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Flashcards in OB/GYN 8% Deck (161):
1

___ predominates in Phase 1 (a.k.a. ___)

Day:

Estrogen predominates
Follicular phase

Day 1-12

Follicular

2

Causes follicle and egg maturation in ___phase

FSH

Follicular (phase 1)

3

Stimulates maturing follicle ___ production

LH

Estrogen production

4

___ causes a sudden ___ surge causes ovulation

Days:

Estrogen causes a sudden LH surge

Day 12-14

5

Phase 3 (a.k.a. ___, a.k.a. ____)

___ surge causes ruptured follicle to become ___, which secretes ___ to ___.

Luteal, Secretory phase

LH
corpus luteum
progesterone
maintain endometrial lining and secretion

6

If pregnancy occurs, ___ keeps the corpus luteum functional until placenta can support itself

blastocyst

7

Estrogen is produced by ____

Provides (positive/negative) feedback on ___.

granulosa cells of follicle

Positive feedback on LH --> LH surge to cause ovulation

8

Inhibins is produced by ___.

Provides (positive/negative) feedback on ____.

Inhibin B levels rise during ___, highest during ___. Increase again during ___.

Inhibin A levels decrease during ___.

granulosa cells of follicle

Negative feedback for FSH

-luteal-follicular transition
-highest during mid follicular phase
-LH peak

late luteal phase

9

Chronic anovulation is caused by ___.

Unopposed estrogen, no corpus luteum --> no ovulation, no progesterone --> continuous estrogen production and stimulation of endometrium w/o progesterone stabilization/induced bleeding

10

Ovulatory dysfunctional uterine bleeding caused by ___.

ovulation with prolonged progesterone secretion d/t low estrogen --> blood loss from endometrial vessel dilation and prostaglandins --> metrorrhagia

11

Tx of acute severe uterine bleed

High dose IV estrogens
D&C if IV estrogen fails

12

Tx of anovulatory dysfunctional uterine bleeding

OCPs
Medroxyprogesterone acetate
Leuprolide

13

Tx of ovulatory dysfunctional uterine bleeding

OCPs
Medroxyprogesterone acetate
Leuprolide
NSAIDs*

14

MC/most important diagnostic for DUB

Endometrial bx

15

Primary amenorrhea = failure of onset of menarche by ___.

15 y/o

16

High FSH in setting of primary amenorrhea suggests problem with ___

ovaries. FSH screaming at unresponsive ovaries

17

Low FSH in setting of primary amenorrhea suggests problem with ___

H-P axis problem. Ovaries don't know what to do without FSH.

18

Breasts that are present, with absent uterus, 46, XX suggests ____

Mullerian agenesis = congenital absence of vagina, uterine agenesis

19

Breasts that are present, with absent uterus, 46, XY suggests ____

Androgen insensitivity = female phenotype d/t testosterone resistance

20

Kallmann's Syndrome =

Hallmark symptom:

Hypogonadotropic hypogonadism --> pituitary secretion of FSH and LH VERY low

Anosmia (lack of smell)

21

Low stature, webbed neck, edema, low hairline, low ears, widely set nipples =

Tx w/:

Turner Syndrome (45, XO)

Tx: estrogen

22

Most common form of secondary amenorrhea

Induces a hypothalamic state in which reduced secretion of ___--> low ___ --> no stimulation of ____ --> ____ is not produced by follicles

Stress related

GnRH
LH and FSH
ovulation
estrogen

23

Progesterone challenge test used for ____

Result interpretation:

determining ovarian disorders in secondary amenorrhea

If withdrawal bleeding = ovarian cause --> anovulatory. Estrogen present to build up the endometrial lining.

If no bleeding = Hypoestrogenic (Hypothalamus-Pituitary failure OR uterine disorder

24

Hypothalamus dysfunction causing amenorrhea occurs when ____

Causes:


Tx:

disruption of pulsatile GnRH --> low FSH and/or LH from pituitary

Causes: Anorexia, weight loss, exercise**
Stress, nutritional deficiency, systemic disease

Tx:
Clomiphene = estrogen agonist/antagonist actions to stimulate gonadotropin release and ovulation
Menotropin = gonadotropin secretion

25

Ovarian disorders causing amenorrhea will show (high/low) FSH, (high/low) LH, (high/low) (Estradiol/Prolactin).

