OBGYN6 Flashcards
(100 cards)
1
Q
Thyroid test change in 1tm PX?
A
Decrease TSH
Increase total T4
normal or mild increase in Free T4
2
Q
What we should do in pregnant with hypothyroidism?
A
Increase dose of T4 with 30 %
3
Q
Why?
A
Not cope with the physiologic change
4
Q
How we should follow?
A
Test TSH and T4 after 4 week
5
Q
What about T3?
A
Not recommended both for follow-up and treatment during Px B/C of short half life make followup difficult.
6
Q
comp of hypothyroidism in Px?
A
Preterm delivery
PPH
Gestational HYTN
Preeclampsia
7
Q
Adenomyosis CM?
A
Multiparous women age > 40 Chronic pelvic pain heavy menstrual bleeding(increase endometrial cavity) Symmetrically enlarged uterus Tender uterus
8
Q
Diagnosis and management?
A
Histology after hysterectomy management conservative (OCP, Progestine only pills)--If fails hysterectomy
9
Q
Active phase(6-10 Cm) disorders?
A
Cervical protection
Cervical arrest
10
Q
Cervical protection
A
cervical dilatation < 1 cm per 2 hr with /withut adequate cintraction
11
Q
management?
A
oxytocin
12
Q
Cervical arrest
A
No dilation within 4 hr with AC(>200 mtvu)
No dilation within 6 hr without adequate contraction
13
Q
management?
A
emergency C/S
14
Q
Post-op delirium(agitation and confusion) causes?
A
anesthesia
shock
opiates
15
Q
anesthesia?
A
Mainly old
start from procedure completion
16
Q
opiates(hydromorphone)
A
Bradycardia
Respiratory depression
17
Q
shock?
A
oozing blood
elapsed normal time
bleeding at the wound site
18
Q
why we take previous IAI rather than neonatal sepsis as an indication of IP?
A
Intraaminiotic infection is polymicrobial
19
Q
Bartholin gland?
A
found in 6 and 8 location
not palpable unless enlarged
20
Q
CM of hyaditid form mole?
A
AUB HG Preeclampsia < 20 week Teca luteal cyst hyperthyroidism
21
Q
management?
A
D&C
OCP for 6 month
serial HCG post evacuation
22
Q
What is mimic?
A
embryonal carcinoma
23
Q
How it mimic?
A
Elevated HCG and symptom related to it
But will have ascitis
24
Q
Tamoxifen S/E
A
End.Polyp in reproductive age
End.Hyperplasia in menopause
Resolve after discontinuation
25
Toxo risk?
undercooked meat
unwashed hands
Cat feces(protozoan oocyst)
26
Maternal symptom?
mild fever
nonpruritic,diffuse MP rash
resolve within a few days
27
fetal?
```
Ventricomegaly
Diffiuse ICC
Hepatosplenomegay
Ascitis
Scizure
Chrioretinitis
IUGR
```
28
diagnosis?
amniotic fluid PCR
29
Management?
spiramycin/pyramitamin-sulfadiazine-folic acid
30
management of sexual assault?
Post-exposure prophylaxis
emergency contraceptive
psychosocial counceling
31
importance of getting endometrial cell on pap smear?
If ag < 45, benign especially within 10 days of menses
| If age >45,do endometrial biopsy
32
management of endometrial hyperplasia?
Do biopsy
if benign--progestin-only tx/hysterectomy
If ca--hysterectomy
On progestin Tx followup with biopsy every 3 month
33
leakage of fluid in the vagina?
SUI
| fluid may be seen in pos vagina
34
OCP and HYTN?
OCP raise B/P around by 5
Not recommended to use in HTN
MOA: Increase angiotensin production from the liver
35
Why laparoscopic biopsy is C/I in high tumor suspicion?
Lead to CA spread
36
CM Epithelial tumor?
Acute:SOB/Distension and vomiting
subacute:abdominal pain and distension
asymptomatic mass
37
U/S future?
solid mass
thick septation
ascitis
38
management in high suspicion?
Exploratory laparotomy
39
postpartum thyroiditis?
```
Painless thyroid
low RUI uptake
resolve within 12 month
not require TX
TPO may be positive
hypo/hyperthyroid symptom
```
40
indication for suction and curettage in abortion?
hemodynamic instability
active bleeding
patient should consent
41
endometriosis PE?
laterally displaced cervix
cervical motion tenderness
firm /fixed uterus
adnexal mass
42
relation to infertility?
may cause tubal adhesion
43
management?
operative laparoscopy
44
Endometrial polyp?
```
In 30 and 40
Normal menstrual bleeding
Slight intermenstrual bleeding
Pain
There may be no apparent PE finding
```
45
How to d/t perimenopausal bleeding?
PMB will have an abnormal menstrual bleeding pattern
46
Importance of laparascopy on endometriosis?
Biopsy for definitive diagnosis
47
Vaginismus treatment?
CBT
Vaginal Dilators
sex education therapy
pelvic physical therapy
48
Is metronidazole if safe in 1st TMP?
Yes
49
the complication of B.Vaginosis?
Preterm delivery
| Increase risk HIV,HSV2,Gonorhea,chlymedia and tricomonas
50
Recurent cystitis in women defn?
>=2 per 6 month
| >=3 per year
51
risk factor?
Sexually active
Postmenopausal age
First UTI at age <15
Spermicide use
52
Prevention?
