OB Shelf Flashcards
1
Q
Hyperglycemia leads to increased risk of
A
Macrosomic infant
2
Q
Excess fluid around infant
- assoc with
A
Fetal hydrops
- Rh incompatabilty
3
Q
Meconium aspiration risks (3)
A
Placental insufficiency
maternal HTN
Preeclampsia
4
Q
Tx acute bacterial mastitis
- nonMRSA
- MRSA
A
NonMRSA= dicloxacillin
- staph aureus
MRSA= Clindamycin
5
Q
Tx vulvar lichen sclerosis
A
clobetasol propionate (topical corticosteroid)
6
Q
cryotherapy tx for
A
warts
7
Q
Tamoxifen
A
Selective estrogen receptor modulator
Increased risk for endometrial carcinoma
8
Q
Endometriosis risk factor for
diagnostic
Tx
A
ovarian cancer
Ultrasound
NSAIDS –> oral contracept –> laparoscopy
9
Q
1st pregnancy was preterm
Second pregnancy given
A
Progesterone
10
Q
Asthma levels
- Mild intermittent
A
Less than 2 days a week
Less than 2 nights/ month
11
Q
Asthma level
- Mild persistent
A
More than 2 days a week but less than 1x a day
More than 2 nights/ month
12
Q
Asthma level
- Moderate persistent
A
Daily
More than 1 night per week
13
Q
Asthma level
- severe persistent
A
Continuous
14
Q
Mild persistent asthma in pregnancy tx
A
Low dose inhaled corticosteriods (buesonide)
15
Q
Epinephrine in pregnancy causes
A
Uteroplacental vasoconstriction
16
Q
Severe presistent asthma tx
A
Prednisone (oral glucocorticoid)
17
Q
Modersate persistent asthma tx
A
Salmeterol
Long acting inhaled beta agonist
18
Q
Cancer with history of endometrosis
A
Clear cell carcinoma
19
Q
Breast cyst with no pain tx
A
observation
20
Q
Forceps assisted delivery risk of
A
perineal laceration
21
Q
Medication for pregnant alcoholic
A
Naltrexone
22
Q
Maculopapular rash on face, trunk and extermities
pinpoint papules
Generalized LAD
- Causes in infant
A
Rubella (torch)
- Deafness, cataracts or retinopathy, PDA, encephalitis, hepatosplenomegaly w/ jaundice, petechial purpural rash (blueberry muffin)
23
Q
Prolonged second stage of labor
A
Failure of fetus to descend after 10 cm dilation for 2 hrs in nulliparious or 3 hrs if epidural
1 hr multiparious or 2 hr w/ epidural
24
Q
Prolonged second stage of labor risk
A
Chorioamnionitis
- ascending bacterial infection after rupture of membranes
25
Tx UTI in pregnancy
Nitrofurantion (Oral)
Ceftriaxone and gentamicin are IV
26
```
Tx to post partumhemorrhage
- STep 1
- STep 2
- STep 3
- STep 4
Last resort
```
Step 1: bimanual massage of uterus
Step 2: Oxytocin
Step 3:
- Misoprostol (if HTN and asthma)
- Carboprost (15-methyl-PGF2-alpha) [Fast acting uterotonic, constrict smooth muscle of uterus to close the bleeding) (CI in asthma)
- Methylergonovine (ergot alkaloid) directly constrict blood vessels (CI inHTN)
STep 4: balloon tamponade
Last resort: SUrgical exploration
27
Raynaud syndrome
Blood vessels narrow when cold or stressed
28
5 y.o w/ bleeding and adnexal mass
Precocious puberty
Granulosa tumor
29
Increased inhibin
Granulosa tumor
30
Granulosa tumor increase in
Estrogen
| Inhibin
31
Increase in alpha feto protein
Yolk sac tumor
32
Elevated lactate dehydrogenase
Tx
dysgerminomas
Sensitive to chemo and radiation
33
Choriocarcinomas have increased
hCG
34
Chorionic villus sample timeline
10-14 weeks
35
Amniocentesis time line
15 weeks
36
Hyperprolactinemia decreases
