q

what can lisinopril cause in pre

A

oligohydramnios, fetal groth retardation, and neonatal hypotension, pulmonary hypoplasia, joint contractires and death

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18
Q

what medicine can be used for migraine in pregnancy

A

amytriptyline

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19
Q

most common cause of sepsis during pregnancy

A

pyelonephritis

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20
Q

what happens to asthma during pregnancy

A

will get worse, so need to increase the use of beta agonists, so then move to adding corticosteroids eventually can go to theophylline

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21
Q

first line treatment for thyroid storm

A

propanolol and PTU

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22
Q

treatment for syphillus no matter what

A

PCN and desensitization even if they are allergic

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23
Q

when should diabetes screening should happen

A

between 24-28 weeks

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24
Q

if people are at high risk for DM when should they be screened for DM

A

should be screened ASAP

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25
Q

BV see what cells

A

clue cells and positive whiff test

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26
Q

what is BV in pregnancy treated with

A

it is treated with metronidazole

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27
Q

what condition has the highest mortality during pregnancy

A

pumonary hypertension

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28
Q

how do you treat asymptomatic MVP

A

you do nothing

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29
Q

how do you treat symptomatic MVP

A

give beta blockers

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30
Q

diagnostic test if the preg patient has PNA

A

chest XR

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31
Q

big risks of obesity during pregnancy

A

increased risk of pre-eclampsia and hypertension of pregnancy. Increased risk of large babies

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32
Q

what are the two most common reasons for anemia in pregnancy

A

acute blood loss and iron deficiency anemia

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33
Q

treatment of SLE in pregnancy

A

steroids

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34
Q

breast cancer treatment in pregnancy

A

modified radical mastectomy

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35
Q

common depression during pregnancy treatment

A

SSRI

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36
Q

what is the treatment for itchy longterm pregnancy

A

it is the Udoxysomething acid

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37
Q

how do you diagnose appendicitis in pregnancy

A

graded ultrasound

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38
Q

what is the biggest symptom of magnesium toxicity

A

respiratory depression

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39
Q

what level of protein in the urine indicates pre-eclampsia

A

over 300 mg

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40
Q

what is the best treatment for pre-eclampsia

A

delivery

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41
Q

what do you give during labor for pre-eclampsia

A

magnesium sulfate

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42
Q

what medication is used for eclamptic seizures

A

magnesium sulfate

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43
Q

at mg level of 11 what usually occurs

A

respiratory depression

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44
Q

at mg of 15 what usually happens

A

cardiac arrest

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45
Q

what is the best contraindication to expectant management in pre-eclampsia

A

it is thrombocytopenia- that baby needs to get out

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46
Q

what does HELLP stand for

A

hemolysis, elevated liver enzymes, low platelets

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47
Q

what is the biggest risk with HELLP

A

rupture of the liver through the liver capsule

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48
Q

what are risk factors of placental abruption

A

trauma, pre-e, and hypertension

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49
Q

what non-invasive testing can look for Rho-immunization

A

look at fetal head dopler

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50
Q

characteristics on US of fetal hydrops

A

ascites, pericardial effusion, pleural fluid, scalp edema, polyhydramnios, placental edema

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51
Q

what amount of blood is neutralized by 300 of Rhogam

A

300 cc of fetal blood

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52
Q

what thing is most indicative of bad rho gam disease in the fetus if present in the amniotic fluid

A

billirubin

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53
Q

baby is 30 weeks and has severed hemolytic disease what should you do

A

transfuse that sucker

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54
Q

marker of dizygotic twins

A

two spirit placentas

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55
Q

what are monochorionic diamniotic twins are at highest risk for

A

congenital anomalies

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56
Q

what os the best thing to prevent preterm delivery during pregnancy

A

make sure there is good weight gain at the start of pregnancy

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57
Q

twin twin transfusion are what kind

A

diamniotic and monochorionic

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58
Q

what is the biggest risk of multiple gestations for the fetus

A

it is pre-term delivery

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59
Q

if one twin is breech and one twin is vertex, what is the best way to deliver them

A

C section

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60
Q

what should you do if the fundus is higher than expected and the AFP is 3x the normal

A

get a sonogram because they is more than one bun in that oven

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61
Q

why are CS rates higher now

A

less VBACs are allowed

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62
Q

common reasons for breech

A

prematurity, previa, fibroids, genetic disorders, and polyhydramnios

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63
Q

what is the biggest risk of shoulder dystocia

A

previous shoulder dystocia

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64
Q

when the patient has a breech delivery- what is most likely to be coming through the cervix first

