OBGYN Flashcards
1
Q
Day 1-14 of menstrual cycle is called____________
_________ hormone predominates
A
Follicular/Proliferative phase
Estrogen predominates
2
Q
Occurs after ovulation typically day 14 called_________
Progesterone is produced by the ____________
A
Luteal/Secretory Phase
Corpus Luteum
3
Q
Normal menstrual cycle begins no earlier than____ days, and no later than____ days
Menstrual cycles lasts
A
21-35 days
3-7 days
4
Q
Hormone that stimulates follicle growth–> Estrogen production
A
FSH
5
Q
Hormone that stimulates ovulation secondary to ______ surge
A
LH (secondary to Estrogen surge)
6
Q
_________ concentration of > 200pg/ml for 50 hours is required for _______ ________ to occur
A
Estrogen
LH surge to occur
7
Q
Maintains the corpus luteum –> continuous Estrogen/progesterone support of endometrium.
A
HCG
No fertilization–> CL degeneration –> Dec. Est/Prog–> Menses
8
Q
Menorrhagia is defined as
A
heavy menses
9
Q
Dysmenorrhea is defined as
A
Menses with cramping
10
Q
Metrorrhagia is defined as
A
intermenstrual periods
11
Q
Precocious puberty occurs at what age?
A
< 8 yoa
12
Q
Delayed Puberty is defined as ?
A
No Thelarche by 13
No menarche by age 16
13
Q
Type of Amenorrhea where the patient previously had a menses, but stops for six months?
A
Secondary Amenorrhea
14
Q
Primary amenorrhea is defined as ?
MCC Genetic or anatomic
A
Absence of menses by 16 w 2ndary Sex development.
Absence of 2ndary Sex development by age 14
15
Q
Primary Amenorrhea MCC “GENETIC”: XO karyotype
Webbed neck, broad chest,
A
Turner’s Syndrome XO
16
Q
Secondary amenorrhea MCC and 2nd MCC?
A
Pregnancy and weight changes
Other: hypothyroidism, PCOS, Cushing’s
17
Q
In primary amenorrhea if uterus is absent “Empty Pouch” you associate amenorrhea with what disorders?
A
Mullerien Agenesis (46XX) (Ovaries w Labial fusion)
Androgen Insensitivity (46 XY) (Male w internal Genitals)
18
Q
Disruption of hypothalamic secretion of GnRH–> Dec. FSH/LH: MCC is anorexia, exercise, celiac disease.
(Secondary Amenorrhea) Tx:
A
Hypothalamic Dysfunction (35%)
Clomiphene (Clomid- Stimulates Gonadotropin H.)
19
Q
Decreased FSH/LH with Incr. prolactin you associate Secondary Amenorrhea with ?
A
Pituitary Dysfunction (Adenoma)
20
Q
Increased FSH/LH with decreased estradiol you associate secondary amenorrhea with ?
Insulin resistant, obesity, Incr. testosterone, LH:FSH 3:1
A
PCOS
21
Q
PCOS patient presentation ?
A
Hirsutism/Hyperandrogenism
Obesity
Ovarian cysts
Amenorrhea/Oligomenorrhea
22
Q
Definition for prolonged time without menstrual bleeding
A
Oligomenorrhea
23
Q
Definition for frequent menstrual bleeding
A
Polymenorrhagia
24
Q
Types of menstrual disorders
A
Chronic Ovulation (Irregular: extreme ages young/old)
"Unopposed estrogen"
Ovulatory (Regular cycles: “Prolonged progesterone”)
25
Tx: for both Menstrual disorders?
Tx: for severe bleeding?
OBC 1st Line (Thins endometrium: Regulates cycle)
Severe bleeding: High dose Estrogen or HD OBC
Sx= Definitive
26
Menorrhagia (heavy) common causes
Leiomyomas
Adenomyomas
Bleeding D/O
Hyperplasia/Carcinoma
27
Tender boggy enlarged uterus: Accompanied by dysmenorrhea and pelvic pain.
Tx:
Adenomyomas
Tx: Hysterectomy
28
Palpable irregular mass on uterine BM exam. Usually develops >30 y/o: Benign tumor (Non-tender)
Tx:
Leiomyoma (Uterine Fibroid)
Tx: Pre-menopause (Leuprolide) Definitive Hysterectomy
29
Menorrhagia cause by bleeding disorders such as ?