High FSH and LH
Low Estradiol

26

Pituitary disorders causing amenorrhea will show (high/low) FSH, (high/low) LH, (high/low) (Estradiol/Prolactin).

Tx:

Low FSH and LH
High Prolactin

Tx:
OCP
Bromocriptine (Dopamine agonists to inhibit prolactin)

27

Asherman's Syndrome =

Dx:

Tx:

Acquired endometrial scarring (overaggressive D and C)

"A"dhesions + "A"menorrhea

Pelvic US showing absence of normal uterine stripe

Tx: Estrogen

28

Primary dysmenorrhea is caused by ___

High prostaglandins = painful uterine muscular wall

29

Premenstrual Syndrome diagnostic criteria:
Minimum of ___ symptoms need to begin ___.
Must be in ____ (prior/during/after) menstruation.
Must be symptom free for ____ in ____ of cycle.
Must occur in ___ cycles.

Minimum of FIVE symptoms need to begin THE WEEK PRIOR TO MENSES.
Must be in 2 WEEKS PRIOR menstruation.
Must be symptom free FOR 7 DAYS in FIRST HALF of cycle.
Must occur in 2 CONSECUTIVE cycles.

30

Severe PMS w/ FUNCTIONAL impairment

Premenstrual Dysphoric Disorder (PMDD)

31

Menopause: increased ___ levels, decreased ___ levels.

Increased FSH >25 (confirms dx)
Decreased estradiol

32

Most effective tx for menopausal vasomotor symptoms (hot flashes/night sweats)

Tx of mood symptoms?

Estrogen

SSRI/SNRI

33

Which of the following is NOT a risk factor for uterine/endometrial polyps?
A. Obesity
B. Cervical polyps
C. HTN
D. Methotrexate

D. Tamoxifen (tx of breast cancer) is a RF

34

Medication tx of uterine/endometrial polyps

Progestins
Leuprolide (GnRH inhibitor)

35

Polycystic Ovarian Syndrome has unknown etiology but possibly d/t ____, which results in ___

Elevated LH:FSH ratio

Suppression of pituitary FSH, constant LH stimulation, anovulation, multiple cysts, theca cell hyperplasia, excess androgens

36

LH stimulates ___ to produce ___, which are shunt to ___, which aromatize into ___.

-theca cells
-androstenedione and testosterone
-granulosa cells
-estrone and estradiol

37

Presentation of Polycystic Ovarian Syndrome

Hirsutism*
Obesity*
Amenorrhea*
Signs of hyperandrogenism (hair, deep voice)

38

"String of pearls" on TVUS

Other dx:

PCOS

LH:FSH > 2 or 3:1

39

Tx of PCOS

-Metformin: restore ovulatory menses
-Clomiphene: stimulate ovulation
-Low dose OCP or spironolactone: hirsutism and acne
-Weight loss
-Dexamethasone?

40

MC pathogen of bacterial vaginosis

Gardnerella

41

T/F: Candida vaginitis has acidic pH <4.5.

True. BV and Trichomonas have basic pH >4.5

42

Lymphogranuloma Venereum (LGV) is caused by ___.

Dx:

Tx:

Chlamydia Trachomatis

Dx:
- Complement fixation test >1:16
- Bubo aspiration and culture for chlamydia

Tx: Doxycycline, tetracycline or erythromycin

43

PAP smear for women age ___ Q ___.

PAP + HPV for age ___ Q ___.

21-65, Q 3 years

30-65, Q 5 years

44

What to do if PAP shows ASCUS?

When do you do colposcopy?

When do you redo pap in 1 year?

What do you do if negative HPV?