A

the butt

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65
Q

what is the biggest risk of placenta acreta

A

from any CS and pregnancies

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66
Q

what does FFP contain when given

A

fibrinogen, factor VIII and V

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67
Q

what are the preconception risks for a person that smokes

A

placenta previa, placental abruption, IUGR, pre-E, infection

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68
Q

what is bloody show

A

the cervix is friable and bleeds when dilated because it is really vascular

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69
Q

differntiate bloody show and cervicitis

A

bloody show occurs with cervical dilation, and cervicitis is bleeding and friable cervix with no dilation

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70
Q

differentiate cervical polyp and cancer

A

the polyp will not be a hard mass, but cervical cancer will. The cervical cancer will be increased risk with smoking

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71
Q

most common cause of preterm labor

A

idiopathic

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72
Q

if the patient is in preterm labor and the GBS status is unknown, what do you do?

A

ampicillin

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73
Q

patient has a fever, slightly dilated,and is in preterm labor, so what should be done (she is contracting)

A

induce labor

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74
Q

what tocolytics are best for with DM patietns

A

give nifedipine

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75
Q

what tocolytics are contraindicated in patients with DM

A

terbutaline and ritodrine

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76
Q

how does Mg sulfate work as a tocolytic

A

competes with Ca for movement into the cell

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77
Q

what are the side effects of terbutaline

A

hypotension, tachycardia, anxiety, chest- tightening

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78
Q

what is the MOA of terbutaline

A

beta adrenergic agent

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79
Q

what are the potential side effects of using indomethacin during pregnancy

A

premature closure of the PDA

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80
Q

what are the potential side effects of nifedipine during pregnancy

A

fetal hypoxia and decreased uteroplacental blood flow

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81
Q

what are some of the positive effects of corticosteroids in the newborn period

A

it can be helpful for the maturity of the lungs, it decreases incidence of NEC, and it decreases the risk of intracerebral hemorrhage

82
Q

where do you not swab for nitrazine testing

A

it is vaginal fluid not cervical. Cervical mucus can cause false positives

83
Q

if there is premature rupture of membranes, how long can you wait before delivery and what is the role of tocolytics

A

tocolytics are for the delay of labor until there is full effect of steroids at 48 hours

84
Q

what is the most common cause of premature rupture of membranes

A

infection usually BV

85
Q

what are variable decels from

A

cord compression

86
Q

what do you give when there is premature rupture of membranes

A

give ampicillin and erythromycin to prolong latency for 5-7 days and prevent ascending infection reduce neonatal sepsis and amnionitis

87
Q

what is an indication for delivery when the patient has premature rupture of membranes

A

if there is a tender funds because then the patient probably has chorioamnionitits

88
Q

what is elevated in the amniotic fluid when there is chorioamnionititis

A

IL6

89
Q

what medication can decrease the chances of premature pre-term rupture of membranes

A

17-alpha hydroxyprogesterone

90
Q

what is the time frame after which you do not give steroids

A

32 weeks

91
Q

36 weeks with premature rupture of membranes- what do you do

A

augment labor

92
Q

when are prostaglandings contraindicated

A

previous CS

93
Q

what should you use with a cervix that isn’t dilating and the patient is contracting

A

use an IUPC

94
Q

what uterotonic is contraindicated when the patient has HTN

A

it is methyergonovine

95
Q

what uterotonic is contraindicated when the patient has asthma

A

hemabate, which is prostaglandin E2 alpha

96
Q

what is PPH blood loss for CS and vaginal

A

CS-1000 and vaginal is 500

97
Q

what problem is common with multiple CS that also have anterior placentas

A

placenta acreta and atony

98
Q

what increases the risk for retained placenta

A

circumvalate placenta, prior CS, prior circlage, fibroids

99
Q

what is the typical treatment for endometritits

A

gentamycin

100
Q

what increases the risk for acute cystitis after pregnancy and what kind of organism causes it

A

it is from indwelling catheter and Ecoli

101
Q

what is happening if the breast is tender and large without erythema

A

it is breast engorgement.