Von Willebrand, Thrombocytopenia, or platelet dysfx
30
Dysmenorrhea due to pelvic pathology: endometriosis or adenomyosis, leiomyomas..
Secondary Dysmenorrhea
31
Primary dysmenorrhea (not due to pathology) is MCC by increased_______--> increased muscle activity
usually starts when?
Prostaglandins
1-2 years post menarche in young females
32
Treatment for dysmenorrhea?
NSAIDS
OBC
Laparoscopy if all fail
33
Cluster of physical, behavioral, and mood changes during the luteal phase (1-2 weeks before menses).
Bloating, breast pain, headache, BM changes, fatigue, muscle aches, depression, hostility, Dec. Libido. TX:?
Premenstrual syndrome "Relieved 2-3 days onset of Per"
Tx: SSRIs or OBC (Drosperinone containing)
34
PCOS Dx: Tx:
Progesterone challenge 10mg Medroxyprog. X 10 days
(No withdrawal bleeding= Hypothalamus/Pituitary failure
or imperforated hymen)
Tx: 1.OBC 2.Spironolactone (Hirsutism)
3. Clomiphene (Ovulation) Metformin- Abn. FSH:LH
4. Weight-loss 5. Sx-restores ovulation
35
term for disorder of acquired scarring of the uterine cavity?
Asherman's Disorder
36
Ectopic endometrial tissue that responds to cyclical hormones. Usually <35 yoa and nulliparity:
Ovaries MC site: --> infertility 25% Tx: X5 options
Endometriosis
Tx- Combined OCPS/NSAIDS
Progesterone- suppresses ovulation
Leuprolide- Suppreses FSH/LH
Danazol- Test induces pseudo-menopause
Laparoscopy ablation/Hysterectomy
37
C- section is biggest RF: post-partum/abortal:
"Foul smelling Lochia", tachycardia, abdominal pain:
Tx:
Endometritis
Tx: Clindamycin + Gentamycin
38
Endometriosis Triad?
Dyspareunia, Dyschezia, Dysmenorrhea
39
MC Gynecologic malignancy U.S: MC post- menopausal. Estrogen dependent: combination OBC protective.
Menorrhagia/ Metrorrhagia: post-menopause bleeding:
Dx- Tx-
Endometrial Cancer
Dx: Endometrial Bx or TVUS E. Stripe > 4mm
Tx: Hysterectomy (Stage I), LAD excision (III), Chemo IV
40
Endometrial gland proliferation: Chronic hyperplasia 2T unopposed estrogen: pre-cancerous
Menorrhagia/ Metrorrhagia: post-menopause bleeding:
Dx- Tx-
Endometrial Hyperplasia
Dx- TVUS E. Stripe > 4mm Tx: Atypia- Hysterectomy
no Atypia- Progestin
41
MC type of cancer found in Endometrium
Adenocarcinoma 80%
42
Second MC gynecologic cancer w highest mortality: RF FmHX, nulliparity, infertility, BRCA-1/2, >50 YOA.
OCPs and high parity are protective. rarely s/sx ntil late in disease. Palpable ovary, ascites*, node (sister MJ)
Dx: Tx:
Ovarian Cancer
Dx: Biopsy Tx: Early: LAD-ectomy
Sx- CA-125 to monitor progress
Chemo
43
MC cancer in Ovaries?
Epithelial 90%
44
Most are asymptomatic: Common in reproductive years: usually unilateral, LLQ/RLQ pain, may rupture or torsion.
Mobile-adnexal mass,Abnormal bleeding, dyspareunia:
Dx: Tx:
Functional Ovarian Cyst (CL cyst fails to degenerate)
Dx: Pelvic US Tx: Supportive <8cm resolve
(US repeat in 6 weeks)
> 8cm= Laparoscopy
45
MC benign Ovarian neoplasm: removed to prevent Torsion or malignant transformation. calcified in Xray
Dermoid Cystic Teratoma
46
3rd MC gynecologic cancer that METS locally. RF incr. sexual activity, multiple partners.
Post coital bleeding/spotting MC sx, pelvic pain, watery DC, metrorrhagia. Dx: Tx
Cervical Carcinoma
Dx: Colposcopy w biopsy/PAP/cytology Tx: Dep. Stage
47
MC cervical cancer?
Squamous 90% (Adenocarcinoma-10%)
48
Cervical cancer MCC?
Prevention?