Dailey antibiotic prophylaxis(Nitrofrantoin,CTM)
| Post-coital prophlaxis(Nitrofrantoin,CTM)
53
When we need cystoscopy/ultrasound?
Other pathology suspected (E.G bladder ca)
If repeated culture after 2 weeks of therapy positive
Culture grows atypical bacteria (e.g protus)
54
Absolute C/I for exersice?
```
PROM
Cervical insuficiency
Preterm labor
Multiple Gestation
Placental abruption and Previa
Preeclampsia/Gestational HTN
Sever Heart and Lung Disease
```
55
Unsafe activity?
Sport risk of collision(e.g football)
High fall risk( e.g gymnnastic)
Scuba diving
Hot Yoga
56
Exercise recommendation in px?
```
Mid intensity
20-30 min/day
most - all day/week
No absolute C/I
No unsafe sports
chest pain during exercise?
```
57
Unsafe activity during exersise?
Dehydrasion(promote contraction)
| Laying back
58
mamary paget disease menifestation?
Persistent,Ulcerative and/or eczematous rash that start from nipple and spread to axilla.pain,Iching and burning in affected muscle.
59
pathophysiology?
cancer that move throgh mamary duct to nipple.
60
Did we need mamography?
Yes
61
Why?
B/C 85% case associated adenocarcinoma and the mass may not palpale.
62
How complet mole formed?
empety ovum By one(duolicate) or two sperm.
63
Lactational amenorhea?
first six month of post partum
>50 percent resume that
Excusive breast feeding
64
how to d/t from shehan syndrome?
IN sheahn syndrom
no lactation
Hypotension
axilery hair loss
65
Indication for admition in PID?
pregnancy
failed outpatient treatment
inablity to tolerate oral medication
Non compliance with medication(adolecent)
sever presentation(sighn of sepsis,Dhn..)
complication(abcess,perihepatitis..)
66
Managment?
Iv cefoxitine/cefotetan + doxycyclin
| Iv clendamycine + gentamycin
67
Polyuria defination?
>3L of urine per day
68
is normal px associated with Polyuria?
no
69
the normal amount in PX?
upto 2 litter withadequate intake(2L)
70
how to clasify polyuria?
Diluted usg< 1.001(water diuresis, PP and DI)
| Concentrated usg>1.001(glucose,urea, and saline)
71
Px and DI?
Px--vasoprisinase--degrade ADH--unmask undiagnsed DI/or exacerbate DI
72
Is patient can prefer c/s w/o indication?
YES
| But provider not obliged--If not comfortable transfer to other provider
73
Utrine rapture CM?
Abdominal and Back pain
Vaginal bleeding
Palpable irregular mass(fetal part)--help to d/t with abrupsion
FHB(Bradycardia,late decceleration and V.deceleration)---first sighn
Utrine contraction tone and frequancy change(inc.(uncomen) or dec)
74
managment?
Emergency laparatomy and C/S
75
placenta previa FHB?
recurent variable deceleration
76
first investigation for ovarian mass?
combined abdominal and pervaginal U/S
77
Whay is CA-125 is not good in premonoposal?
increased by many other pathology(like endometriosis,liomyoma and lupus)
78
What should be answear for parents enqiry about thier childrens diagnosis?
tell it needs patient permition
79
What are medical emanicipation for minor?
```
contraception
STD treatment
Px care
emergency case
mental/substance disorder
```
80
What are =legaly emanicipation for minor?
```
parent
finanicial indepedent
married
High school graduate
active military service
```
81
POP defination?
```
cystocele--blader
rectocele--rectum
enterocele--intestine
vault--utrus and vagina apex
podecencia(all)
```
82
Risk factors?
Post menoupose
Hysterectomy
obesity
multiparity
83
mechanism?
weaken CT
decrease muscle tone
increase IAP
84
managment?
pissary
kegel ex.
wt loss
surgery
85
symptoms?
urinady(dificulty in voiding,retension..)
enteric(constipation..loss of continence)
pelvic presure
sexual dysfunction
86
First Degree Relative
A first degree relative is a family member who shares about 50 percent of their genes with a particular individual in a family. First degree relatives include parents, offspring, and siblings.
87
Second-degree relatives?
include an individual's grandparents, grandchildren, uncles, aunts, nephews, nieces, and half-siblings.
88
which one is risk for breast ca?
first degree
89
most common risk factor for breast Ca?
age
90
mamography indication?
age > 50
91
risk of post term?
```
age >35
nulliparity
obesity
previous history
fetal anomaly(anecephaly)
```
92
when we need delivery in GA>41
Non reasuring BPP
sighn of UPI(oligohydraminos)
43 week
93
Pathophysiology of PCOS?
high per,conversion and low SHBG--High esteron--High frequancy short duratin GNRH--preferensial LH producn to that of FSH--defective follicular maturation---anovulation
94
screaning tool for ovarian ca?
not establishd
| for genetics risk in first relative do genetic screaning
95
Recomended vacine for all preagnants?
Tdap
RH(antiD)
Inativated influanza
96
given for onley high risk?
```
HeB
HeA
meningococal
pcv
H.Influnza
Varicela zoster imuniglobulin
```
97
C/I?
```
Live atiunated one
MMR
HPV
Live atunated influanza
VZV
```
98
when to give ?
Imidiatlet post partum
99
Tuberculin skin test during ANC?
For high risk to develop disease(IC,recent contact)
| Require Tx during PX
100
reapet viral titer ?
when first diagnosis is indeterminate?
