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Flashcards in OBGYN Deck (69)
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1
Q

Do you pap smear pts w/history of hysterectomy?

why or why not?

A

Pap smear screening is not indicated in patients who have had a hysterectomy, unless it was done for cervical cancer or a high-grade cervical dyspalsia.

2
Q

women age 30-65.

-how often should they be cotested cytology/HPV?

A

Should be screened with cytology and HPV testing (‘‘cotesting’’) every five years.

3
Q

Initial triage of finding atypical squamous cells of undetermined significance (ASCUS) on a Pap smear?

A

HPV typing is an option in the initial triage of the finding of atypical squamous cells of undetermined significance (ASCUS) on a Pap smear

4
Q

women age 21-29

-how often should they have pap smear?

A

Every three years.

5
Q

When is a DEXA scan indicated?

A

DEXA scan is only recommended in patients with risk factors for osteoporosis prior to age 65.

6
Q

Women 40+ how often do they get mammograms?

A

ACOG recommends that women aged 40 years and older be offered screening mammography annually.

7
Q

When do you begin colonoscopies and how often do you get them?

A

For patients with average risk for colon cancer, the recommended screening is to begin colonoscopy at age 50 and then every 10 years, if normal

8
Q

Physiologic dyspnea of pregnancy is present in up to ___% of women by the ____ trimester.

A

Physiologic dyspnea of pregnancy is present in up to 75% of women by the third trimester.

9
Q

respiratory alkalosis/acidosis in pregnancy is normal

-which?

A

alkalosis

10
Q

Why are pregnant pts at risk for pulmonary edema?

A

Plasma osmolality is decreased during pregnancy which increases the susceptibility to pulmonary edema.

11
Q

Name 2 tocolytics:

A

terbutaline, nifedipine.

12
Q

What happens to cardiac output during pregnancy?

-What happens to systemic vascular resistance in pregnancy?

A

The cardiac output increases up to 33% due to increases in both the heart rate and stroke volume.
-The SVR falls during pregnancy

13
Q

The quadruple test

A

maternal serum alpha fetoprotein, unconjugated estriol, human chorionic gonadotropin, and inhibin A.

14
Q

What is 1st trimester screen for Downs?

A

Nuchal translucency measurement with maternal serum PAPP-A and free Beta-hCG (known as the combined test) is a first trimester screen for Down syndrome

15
Q

Folic acid:

  • dose for normal pts?
  • dose for high risk pts?
A
  • non-high risk patients is 0.4mg/day

- 4 mg of folic acid daily before conception and through the first trimester.

16
Q

How can dehydration lead to braxton hicks contractions?

A

ADH can mimic oxytocin effects & cause contractions.

17
Q

1st trimester abortion: think what first?

A

chromosomal abnormalities

18
Q

3 signs of placenta separation:

A

cord lengthening, gush of blood, uterine fundal rebound as placenta detaches from wall.

19
Q

4th degree laceration: what needs to happen?

A

anal mucosa is entered

20
Q

Spinal vs epidural: which more common in C/S?

A

C/S: spinal.

Vaginal: epidural.

21
Q

Complication of spinal/epidural:

A

Mat. hypotension due to dec. SVR. Can lead to dec. placental perfusion & fetal brady.

22
Q

Is general anesthesia used in OB?

A

Only for emergent C/S.

23
Q

Stage 1 of labor:

A

Extends until complete cervical dilation.

24
Q

Stage 2 of labor:

A

Extends until delivery of infant.

25
Q

Stage 3 of labor:

A

Extends until placental delivery.

26
Q

previa vs abruption:

  • which one is painful?
  • which one has bright red blood?
A
  • abruption = painful

- bright red blood = previa (dark = abruption).

27
Q

placental abruption:

-main risk factor?

A

HTN

28
Q

placental abruption:

-Tx?

A

Only need rapid delivery if severe. If small, give bethamethasone and tocolytics to prolong til 34 wks.

29
Q

ritodrine

-what is it?

A

tocolytic

-beta2 agonist (causes smooth muscle relaxation).

30
Q

Best way to rule out MgSO4 tox?

A

Test DTRs.

-

31
Q

How do prostaglandins cause contractions?

A

inc. intracellular calcium.

