OBGYN Flashcards
(225 cards)
1
Q
adenomyosis
A
cyclic pelvic pain with menstruation, heavy bleeding
typically in parous 40+ woman
- PE; soft, boggy, uniformly enlarged uterus
2
Q
breast lump found on PE, now what?
A
> 30- mammaography +/- US
<30 - US+/- mammography
3
Q
epidural anesthesia AE
A
- ) leakage of CSF into dura- symptoms: postural headache
- ) total spinal/high spinal: when anesthesia ascends to head and depresses brainstem- causes bradycardia, hypotension, and respiratory difficulty
- ) hypotension caused by sympathetic Ns involvement leads to venous pooling, decreased preload, decreased contractility
4
Q
stroke/other thrombotic event + recurrent pregnancy loss
A
Antiphospholipid syndrome
5
Q
for labor to be arrested, what needs to be met?
A
- > 4 hrs of no cervical change with ADEQUATE contractions
- >6 hrs of no cervical change WITHOUT adequate contractions
6
Q
treatment for arrested labor vs protraction of labor?
A
arrest- c section
protraction- oxytocin
7
Q
whats adequate contraction
A
> 200 MVUs
8
Q
how do you work up decreased fetal movement in a fetus WITH heart beat
A
- do a non-stress test for >40min to assess if the fetus is just in regular sleep cycle or if something is wrong. Reactive= 2+ acc and is normal and can rule out fetal acidemia
- if nonreactive, you can do either a BPP (biophysical profile) or CST (contraction stress test). dont do CST if there are contraindications to labor, like placental previa or prior mymectomy!
9
Q
what is BPP
A
a test to assess fetal oxygenation, a score less than 8/10 suggests placental dysfunction. Each category gets either 0 or 2
- NST
- amniotic volume: single pocket >/=2 cm or index>5
- fetal movement>/=3
- > /=1 flex or ex
- > /=1 breathing in 30 sec
10
Q
in a fetus without doppler heart beat whats next?
A
transabdominal US to find heart beat. if not there, it confirms fetal demise.
11
Q
define pre-ecclampsia
A
BP > 140/90 on 2 occasion with proteinuria prot:creat>0.3 at greater than 20 wk
12
Q
define pre-ecclampsia w severe features
A
either severe htt > 160/110
creat>1.1, elevated transaminases, plt <100,000, headache or visual changes
13
Q
pt w nonviable fetus in breech position
A
- do vaginal delivery not csection
14
Q
how can you figure out cause of FGR?
A
- if symmetric (aka head and body are smaller by same amt) its most likely a 1st tri prob such as chromosomal abnormality
- if asymmetric (aka head and body smaller by diff amounts) most likely a 2nd/3rd tri prob like htt
15
Q
what is intertrigo
A
red beefy plaques in skin folds usually due to candida
16
Q
when to stop PAP
A
age 65 with no history of CIN 2+ and 3 consecutive neg paps
17
Q
how can you tell normal pregnancy vomitting from hyperemesis gravidum
A
get a urine ketones
18
Q
how do you treat a pt with confirmed chlamydia by NAAT
A
just azithromycin or doxy
19
Q
what are causes of maternal virilization in pregnancy
A
- placental aromatase def
- luteoma - bilat solid mass on ovaries
- theca lutein cyst - bilat cystic (low risk of fetal vir)
- sertoli leydig tumor - solid unilat ovarian mass
20
Q
lichen sclerosis on genitals treatment
A
high dose corticosteroid ointment, clobetasol
21
Q
what do you do if uterus prolapses during placental traction
A
- 2 large bore IVs with crystalline fluids and blood products
- replace the uterus, LEAVE THE PLACENTA ON THE UTERUS to prevent massive hemorrhage
22
Q
ovarian cyst with hyperechoic calcifications?
A
dermoid
23
Q
loss of fetal station (fetus goes from station 0 to -3)
A
pathognomonic for uterine rupture
24
Q
what is tachysystole?