HPV reflex testing

If + HPV >24 y/o --> colposcopy

If + HPV and 21-24 y/o --> redo pap in 1 year

If - HPV --> back to routine schedule

45

Chancroid caused by what pathogen?

Co-infection?

Presentation?

Tx?

Haemophilus ducreyi

Co-infect: HSV, T. pallidum

Presentation: EXTREMELY painful ulcers w/ soft, ragged edges
Malaise, HA, anorexia

Tx: Azithromycin*
Cetriaxone, Cipro

46

Leading cause of infertility and ectopic pregnancy in young, Nulliparous, sexually active women

Tx:

Pelvic Inflammatory Disease (PID)

Broad spectrum abx, at least 2: Cetriaxone + doxycycline

47

Condyloma Acuminata caused by ____

Dx:

Tx:

HPV strain 6, 11

Dx: Acetic acid --> appear white raised plaques

Tx:
Cryotherapy
Podofilox (CI in pregnancy)
Imiquimod

48

Syphilis is caused by ____

Presentation of each stage:

Treponema pallidum

Initial (10-60 days):
Chancre
Secondary (1-3 months):
- Condylomata lata = soft, flat, moist papules scattered on perineum
- scattered discrete coppery papules on palms of hand/feet
Tertiary:
Gummas: granulomas of skin

49

Dx of Syphilis

Dark field microscopy
+
Direct fluoresecent antibody tests
- Screening: VDRL, RPR (rapid plasma reagent)
- Confirm: TPPA (Treponema pallidum particle agglutination assay), FTA-ABS (Fluorescent treponemal antibody absorption test )

50

Screening for syphilis during pregnancy with ___

RPR antibody

51

Tx of syphilis

Benzathine Penicillin G
PCN allergy: Doxycycline

F/u w/ VRDL titers at 3, 6, 12 months

52

Genital herpes most commonly caused by ___.

Viral shedding occurs for ___.

Time it takes to heal?

HSV-2

3 weeks

10-22 days

53

Dx of genital herpes

Tzanck smear*
PCR testing

54

Precaution for pregnant women w/ active genital herpes lesions

Disseminated infection in neonates

Require C-section delivery

Encephalitis, eyes, skin, mucosa

55

Thinning of epidermis and fibrosis of dermis --> leukoplakia, thinning (parchment-like) vulvar skin

T/F: It causes increased risk for vulvar basal cell carcinoma.

Vulvar Lichen Sclerosus

False. Squamous carcinoma

56

Hyperplasia of vulvar squamous epithelium associated w/ chronic itching and irritation causing thicker, leathery skin

T/F: No risk of cancer development

Lichen Simplex Chronicus

True

57

Fetal complications of Erythema infectiosum (5th's dz)

Fetal loss
Fetal hydrops
Fetal viral myocarditis

58

Adults with 5th's dz present w/

Rash, fever, lymphadenopathy, arthritis
Acute transient aplastic crisis*

59

All of the following are risks of Ovarian Neoplasms EXCEPT:
A. Early menarche
B. Nulliparity
C. Late menopause
D. OCPs

D. OCPs are protective.

Risk = uninterrupted ovulation. Infertility

Protective = multiparity, breastfeeding, hysterectomy, chronic anovulation

60

Tumor marker used to monitor Ovarian Neoplasms

CA-125

61

MC type of Ovarian neoplasm

Epithelial

62

Highest mortality of all gynecological cancers

Ovarian cancer

63

T/F:OCPs are protective against breast cancer.

FALSE: unopposed estrogen is a risk factor of breast cancer.
Other risk factors: AGE ***, nulliparity, early menarche, late menopause

OCP is protective in Ovarian Cancer.

64

MC type of breast cancer

Invasive ductal carinoma

65

Most common gynecological cancer

Endometrial cancer

66

Gynecological cancer that is ESTROGEN dependent

Endometrial cancer

Biggest risk factor = high estrogen exposure

67

MC site of metastasis in endometrial cancer

Lungs
Do CXR

68

90% of vulvar cancers are ____.