HPV- 16 and 18 (31-33)
Prevention- Gardasil and Gardasil 9 <15 YOA X2 doses
>15 YOA X3 doses
49
Cervical screening cancer guidelines
Start: 21 YOA DC: 65
21-29 YOA: Every 3 years
> 30 YOA: Co-Test Q 5 years
50
PAP smear cervical cytology results
HPV positive and
Negative for intraepithelial malignancy (no neoplasia)
if >25 YOA- Cytology and HPV testing in 12 months
or Genotype for HPV 16 and 18
51
PAP smear cervical cytology results
Squamous cell Abn.- ASC-US (Undetermined sig.)
HPV Negative? HPV Positive
> 25 YOA- HPV Negative- repeat PAP/Co test in 3years
Positive- colposcopy w Bx
Or repeat PAP in 1 year
52
PAP smear cervical cytology results
ASC-H (cant exclude high intraepithelial lesion) HSIL
Colposcopy (Acetic acid accentuation of lesion)
53
PAP smear cervical cytology results Dx: Tx:
LSIL (Low grade intraepithelial lesion) CIN I
> 30 YOA HPV neg/positive?
25-29 YOA- Colposcopy w biopsy
>/= 30 YOA- HPV negative=repeat cytology x1 year
positive= colposcopy w biopsy
Tx: LEEP or Cold Knife conization
54
PAP smear cervical cytology results Dx: Tx:
HSIL (CIN II, III, carcinoma in situ)
Colposcopy w biopsy in all ages
Tx: Tx: LEEP or Ablation (cautery)
55
inability to maintain pregnancy 2T premature cervical dilation. Vaginal bleeding/DC in 2 trimester. painless
Tx:
Cervical Insufficiency (Incompetent cervix
Tx: Cerclage (suture of cervical OS) and bedrest
56
tender gland enlargement, unilateral vulvar mass (Inferior vulva) may be to E. Coli, staph or gonorrhea.
Non-tender in non-infected
Bartholin Cyst/Abcess
57
MC cancer of the vulva?
MC presentation
Squamous 95%
Pruritus (Red-white ulcerative crusted lesions)
58
Vaginal dryness, dyspareunia, vaginal inflammation, infection, recurrent UTI.
Tx
Vulvovaginal Atrophy
Tx: Vaginal Estrogens
Ospemifene- estrogen agonist in vagina and bone
59
Increased FSH/LH with decreased estrogen--> cessation of menses for > 1year. Dx Tx?
Hot flashes, menses alterations, mood changes, hyperlipidemia, osteoporosis, dyspareunia, incontinence
Menopause
Dx- FSH essay most sensitive test > 30 IU/ml
Increased FSH/LH w decreased Estrogen
Tx- Estrogen + Progesterone, Ca2+ vit. D, Hysterectomy
60
Palpable mass on ovary: associated with endometriosis.
"Chocolate cysts"
Endometrioma
61
MC breast D/O: Tender, BL, multiple, mobile. Fluid filled 2T exaggerated response to hormones. 30-50 YOA
Dx: TX:
Fibrocystic Breast D/O
DX: US or FNA Tx; Self resolve or FNA
62
2nd MC benign breast D/O: non-tender, mobile, rubbery lump. may enlarge w pregnancy. Gradual growth
Teens to early 20s Dx: Tx:
Fibroadenoma of breast
Dx: None Tx: Self resorb (No Sx needed)
63
Inflammation of the breast. Mostly in lactating women. S. Aureus MC. UL breast pain. tender warm + nipple DC
induration and fluctuance. Dx: Tx:
Mastitis/ Breast Abscess
Dx: Clinical Tx: Warm compress, nurse, Diclox/Nafcillin
Breast Abscess DC feeding and I/D
64
Breast cancer types
Ductal Carcinoma-
Lobular carcinoma-
Medullary, Tubular, Metastatic, Mucinoid
65
Does not penetrate the basement membrane. Associated with lymphatic METS esp. axillary MC 75-80%
Ductal Carcinoma In Si Tu
66
may not progress but associated with risk of invasive breast cancer.
Lobular Carcinoma
67
Breast cancer clinical manifestations
Breast mass- painless, hard, fixed
skin changes- redness, skin retraction, inverted nipple
itchiness, peau de orange
68
MC location of breast cancer?
Upper outer quadrant
69
Diagnosis initial SOC < 40?
DX if highly suspicious of malignancy?