FSH, LH, Estrogen
37
Initial assessment of newborn
```
Heart rate
Respiratory effect
Muscle tone
reflex irritabilty
color
```
38
Kleihauer-Betke (KB test)
measures amount of fetal blood passed into maternal circulation
tells amount of Rh immunoglobulin to be given in Rh (-) mothers
Detects fetomaternal hemorrhage
39
PROM risks
```
smoking
Substance abuse
Maternal age less than 18 or greater than 40
PPROM in prior pregnancy
insuffiecent prenatal care
infection
```
40
Fetal biophysical profile
```
Amniotic fluid vol
Fetal breathing
Fetal movements
Fetal tone
non stress test
```
(NOT size)
41
```
Lower abdominal pain bilateral
Fever
Diffuse abdominal tenderness in lower quadrant
rebound tenderness
Adnexal tenderness
```
PID
42
PID tx
Ceftrixone and doxycycline (outpatient)
Cefoxitin and doxycycline (inpatient) or clindamycin or gentamicin
43
Chlamydia tx
azithromycin
44
Urethritis tx
cover chlamydia and gonorrhea
ceftriaxone + azithromycin
45
Gonorrhea tx
Ceftriaxone
46
Tichomonas vaginalis tx
Ceftriaxone, doxycycline, metronidazole
47
Asymptomatic bacteriuria tx
Cephalexin
48
Baby w/ neonatal abstience syndrome of heroin
Sleep wake disturbanes
hyperactive reflexes
difficulty feeding
49
Cocaine in baby
Tremors
| Episodes of apnea or tachypnea
50
First line tx prolonged heavy bleeding
ORal estrogen
D& C if unstable
NSAID if cant take estrogen
51
Depression in pregnancy or breast feeding
Sertraline (SSRI)
Second line= bupropion or venlafaxine
3rd norttiptyline
Paroxetine CI
52
Seizure prophylaxis
Magnesium sulfate
53
Anti HTN therapy
hydralize
54
Pregnancy values that increase
```
CO
HR
SV
Plasma volume
Red blood cell mass
Thyroid binding globulin
```
55
Pregnancy values that decrease
```
Systemic vascular resistance
Hemoglobin
Hematocrit
Residual volume
Functional residual capacity
Mean arterial pressure
Serum creatinine
```
TSH in first trimester
56
Menopause + hx of pulm embolism
Estrogen contraindicated
Tx= SSRI (paroxetine)
57
Sterile fashion
Iodine/ betadine
Shell fish allergy
58
Hellp syndrome
Hemolysis ( burr cell, bilirubin > 1.2)
Elevated liver enzymes
Low platelets <100
No HTN or proteinuria
59
Recurrent pregnancy loss
3 or more consecutive spontaneous abortions in first trimester with same partner
- SOnohysterography for anatomy
Immunology workup
anticardiolipin and lupus Ab
Karyotype
60
Induces ovulation
Clomiphene citrate
61
Flu vaccine give
in fall and winter
62
Condyloma acuminate tx in pregnancy (warts
Trichloroacetic acid
Cryoblastion if fails
63
Mullerian agenesis
congenital abence of both the uterus and vagina
Normal ovaries
Normal secondary sexual characteristics
64
Order of developemnt
Thelarche
Pubarche
Growth spurt
Menarche
65
D & C done at
before or at 16 weeks
66
Abnormal uterine bleeding
Uterus enlarged
Boggy (soft) and tender
Adenomyosis
67
Breasts, no pubic hair, vagina with blind pouch, no uterus or ovaries
Androgen insensitivity
68
Papp-a test
11- 14 weeks
69
Alpha fetoprotein test
15-22 weeks
70
```
Maculopapular rash over body
Multiple partnrs
Muscle aches
Fever
Night sweats
```
Acute HIV infection
71
DHEA-S
marker for adrenal dysfunction
72
```
Lower abdominal pain
Pain w/ intercourse
Fever before onset of pain
Abdominal distension
