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OBGYN Flashcards

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1
Q

Degrees of vaginal laceration

A
  1. Skin
  2. Muscle
  3. Anus
  4. Rectum
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2
Q

normal blood loss during pregnancy

A

500ml for vaginal delivery
1L for C Section

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3
Q

Identical twins

A

Monochorionic: eggs split into perfect halves

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4
Q

Ovarian hyperstimulation syndrome

A

Used clomiphene and then gained wait and got enlarged ovaries

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5
Q

Normal AFI Range

A

5-20

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6
Q

Stages of Labor

A

I: Labor until 10cm Dilation
II: 10cm Dilation until Delivery
III: Delivery of the placenta

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7
Q

Vertex presentation

A

Posterior Fontanel (triangle shape) presents first

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8
Q

Sinciput presentation

A

Anterior presentation (diamond shape) presents first

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9
Q

Face presentation

A

Mentum anterior
Do a forceps delivery

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10
Q

Compound presentation

A

Arm or hand on head
Vaginal delivery

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11
Q

Complete Breech

A

Butt down, criss cross legs

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12
Q

Frank Breech

A

Butt down, legs folded up

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13
Q

Footling / incomplete breech

A

Butt down, hips flexed
One foot sticking out of the cervical os

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14
Q

When can you do a vaginal delivery on someone who had a previous c-section

A

The C-Section was low-transverse (non-classical)

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15
Q

Early deceleration

A

NORMAL from head compression

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16
Q

Late deceleration

A

Uteroplacental insufficiency (no oxygen or nutrients)

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17
Q

Variable deceleration

A

Cord compression: reposition mom

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18
Q

Increased beat-to-beat variability

A

Fetal hypoxia

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19
Q

Decreased beat-to-beat variability

A

Acidemia

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20
Q

Pre-eclampsia

A

HA, vision changes, epigastric pain
From ischemia to the placenta
Tx: Mag, delivery, hydralazine / labetalol

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21
Q

Eclampsia

A

> 140/90 with seizures
Give 5mg mag bolus, 2mg maintenance

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22
Q

Chorioamnionitis

A

Fever, uterine tenderness, decreased FHR

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23
Q

Amniotic fluid embolism

A

SOB (from PE)

