Ob/Gyn Flashcards
(201 cards)
1
Q
uterine fundal tenderness
A
endometritis
2
Q
most common cause of PPH
A
uterine atony
3
Q
what bugs cause endometritis
A
polymicrobial involving strep and staph overall
4
Q
most significant risk for post partum depression
A
previous depression
5
Q
breast feeding decreases the risk of what kind of cancer
A
ovarian
6
Q
best way to stop breast feeding
A
breast binding, ice packs, and avoidance and stimulation, NSAIds
7
Q
what are the risks of trying to stop breast feeding with medications
A
increased thromboembolic events
8
Q
what hormone causes milk production
A
prolactin
9
Q
what hormones inhibit milk production in the breast
A
estrogen and progesterone. Progesterone withdrawal leads to the prolactin rising in the breast
10
Q
intense nipple pain is caused by what organism
A
candida
11
Q
how many poopy diapers in a day
A
3-4 per day
12
Q
how many wet diapers per dau
A
6 per day
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
14
Q
how long do you wait for repeat beta HCG with ectopic pregnancy
A
48 hours
15
Q
what is the biggest risk factor for ectopic pregnancy
A
prior ectopic pregnancy
16
Q
person with DM1 is preg, what is the biggest risk to the baby
A
IUGR
17
Q
what can lisinopril cause in pre
A
oligohydramnios, fetal groth retardation, and neonatal hypotension, pulmonary hypoplasia, joint contractires and death
18
Q
what medicine can be used for migraine in pregnancy
A
amytriptyline
19
Q
most common cause of sepsis during pregnancy
A
pyelonephritis
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
21
Q
first line treatment for thyroid storm
A
propanolol and PTU
22
Q
treatment for syphillus no matter what
A
PCN and desensitization even if they are allergic
23
Q
when should diabetes screening should happen
A
between 24-28 weeks
24
Q
if people are at high risk for DM when should they be screened for DM
A
should be screened ASAP
25
BV see what cells
clue cells and positive whiff test
26
what is BV in pregnancy treated with
it is treated with metronidazole
27
what condition has the highest mortality during pregnancy
pumonary hypertension
28
how do you treat asymptomatic MVP
you do nothing
29
how do you treat symptomatic MVP
give beta blockers
30
diagnostic test if the preg patient has PNA
chest XR
31
big risks of obesity during pregnancy
increased risk of pre-eclampsia and hypertension of pregnancy. Increased risk of large babies
32
what are the two most common reasons for anemia in pregnancy
acute blood loss and iron deficiency anemia
33
treatment of SLE in pregnancy
steroids
34
breast cancer treatment in pregnancy
modified radical mastectomy
35
common depression during pregnancy treatment
SSRI
36
what is the treatment for itchy longterm pregnancy
it is the Udoxysomething acid
37
how do you diagnose appendicitis in pregnancy
graded ultrasound
38
what is the biggest symptom of magnesium toxicity
respiratory depression
39
what level of protein in the urine indicates pre-eclampsia
over 300 mg
40
what is the best treatment for pre-eclampsia
delivery
41
what do you give during labor for pre-eclampsia
magnesium sulfate
42
what medication is used for eclamptic seizures
magnesium sulfate
43
at mg level of 11 what usually occurs
respiratory depression
44
at mg of 15 what usually happens
cardiac arrest
45
what is the best contraindication to expectant management in pre-eclampsia
it is thrombocytopenia- that baby needs to get out
46
what does HELLP stand for
hemolysis, elevated liver enzymes, low platelets
47
what is the biggest risk with HELLP
rupture of the liver through the liver capsule
48
what are risk factors of placental abruption
trauma, pre-e, and hypertension
49
what non-invasive testing can look for Rho-immunization
look at fetal head dopler
50
characteristics on US of fetal hydrops
ascites, pericardial effusion, pleural fluid, scalp edema, polyhydramnios, placental edema
51
what amount of blood is neutralized by 300 of Rhogam
300 cc of fetal blood
52
what thing is most indicative of bad rho gam disease in the fetus if present in the amniotic fluid
billirubin
53
baby is 30 weeks and has severed hemolytic disease what should you do
transfuse that sucker
54
marker of dizygotic twins
two spirit placentas
55
what are monochorionic diamniotic twins are at highest risk for
congenital anomalies
56
what os the best thing to prevent preterm delivery during pregnancy
make sure there is good weight gain at the start of pregnancy
57
twin twin transfusion are what kind
diamniotic and monochorionic
58