Guarding and severe tenderness
```
tuboovarian abscess
Rupture (hypotension, tachhycardia, fever)
73
Tuboovarian abscess
CLindamycin, metronidazole, cefoxitin
74
Varicella zoster infxn can cause
Tx
Limb hypoplasia, IUGR, cicatricial (scarred) skin lesions, chorioretinitis
Tx: varicella zoster immune globulin (last 10 days)
75
Acyclovir
Minimize risk of vertical transmission of herpes simplex
76
Tx toxoplasmosis
Spiramycin
77
Fever
Uterine tenderness
Purulent lochia after postpartum
Increased neutrophil
Postpartum endometritis
| - Clindamycin and gentamicin
78
PMS tx
SSRI (sertraline)
79
Buproprion
tx depression plus want to stop smoking
80
Preeclampsia occurs as a result of
Hypoperfusion to the placenta due to abnormal remodeling of spiral arteries with fail to expand as expected causing hypoperfusion and ischemia
81
Amorphic calcifications in unilateral breast
Ductal carcinoma in situ
82
Unilateral breast discharge
Intraductal papilloma
83
Heavy vaginal bleeding
pelvic pressure
N/V
hCG > 100,000
hydatidiform moles
84
Post partum hemorrhage =
risk factor
> 500 ml during vaginal
> 1000 during c-section
Fetal macrosomia
85
Irregular menstrual bleedign w/ lighter periods > 6 months after D&C or endomyometritis with previous nromal menses
```
uterine synechiae (asherman syndrome)
- intrauterine adhesions
```
86
Cause methotrexate to fail
hCG > 5000,
gestational sac larger tahn 3 to 4 cm
fetal heart tones
87
Poorly controlled blood sugars leads to in baby
Hyperinsulinemia
Hyperglycemia
Macrosomia
88
Low grade squamous lesions over 25 y.o
Colposcopy
89
Turners risk of
constipation
90
Tx precocious puberty
GnRH agonist (leuprolide)
91
Most common complication of c section
Post op ileus
92
Mittelschmerz
Middle pain
| Lower abdominal or pelvic pain that occur midway during menstrual cyclat at time of ovulation
93
Bacterial vaginosis tx
| - character
Thin grey white malodorous discharge, ph 4.5-5, clue cells
Metronidazole
94
Condition that only occurs in pregnant diabetics
Sacral agenesis
95
```
White classification
A
B
C
D
R
F
H
T
```
```
A: Gestational
B: > 20 y.o for less than 10 yr
C: 10-19 y.o, for 10-19 years
D: < 10 y.o, for 20 years
F: Nephrolopathy, proteinuria **
H:Heart
R: retinopathy
T: renal transplant
```
96
Chronic HTN if present how long after
> 12 weeks
97
Dont give magnesium sulfate in
myasthenia gravis
98
Betamethasone increases what in mother
Glucose
STeroid therapy
99
Preeclampsia
```
New onset HTN
Proteinuria > 300 mg
Edema
Headache
Visual disturbances
Abdominal pain
```
100
Fever nausea
Anorexia
Abdominal pain periumbilicus --> RLQ or upper abdomen
Appendicitis
101
Upper abdominal pain to back
Fever
N/V
Elevated amylase and lipase
Pancreatitis
102
Hair bearing skin, scalp, anils, oral mucous membranes, vulva
Inflammation, mucocutaneous eruptions and blisters that flare and remission
Burning itching
Lacy reticulated lesions on labia
No scarring or fibrosis
Lichen planus
Corticosteroids
103
Trisomy 21 labs
AFP down
Estriol down
hCG up
Inhibin up
104
growth rate
- 15 weeks
- 20 weeks
- 20-32 weeks
- 32-34
- 15 weeks= 5 grams
- 20 weeks= 10 grams
- 20-32 weeks= 20 grams
- 32-34= 30 grams
105
Metoclopramide causes
hyperprolactinemia