A
increased rate of uterine contractions, More than 5 in 10 mins, for over 30 mins
25
what is the pathophys of gestational diabetes mellitus?
increased insulin resistance because of HPL to help shunt more glucose to fetus. If the insulin resistance overpowers the pancreatic B cell insulin production, this leads to GDM
26
breast that is erythematous, warm, with dimpling in setting of no fever
Inflammatory Breast Carcinoma.
(not mastitis, not abscess).
peau dorange
27
physiologic changes during pregnancy for mom?
- hypercoag. state: increase in fibrinogen, decrease prot C/s
- gestation thrombocytopenia
- dilutional anemia
- renal: increased GFR and RBF causes decreased BUN and creat, BM more permeable so more urine protein
28
variable deceleration
- "Intermittent"nadir does not correspond to contraction peak >50%
- "recurrent" nadir does correspond to peak, BUT are sharper and steeper, must be <15 sec from onset to nadir
causes: cord compression, cord prolapse,oligohydramnios
29
early contraction
- nadir occurs at same time as contraction peak, must be >30 sec from onset to nadir
causes: fetal head compression, or can be normal
30
late contraction
nadir occurs after contraction; must be >30 sec from onset to nadir
causes: placental insufficiency
31
what is the treatment for variable decelerations?
- if intermittent, risk of fetal acidemia is low, and treatment not needed
- if "recurrent" risk of fetal acidemia is greater, and treatment needed. 1st line is maternal repositioning. 2nd line amnioinfusion
32
how to manage endometriosis
- NSAIDs, hormonal contraceptives
| - if these fail do a laparoscopy
33
what is a main side effect of endometriosis
infertility
34
how do you manage pre-term labor?
if <34 wks try nifedipine or indomethacin which are tocolytics
>34 wks, deliver. if in breech or contraindication to labor do c-section
35
what is chorioamnitis
- an intramniotic infection due migration of vaginal or enteric flora through cervix.
- increased risk in prolonged ROM >18 hrs, protracted labor
- to diagnose: maternal fever + either: fetal tachy (>160) or maternal tachy (>100), maternal leukocytosis, uterine fundal tenderness, purulent amniotic fluid
36
Raloxifene
estrogen antag in breast and uterus,agonist in bone
| contraindication: VTE
37
ecoli bacturia treatment
1st tri-not bactrim!! can use nitrofurantain, ceflexin, amox-clav
38
how to suppress lactation?
- engorgement of breasts itself leads to supression via negative feedback. it is not recommended to use dopamine agonists. Just advise a comfortable supportive bra and NSAIDS
39
how do you manage chorioamnitis?
- broad spectrum antibiotics
- NSAIDs to break maternal fever
- labor augmentation
- do NOT give tocolytics, and do NOT wait for expectant management
40
management of hyaditiform mole?
- D&C, followup with quants until undetectable, then follow for 6 mo, do contraception and can TTC after 6 mo.
- signs that HM has progressed to gestational trophoblastic neoplasia: if quant doesn't become undetectable and plateaus, if quant increases in the 6 mo
41
cyst at 4 and 8 oclock of vaginal itroitus
Bartholin cysts
42
pararethral cysts
skenes glands
43
how to treat a positive PAP in a pregnant pt
- if HSIL, then need immediate culposcopy and cervial biopsy DO NOT DO endocervix curettage! then follow up with LEEP if needed
- if ASCUS or LSIL, then do HPV co test
44
when do you do rectovaginal swab for GBS
35-37 wk
45
painless vaginal bleeding in 3rd trimester pregnant woman with loss of FHR variability
placenta abruptio
46
what can a progestin challenge test show
if no bleeding occurs it can be suggestive of a low estrogen state
47
post coital bleeding+ friable cervix+ discharge
acute cervicitis
need NAAT testing to prove NG or CT
usually no organisms on light microscopy
48
obesity amennorrhea is caused by?
anovulation
49
what are the 3 D's of endometriosis ?