what is the biggest risk of multiple gestations for the fetus
it is pre-term delivery
59
if one twin is breech and one twin is vertex, what is the best way to deliver them
C section
60
what should you do if the fundus is higher than expected and the AFP is 3x the normal
get a sonogram because they is more than one bun in that oven
61
why are CS rates higher now
less VBACs are allowed
62
common reasons for breech
prematurity, previa, fibroids, genetic disorders, and polyhydramnios
63
what is the biggest risk of shoulder dystocia
previous shoulder dystocia
64
when the patient has a breech delivery- what is most likely to be coming through the cervix first
the butt
65
what is the biggest risk of placenta acreta
from any CS and pregnancies
66
what does FFP contain when given
fibrinogen, factor VIII and V
67
what are the preconception risks for a person that smokes
placenta previa, placental abruption, IUGR, pre-E, infection
68
what is bloody show
the cervix is friable and bleeds when dilated because it is really vascular
69
differntiate bloody show and cervicitis
bloody show occurs with cervical dilation, and cervicitis is bleeding and friable cervix with no dilation
70
differentiate cervical polyp and cancer
the polyp will not be a hard mass, but cervical cancer will. The cervical cancer will be increased risk with smoking
71
most common cause of preterm labor
idiopathic
72
if the patient is in preterm labor and the GBS status is unknown, what do you do?
ampicillin
73
patient has a fever, slightly dilated,and is in preterm labor, so what should be done (she is contracting)
induce labor
74
what tocolytics are best for with DM patietns
give nifedipine
75
what tocolytics are contraindicated in patients with DM
terbutaline and ritodrine
76
how does Mg sulfate work as a tocolytic
competes with Ca for movement into the cell
77
what are the side effects of terbutaline
hypotension, tachycardia, anxiety, chest- tightening
78
what is the MOA of terbutaline
beta adrenergic agent
79
what are the potential side effects of using indomethacin during pregnancy
premature closure of the PDA
80
what are the potential side effects of nifedipine during pregnancy
fetal hypoxia and decreased uteroplacental blood flow
81
what are some of the positive effects of corticosteroids in the newborn period
it can be helpful for the maturity of the lungs, it decreases incidence of NEC, and it decreases the risk of intracerebral hemorrhage
82
where do you not swab for nitrazine testing
it is vaginal fluid not cervical. Cervical mucus can cause false positives
83
if there is premature rupture of membranes, how long can you wait before delivery and what is the role of tocolytics
tocolytics are for the delay of labor until there is full effect of steroids at 48 hours
84
what is the most common cause of premature rupture of membranes
infection usually BV
85
what are variable decels from
cord compression
86
what do you give when there is premature rupture of membranes
give ampicillin and erythromycin to prolong latency for 5-7 days and prevent ascending infection reduce neonatal sepsis and amnionitis
87
what is an indication for delivery when the patient has premature rupture of membranes
if there is a tender funds because then the patient probably has chorioamnionitits
88
what is elevated in the amniotic fluid when there is chorioamnionititis
IL6
89
what medication can decrease the chances of premature pre-term rupture of membranes
17-alpha hydroxyprogesterone
90
what is the time frame after which you do not give steroids
32 weeks
91
36 weeks with premature rupture of membranes- what do you do
augment labor
92
when are prostaglandings contraindicated
previous CS
93
what should you use with a cervix that isn't dilating and the patient is contracting
use an IUPC
94
what uterotonic is contraindicated when the patient has HTN
it is methyergonovine
95
what uterotonic is contraindicated when the patient has asthma
hemabate, which is prostaglandin E2 alpha
96
what is PPH blood loss for CS and vaginal
CS-1000 and vaginal is 500
97
what problem is common with multiple CS that also have anterior placentas
placenta acreta and atony
98
what increases the risk for retained placenta
circumvalate placenta, prior CS, prior circlage, fibroids
99
what is the typical treatment for endometritits
gentamycin
100
what increases the risk for acute cystitis after pregnancy and what kind of organism causes it
it is from indwelling catheter and Ecoli
101
what is happening if the breast is tender and large without erythema
it is breast engorgement.
