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Flashcards in Ob/Gyn UWorld Deck (91)
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1

what should you be concerned about in a baby with shoulder dystocia

clavicular fractures may result in C8-T1 brachial plexus injury that may result in Horner syndrome, Erb-Duchenne palsy, or Klumpke palsy

-usually resolve spontaneously

2

cystocele
rectocele
enterocele
apical prolapse

bladder prolapse
rectum prolapse
small intestine prolapse
uterus or vaginal valt prolapse

3

what can cause sharp groin pain in a pregnant woman

round ligament pain

4

what increases risk of uterine rupture the most during pregnancy/labor

past uterine surgeries (like a classical/vertical c-section or a uterine myomectomy)

-if these pts are giving birth again do a laparotomy and delivery

5

what do amphetamines do to a baby in utero

fetal growth restriction

6

second line to oxytocin (ptosin) in a pt with postpartum hemorrhage and why would each of these be contraindicated

Methylergonovine (contraindicated in hypertension)

Carboprost (contraindicated in asthma)

7

risks of combined OCPs

-venous thromboembolism
-hypertension
-hepatic adenoma
-stroke/MI (both rare)
-cervical cancer

8

pt with breast dimpling, peau d'orange, edematous, erythematous, and painful breast with nipple flattening/retraction

inflammatory breast carcinoma
-if pt also has axillary lymphadenopathy you can assume its likely spread

9

unilateral bloody nipple discharge

intraductal papilloma

10

management of intrauterine fetal demise

20-23 weeks --> dilation and evacuation OR vaginal delivery
24+ weeks --> vaginal delivery (induce labor)

*Note: retention of the fetus for several weeks can lead to coagulopathy in the mom

11

cervical insufficiency and whatre the risk factors

painless dilation of the cervix that can lead to second trimester pregnancy loss

risk factors
-cervical conization or LEEP
-mechanical cervical dilation
-obstetric cervical laceration
-uterine anomalies

12

modifiable breast cancer risk factors

hormone replacement therapy
nulliparity
increased age at first live birth
alcohol consumption

13

lifetime risk of breast cancer for every woman

1/8

14

melasma

-acquired hyperpigmentation disorder that commonly occurs during pregnancy
-usually involves sun-exposed areas on the face
-diagnosed clinically and resolves postpartum
-tell pt to avoid sun exposure and use sunscreen

15

what is a major contraindication of any estrogen containing contraceptives

hypertension

16

what to lookout for when given pap smear data on a postmenopausal woman

endometrial cells seen after the age of 45 is an abnormal finding (this is normal on women less than 45yo)
-endometrial shedding may be due to endometrial hyperplasia/cancer
-do endometrial biopsy if this finding is seen

17

intermenstrual spotting without uterine enlargement (no prolonged menses)

endometrial polyps

18

pt seems like a girl then during puberty is more like a boy and you find clitoromegaly and bilateral labial masses

5-alpha reductase deficiency
-virilization during puberty due to increased levels of testosterone

19

how does androgen insensitivity present

normal female with no uterus or fallopian tubes, rudimentary vagina
--possibly with bilateral labial masses

20

patient postop from hysterectomy with unilateral nonradiating costovertebral angle pain, nausea, and vomiting
-normal renal function

hydronephrosis from ureteral injury during surgery

21

steps in dealing with a uterine inversion

1. manual replacement of the uterus
2. placental removal
3. administer uterotonics

22

what is a leiomyoma

proliferation of smooth muscle cells within myometrium

23

what is the acid-base normal for a pregnant woman

respiratory alkalosis

24

what is a main cause of stress incontinence

weak pelvic floor muscles
-urethral hypermobility and reduced bladder support

25

delivery in pts with HIV

if they consistently take their meds and have a viral load less than 1000 you can do normal expectant management and delivery without any additional drugs

if they are inconsistent with meds and have a viral load more than 1000 you want to administer intrapartum zidovudine and do a c-section

26

Patient with colicky pain with an ultrasound seeing an ovarian cyst with calcifications and hyperechoic nodules

Mature dermoid cyst

27

how to manage a pt with a history of preterm birth

-intramuscular progesterone during the second and third trimesters
-cervical length measurements by transvaginal ultrasound during the second trimester
-cerlage placed if cervix is short

28

pagets disease of breast

extension of underlying DCIS/invasive breast cancer up the lactiferous ducts and into the contiguous skin of nipple --> eczematous patches over nipple and areolar skin

usually associated with intraepithelial adenocarcinoma cells

29

how to treat neonatal thyrotoxicosis

-maternal antibodies self-resolve in 3 months
-methimazole PLUS beta-blocker

30

ABO incompatibility b/w mother and baby

usually mother is O and baby is A or B
-affected infants are usually asymptomatic at birth or have mild anemia and may develop neonatal jaundice that typically responds to phototherapy