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24
Q

Endometritis

A

Post-partum uterine tenderness

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25
Incomplete molar pregnancy
2 Sperm, 1 Egg: 69XXY Embryo parts present
26
Complete molar pregnancy
2 Sperm, barren egg: 46XX / XY Bunch of grapes, no embryo
27
Threatened abortion
Cervix Closed, Baby has HR Treat with bed rest
28
Inevitable Abortion
Cervix Open, Baby Intact Tx: Cerclage (Sew cervix shut until term)
29
Incomplete Abortion
Cervix is open, no fetal HR, just products of conception D&C to prevent infection of placenta
30
Complete Abortion
Cervix is closed, no fetal remnants. Gone. Check b-hCG
31
Missed Abortion
Cervix is closed, no fetal HR, just products of conception Tx: D&C
32
Velamentous cord insertion
Fetal vessels insert between chorion and amnion
33
Kleihauer-Betke Test
Detects percentage of fetal blood in maternal circulation
34
Post-Partum depression
Depression post-delivery for more than 2 weeks SSRI and CBT
35
McCune Albright
Precocious sexual development Polyostotic fibrous displasia (Whorls of CT) "coast of Maine" pigmented skin macules
36
Adenomyosis
Endometrial tissue in the myometrium Uniformly enlarged and boggy uterus
37
Kallman syndrome
No GnRH and Anoismia
38
Savage's syndrome
Ovarian resistance to LH/FSH
39
Turner's
High FSH, Low E2 Coarctation of the aorta, bicuspid aortic valve
40
Progesterone challenge test
If there's vaginal bleeding, there's estrogen No bleeding? No E2 or ovaries Increased FSH: Ovarian problem Decreased FSH: Pituitary problem
41
Mittelschmerz
Pain with ovulation
42
HPV
dsDNA, vaccine blocks 6, 11, 18
43
Genital lesion with painful necrotic center
Chancroid (H Ducreyi, G- Rod) "School of fish" pattern
44
Lymphogranuloma Venereum
Painless ulcers, abscessed nodes, genital and elephaniasis Caused by Chlamidia
45
Granuloma inguinale
Spreading ulcer, Donovan bodies From Klebsiella granulomatis (Rod) Seen in phagocyte cytoplasm, tissue of infected
46
Epididymitis
Unilateral scrotal pain decreased by support
47
Blind baby
Congential: CMV Neonatal: Chlamydia (later, gonorrhea)
48
In-utero rubella infection
Cataracts, hearing loss PDA Blueberry muffin rash from face, spreading to trunk
49
In-utero CMV infection
Spastic diplegia of legs Hepatosplenomegaly Blindness, central calcifications
50
In-utero HSV-2 infection
Temporal lobe envephalitis Must offer c-section if they have active lesions
51
In-utero syphilis infection
Lip fissure (Rhagades) Saber shin, razor teeth, mulberry molars
52
Lobular breast carcinoma
Cells line up single file Contralateral breast is the primary cancer site
53
Comedocarcinoma
Multiple focal areas of necrosis (blackheads) DCIS
54
Intraductal Papilloma
Bleeding from nipple Most common cause of unilateral red discharge
55
Ductal carcinoma
Worst Px
56
Sarcoma Botryoides
Vaginal cancer, ball of grapes
57
Sister Mary Joseph nodule
Ovarian CA that has spread to the umbilicus
58
Meig's Syndrome
Pleural effusion + Ovarian fibroma + Ascites
59
Nagele's rule for due date
LMP + 9 mo + 7 days
60
Chorionic villous sampling
12 - 14 weeks, risks limb defects
61
FAS
Long philthrum Midfacial hypoplasia Short palpebral fissures
62
Isotretinoin teratogenic effects
Congenital deafness Congenital heart defects
63
Fetal hydantoin syndrome
From Phenytoin Ocular hypertelorism, strabismus Short nose, low bridge Accentuated "cupids bow" lip Distal phalangeal hypoplasia
64
Fetal Valproate syndrome
CNS abormalities GU defects Developmental delay, limb defects
65
Warfarin teratogenic effects
Chondrodysplasia: stippled epiphysis Multiple ossification centers
66
PPD+
CXR+: RIPE CXR-: INH and B6 for 6 MO
67
Quad screen for T21
AFP and Estriol DOWN hCG and Inhibin A UP
68
Quad screen for T18
EVERYTHING DOWN AFP, hCG, Estriol, Inhibin A
69
Abe for pregnant UTI
Nitrofurantoin first line Cephalexin or amoxicillin second line
70
Ph in vaginal infections
above 4.5? BV and Trich Normal? Candida
71
Multinucleated giant cells
HSV
72
Mom with HIV
AZT at 14 weeks until C-section delivery Breast feeding c/I Neonate gets AZT for 6 weeks, check again
73
What kind of placenta previa can be delivered vaginally
marginal (more than 2 cm from os)
74
Vasa previa
AROM Painless vaginal bleeding Fetal bradycardia Tx: Immediate C Sec
75
PCOS
Increased LH, decreased FSH. 3:1 Tx w/ clomiphene, letrozole (aromatase inhibitor), spironolactone
76
Tx PID
Ceftriaxone, Doxycycline Inpatient substitute Cefoxitin / Cefotetan
77
Chorioamniitis
Need confirmed PROM Uterine tenderness, maternal fever
78
Tx Pre-Eclampsia
Admit: Mg (5g bolus, 2g/hr), labetalol, nifedepine Hydralazine (can cause SLE-Like Sx)
79
Pap testing
Start at 21 yo below 30: do it every 3 years with cytology 30+: same, or q5y w/ HPV co-test d/c at 70 if there's 3 negative paps
80
LSIL management
Below 30: repeat in 6 mo until 2 negative paps Positive repeat? Colposcopy, endocervical curettage Positive repeat w/ pregnancy: Ectocervical Over 30: HPV test+ do colposcopy. Neg PAP/HPV q3y Same colposcopy procedure
81
Preferred SERM
Raloxifene because it antagonizes the endometrium rather than agonizes it. Won't cause hyperplasia
82
Bishop Score 1 pointers
Dilation: 1-2 cm Effacement 40 - 50 Consistency: Medium Position: Mid Fetal station: -2
83
Bishop Score 2 pointers
Dilation: 3-4 cm Effacement 60-70 Consistency: Soft Position: Anterior Fetal station: -1 - 0
83
Bishop Score 3 pointers
Dilation: 5+ Effacement 80+ Fetal station: +1 - +2

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