Initial-US (Best <40 YOA)
Mammogram (High suspicion) and Bx
70
Breast cancer staging
Stage 0: DCIS, LCIS, precancerous
Stage I-III: w/I breast/regional lymph node
Stage IV: Metastatic BC
71
Neoadjuvent Hormone therapy
Anti-estrogen
Aromatase inhibitor (Decr. Estrogen production)
Monoclonal Ab Tx- HER2 G-factor (+)
72
Adjuvent therapy
Lumpectomy-
Mastectomy-
SLND (Sentinel Lymph node dissection)
73
Lower abdominal pain, dyspareunia, fever, purulent DC, Adnexal tenderness, WBC> 10K, (+) chandelier's
(+) Cervical motion tenderness: Ascending infx of reproductive tract. Dx: Tx:
Pelvic nflammatory disease
Dx: HcG R/O Ecto Prego
Tx: OP- Doxy, Ceftr, Metro
IP- IV doxy, Cefotetan, vanc/Gent
74
What is Fitz-Hugh Curtis Syndrome ?
RUQ pain associated with hepatic fibrosis and peritoneal involvement of PID. Normal LFTs
"peri-hepatitis"
75
Exotoxin producing S. Aureus. seen with tampon use or diaphragm sponge > 24 hours. Tx:
Sudden onset high fever: diffuse erythematous macular rash, fever 102.2, tachycardia, desquamation. HYTN
Toxic Shock Syndrome
Tx: Vancomycin + Gentamycin
76
Frothy yellow green DC: Strawberry cervix: pH > 5
Mobile protozoa;
Dx: Tx:
Trichomoniasis
Dx: Wet mount Mobile Tx: Metronidazole 2 G X1
500 mg BID X 7days
(Tinidazole next line)
77
Thin watery Grey white DC: Fishy odor rotten smell: Clue cells bacteria covered: pH >4.5: (____ criteria)
Dx: Tx:
Bacterial Vaginosis (Amsel Criteria)
| Dx: KOH prep Tx: Metronidazole I-vag X 7days
Vancomycin next line
78
Vaginal vulvar erythema, swelling, itchiness, burning when urine touches. Dysuria/dyspareunia. pH <4. 5
Dx: Tx:
Candidiasis
Dx: Yeast/spores KOH Tx: I- vag Clotri/Mico or nystatin
79
Long Acting progestins that last 3 years: least failure rate: -->osteoporosis;
Etonogestrel (Implanon)
80
Long Acting progestins that last 3 months: least failure rate: -->osteoporosis; Infertility up to 2 years
Medroxyprogesterone (Depo-Provera) Injectable
81
applied every week X3 weeks not used x1 week. Better compliance. less effective is patient is underweight
Ethinyl Estradiol/ Norelgestromin (Ortho-Evra Patch)
82
applied X3 weeks with 1 week off; removed during intercourse but must be replaced within 3 hours
Etonogestrel /Estradiol (Nuva-ring)
83
Progestin only: safe during lactation: Decreases endometrial cancer: less PID. Incr ectopic prego
"Mini-Pill"
84
Most effective form of contraception: 5 year duration: increased risk of PID
Levonorgestrel (Mirena) IUD
85
10 year duration of action. no hormonal use: Increased risk of PID
Copper (Paragard)
86
Beneficial if taken w/I 72 hours of unprotected sex
Levonorgestrel X2 0.75mg 12 hours apart or
Levonorgestrel X1 1.5mg dose
87
Emergency contraception of up to 120 hrs within intercourse?
Ulipristal Acetate (Ella)
88
Emergency contraception within 5 days of intercourse?
Copper IUD ( Paragard)
89
In obstetrics, what is Ladin's sign?
Uterus softening after 6 weeks
90
What is Hegar's sign ?
uterus isthmus softening after 6-8 weeks
91
What is Goodell's sign
Cervical softening due to incr. vascularization 4-5 weeks gestation
92
what is chadwick's sign ?
bluish coloration of the cervix and vulva 8-12 weeks
93
Fetal hart tones will be heard at how many weeks ?
What is the normal rate?
10-12 weeks EGA
120-160
94
At what EGA will the patient feel fetal movements?
16-20 weeks
95
heart beat with US can be seen at what EGA?
5-6 weeks
96
Rhogam testing is conducted when?
@ 28 weeks and within 72 hours of birth
97
Highest risk factors for Ectopic pregnancy?
History of prior ectopic pregnancy
Previous Abdominal/ Tubal surgery or PID (adhesions)
98
Ectopic Pregnancy triad?