Develop from 2 pathways:

squamous cell carcinoma

1. HPV 16 and 18
2. Long standing lichen sclerosus

69

T/F: You should stop breastfeeding if you have mastitis.

False. Stop breastfeeding w/ breast abscess. Continue breastfeeding in mastitis.

70

T/F: Fibroadenomas may fluctuate with menstrual cycle.

False. Fibroadenomas do NOT change. Fibrocystic breast changes fluctuate w/ menstrual cycle.

71

Cystocele presents with ____

Stress urinary incontinence
Feeling of vaginal fullness

72

Procidentia

Cervix extends beyond vulva

73

Definitive dx of ovarian torsion

Laparoscopy

US can't r/o

74

All of the following are ABSOLUTE CI for estrogen EXCEPT:
A. DVT/PE
B. Stroke
C. CAD
D. Thromboembolic d/o
E. Breast/endometrial cancer

D. Thromboembolic d/o is a RELATIVE CI

75

1st line tx for endometriosis

Combination OCPs + NSAIDs

--> severe cases: Depot Leuprolide injections (GnRH agonist) --> decrease pituitary, no LH and FSH

76

Decreased pelvic organ mobility, endometrium proliferates outside of uterus and leads to pain, eventual scar tissue development in pelvis =

Endometriosis

77

Ectopic endometrial tissue within myometrium (muscle layer of uterine wall) =

Presentation:

Adenomyosis

Tender symmetrically, "boggy uterus"

78

Tx of Adenomyosis:

Total Abdominal Hysterectomy (TAH) = only effective treatment

79

#1 risk factor of Leiomyomas/fibroids:

#1 presentation symptom:

ESTROGEN:
multiparity, late/menopause/early menarche, oral estrogen

Menorrhagia

80

All of the following are charcteristics of Leiomyomas EXCEPT:
A. Nontender
B. Irregular
C. Firm
D. Symmetric

D. Asymmetric. Adenomyosis is symmetric, soft, tender.

81

Leiomyomas are differentiated from adenomyosis by ____ seen on MRI/US

pseudocapsule

82

Treatment of Leiomyomas

Definitive tx?

-Observation if asymptomatic other than menorrhagia
- Saline infusion sonohysterography
-Progestins, Leuprolide, Mifepristone
-NO estrogen

Definitive: Hypsterectomy

83

Causes of ovarian cysts include all EXCEPT:
A. Hyperthyroidism
B. Early Menarche
C. Use of Tamoxifen
D. Early menopause

A, D.
HYPOthyroidism

84

Detrusor muscle is under ___ control.

Internal sphincter is under ___ control.

External sphincter is under ___ control.

Detrusor muscle is under PARAsympathetic (Beta-adrenergic) control.

Internal sphincter is under ALPHA-adrenergic control.

External sphincter is under ___ control.

85

History of Imipramine use for postpartum depression may cause ___

Hyperprolactinemia --> infertility
(and visual changes)

86

Most common cause of infertility

Polycystic Ovarian Syndrome --> causes increased levels of estrogen production --> inhibit FSH and LH

87

Criteria for PCOS dx:

2 of 3:
-Oligo and/or anovulation
-Hyperandrogenism --> test Testosterone
-Polycystic ovaries on US --> "string of pearls"

88

Tx of Polycystic Ovarian Syndrome (PCOS)

-METFORMIN: lowers glucose, insulin, testosterone levels --> spontaneous ovulation
-Estrogen receptor modifiers
-Clomiphene (Clomid) --> inhibit negative feedback of estrogen on release of gonadotropin

89

Ladin's Sign =

Piscacek's Sign =

Goodell's or Hagar Sign =

Chadwick's Sign =

Ladin's Sign = uterus softening at 6 weeks

Piscacek's Sign = palpable uterus lateral bulge at 7-8 weeks

Goodell's or Hagar Sign = cervical softening at 4-5 weeks

Chadwick's Sign = Cervix/vulvar bluish at 8-12 weeks

90

G4P1123 =

G = # of times women has been pregnant
P = number of pregnancies that resulted in birth at or beyond 20 weeks
TPAL = Term, Preterm, Abortuses, Living children

