OBGYN 10 Flashcards
(53 cards)
What is an enterocele
Defect of the pelvic muscular support of the uterus and cervix (if still in situ) or the vaginal cuff (if hysterectomy). The small bowel and/or omentum descend into the vagina
What is a pessary
Synthetic device used to act as a “hammock” to suspend the pelvic organs
What can happen to a baby born to a mom with Graves
Neonatal thyrotoxicosis - due to transplacental passage of anti-TSH receptor antibodies during the third trimester
Baby born with sx of hyperthyroidism (warm skin, tachycardia, irritability, low birth weight)
Tx of neonatal thyrotoxicosi
- Temporary Methimazole PLUS beta-blockers
- Self-resolves within 3 months
Tx of postpartum endometritis
♣ Clindamycin and Gentamicin
Treatment of hydatidiform moles
• D&C
• Monitoring of b-hCG
o Want to monitor until b-hCG is undetectable and then for another 6 months
o Newly elevated b-hCG is diagnostic for gestational trophoblastic neoplasia
o Contraception is necessary during surveillance period so you can accurately follow b-hCG levels
What is an ovarian tumor containing thyroid tissue called?
Struma ovarii
What are the subtypes of ovarian germ cell tumors
Teratoma, dysgerminoma, endodermal sinus tumor, choriocarcinoma
Most common complication of mature teratomas
Ovarian torsion
What are the subtypes of ovarian epithelial tumors
Serous, mucinous, endometriod, Brenner
What are the subtypes of ovarian sex cord-stromal tumors
Granulosa-theca
Sertolig-Leydig
Fibroma
Describe presentation of Granulosa-theca cell tumor
- Precocious puberty
- Menorrhagia/metrorrhagia
- Postmenopausal bleeding
Describe the ovarian sizes that are concerning for tumor and management of different sizes
< 5 cm = most likely functional cyst; observe
5-10 cm = get US; septations, solid components, or growth on surface of inner lining are all indication for operation; if those all absent, can observe and re-US in 1 month
> 10 cm = operate
At what age is there a sharp decline in a woman’s follicle number
> age 35
How does ABO incompatibility present in a newborn
MILD hemolytic disease - most babies are asymptomatic or mildly anemia at birth
May need phototherapy for hyperbilirubinemia
What are the 2 levels that are decreased in both Trisomy 21 and 18
Alpha-fetoprotein and estriol
THINK: boy (alpha) and girl (estriol)
What are causes of elevated AFP
NTD, abd wall defects, multiple gestation
Describe potential side effect of epidural + treatment
Epidural can lead to hypotension in mom –> placental insufficiency (recurrent late decelerations)
Tx = IV fluids, then vasopressor (e.g. Ephedrine - causes vasoconstriction of the peripheral vasculature but spares the uterine arteries)
What is considered term pregancy
37-42 weeks
identify each type of Diabetes classification (A1, A2, B, C, D, R, F, H, T)
- A1 = gestational; no meds
- A2 = gestational; meds
- B = onset >20 y/o; duration <10 years
- C = onset 10-19 y/o; duration 10-19
- D onset <10 y/o; duration >20 years
- R = proliferative retinopathy
- F = nephropathy (>500 mg/day)
- H = atherosclerotic heart disease
- T = prior renal transplant
Management of placenta previa
Expectant management as long as no excessive bleeding
C-section at 34 weeks
Management of placenta accreta
Hysterectomy
Next step in managment of ASCUS on pap smear
HPV typing
What might you expect to see in an arterial blood gas of a pregnancy woman
Compensated respiratory alkalosis (low CO2 with compensatory low HCO3)
Low CO2 is due to the increased minute ventilation during pregnancy