106
Vasectomy not effective for
3 months
107
Text for uterine leiomyomas (fibroids)
Transvaginal ultrasonography
108
+ BRCA test
Mammography + MRI every 6 months alternating
109
Primary dysmenorrhea cuases by
| tx
excess of protstaglandins
Tx : NSAID (COX1/2 inhbitor)
110
Threatened miscarriage time
< 20 weeks
111
Vaccum assisted delivery risk
Cephalohematoma --> hyperbilirubinemia
112
Heavy menstrual bleeding check
PT and PTT
113
Pencillin allergy
Clindamycin + gentamicin
114
Early term
37 weeks 0 days to 38 weeks 6 days
115
Full term
39 weeks 0 days --> 40 weeks 6 days
116
Post term
after 42 weeks
117
Cardinal movements of labor
```
Engagement
Descent
Flexion
Internal rotation
Extension
External rotation
Explusion
```
118
What other organ system at risk w/ menopause
Cardiovascular disease
Estrogen cardioprotective and decreases LDL
119
Dia Dia twin time line
first 72 hours
120
Mono dia twin separation
4 to 8 days
121
Mono mono twins sep
8-12 days
122
Conjoined twins sep
13 days
123
Sonohysterogram:
imaging of uterus
| fluids into uterus via cervix to examine lining
124
Hystosalpingogram
xray of uterus and fallopian tubes (infertility)
125
Hyperemesis -->
Ketouria and weight loss
126
Reduce post op infection for c section
Prophlaxis cefaxolin
127
Painless, erythematous round firm ulcer with raised edges
Tx
Syphillis
Pencillin G
128
Painful vesicles
tx
Herpes
Oral acyclovir
129
Ppaule or shallow ulcer w/o raised border, painless
Lymphogranuloma venereum
Oral doxycycline
130
Painful demarcated non indurated ulcer
Chancroid
IM ceftrixone
131
CMV infection
hearing impairment
Amniocentesis test
132
Fetal growth resistriction < 10 % -->
cerebral palsy
| hypoxic damage to brain
133
Increasing branching of the ductular trees and increased secretory gland formation
1st trimester
134
Breast changes
- Initial stages
- First trimester
- 2nd trimester
- 2nd/3rd trimester
- 3rd trimestser (36 wk)
- Time of labor
Initial stages
- Increased bud branching
- Increased secretory glands on each bud
First trimester
- Increasing branching of ductular tree
- Increase secretory gland formation
2nd trimester
- glandular tissue proliferation w/ ductal homogrenization
2nd/3rd trimester
- Lobular formation and enlargement
- ELiminating fat and stroma for glandular tissue and ductal trees
(enlargement and tenderness)
```
3rd trimestser (36 wk)
- Distension of lumens by accumulation of secretory material
```
Time of labor
- glandular proliferation and mitosis
135
- glandular tissue proliferation w/ ductal homogrenization
2nd trimester
136
Increased bud branching
Initial stages
137
- Distension of lumens by accumulation of secretory material
3rd trimestser (36 wk)
138
- Increasing branching of ductular tree
| - Increase secretory gland formation
First trimester
139
Increased secretory glands on each bud
Initial stages
140
- glandular proliferation and mitosis
Time of labor
141
Febrile illness w/ myalgia, arthralgias, LAD, lacy erythematous rash
Parvovirus B 19
142
Infant w/ anemia
High output congestive heart failure
Cardiomyopathy
Parvovirus B 19
143
Antiviral for Hep B
Tenofovir
144
Pregnancy weight gain
BMI less tahn 18.5 = 28 to 40
25- 29.9 --> 15 to 25 lbs
> 30 gain 11 to 20