Woman gave birth to set of preterm twins, 1 38 week infant, 2 miscarriages

91

Expected Due Date =

1st day of LMP - 3 months + 1 week, + 1 year

92

Fundal height:
___ weeks = pubic symphysis
___ weeks = umbilicus
___ weeks = elevates ~ 1 cm above umbilicus for each week of pregnancy

12 weeks = pubic symphysis
20 weeks = umbilicus
After 20 weeks = elevates ~ 1 cm above umbilicus for each week of pregnancy

93

Preterm =

Term =

24-37 weeks = preterm

37-42 weeks = term

94

Triple Screening at ___ weeks

What is tested?

15-20 weeks

alpha Fetoprotein (a-FP), b-HCG, Estradiol

95

low a-FP, HIGH b-HCG, low estradiol suggests ___

Trisomy 21

96

HIGH a-FP suggests ___

Open neural tube defect
OR
multiple gestation

97

low a-FP, low b-HCG, low estradiol suggests ___

Trisomy 18 --> stillborn or die w/i 1 year

98

Fetal imaging start at ____ weeks.
GBS screening at ___.

18-22 weeks

32-37 weeks

99

Chorionic VIllus Sampling can be performed at ___.

Amniocentesis can be performed at ____.

9-12 weeks (earlier than amniocentesis)

> 15 weeks

100

Macrocytic anemia, tongue soreness, numbness/tingling of feet, impaired cognitive function suggests ___ deficiency

Cobalamin (B12) deficiency

101

Quad screen includes:

alpha Fetoprotein (a-FP), b-HCG, Estradiol AND Inhibin-A

Detects Down Syndrome 81%, 5% false positive

102

Gestational diabetes screen performed at ___ weeks with ____. If elevated > ____, f/u w/ ____. Diagnosis established when ___.

27 weeks
1 hr glucose tolerance test
>135
3 hr GTT
2 or more of 4 tests are abnormal

103

Sex of fetus determined at ___ weeks via US.

18 weeks

104

#1 tx of Hyperemesis gravidarum

Pyridoxine (vit B6) +/- doxylamine (Unisom)

105

hCG levels double every ____, peaks at ____ in normal pregnancy

48 hrs
10-12 weeks

106

PUPPP =

pruritic urticarial papules and plaques of pregnancy = papulovesicular lesions on trunk and extremities

107

T/F: Mother is considered G1P2 if she is pregnant with twins

False: Still G1P1

108

APGAR scoring evaluated at ____ after birth.
Score and meaning:

7-10 = good
4-6 = assist, stimulate
<4 = resuscitate

109

APGAR stands for? How is each category scored?

Appearance: 2 = pink all over; 1 = pink w/ blue extremities; 0 = blue/pale

Pulse: 2 = > 100 bpm, 1 = <100 bpm, 0 = absent

Grimace: 2 = cough/sneeze/vigorous cry; 1 = grimace/slight cry, 0 = no response

Activity: 2= active movement, 1 = some movement/flexed extremities, 0 = limp

Respiration: 2 = slow/crying, 1 = slow, irregular, 0 = absent

110

What type of abortion?
Bleeding before 20 weeks gestation

Threatened abortion. "Catch-all" dx

111

What type of abortion?
Some but not all intrauterine contents expelled

Incomplete abortion

Tx: D and C

112

What type of abortion?
Dilated cervical os, cramping, +/- bleeding

Inevitable abortion

113

What type of abortion?
POCs have been completely expelled from uterus

Complete abortion

114

What type of abortion?
Fetal demise w/o cervical dilatation
Asymptomatic

Missed abortion

115

What type of abortion?
With intrauterine infection

Septic abortion

116

Medical abortion most commonly use ____.
Time limits?

Mifepristone + Misoprostol

24-48 hrs --> up to 9 weeks gestation

117

Spontaneous abortion = loss of pregnancy without outside intervention before ___.