Dysmenorrhia
Dysparuenia
Dyschezia
50
how much folic acid for woman with prior preg w neural tube defect
4mg
51
what is the first step of evaluating the risk of preterm labor?
- TVUS in 2nd trimester to see how short the cervix is
52
how do you manage preterm labor risk
1. ) no history of preterm labor but short cervix- progesterone vaginal pill
2. ) history of preterm labor only- progesterone IM shot in 2nd trimester
3. ) history of preterm labor + short cervix- progesterone IM shot+ cerclage.
53
Methylergonovine is a ? contraindications are?
- uterotonic
| - contraindication: htt
54
carboprost is a ? contraindications are?
- uterotonic
| - contraindication: asthma
55
US shows adnexal mass with debris in the setting of fever, leukocytosis, and increase of Ca 125 and inflamm markers in a 40 yo?
tubo-ovarian abscess.
56
DCIS vs intraductal papilloma
while they might both present with unilateral bloody nipple discharge, but DCIS would show mammogram abnormalities
57
placenta previa management
diagnosed @ 18- 20wk.
advise no intercourse, no digital cervical exams
delivery by Csection at 36-37 wk
58
kleihauer betke test
may need higher dose of rhogham post partum, this test can determine that
59
when should you schedule a planned C-section
only at 39 wk or later
60
mammogram at?
40+
61
colonoscopy at?
50+ repear every 10 yr ; if you have a fam member with Colon ca under 60 then you can get it at 40 and repear every 5 years
62
biggest osteoporosis risk factor
family history
| age > 60
63
what are the respiratory changes seen in pregnancy
IRV, TV, and IC increases
RR stays the same
- FRC decreases by up to 80%
hence the resp alkalosis of pregnancy
64
how do thyroid hormone levels change in pregnancy
there is more TBG, so total levels of T3 and T4 will increase but free levels of T3 and T4 should be the same
65
what are the wt gain recs for preg
underwt: 30-40
normal- 25-35
overweight: 12-25
obese: 11-20
66
CVS can detect what
- karyotype abnormalities
| - CF
67
folic acid doses ?
0.4 if no risk
| 4 if previous NT defect
68
MOST common cause of increased AFP?
- underestimated GA
69
amniocentesis vs quad screen vs CVS
amnio is for women who are >35 and have an abnormal finding to asses chrom abnorm
quad screen is for everyone to asses chrom abnorm
CVS is specific for DS.
70
what do you do if you can't obtain fetal heart rate and pt is in labor
apply fetal scalp electrode
| DO NOT give epidural until FHR is monitored
71
BRCA positive patient contraception
copper IUD, no hormones whatsoever
72
what are the different ABO incompatibility
if a mom is O, she most likely has ab preformed to A and B which can cross the placenta. fetus might experience mild hemolytic disease
if mom is A or B, the antigens on the RBC are too large IgM pentamers and will not cross the placenta
73
Tamoxifen where are its effects? whats its side-effect?
-antagonist in the breast
- agonist in the uterus
- can prevent ovarian ca, not enough studies
most common side effect is hot flash
74
PPROM management?
if under 34 wk, and with infection or if over 34 wk deliver. give penicillin+ corticosteroids, do not give tocolytics
- if under 34 wk and without infection give penicillin and corticosteroids and wait
75
HIV in pregnancy management
best way to prevent transmission is the 3 drug therapy
76
gait ataxia, eye nystagmus, and alt mental status in pt with hyperemesis gravidum
Thiamine Def- Wernicke's encephalopathy
77
Todd paralysis
transient unilateral weakness post seizure
78
anterior vs posterior shoulder dislocation
ant: FOOSH, causes slight abducation and ex rot
post: ex seizure, causes adduction and in rot
79
post partum endometritis
uterine cavity gets polymicrobial infection from vaginal flora during delivery.
usually presents >24 hr after delivery. signs= fever, purulent lochia, uterine tenderness
treatment: gent + clinda
80
condyloma acuminata
genital warts
81
what is the discretion area for bHCG levels
>1500 you should see something on US
82
recurrent candida + urinary symptoms like increased frequency
check Hba1c
83
do OCPs cause wt gain?