1. Unilateral pelv/abd pain
2. Vaginal bleeding
3. Amenorrhea
99
severe abdominal pain, dizziness, NV, signs of shock, syncope, tachycardia, and hypotension are assoc. with?
Ectopic Pregnancy Rupture
100
How is the diagnosis and what is the treatment of Ectopic pregnancy?
Dx: 1. Serial HcGs q 2-3 days
2. TVUS- empty Gestational sac, Non- IUP, HcG > 2K
Tx: Unruptured: Methotrexate: Stable, <4cm, HcG < 5K
(+ leucovorin= Multi dose)
Rutured: Salpingostomy 1st choice
101
Type of abortion where- Some Products of conception expelled, some retained and presence of Dilation?
Incomplete Spontaneous Abortion
| Dilation and Evacuation with all retained abortions
(Also- Rhogam if mom is Rh - )
102
Type of abortion where- NO Products of conception expelled, some retained and presence of progressive Dilation?
Inevitable Spontaneous Abortion
103
Type of abortion where- NO Products of conception expelled and the cervical OS is closed?
Threatened Spontaneous Abortion
104
Type of abortion where- All Products of conception expelled and cervical OS is closed?
Complete Spontaneous Abortion
105
Type of abortion where- NO Products of conception expelled and cervical OS is closed?
Missed Spontaneous Abortion
106
Foul brownish discharge, fevers, chills. Some POC retained Cervical OS closed with cervical motion T.?
Septic Spontaneous Abortion (BS ABX)
107
defined as HTN without proteinuria after 20 weeks EGA resolving w/I 12 weeks PP?
Transitional (Gestational) HTN
108
defined as HTN + proteinuria +/- edema >20 wks EGA. Thrombocytopenia
Proteinuria >300mg (> 5G=severe): BP >140/90 twice 6 hours apart but not over week. Tx: ?
Pre-eclampsia
Tx: Mild- Delivery >/= 37 weeks: < 34= bed rest daily BP
Severe- Prompt Delivery only cure
109
HTN + Thrombocytopenia + Proteinuria + Seizures or Coma
Tx:?
Eclampsia
Tx:Magnesium Sulfate
Lorazepam (2nd Line) "Delivery once stable"
110
Treatment of HTN for Pre-eclampsia/Eclampsia?
Hydralazine, Labetalol ( or Nifedipine for Pre-)
111
Treatment of HTN for pregnancy with BP 150/100?
Methyldopa (TOC)
| Labetalol ( Hydralazine or Nifedipine)
112
3rd trimester sudden onset of painless bright red bleeding. No abd. pain or uterine tenderness.
No fetal distress: Dx: Tx?
Placenta Previa
Dx: US localizes placenta
Tx: Admit 1. Mag Sulfate inhibits contractions
2. CS given between 24-34 weeks (Lungs)
3. Delivery when stable
113
3rd trimester sudden onset of painful dark red bleeding. Severe abd. pain or uterine tenderness/ rigidity:
Fetal distress (Bradycardia) Dx: TX:
Abruptio Placenta
Dx: US ( NO pelvic exam)
Tx: Stabilize (hemodynamically) Immediate Delivery
114
What is the MCC of Abruptio Placenta ?
Maternal HTN
115
how do you diagnose Gestational Diabetes?
How do you confirm Gestational Diabetes?
50 G Oral Glucose challenge test @ 24-28 EGA Confirm: 100G 3 hours Oral GTT (GS) fasting @ a.m (>140 in 1 hour)-->
1 hour= >180 3 hours> 140 fasting> 95
116
What is the treatment of choice for Gestational Diabetes?
Insulin (0.8 IU/kg 1st Tri.) then 1.0, then 1.2 IU
| Labor induction @ 38 weeks
117
Post-Partum depression occurs within______ PP?
2 weeks-2months PP
118
Post-Partum blues occurs within _______ PP?
2-4 days PP
119
Major-Depression occurs > ______ PP?
2 months (2 weeks- 12 months)
120
Painless vaginal bleeding, uterine size/date mismatch, Hyperemesis gravidarum.
B-HcG markedly elevated > 100K: US- snowstorm "Cluster of grapes" Tx:
Gestational Trophoblastic Disease (Molar Pregnancy)
Tx: Surgical Uterine evacuation (Suction Curettage)
METS- Chemotherapy (Methotrexate)
"No pregnancy for a year"
121
Neoplasm due to abnormal placental development with trophoblastic tissue from gestational tissue? 80% benign
Hydatidiform Mole
122
What are the two types of Hydatidiform Mole?
