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Flashcards in OBGYN Deck (39):
1

threatened abortion

-closed cervical os
-Threat but nothing is happening yet, no treatment unless condition worsens and return to ER

2

inevitable abortion

open cervix
Sac low w/in uterus
Sac surrounded by perigestational hemorrhage
Dilated cervix

3

incomplete abortion

Cervical os open
Some products of conception (POC) already expelled

4

complete abortion

POC completely expelled
Cervix closed
no tx required

5

missed abortion

No fetal heart beat after 8 weeks w/ minimal or no symptoms

6

septic abortion

Any type of abortion in presence of endometritis

S&S:
↑ temperature & WBC count, Lower abdominal pain
Cervical motion tenderness
Foul uterine discharge

Txt: Evacuate pregnancy, IV antibiotics (ampicillin,-sulbactam, clindamycin)

7

who gets rhogam

Rh- negative women should receive Rh (D) immune globulin 300 micrograms IM

8

what suggests an incomplete abortion or ectopic

Absence of gestational sac w/ a B-hCG>1000mIU/mL suggests incomplete abortion/ectopic pregnancy

9

ectopic etiology

Previous episode of PID (from inflammation)

Tubal surgery

Pelvic surgery

Assisted reproductive technology IVF

10

ectopic triad

Abdominal pain

Vaginal bleeding

Amenorrhea

11

this lab result indicates an ectopic
this lab result is indeterminate

BHCG >6000 mIU/mL w/ empty uterus
BHCG ≤1000 mIU/mL, repeat in 2 days

12

hyperemisis gravidum

Intractable nausea & vomiting w/out significant abdominal pain
IV fluids (D5NS or D5LR)
Anti-emetics

13

oral hypoglycemic agents are contraindicated in

pregnant diabetic pts

14

how to treat hyperthyroidism in pregnancy

PTU (propthiouracil)
Thyroid storm: fever, volume depletion & cardiac decompensation

15

simple cystitis tx

-nitrofurantoin
-amoxicillin
-cephalexin

16

pyelo tx

-ceftriaxone/cefazolin
-ampicillin + genta

17

what med to avoid for seizure disorder pts

Valproic acid avoided b/c association w/ neural tube defects
Place patient in left lateral decubitus position to maximize placental oxygenation

18

HIV + pts should be placed on

zidovudine >14 weeks gestation

19

in any domestic violence, you must administer

rhogam is pt is Rh -

20

blunt trauma <20
>20 weeks

reaasurance
get a non-stress test, fetal monitor

21

when are speculum and pelvic exam C/I?

2nd half of pregnancy, don't do till US obtained

22

abruptio placentae risk factors

HTN, DM, Chronic renal Dx
Advanced maternal age
Multiparity,
Smoking
Cocaine use,
Previous abruption
Abdominal trauma

23

how does abruptio placentae present

-dark red painful bleeding
-abdominal pain

24

how does placenta previa present?

Painless bright red vaginal bleeding after 28 weeks gestation
avoid pelvic exam

25

things to consider with preterm labor

-normal is 40 weeks, anything <37
-give glucocorticoids to hasten fetal lung maturity

26

pre-eclampsia
vs eclampsia

BP >140/90 or >20 rise in systolic or >10 in diastolic
proteinuria
generalized/pedal edema or weight gain >5 lbs in 1 week
typically > 20 weeks gestation
all of above + seizures

27

how to tx pre-eclampsia

-labetalol, hydralazine, nifedipine
-Mg sulfate for severe

28

HELLP (variant of pre-eclampsia)

Hemolysis
Elevated Liver enzymes
Low Platelet count
presents with abdominal pain

29

to to tx HELLP

-Mg sulfate
-labetalol
-definitive tx requires delivery of fetus

30

postpartum hemorrhage

Uterus is enlarged & “doughy” w/ uterine atony
Vaginal mass is suggestive of inverted uterus
Bleeding inspite of good uterine tone & size may indicate retained products of conception

31

mittleschmerz

 "ovulation pain" or "midcycle pain".

32

m/c noninfectious cause of acute pelvic pain

ovarian cysts

33

ovarian torsion

surgical emergency
US is test of choice to dx

34

gold standard dx of PID

laparoscopy

35

PID definition

clinical syndrome in which microorganisms present in the cervix & vagina ascend into the normally sterile areas of the upper genital tract & causes an inflammatory reaction in the uterus (endometritis), FT (salpingitis) & adjacent structures (pelvic peritonitis)

36

how to tx PID inpt

Cefotetan 2 g IV every 12 hours OR
Cefoxitin 2 g IV every 6 hours PLUS Doxycycline 100 mg orally or IV every 12 hours(OR)

37

how to tx PID outpt

ceftriaxone IM single dose
doxy +- metro

38

Most frequent benign disorder of breast

fibrocystic changes
Symptoms most prominent pre-menstrually, pain and lumpiness tends clear up once your menstrual period begins

39

MCC mastitis

-s. aureus
-Cephalexin or dicloxacillin
-IMPORTANT - R/O inflammatory breast CA if no response to antibiotics