Myth. No they do not
84
intrauterine demise with bone fractures and hypoplastic thoracic cavity
OI 2
85
how does abruptio placentra present
back pain or abdominal pain in a pt w/ or w/o bleeding (b/c bleed can be behind + contained by placenta) and FHR variations can indicate severity. sometimes uterine height can be larger than expected.
86
when would you offer external cephalic version?
- if the fetus is atleast 37 wks, in breech position, and mom has no contraindications to vaginal delivery and desires a vaginal delivery.
87
when in a pregnancy do you give RhD ?
28-32 wks Gest
| and 72 hr post delivery if (+)
88
most likely cause of bleeding in an operative vaginal delivery
some unresolved laceration. check GU tract, check GI tract, check vaginal canal
89
signs of pre-ecclampsia at less than 20wk is due to?
Hyaditiform Mole
90
management of IUFD
>24 wk vaginal delivery
| <24 wk D+C
91
delivery of PPROM is usually >34 wk GA, but what are indications to deliver prior to that?
- signs of infection: increased fetal HR, fever
92
management of finding atypical glandular cells
this is concerning for cervical or endometrial adenocarcinoma. need to do the following: (1) colposcopy (2) endometrial biopsy (3) endocervical curettage
93
no urination 6 hours post partum, with overflow incontinence?
acute post partum urinary retention usually due to epidural causing detrusor underactivity aka bladder atony, cath her!
94
what are exercise rec for pregnant women?
20-30 min of moderate activity a day. Contact sports, gymnastics, skiing, high fall risk sports are contraindicated.
exercise contraindicated in women with pre-ecclampsia, risk of preterm delivery,
95
what causes enlarged ovaries in Hyatidiform Mole?
- the proliferative trophoblastic tissue makes a lot of BHCG that stimulates the ovaries to make theca lutein cysts
96
low pregnancy wt can cause
preterm labor
| FGR
97
if youve had a classic c-section what is contraindicated
a vaginal delivery. must do next birth as csection
98
aromatase def?
normal internal genitalia, virilization, osteoporosisat puberty, small breasts, and acne/hair
99
when do you do oral glucose tolerance test
- at end of 2nd trimester
100
clear mucus from vagina?
can be due to ovulation
101
sexually active w RUQ pain and lower abdominal pain
Fitz Hugh Curtis
102
ovarian cancer vs teratoma
keep an eye on the age
| also ca will show ascites, and septations with solid components.
103
why can oxytocin prolonged exposure cause seizure?
oxytocin looks like ADH, which can cause increased water retention leading to seizure. note that this will be in the setting of hyponatremia
104
Mg toxicity after MG administration
due to renal insuff.
105
pseudocyesis
when pt has somatization of pregnancy. feels pregnancy symptoms and may even read a NEG pos test as POS
106
whats the best way to estimate gestational age?
- first trimester US has less discrepency than 2nd or 3rd
107
how to medically manage preterm labor
>34 wk +/- bethamethosone and penn
32-34 wk: bethamethasone, penn, and tocolytics (nifedipine or indomethacin)
less than 32 wk: bethamethsone, penn, tocolytics, and MgSO4 (for neuroprotective)
108
primary amenorrhea ages
13 w/o 2ndary sex
| 15 w/o 2ndary sex
109
if you suspect granulosa tumor what else do you have to check
EMB bc endometrial hyperplasia.