20 weeks gestation

118

Placenta previa =

Tx:

PainLESS uterine bleeding 27-32 weeks

C section if 37 weeks OR unstable
Otherwise: observe, hgb checks, steroids

119

Premature placenta separation from uterine wall with hemorrhage =

Presentation:

Dx:

Risks:

Placental abruption (abruption placentae)

PainFUL bleeding**

US is NOT HELPFUL in dx. Pelvic exam and hx ONLY.

Risk: TRAUMA**

120

Toxoplasmosis during pregnancy can cause ___ in newborn.

hepatosplenomegaly

121

T/F: Rubella vaccine is administered at 16 weeks of pregnancy to prevent congenital disease.

FALSE: DO NOT give vaccine during pregnancy

122

Most common congenital infection =

Cytomegalovirus

123

Women with 1-2 prior second-trimester pregnancy losses or preterm births + cervical length < 25 mm on TVUS or advanced cervical changed on PE before 24 weeks =

Incompetent cervix

124

Tx of incompetent cervix for
Previable fetus:
Viable fetus:

Previable fetus:
elective termination OR
Cerclage placement (suture cervix to hold it closed)

Viable fetus:
Betamethasone (glucocorticoid to enhance fetal lung maturity) + strict bed rest
Tocolytics (Ritodrine) = prevent contractions and progression of labor if there is preterm labor contractions

125

Universal Gestational Diabetes screening is recommended for all pregnant women at ____ weeks.

Screening =

Definitive diagnosis =

24-28 weeks

Screening:
-Random blood sugar >200 OR fasting glucose >126 on 2 occasions = diagnostic
-Non-fasting 50 gm oral glucose challenge test > 140 = positive

Definitive:
3 hour glucose tolerance test

126

Tx of choice for gestational diabetes

If fasting blood glucose is high, use ___
If postprandial glucose is high, use ___
If both fasting and postprandial glucose are high, then ___

Insulin

Fasting: NPH insulin at bedtime
Postprandial: regular insulin before meals
Both: NPH before breakfast and bedtime + regular insulin before each meal

127

Gestational HTN = Persistent ___ mmHg, (with/without) proteinuria, at or after ___ weeks.

Tx:

>140/>90
WITHOUT
20 weeks

Tx: methyldopa

128

Preeclampsia = ___ mmHg + ____

Tx:

>140/>90
Porteinuria of 0.3 gm or greater in 24 hr urine

Tx: bedrest, Methyldopa

129

HELLP syndrome =
Seen in ___

Hemolysis, Elevated Liver enzyme, Low Platelet

Severe preeclampsia (>160/110, >5 gm protein in 24 hrs)

130

Tx of severe preeclampsia

-Antihypertensive
-Mg sulfate = seizure prophylaxis
-Betamethasone x2 24 hrs apart = speed up lung development if under 33 weeks
Induce delivery

131

Occurrence of 1 or more conuslions in presence of preeclampsia =

Tx:

Eclampsia

Tx: Mg sulfate for seizures --> may cause hyporeflexia --> Ca gluconate

132

Painless, abnormal vaginal bleeding, preeclampsia, tachycardia, tachypnea is presentation of ___.

Molar pregnancy

133

Dx of molar pregnancy:
hCG =
US shows ___

hCG >100,000
US: cluster of grapes, snowstorm appearance

134

Complete mole =
karyotype:

Partial mole =
karyotype:

Complete: 46XX
Fertilization of egg that had no chromosomes

Partial: 69XXY
Fertilization of ovum by 2 sperms

135

Complete moles have a 2 % chance of developing into ___.