102
Pfannenstiel incision
it is the bikini line incision for CS
103
what should you do if there is pain along the incision of a CS
incise, explore and drain
104
postpartum patient with RUQ, fever, nausea, and other symptoms along these lines has what
cholecystitis
105
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
She has septic pelvic thrombophlebititis- needs to be treated with anticoagulation and antibiotics
106
what is the most common cause of fever POD1
it is lungs atelectasis
107
what are the two drugs you would want to use for endometritis following a CS
gent +clinda(clinda covers the anaerobes)
108
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
meningititis and she needs a lumbar puncture
109
what is the biggest risk factor for postpartum psychiatric issues
previous psychiatric issues
110
what is the biggest side effects of SSRIs in these postpartum patients
it is sleep disturbance, decreased libido
111
what are the third trimester side effects of SSRIs in the neonatal period
it is agitation and EPS symptoms
112
if a patient is depressed, what else should you ask about
ask about suicide
113
what phase of the cycle do PMS and PMDD happen
in the luteal phase through the end of menstruation.
114
what is the best first step to diagnose PMS and PMDD
it is to ascertain the timing of symptoms
115
what is postpartum blues
sleep and mood disturbances in the days following delivery, and they last for less than two weeks
116
patient is at 41 weeks and is fine otherwise, but not ready for labor... what should you do
check the AFI and then look at NST
117
what is associated with posterm deliveries
it is fetal adrenal hypoplasia, placental sulfatase deficiency, anencephaly
118
late and post-term pregnancies are associated with what
macrosomia, oligohydramnios, meconium aspiration, uteroplacental insufficiency, and dysmaturity
119
what does a baby look like with dysmaturity
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
if the cervix is long high and closed, what should you do to start the patient off for labor induction
you should start her with prostaglandins to ripen the cervix
121
what is the biggest risk for post-term delivery
previous post term pregnancy
122
Intrauterine growth restriction requires what after 33 weeks-
biweekly testing
123
fat in the dilation in curettage tube- what is it
omentum- laparotomy
124
what head size is indicated for CS
12 cm
125
what do vacuum surgical deliveries help with or decrease the rate of
maternal lacerations
126
most likely complication of tubal
pregnancy
127
side effects of depo in the first few months
bleeding in between period times.
128
what type of cancer do OCPs decrease
endometrial and ovarian
129
what is the biggest problem with tubal sterilization
regret by the patietn
130
which has less poor outcomes: TS or vasectomy?
vasectomy because it is an out-patient procedure as opposed to a TS which is an OR procedure
131
what is the best BC for heavy or abnormal uterine bleeding
mirena
132
what is the contraindication to the patch OCP
weight. Cannot use if over 198
133
what is it if the patient has a positive pregnancy test, fever, open cervical os, and bleeding
septic abortion
134
how do you treat a septic abortion
broad abx and uterine evacuation
135
how do you treat for an antiphospholipid antibody pregnant woman
heparin and aspirin
136
which has higher blood loss medical or surgical abortion
medical
137
what is the contraindication to manual aspiration abortion
it must be under gestational age of 8weeks
138
what is the least invasive treatment for missed ab
misoprostol
139
if there is bleeding following after medical abortion, what should you do
D&C because the bleeding is from retained products of conception
140
clue cells are associated with what, and who do you treat and with what
BV, metronidazole, and only her
141
petichiae on the cervix, and frothy copious discharge, and are associated with what, and who do you treat and with what
trichmonas, treat with metronidazole, and treat her and partner
142
pain with insertion or penis or tampon, and no other fiindings- what is it and treatment
vulvobulbodynia- treat with TCA
143
excoriations, white plaques, itching, dryness on outside- what is it
lichen chronicus simplex
144
patient is leaving for Europe and has cervical discharge, and so what should you treat her with since the tests are not back