110
what is septic thrombophelbitis
post partum or post op phlebitis of ovarian or pelvic veins. it is a diagnosis of exclusion which has a fever unresponsive to ab
111
how do infants born to moms with graves disease present
with thyrotoxicosis vs the anti TSH ab cross placenta and cause hyperthyroid in baby
112
acute maculopap rash involving palms and soles
TSS
113
what puerperineum
shaking, chills, and lochia
114
how to eval 2ndary amenn
TSH, FSH, PRL
115
pt with active HSV in labor
do csectin
| do 36 wk acyclovir treatment to lower risk of active infection
116
umbilical cord prolapse management
elevate fetal head, call for emergent csection
| DO NOT try to put the umbilical cord back, do not tell pt to start pushing, do not use forceps
117
when do you give Pitocin to bring along labor?
if contractions are not powerful enough, you need to place iUPC to determine this
118
fetal hydantoin features are ?? caused by?
features are small body, microcephaly, mid face hypoplasia , microcephaly,cleft lip and palate, digital hypoplasia, hirsutism, devptl delay
caused by anticonvulsants- like phenytoin and carbamazepine
119
how can you tell apart placenta previa and vasa previa
placenta is loss of mother's blood for FHR is normal. vasa is fetal blood so FHR shows deterioration
120
twin twin transfusion syndrome
monochorionic pregnancy where donor twin is small and pale and recipient twin in large and plethoric.
recipient twin is at risk for: polycythemia, hydrops, polyhyrdamnios
donor twin at risk for oligohydramnios, and IUGR
121
infants born to diabetic moms are at risk for
```
hypoglycemia
hypocalcemia
RDS
hyperbilirubinemia
polycythemia
```
122
what are contraindications to giving newborn nalaxone
any history of substance use in mom during pregnancy
123
breast feeding decreases the risk of what cancer
ovarian
124
methylergonovineiscontraindicated in what
pre-ecclampsia and hypertension
| has vasoconstrictive properties
125
what are the milk hormones
progesterone is for PROduction
| oxytocin is for ejection. oxy is stimulated by suckling
126
whats the progesterone level for a viable uterine pregnancy?
>25
127
when do you screen for gest diabetes
at 24 and 28 wks if no other risk. but if over 30 BMI do it at first visit. Do 1 hr GTT then do 2 hr
128
systolic ejection murmur with a click in pregnancy is?
MVP give Bblocker if symptomatic
129
T/F Chest Xray is ok if you suspect pneumonia?
True its ok
130
being overweight puts you at risk for what pregnancy things
- htt
| - pre-ecclampsia
131
what drug can you not use for depression in pregnancy
cannot use Paroxetine!! will cause cardiac defects
132
what causes excess itching in pregnancy?
intrahepatic cholestasis of pregnancy. bile salt deposited in the dermis which causes itching.
treatment: ursodeoxycholic acid or naltrexon
133
when is the risk of congenital varicella the lowest?
first trimester
134
what does mg tox look like and what do you do
when pt has resp failure (suddenly less RR) or has loss of deep tendon reflexes.
stop MgSO and give CaGluconate
135
What is the goal of antihypertensive therapy in a pre-ecclampsia exacerbation
90-100 is considered 'safe'
136
what can be seen with RH disease on US?
collection of fluid in 2+ cavities ex ascites, pericarditis, scalp edema.
also extramedullary hematopoiesis like helpatosplenomegaly
137
100 mcg of Rhogham neutralizes how many fetal RBC? how much blood?
RBC- 5 cc
blood- 10 cc
cc= mL
138
which ab's are concerning for isoimm in preg
Lewis Lives
Duffy dies
Kell kills
139
if hemolytic disease is severe in utero what should you do?
- deliver
- if too young to delivery than do intrauterine transfusion
- if that doesn't work do maternal plasmapheresis
140
twin twin transfusion occurs in
monochorionic diamniotic pregnancy
141
when is radiation exposure most likely to cause intellectual disability
8-15 wk GA
142
what is the turtle sign
fetal head retraction, a sign of fetal shoulder dystocia. do mcroberts manuever
143
multiple prior csections puts mom at risk for what preg complication
placenta accreta
144
what condition is MgSO4 contraindicatedin
MG
145
bethamethason in preterm labordoes what
increase fetal pulm maturity and decrease RDS risk
decrease IVH risk
decrease nec enterocolitis risk
146
fetal fibronectin
high NPV for preterm labor
| a sticky protein btw the amniotic mem and decidua
147
how does Magnesium sulfate work?
