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Flashcards in OBGYN Deck (49):
1

Sheehan Syndrome

Infarction of pituitary d/t postpartum hemorrhage., Presents as failure of postpartum lactation, failure to resume menses after delivery, Labs: LOWWW TSH

2

Tx. of Depression during pregnancy

ECT

3

What method is used by gyn surgeons to ensure that ureters were not accidentally damaged?

IV Indigo Carmine Administration, The ureter is deep within the female pelvis and courses along lateral side of the uterosacral ligament where it then enters the base of the broad ligament. It also passes under the uterine artery at the level of the cervical os. 50-80% of ureteral damage during surgery is during gynecological procedures.

4

Chlamydial bacterial conjunctivitis

mucopurulent discharge 5-14 days post delivery

5

What do you give to pregnant mother with chlamydia?

Azithromycin

6

Risk factors for Breast ca.

Female, older, hx. of breast ca. OR Fibrocystic change with cellular atypia, Breast ca. in 1st degree relative, Nulliparity

7

Breast Ca. Staging

0: Cis, 1:

8

Most common causal organism for Breast Abscess? Tx.

Staph species, Tx: Cephalexin and Dicloxacillin

9

Erythema toxicum neonatorum

benign "eczema" of red pustules with halos, and Eosinophils that shows up 1-3 days after delivery and resolves in 1-2 wks without treatment

10

Amniotic Band Syndrome (Streeter Dysplasia)

Multiple constricted bands (e.g. on fingers) due to fibrous bands that result from sac disruption

11

Phocomelia

Seal flipper fins assoc. with Thalidomide use

12

Radiation exposure in pregnancy

13

Risk factors for Eclampsia

Multiple gestations, Hydatidiform mole/extrauterine pregnancy, African American/Hispanics, Age >35 y.o., DM, collagen vascular dz, thrombophilia

14

Renal manifestation in Turner Syn

Horseshoe kidney

15

Tx for chorioamnionitis and postpartum endometritis

Ampicillin + Gentamicin OR Clindamycin + Gentamicin

16

Maternal complications associated with chorioamnionitis

Uterine atony, Endometritis, C-section

17

Tx Incomplete Abortion?

Dilatation and curettage, Misoprostol if

18

Rubella Ab Titers are to be obtained when? Why? Tx

Initial prenatal visits. Congenital rubella syndrome has defects with hearing, heart, eyes. Pregnant women should not receive rubella vaccine until postpartum

19

HELLP

Hemolysis, Elevated Liver enzymes, Low Platelets, Dx: Peripheral blood smear showing schistocytes

20

Premature Ovarian Failure (primary hypogonadism

Inc. FSH and LH, FSH:LH >1.0, Dec. Estrogen levels

21

Asymptomatic Bacteruria, Risks? Tx?

>100K CFU with no S&S UTI, cystitis --> acute pyelonephritis --> maternal/fetal morbidity, Tx: Amoxicillin x 10d, Nitrofurantoin, Cephalexin

22

Tx. for Opioid-dependent pregnant woman

Methadone

23

Post-partum blues resolve by

Wk 2

24

Premenstrual Dysphoric disorder (PMDD) reolves when

1-2 days after onset

25

Ovarian germ cell tumor/embryonal carcinoma tumor marker?

AFP (will also have elevated BhCG)

26

Sequelae of Gestational Diabetes

hypoglycemia (2ndary to hyperinsulin state), respiratory distress, polycythemia and hyperbilirubinemia, hypocalcemia/hypomagnesemia

27

Breastfeeding Failure Jaundice

happens 1st wk of life, decreased bilirubin elimination (d/t lactation failure), S&S: dehydration, no yellow stools passed, Tx: Breastfeed 15 min per side q2-3 hrs

28

Breast Milk Jaundice

starts at age 3-5d, high levels B-glucoronidase in breast milk deconjugates intestinal bilirubin and increased enterohepatic circulation

29

Newborn with Milk Protein Allergy

diarrhea and vomiting 4-7d after starting cow-based formula, Note: Lactose is present in breast milk, and patients with a Congenital Deficiency of Lactase will also have symptoms while breastfeeding. Symptoms only after starting cow's milk is more of a Milk Protein Allergy.

30

Fanconi Anemia

AutoRec. chromosomal breaks on genetic analysis, S&S: aplastic anemia, abnormal thumbs, cafe au lait, large freckles, deafness, Tx: Hematopoietic stem cell transplant

31

Absence Seizures keywords

daydreaming episodes

32

Fitz Hugh Curtis, d/t

Pain in: RUQ, RLQ, shoulder, gallbladder, Cervical os discharge and motion tenderness, d/t Chlamydia

33

Tx. pyelonephritis in pregnancy

Ceftriaxone

34

Hepatic Adenoma, S&S, assoc. w/, Tx.

benign epithelial tumor that shows up as encapsulated, well circumscribed mass with central area of necrosis and calcifications on CT, assoc. w/ women of childbearing age, OCP and steroid use, Tx: cessation of OCP/steroids

35

Endometriosis keywords, Tx

dyspareunia and dysmenorrhea, radiating to rectum, Tx: COCPs - they induce atrophy of the ectopic endometrial tissue

36

Postpartum Thyroiditis, Tx

diffusely enlarged, firm, painless thyroid, Tx: Propranolol

37

Primary dysmenorrhea

recurrent crampy abdominal pain but no pelvic pathology present

38

Secondary dysmenorrhea

recurrent crampy abdominal pain secondary to pelvic pathology

39

What drug is used to prevent pre-term birth in patients with cervical insufficiency? When is it given?

17-a-Hydroxy-Progesterone Caproate, At 16 weeks

40

When is an Anatomic Screen using Ultrasound indicated And for what?

Weeks 18-20, Used to diagnose NTDs, anencephaly, encephalocele, myelomeningocele

41

When is a surgical cerclage be performed?

At weeks 13-14. (As gestational increases, risk of cervical dilation increases)

42

Tx. Gestational HTN, pre-eclampsia (before delivery)

Labetalol (unless she has asthma), M-dopa, Hydralazine, Nifedipine

43

Adding what med to Tamoxifen or Anastrozole will increase disease-free survival in premenopausal women with Stage I or II breast ca?

Zolendronic Acid (a bisphosphonate)

44

What spinal levels is uterine contraction and visceral pain?
Descent of the head into perineum results in somatic pain of what spinal levels?

T10-L1

S2-S4

45

Levels of TBG, TSH, Total T4, and Free T4 in Normal Pregnancy

Estrogen causes TBG to increase so...

Inc. TBG
No change TSH
Inc. Tot T4
No change Free T4

46

Treatment of choice for DVT in pregnancy?

SQ LMWH (e.g. Dalteparin, Enoxaparin)

47

Phyllodes Tumor keywords

Tx

large, solid (hypoechoic), well circumscribed, smooth, polylobulated mass that rapidly grows

Tx: Wide Local excision

48

Tx. Pelvic Inflammatory Disease (PID) inpatient and outpatient

Inpatient: Clindamycin + Gentamicin

Outpatient: Ceftriaxone + Doxycycline (Azithromycin if pregnant)

49

Which types of HPV are associated with vulvar cancer?

16, 18
31