Flashcards in OBGYN Deck (49):
Infarction of pituitary d/t postpartum hemorrhage., Presents as failure of postpartum lactation, failure to resume menses after delivery, Labs: LOWWW TSH
Tx. of Depression during pregnancy
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.
Chlamydial bacterial conjunctivitis
mucopurulent discharge 5-14 days post delivery
What do you give to pregnant mother with chlamydia?
Risk factors for Breast ca.
Female, older, hx. of breast ca. OR Fibrocystic change with cellular atypia, Breast ca. in 1st degree relative, Nulliparity
Breast Ca. Staging
0: Cis, 1:
Most common causal organism for Breast Abscess? Tx.
Staph species, Tx: Cephalexin and Dicloxacillin
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
Amniotic Band Syndrome (Streeter Dysplasia)
Multiple constricted bands (e.g. on fingers) due to fibrous bands that result from sac disruption
Seal flipper fins assoc. with Thalidomide use
Radiation exposure in pregnancy
Risk factors for Eclampsia
Multiple gestations, Hydatidiform mole/extrauterine pregnancy, African American/Hispanics, Age >35 y.o., DM, collagen vascular dz, thrombophilia
Renal manifestation in Turner Syn
Tx for chorioamnionitis and postpartum endometritis
Ampicillin + Gentamicin OR Clindamycin + Gentamicin
Maternal complications associated with chorioamnionitis
Uterine atony, Endometritis, C-section
Tx Incomplete Abortion?
Dilatation and curettage, Misoprostol if
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
Hemolysis, Elevated Liver enzymes, Low Platelets, Dx: Peripheral blood smear showing schistocytes
Premature Ovarian Failure (primary hypogonadism
Inc. FSH and LH, FSH:LH >1.0, Dec. Estrogen levels
Asymptomatic Bacteruria, Risks? Tx?
>100K CFU with no S&S UTI, cystitis --> acute pyelonephritis --> maternal/fetal morbidity, Tx: Amoxicillin x 10d, Nitrofurantoin, Cephalexin
Tx. for Opioid-dependent pregnant woman
Post-partum blues resolve by
Premenstrual Dysphoric disorder (PMDD) reolves when
1-2 days after onset
Ovarian germ cell tumor/embryonal carcinoma tumor marker?
AFP (will also have elevated BhCG)
Sequelae of Gestational Diabetes
hypoglycemia (2ndary to hyperinsulin state), respiratory distress, polycythemia and hyperbilirubinemia, hypocalcemia/hypomagnesemia
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
Breast Milk Jaundice
starts at age 3-5d, high levels B-glucoronidase in breast milk deconjugates intestinal bilirubin and increased enterohepatic circulation
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.
AutoRec. chromosomal breaks on genetic analysis, S&S: aplastic anemia, abnormal thumbs, cafe au lait, large freckles, deafness, Tx: Hematopoietic stem cell transplant
Absence Seizures keywords
Fitz Hugh Curtis, d/t
Pain in: RUQ, RLQ, shoulder, gallbladder, Cervical os discharge and motion tenderness, d/t Chlamydia
Tx. pyelonephritis in pregnancy
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
Endometriosis keywords, Tx
dyspareunia and dysmenorrhea, radiating to rectum, Tx: COCPs - they induce atrophy of the ectopic endometrial tissue
Postpartum Thyroiditis, Tx
diffusely enlarged, firm, painless thyroid, Tx: Propranolol
recurrent crampy abdominal pain but no pelvic pathology present
recurrent crampy abdominal pain secondary to pelvic pathology
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
When is an Anatomic Screen using Ultrasound indicated And for what?
Weeks 18-20, Used to diagnose NTDs, anencephaly, encephalocele, myelomeningocele
When is a surgical cerclage be performed?
At weeks 13-14. (As gestational increases, risk of cervical dilation increases)
Tx. Gestational HTN, pre-eclampsia (before delivery)
Labetalol (unless she has asthma), M-dopa, Hydralazine, Nifedipine
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)
What spinal levels is uterine contraction and visceral pain?
Descent of the head into perineum results in somatic pain of what spinal levels?
Levels of TBG, TSH, Total T4, and Free T4 in Normal Pregnancy
Estrogen causes TBG to increase so...
No change TSH
Inc. Tot T4
No change Free T4
Treatment of choice for DVT in pregnancy?
SQ LMWH (e.g. Dalteparin, Enoxaparin)
Phyllodes Tumor keywords
large, solid (hypoechoic), well circumscribed, smooth, polylobulated mass that rapidly grows
Tx: Wide Local excision
Tx. Pelvic Inflammatory Disease (PID) inpatient and outpatient
Inpatient: Clindamycin + Gentamicin
Outpatient: Ceftriaxone + Doxycycline (Azithromycin if pregnant)