102
Q

Pfannenstiel incision

A

it is the bikini line incision for CS

103
Q

what should you do if there is pain along the incision of a CS

A

incise, explore and drain

104
Q

postpartum patient with RUQ, fever, nausea, and other symptoms along these lines has what

A

cholecystitis

105
Q

patient presents with fever that has been non-responsive to antibiotics. No issues on abdominal exam. Lochia and discharge are normal. She is eating fine, she is ambulating well- what does she have and what treats it

A

She has septic pelvic thrombophlebititis- needs to be treated with anticoagulation and antibiotics

106
Q

what is the most common cause of fever POD1

A

it is lungs atelectasis

107
Q

what are the two drugs you would want to use for endometritis following a CS

A

gent +clinda(clinda covers the anaerobes)

108
Q

a patient received an epidural early in the day, and now she is complaining of neck pain and photophobia- what does she have and what diagnostic test does she need

A

meningititis and she needs a lumbar puncture

109
Q

what is the biggest risk factor for postpartum psychiatric issues

A

previous psychiatric issues

110
Q

what is the biggest side effects of SSRIs in these postpartum patients

A

it is sleep disturbance, decreased libido

111
Q

what are the third trimester side effects of SSRIs in the neonatal period

A

it is agitation and EPS symptoms

112
Q

if a patient is depressed, what else should you ask about

A

ask about suicide

113
Q

what phase of the cycle do PMS and PMDD happen

A

in the luteal phase through the end of menstruation.

114
Q

what is the best first step to diagnose PMS and PMDD

A

it is to ascertain the timing of symptoms

115
Q

what is postpartum blues

A

sleep and mood disturbances in the days following delivery, and they last for less than two weeks

116
Q

patient is at 41 weeks and is fine otherwise, but not ready for labor… what should you do

A

check the AFI and then look at NST

117
Q

what is associated with posterm deliveries

A

it is fetal adrenal hypoplasia, placental sulfatase deficiency, anencephaly

118
Q

late and post-term pregnancies are associated with what

A

macrosomia, oligohydramnios, meconium aspiration, uteroplacental insufficiency, and dysmaturity

119
Q

what does a baby look like with dysmaturity

A

they have long fingernails, look frail, are meconium stained, so they are yellow-green in appearance, and small placenta. They are at increased risk of still birth

120
Q

if the cervix is long high and closed, what should you do to start the patient off for labor induction

A

you should start her with prostaglandins to ripen the cervix

121
Q

what is the biggest risk for post-term delivery

A

previous post term pregnancy

122
Q

Intrauterine growth restriction requires what after 33 weeks-

A

biweekly testing

123
Q

fat in the dilation in curettage tube- what is it

A

omentum- laparotomy

124
Q

what head size is indicated for CS

A

12 cm

125
Q

what do vacuum surgical deliveries help with or decrease the rate of

A

maternal lacerations

126
Q

most likely complication of tubal

A

pregnancy

127
Q

side effects of depo in the first few months

A

bleeding in between period times.

128
Q

what type of cancer do OCPs decrease

A

endometrial and ovarian

129
Q

what is the biggest problem with tubal sterilization

A

regret by the patietn

130
Q

which has less poor outcomes: TS or vasectomy?

A

vasectomy because it is an out-patient procedure as opposed to a TS which is an OR procedure

131
Q

what is the best BC for heavy or abnormal uterine bleeding

A

mirena

132
Q

what is the contraindication to the patch OCP

A

weight. Cannot use if over 198

133
Q

what is it if the patient has a positive pregnancy test, fever, open cervical os, and bleeding

A

septic abortion

134
Q

how do you treat a septic abortion

A

broad abx and uterine evacuation

135
Q

how do you treat for an antiphospholipid antibody pregnant woman

A

heparin and aspirin

136
Q

which has higher blood loss medical or surgical abortion

A

medical

137
Q

what is the contraindication to manual aspiration abortion

A

it must be under gestational age of 8weeks

138
Q

what is the least invasive treatment for missed ab

A

misoprostol

139
Q

if there is bleeding following after medical abortion, what should you do

A

D&C because the bleeding is from retained products of conception

140
Q

clue cells are associated with what, and who do you treat and with what

A

BV, metronidazole, and only her

141
Q

petichiae on the cervix, and frothy copious discharge, and are associated with what, and who do you treat and with what

A

trichmonas, treat with metronidazole, and treat her and partner

142
Q

pain with insertion or penis or tampon, and no other fiindings- what is it and treatment

A

vulvobulbodynia- treat with TCA

143
Q

excoriations, white plaques, itching, dryness on outside- what is it

A

lichen chronicus simplex

144
Q

patient is leaving for Europe and has cervical discharge, and so what should you treat her with since the tests are not back

A

give her azithromycin and ceftriaxone

145
Q

what do you do for a painful vulvar lesion

A

biopsy it

146
Q

tenderness over the adnexa and lower abdomen, and mucopurulent cervicitis- what is the diagnosis