32
Q

Most common concern in PROM?

A

chorioamnionitis

-give mom broad-spectrum ABxs

33
Q

cause of variable decels?

A

cord compression

34
Q

desired vertex presentation?

A

occiput anterior

35
Q

Prolonged decel = how many min?

Bradycardia = how many min?

A
  • PD = >2 min
  • brady = >10 min

*if brady dont resolve in 4-5 min: Code Green/deliver vaginally ASAP.

36
Q

AFI

-oligo vs poly, what cutoff values?

A

20 = poly

37
Q

MCC of oligohydramnios?

A

ROM

38
Q

How much is standard dose of Rhogam?

-how much fetal blood will it eradicate?

A
  • .3mg

- 15 mL of fetal RBCs = 30 mL of fetal blood w/hct of 50.

39
Q

ACOG definition of post term

-greater than how many weeks?

A

> 42 wks

40
Q

Mortality rate of mono-mono twins?

A

50% secondary to cord entanglements.

41
Q

dizygotic twins

  • how many amnions?
  • how many chorions?
A

always di-di.

42
Q

Twin-twin transfusion syndrome

-only happens when?

A

monochorionic twins.

-must share placenta for this to occur. Duh!

43
Q

vertex-breech twins

-how do you deliver?

A

vaginally

44
Q

How much protein in urine to Dx severe pre-eclampsia?

A

5g protein/24 hrs

45
Q

How do pts usually present w/HELLP syndrome?

A

RUQ pain.

46
Q

Pre-eclampsia ruled out if urine protein less than what?

A
47
Q

Tx for MgSO4 tox:

A

calcium chloride or calcium gluconate

48
Q

Criteria for superimposed pre-eclampsia on chronic HTN?

A

rise in BP 30/10

49
Q

+ 1hr GTT = ?

A

> 130 mg/dL

-then do a 3 hr GTT

50
Q

DM-A1

A

gestational DM, diet controlled

51
Q

DM-A2

A

gestational DM, insulin controlled

52
Q

IV PCN G given when?

A
  • GBS +

- ROM > 18 hrs til delivery

53
Q

Most sensitive screening test for chorioamnionitis?

A

IL-6 in amniotic fluid

54
Q

Congenital rubella:

-Sxs:

A

Classic triad: PDA (or pulmonary artery hypoplasia),

cataracts, and deafness & “blueberry muffin” rash.

55
Q

congenital CMV

-Sxs:

A

Hearing loss, seizures, petechial rash, “blueberry muffin” rash.

56
Q

Can you breastfeed your child if you’re HIV +?

A

No.

57
Q

Chlamydia

-Tx during pregnancy?

A

azithro, amox, erythro

-doxy & tetracycline = C/I in pregnancy

58
Q

congenital toxoplasmosis

  • Tx for mother?
  • Tx for infant?
A
  • mom = spiramycin

- baby = pyrimethamine & sulfadiazine w/folic acid.

59
Q

Hyperemesis gravidum

-what causes the N/V?

A

high levels of bHCG.

-seen frequently in molar pregnancies.

60
Q

Is hepatic P450 system inc or dec during pregnancy?

A

Inc. due to estrogen.

61
Q

1st line Tx for pregnant woman w/pulm art HTN or eisenmenger?

A

abort pregnancy

62
Q

pregnant pt w/hypothyroidism

-management?

A

inc dose of levothyroxine by 25-30% bc inc. Vd & inc. binding proteins.

63
Q

benzos v barbs

-which ones teratogenic?

A

benzos = teratogenic

64
Q

How long should you wait after vaginal delivery before having sex again?

A

6 weeks

65
Q

Uterine atony

-Tx if pitocin & uterine massage fail?

A

methergine aka metherergonovine (C/I in HTN).

-next step is hemabate aka PGF2 alpha (C/I asthmatics).

66
Q

Tx for mastitis

A

dicloxacillin PO

-bc usually due to s. aureus.

67
Q
  • colpos

- meaning?

A

vagina

68
Q

lichen sclerosis

  • pre-malignant?
  • Tx:
A
  • no

- clobetasol ointment.

69
Q

bartholin gland cyst

-can it be cancerous?

A

yes

-take biopsy.