- it competes with Ca entry into the myometrium
148
whats the point of tocolysis
to allow time for steroids to work
149
amp and erythromycin apart from preventing chorio can do what else?
prolong latency for 5-7 days
150
17 OH progesterone can decrease risk of
PPROM
151
when is labor recommended for women with PPROM?
34 wks
| later than that increases risk of chorio
152
1st step in management of minimal fhr variation
fetal scalp stim
153
methylergonovineiscontraindicated in what
pre-ecclampsia and hypertension
154
whats the def of PPH
>500 cc post vaginal delivery
| >1000 cc post csection
155
how to surgically manage uterine atony
B stitch
156
endometritis treatment
amp and gent
| or after csection gent and clinda
157
t/f breast engorgement can cause low grade fever
T
158
septic thrombophlebitis
a diagnosis of exclusion. post partum fever due to clot in one of the pelvic arteries
159
SSRI side effects
sleep disturbance
| sex def
160
3rd trimester SSRI use can cause?
- extrapyramidal symptoms, poor feeding, agitation
161
post term pregnancy are associated with
fetal adrenal hyperplasia, placental sulfatase def, anencephaly, unknown dates
162
post term pregnancies cause
macrosomia, oligohydramnios, meconium aspiration, placental insuff
163
what does amniotic infusion cure
repetitive variable decelerations
164
fetal dysmaturity
when fetus is more than 43 wk
| withered, meconium stained, long nails, small placenta
165
what an IUGR cause later in life
- cardiac disease, T2DM, htt, stroke COPD
166
DepotProvera side effects
usually causes irregular bleeding for 2-3 months, but by 1 year half of the pts are amenorrheic
167
Insufficient urethral sphincter fix
urethral bulking techniques
168
definitive tx for endometriosis
hysterectomy and BLSO
169
chadwick sign
blue cervix, indicative of pregnancy
170
dysmenorrhea within 2 years of menarche is most likely due to
prostaglandin production
171
Factor Vleiden mom, IUFD, wheres the clot?
ureteroplacental A NOT the umbilical cord!! bc moms rbc dont cross placenta!
172
what medication for women with hypothalamic amenorrhea
COCs
173
in setting of normal DHEA, testosterone, andTSH what other lab could you order for hirsutism? why?
17OHProg for late onset CAH
174
how to f/u suspected cushings
overnight dexamethasone
| 24 hr urinary cortisol
175
what is postpartum telogen effulvium?
increased estrogen levels in pregnancy cause synchronized hair growth, with decrease in the estrogen all the hair is lost at the same time.
176
after OCP what can be used as pharmacotherapy for hirsutism
Spironolactone
177
what is danazol for
endometriosis
178
primary vs secondary dysmennorrhea?
primary is unknown cause
| secondary is KNOWN underlying cause like endometriosis
179
what causes menopausal symptoms in a post menopausal pt s/p hysterectomy w LSO
- menopausal ovaries create androgens still, so post TAL LSO they stop producing the adrogens which can be perpipherally converted, causing return of menopausal symptoms
180
estrogen replacement therapy has what effect on lipid profile
HDL up
| LDL and TG low
181
how to eval infertility with a history of PID
- hysterosalpingogram
182
exercise induced hypothalamic amenorrhea has what hormone levels?
low FSH but low estrogen
183
PMS treatment
Calcium 1200
184
partial mole vs complete mole
partial HAS fetal parts and is XXY caused by dispermy
complete NO fetal parts bc empty egg and one sperm 46XX
complete has higher risk than partial for GTN
185
molar pregnancy is often accompanied by what other symptoms?
