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Obstatrics and Gynacology > OBGYN8 > Flashcards

OBGYN8 Flashcards

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1
Q

Acute fatty liver of Px CM?

A

Nausea and vomiting
RUQ pain
Fulminant liver failure

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2
Q

Lab?

A 
Increase transaminase(2-3x)
Hypoglycemia
Hyperbilirubinemia
Thrombocytopinea
DIC
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3
Q

Management?

A

Immediate delivery

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4
Q

Pathophysiology?

A

Defective maternal-fetal fatty acid metabolism–Liver inflammation–Fulminant hepatitis–MOF/DIC
ARF–Due to Hepatorenal syndrome

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5
Q

Normal post void volume?

A

Men<50

Female <150

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6
Q

Indication to ECV?

A

breach /transverse presentation

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7
Q

C/I?

A

Any c/i to vaginal delivery
Previous c/s
Massive myomectomy
Placenta previa

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8
Q

Complication?

A

AP
PROM
Preterm labor

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9
Q

acute fatty liver of pregnancy common in what trimester?

A

3rd

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10
Q

LFT in HG?

A

will be elevated

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11
Q

CM?

A

Oculomotor dysfunction
Encephalopathy
Postural and gait ataxia

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12
Q

symptomatic cholelithiasis in Px pathophysiology?

A

estrogen–increase cholesterol hypersecreasion

Progesterone–Decrease gallbladder motility

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13
Q

CM?

A

Rec RUQ pain radiates to the back and exacerbated after eating.

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14
Q

Diagnosis?

A

echogenic mass on u/s

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15
Q

management?

A

conservative(pain control)

cystectomy after px

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16
Q

Clinical future of menopause?

A 
Vasomotor Sx(hot flashes and night sweet)
Oligomenorhea/amenorrhea
Sleep disturbance
Decrease libido
Depresion
cognitive decline
Vaginal atrophy
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17
Q

diagnosis?

A

symptom + elevated FSH

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18
Q

why we should exclude hypertyroidism before starting menopause Tx?

A

Both mainly occur 30/40

Symptom overlap

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19
Q

Treatment?

A

Vaginal estrogen cream

Hormonal replacement therapy

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20
Q

Px and MS?

A

physiologic raise in BV and HR–Increase TMV pressure–increase RA pressure–pulmonary congestion(symptomatic) and AF

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21
Q

Px and HCM?

A

Hypervolemia–reduce LVO–decrease symptom

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22
Q

PP risk factor?

A

previous PP
uterine surgery
MG

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23
Q

CM?

A

painless vaginal bleeding after 20 wk of gestation

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24
Q

diagnosis?