Choriocarcinoma

136

Sheets of anaplastic cytotrophoblasts and syncytiotrophoblasts w/o chorionic villi =

Choriocarcinoma

137

Choriocarcinoma tx

Methotrexate
Actinomycin D

138

Tx of Rh-Incompatibility

300 mg Rh immunoglobulin given to Rh - mother at 28 weeks and within 72 hours of delivery

139

Erb palsy

Fetal brachial plexus injury

Complication d/t shoulder dystocia

140

Tocolytics =

Examples:

medication that suppresses premature labor

-Betaminmetics* (ritodrine, terbutaline)
-Magnesium sulfate
-Nifedipine (CCB)
-Indomethacin (anti-prostaglandins)
-Oxytocin ANTAgonists

141

Tx of preterm labor =

-Tocolytics
-Dexamethasone/betamethasone (stimulate fetal lung development)
-GBS prophylaxis: PCN

142

Prenatal screening for vaginal and rectal GBS at ____ weeks.

32-37

143

MC cause of life-threatening infections in newborns.

GBS

Sepsis, meningitis, newborn pneumonia

144

Prolapsed umbilical cord will cause ____ after membrane rupture

severe variable deceleration or bradycardia

145

Abnormal accumulation of fluid in fetal tissue =

Hydrops fetalis (fetal hydrops)

146

All of the following are reassuring fetal status EXCEPT:
A. Minimal variability
B. Active fetal movement
C. 2 accelerations in 20 minute period

A. Moderate variability (6-20 bpm) is good. Minimal (<5 bpm), marked (>20 bpm) or absent variability is bad.

Reactive strip = 2 accelerations of >15 seconds w/ peak of >15 bpm in 20 min period

147

Uterine myometrium fails to contract following delivery =

Tx:

Uterine atony

Tx:
- Bimanual uterine massage*
- Uterotonic agents =
IV oxytocin*
Prostaglandins (CI in asthma)
Methylergonovine (CI HTN/pre-eclampsia)
Bakri Balloon (good for HTN)

148

Bloody mass seen near introitus after delivery =

Tx:

Uterine inversion

Tx: ** Steps
1. Uterine relaxants/tocolytics (Mg sulfate, terbutaline)
2. Replace proper position (place fist inside uterus)
3. Uterotonics agents (oxytocin)

149

Sheehan Syndrome

Tx:

Pituitary infarct d/t hypovolemia and hypotension
--> absence of lactation d/t loss of prolactin OR no restart of menstruation d/t loss of gonadotropins

Tx: find cause, fluid resuscitation, blood transfusion

150

Tx of endometritis
Prophylaxis:
W/ C-section:
W/ vaginal delivery:

Prophylaxis: 1st gen cephalosporin during C-section

W/ C-section: Clindamycin + gentamicin
W/ vaginal delivery: Ampicillin + gentamicin

151

What congenital disorder?
Rocker bottom feet

Trisomy 18

152

Klinefelter syndrome = ___ karyotype

(high/low) testosterone, (high/low) FSH/LH

Phenotype:

47, XXY

low testosterone, high FSH/LH

Male, hypogonadism
Long extremities
Decreased intelligence, behavioral problems

153

Low birth weight, poor muscle tone, microcephaly, language difficulties, profound retardation =

Results from ___.

Cri Du Chat

Deletion of long arm of chromosome 5

154

Diagnosis of Premature Rupture of Membranes (PROM)

Direct visualization
Fern test OR nitrazine paper: pH >6.5

155

MC cause of infertility

Endometriosis

156

Classic triad presentation of Endometriosis

Premenstrual pelvic pain
Dysmenorrhea
Dyspareunia (pain w/ sex)

157

Definitive diagnosis of Endometriosis

Laparoscopy

158

Premature labor = Regular uterine contractions w/ progressive cervical changes before ___ weeks gestation.
Cervical dilation =
Effacement =

37 weeks

>3 cm cervical dilation
> 80% effacement

159

Tx of choice of chronic HTN in pregnancy

What meds should be avoided?

Methyldopa if BP > 150/100


Avoid ACEI** and diuretics

160

BP med should be started if BP > ____ in preeclampsia

> 180/110

Hydralazine**, Labetalol, Nifedipine

161

Schiller Test

Evaluates cervix after abnormal Pap smear. Iodine staining highlights areas of rapid cell turnover.