A

it is salpingitis

147
Q

what do you do to treat drainpipe urethra

A

urethral bulking

148
Q

what do you use to treat detrusor instability

A

oxybutanin or other anti-cholingergics

149
Q

what position of surgery treats cystoceles

A

pubocervical fasica and arcus fascia being fixed

150
Q

what is urge incontinence

A

it is when there is residual and detrusor instability

151
Q

what do you do if a prolapse is asymptomatic

A

reassurance and watching it

152
Q

what is the first line treatment for symptomatic prolapse

A

pessary first

153
Q

what is the best endometriosis treatment for a young nullparious patient

A

laser ablation

154
Q

after NSAIDs fail for endometriosis what is the next treatment of choice

A

OCP

155
Q

what is the best diagnostic test for endometriosis

A

it is diagnostic laporotomy

156
Q

what do you treat endometriosis that makes someone infertility

A

give them clomiphene

157
Q

when do you give under 28 weeks

A

mg, beclamethasone,

158
Q

how do you test for hypothalamic pit axis issues ammenorhea

A

look at FSH level

159
Q

if there is an older lady with ammenorhea whats the first test

A

pregnancy

160
Q

what does PCOS put you at an increased risk for

A

endometrial cancer

161
Q

elevated DHEAS and hairy woman

A

adrenal tumor

162
Q

why does hair fall out after preganncy

A

it falls out because of the drop in estrogen

163
Q

what age is most common for theca leydig cell tumors

A

testosterone secreting tumors are most common from 20-40

164
Q

treatment of hirsutism from PCOS

A

OCP and spirolactone

165
Q

what is the most common cause of menorhagia in young girls

A

von wildebrand disease

166
Q

why should you remove a polyp

A

for fertility reasons

167
Q

what hormone is increased in PCOS

A

testosterone

168
Q

how do you remove a fibroid and preserve fertilit

A

hysteroscopy with myomectomy

169
Q

what kind of cancer is higher risk for transplant patients

A

cervical

170
Q

what birth control has the side effect of irregular bleeding

A

nexplanon

171
Q

why do OCPs work for painful periods

A

it causes endometrial atrophy

172
Q

what should you test for in sexually active under 25 yo

A

STDs

173
Q

what is the definitive treatment for abnormal uterine bleeding

A

hysterectomy

174
Q

is endometriosis frist or secondary dysmenorhea

A

it is secondary dysmennorhea

175
Q

if you suspect fibroids, what should be done

A

endometrial biopsy if there is abnormal bleeding

176
Q

well-circumscribed non-encapsulated myometrium describes the pathology of what

A

fibroids

177
Q

what are the symptoms and age range for endometrial poly

A

40-50 and have increased spotting and worse cramping

178
Q

what is the first line treatment for painful menses

A

NSAIDs

179
Q

what is the primary contraindication to estrogen therapy

A

it is abnormal bleeding to begin with

180
Q

what mg of calcium do post-menopausal women require each day

A

1200mg

181
Q

can menopause recur with removal of ovaries

A

yes, it recurs because there is decreased androgens made by the ovaries in the body

182
Q

what does HRT do to cholesterol levels

A

decrease LDL and increase HDL

183
Q

what level is decreased in women with running induced amennorhea

A

it is low estrogen but normal FSH

184
Q

what level can determine how many eggs are left overall

A

anti-mullerian levels

185
Q

timing of PMS vs. hypothyroid

A

hythyroid occurs consistently throughout the cycle

186
Q

what electrolyte and vitamin deficiencies correlate with PMS

A

Mg, Ca, B6

187
Q

what ethnicity has the highest incidence of molar pregnancy

A

asians

188
Q

what is the percent chance of recurrence of molar preganancy

A

2%

189
Q

typica appearance of molar pregnancy on US

A

snowstorm uterus

190
Q

karyotype of partial mole

A

XXY

191
Q

how long do you wait after molar pregnancy

A

6months after beta HCG normalizes

192
Q

which type of molar pregnancy carries a higher risk of cancer

A

complete

193
Q

how is vaginismus treated

A

dilators

194
Q

how is orgasmic disorder treated

A

sensate focus

195
Q

after a rape, what should you test for at followup in 6 weeks

A

HIV and syphillus

196
Q

how long after intercourse can emergency contraception be used

A

72 hours

197
Q

where is the best place for abuse hotlines

A

bathrooms for privacy

198
Q

women on immunosuppressive therapy with vulvar itching from what

A

it is HPV

199
Q

VIN2 treatment

A

laser

200
Q

what is pages of the vagina

A

it looks like years infection in situ infection of the vulva

201
Q

what is the biggest risk of vulvar cancer

A

HPV

Third Year (1 decks)

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