A

TA then TV u/s

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25
Management?
Routine ANC in the early phase Repeat u/s at 28--90 % resolve If persist elective c/s at 35-37
26
Management at all gestational age?
Pelvic rest avoid sex no PV
27
When do they need in-patient admission?
In a time of bleeding
28
Px patient with penicillin allergy but positive VDRL tx?
check for penicillin allergy | if positive do desensitization
29
Why alternative antibiotic not used?
they are ineffective (azitro/erytro due to high resistant profile of TP to macrolide) C/I--doxycyclin(can be used in non-pregnants
30
why SUI common in post-menopause?
Pelvic floor muscle laxity | mucosal athropy
31
Overflow incontinence management?
Cholinergic agonist | Intermittent self-catheterization
32
Origin of bleeding in PP?
Maternal
33
Management of PP with active bleeding?
Admit and expectant (if fetomaternal condition stable)
34
HIV management during PX?
Ante/intra/post partum
35
Antepartum?
HIV viral load-at initial-2-4 wk then monthly until undetectable--E 3 month after undetectable CD4 every 3-6 month Resistance testing if not done previously ART initiation immediately Avoid amniocentesis unless viral load < 1000
36
Intrapartum?
Avoid AROM/FSM/OVD If viral load =<1000--Vaginal delivery If viral load >1000--Zvd + C/S
37
Postpartum?
Mother cont.ART Infant Maternal viral load <=1000--Zvd Maternal viral load >1000--MultiART
38
emergency contraceptive preference?
depend on time/efficacy and presence of C/I
39
Time?
Copper containing IUCD and Ulipristal 0-120 hr | levonogestril and OCP--0-72
40
efficacy?
CC IUCD-->=99 Ulpristal--98-99 levonpgestril--59-94 OCP--47-89
41
C/I for CC IUCD?
Active pelvic infection Sever uterine distorsion Wilson disease complicated organ transplant
42
C/I for the other 3?
NO
43
MOA for CC IUCD?
Induce IU inflammation--Cytotoxic for ova and sperm | Inhibit implantation
44
MOA for Ulipristal?
Progesterone receptor modulator--inhibition or delay of ovulation via suppression of the LH surge.
45
MOA levonorgestrel?
inhibition or delay of ovulation via suppression of the LH surge.
46
MOA OCP?
Multiple tablets--high levonorgestrel--inhibition or delay of ovulation via suppression of the LH surge. predispose to estrogen excess--nausea
47
How to d/t exercise-induced amenorrhea from hyperandrogenic (CAH OR ANDROGEN ABUSE) cause?
In hyperandrogenism Virilization(deepening voice, baldness, clitoromegaly) HTN(CAH) Mood disorder and aggression(Androgen abuse)
48
EIA CM?
``` strenuous exercise relative caloric deficiency amenorrhea infertility stress fracture ```
49
Hormone level?
low GnRH LOW FSH and LH Low estrogen
50
management?
increase caloric intake estrogen vitamin D/ca
51
first-line tx for asymptomatic bacteriuria?
Amoxa/Clav--cephalexin--nitrofurantoin
52
pelvic mass and intermittent abdominal pain relation?
Intermitent torsion(mainley during exersise) --pain
53
MCT management?
cystectomy
54
Vaginal hematoma risk factor?
Nuliparity Macrosomia OVD prolonged second stage
55
Pathophysiology?
uterine artery injury during delivery--Blood accumulates in para vaginal space
56
CM?
Occult bleeding/No visible vx bleeding Vaginal mass--may protrude Hypovolemic shock Rectal or vaginal pressure
57
management?
Non expanding--F-Up | Expanding--surgery/embolization
58
Gestational sac diameter use and accuracy?
4.5-6wk | +-5-7 day
59
CRL?
7-10--+-3 | 10-14---+-5
60
BPD/HC/FL
14-20---+-7 21-30----+-14 >30---+-21-28
61
most accurate for GA estimation?
CRL
62
Reliable LMNP?
varies by 7 day in 1st and 1o day in third
63
HCG measurement parameter?
began 8 days of fertilization double in every 48 hr the peak in 6-8 week
64
use?
preserve corpus lutetium for progesterone production Male sex diferentiation maternal hormone production
65
Risk factors for shoulder dystocia?
``` Fetal macrosomia Maternal obesity Excessive wt gain during px Gestational DM Post-term px ```
66
Warning sign?
protracted labor | retraction of the fetal head into perineum after delivery
67
Adenomysis risk factor?
Age>40 Multiparity previous uterine surgery
68
eclampsia?
Generalized TCS in the setting of HTN
69
Impending symptom?
Headache and blurring of vision ALTERED MENTAL STATUS RUQ or epigastric pain SOB
70
management of eclampsia?
MgSO4 Antihypertensive Immediate delivery
71
Complication?
Abruption DIC Cardipulmonary arrest
72
ethiology of lower back pain during px?
Enlared utrus--Exagurated lordosis Joint/Ligament laxity--Increase progestrone/relaxin Weak abdominal muscle
73
Risk factors?
Execive wt gain Chronic back pain Back pain in prior px multiparity
74
managment?
Behavioral Heating pads Analgesics
75
a common cause of IUFD?
Unknown
76
What we should do?
Do fetal karyotype Biopsy of placenta Mother(APS screening)
77
CIN 3 management?
First, do conization(help for both diagnosis and tx) then proceed based on margin result?
78
margin have ca cell?
hysterectomy or repeat conization
79
If negative?
do Papa and HPV screening e 1-2 year

Obstatrics and Gynacology (18 decks)

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