Complete- 46 XX all paternal
| Incomplete- Eggs fertilized by 2 sperm
123
What does Dizygotic gestation mean?
Fertilization of two Ova by 2 different sperm (Fraternal)
124
What does Monozygotic gestation mean?
Fertilization of one ovum (Identical)
125
Hemolytic anemia, jaundice, kernicterus, hepatosplenomegaly that can lead to Hydrops Fetalis?
Rh alloimmunization
126
Preventive management of Rh alloimmunization?
1. Rhogam @ 28 weeks EGA
2. Rhogam within 72 hours of delivery
3. Rhogam if any potential cross mix blood (Trauma)
127
Severe, excessive morning sickness (with NV) associated with weight loss or electrolyte imbalance
Persists >16 weeks EGA Tx:
Hyperemesis Gravidarum
Tx: High protein foods: small frequent meals: Parenteral nutrition if severe: Pyridoxine (B6)+ Doxylamine 1st
(Promethazine dimenhydrinate)
128
Stages of Labor
Stage I- Cervix dilation (Latent-effacement Active- 3-4cm dilation)
Stage II- Cervical dilation to delivery of fetus
Stage III- Delivery of placenta and after birth
129
Stages of Delivery
Delivery of Fetus
Passive phase- complete dilation to mother expulse efforts
Active phase- Mother expulse efforts to fetal delivery
130
Three signs of placental separation? (0-30 minutes)
1. Gush of blood
2. Lengthening of Umbilicus
3. Firm Fundus
131
MCC of post-partum hemorrhage >500ml
Tx:
Uterine Atony (Non contracting- soft boggy uterus)
Tx: Uterine massage: Oxytocin: Misoprostol: Methylergonovine
132
Premature Rupture of membranes Diagnosis?
- Nitrazine (Blue paper test)- pH >6.5
- Fern Test: Crystallization of Estrogen/Amniotic fluid
- US
- Fetal Fibronectin present (pre-term)
133
Causes of Premature Rupture of membranes
prior preterm delivery, STDs, smoking
134
Premature labor is defined as ?
What dilation and effacement?
Regular contractions (>4-6 hours) w progressive cercival changes before 37 weeks.
>3cm dilation > 80 effacement
135
Tocolytics that suppress uterine contractions?
- Indomethacin
- Nifedipine (CCBs)
- Magnesium sulfate
- Beta2 agonist Terbutaline
136
Group B strep ABX prophylaxis?
Ampicillin --> then Amoxicillin and Azytrhomycin
PCN- Cephazolin --> cephalexin and Azytrhomycin
137
Dystocia causes 3 Ps
Power- weak/absent contraction
Passenger- size/position
Passage- uterus/ soft tissue abnormalities
138
Nonmanipulative management that increases pelvic opening with hyperflexion
Mc Robert's maneuver
139
Manipulative management that requires fetal 180 shoulder rotation
Corkscrew maneuver
140
Induction of labor management? (Early and late)
Early- Cervidil- Prostaglandin Gel: Balloon (Laminaria)-- cervical ripening
Late- <1 cm : IV Oxytocin: Amniotomy (Rupture) cervix partially dilated
141
Daily recommended Vitamin D and calcium
Calcium: 1000 mg/day for women up to 50 and men up to 70, (1200 mg/day for older adult)
Vit. D: Adults: 800-2000 IU/day (400 kids/adolescent)
142
Dexa scan normal limits? Osteoporosis Dexa scan?
- Normal – T score of +1.0 to -1.0
- Osteopenia – T score of -1.0 to -2.5
-Osteoporosis – T score of
143
End Due Date Nagele's ?
add 7 days and subtract 3 months to 1st day of LMP
144
Thought to be a form of severe pre-eclampsia that occurs in 10% of pre-eclamptic patients
can occur in the absence of elevated BP
HELLP Syndrome
145
What does HELLP syndrome stand for?
Hemolysis, Elevated Liver enzymes and Low Platelets
146
summation of the largest cord-free vertical pockets in each of the four quadrants of an equally divided uterus
Amniotic Fluid Index
147
Greatest Breast cancer RFs?
Age: BRCA1/2 1st relative: Nulliparity: Menarchy <12:
148
USPTF recommendations for Breast cancer screening?
>50-74 : Biennial Mammography
BRCA1/2: @ 25 Annual