give her azithromycin and ceftriaxone
145
what do you do for a painful vulvar lesion
biopsy it
146
tenderness over the adnexa and lower abdomen, and mucopurulent cervicitis- what is the diagnosis
it is salpingitis
147
what do you do to treat drainpipe urethra
urethral bulking
148
what do you use to treat detrusor instability
oxybutanin or other anti-cholingergics
149
what position of surgery treats cystoceles
pubocervical fasica and arcus fascia being fixed
150
what is urge incontinence
it is when there is residual and detrusor instability
151
what do you do if a prolapse is asymptomatic
reassurance and watching it
152
what is the first line treatment for symptomatic prolapse
pessary first
153
what is the best endometriosis treatment for a young nullparious patient
laser ablation
154
after NSAIDs fail for endometriosis what is the next treatment of choice
OCP
155
what is the best diagnostic test for endometriosis
it is diagnostic laporotomy
156
what do you treat endometriosis that makes someone infertility
give them clomiphene
157
when do you give under 28 weeks
mg, beclamethasone,
158
how do you test for hypothalamic pit axis issues ammenorhea
look at FSH level
159
if there is an older lady with ammenorhea whats the first test
pregnancy
160
what does PCOS put you at an increased risk for
endometrial cancer
161
elevated DHEAS and hairy woman
adrenal tumor
162
why does hair fall out after preganncy
it falls out because of the drop in estrogen
163
what age is most common for theca leydig cell tumors
testosterone secreting tumors are most common from 20-40
164
treatment of hirsutism from PCOS
OCP and spirolactone
165
what is the most common cause of menorhagia in young girls
von wildebrand disease
166
why should you remove a polyp
for fertility reasons
167
what hormone is increased in PCOS
testosterone
168
how do you remove a fibroid and preserve fertilit
hysteroscopy with myomectomy
169
what kind of cancer is higher risk for transplant patients
cervical
170
what birth control has the side effect of irregular bleeding
nexplanon
171
why do OCPs work for painful periods
it causes endometrial atrophy
172
what should you test for in sexually active under 25 yo
STDs
173
what is the definitive treatment for abnormal uterine bleeding
hysterectomy
174
is endometriosis frist or secondary dysmenorhea
it is secondary dysmennorhea
175
if you suspect fibroids, what should be done
endometrial biopsy if there is abnormal bleeding
176
well-circumscribed non-encapsulated myometrium describes the pathology of what
fibroids
177
what are the symptoms and age range for endometrial poly
40-50 and have increased spotting and worse cramping
178
what is the first line treatment for painful menses
NSAIDs
179
what is the primary contraindication to estrogen therapy
it is abnormal bleeding to begin with
180
what mg of calcium do post-menopausal women require each day
1200mg
181
can menopause recur with removal of ovaries
yes, it recurs because there is decreased androgens made by the ovaries in the body
182
what does HRT do to cholesterol levels
decrease LDL and increase HDL
183
what level is decreased in women with running induced amennorhea
it is low estrogen but normal FSH
184
what level can determine how many eggs are left overall
anti-mullerian levels
185
timing of PMS vs. hypothyroid
hythyroid occurs consistently throughout the cycle
186
what electrolyte and vitamin deficiencies correlate with PMS
Mg, Ca, B6
187
what ethnicity has the highest incidence of molar pregnancy
asians
188
what is the percent chance of recurrence of molar preganancy
2%
189
typica appearance of molar pregnancy on US
snowstorm uterus
190
karyotype of partial mole
XXY
191
how long do you wait after molar pregnancy
6months after beta HCG normalizes
192
which type of molar pregnancy carries a higher risk of cancer
complete
193
how is vaginismus treated
dilators
194
how is orgasmic disorder treated
sensate focus
195
after a rape, what should you test for at followup in 6 weeks
HIV and syphillus
196
how long after intercourse can emergency contraception be used
72 hours
197
where is the best place for abuse hotlines
bathrooms for privacy
198
women on immunosuppressive therapy with vulvar itching from what
it is HPV
199
VIN2 treatment
laser
200
what is pages of the vagina
it looks like years infection in situ infection of the vulva
201
what is the biggest risk of vulvar cancer
HPV