- HCG looks like T4, so youll be hyperthyroid with weight loss, increased DTRs, etc but with LOW TSH
- also will have ovarian stim so see cysts
186
T/F Bartholin Gland cyst in post menopausal women
- most likely a bartholin gland malignancy
187
invasive vs microinvasive cervical cancer
invasive invades past BM >3 cm
| invasive invades past BM <3 cm
188
when do you do cervical colonization
with a pos ECC
189
most common symptom of fibroids
heavy menstrual bleeding
190
vagismus therapy
- vaginal dilators
191
MS causes what kind of incontinence
urge- bladder hyperactive
192
what is tachysystole
more than 5 contractions every 10 mins for 30 min period
193
chickenpox during pregnancy
give baby Varicella IG
| if baby shows signs of pox give acyclovir
194
decreased breath sounds and fever 2 days s/p c-section
atelectasis
195
why are younger women more susceptible to GC/CT
because bigger transitional zone on cervix. more columnar epithelium outside os than MUCH after puberty
196
pregnant woman comes in for 1st prenatal visit with FH of DM, whats the management?
1 hour Glucola at initial visit.
| if no FH you can wait til 28 wk screen for GDM
197
1 hr Glucola limit
>140
198
under what pressure is it considered hypotonic contractions
>40 mmHg
199
what is idiopathic hirsutism
normal Test DHEA levels but hirsute
| cause: increased 5a-reductase, which causes increased test-->DHT, which is more potent
200
if VDRL + whats next in confirming syphillis
FTS-AB
201
PAP tests for HIV pt
2x first year then annually
202
sudden fetal decel after SROM when fetus is in -1
chance of cord prolapse
| do pelvic exm
203
contraindications to OCPs
1. ) >35 yo smoker
2. ) uncontrolled htt
3. ) DVT
204
vaginal bleeding, pelvic mass, + hydroureter
cervical cancer
205
if GBS is unknown under what conditions do you give abx
1. ) SROM for 18+hr
2. ) fever
3. ) history of GBS
4. ) preterm
206
fetal anemia shown by what on FHR
sinusoidal waves
207
signs of virilization
clitoromegaly, changein voice, muscle distribution changes
208
how to tell apart PCOS from sertoli leydig tumor
clitoremgaly and other signs of virilization are only seen in sertoli leydig
209
bartholin duct cyst vs abscess
cyst can be symptomatic or asymptomatic but it is never tender or erythematous
the abscess meanwhile is tender and erythematous
210
what are severe features of pre-ecclampsia
plt <100000
transamnitis
head ache visual changes
creatinine >1.1
211
whats the most effective strategy in reducing HIV transmission during birth
combination HAART
| c-section can also help if load >1000
212
frequent complication of dermoid cyst is _____ but not so mch ___
torsion NOT rupture
213
what do thyroid hormones look like in pregnancy
elevated total T3 and T4 (estrogen inc TBG)
decreased TSH (bHCG binds TSH receptors and causes neg feedback)
normal free T4
214
what is genitourinary symptoms of menopause
urogenital atrophy causes urgency incontinence
215
what is anemia in pregnancy
<10.5
216
what is pubic symphysis diaphysis
progesterone loosens the pubic symphysis. macrosomia, multiparity, and forceps can cause a symptomatic pubic symphysis diastasis which causes midline abdominal pain that might shoot ot the back or down the legs in change of position
217
FGR signs
thin loose skin, wide ant fontanelle, thin umbilical cord
218
whats the first step in evaluating a pt's risk for preterm labor
transvaginal US
| digital cervical exam and abdominal US also work but are not as indicative.
219
what is contraction stress test
external monitoring of FHR during labor or induced contractions
220
define oligo
biggest pocket <2 cm , AFI < 5
221
NST can ____ BPP assess ____
rule out fetal acidemia
| BPP assess fetal oxygenation
222
Behcet syndrome
vascular problem with oral andgenital ulcers
223
condyloma accuminata treatment
trichloroacetoacid or pdophyllin resin
224
MVA successful before??
8wk
225
PID therapy
Cef + Doxy (or gent)
