Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Gynae obs And Male Reproductive > Obs > Flashcards

Obs Flashcards

(222 cards)

Start Studying
1
Q

How to assess GESTATIONAL AGE via US?

A

1st trimester—-> Gestational sac diameter

1st and 2nd—-> Crown rump length

2nd and 3rd—-> Biparietal diameter / head circumference/ femur length

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Important point of gestational age assessment

A

If USG during 2nd and 3rd trimester shows discrepancy between EGA (calculated from 1st trimester crown rump length) and fetal measurements, growth problems should be considered (e.g. fetal macrosomia, fetal growth restriction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define Anemia in pregnancy

A

Anemia in pregnancy defined as: Hb <11 g/dl in 1st and 3rd trimester and <10.5 g/dl in 2nd trimester

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the risk factors for HYPEREMESIS GRAVIDARUM?

A

Past hx of HYPEREMESIS GRAVIDARUM
Multiple gestation
Gestational trophoblastic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How to manage GESTATIONAL TROPHOBLASTIC DISEASE (GTD)?

A

D and C

F/u with Contraception and regular monitoring of B-HCG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Name the vaccine given in WOMEN OF CHILDBEARING POTENTIAL

A

Tdap

Inactivated influenza vaccine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Name the vaccine contraindicated during pregnancy

A

HPV
MMR

Varicella
Small pox

Intra nasal influenza vaccine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Name the general test done in first prenatal visit

A

Cervical cytology
Rh type and antibody screen

Cbc
Genetic testing for down syndrome and Cystic fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Name the the general infectious test done in first prenatal visit

A

Rubella and Varicella

Urine culture

Syphilis testing and HBV antigen
Chlamydia and HIV testing

Influenza

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Consequences of syphilis in pregnancy

A

Pregnancy effects—–>preterm labor / Intrauterine fetal demise

Fetal effects—->Hepatomegaly and jaundice
H.anemia with low.PLTs
Long bones abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

when to sample and how to t/m Group B.Strep?

A

Rectovaginal culture at 35-37 weeks gestation

Give Pencillin as a t/m

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the indications of GBS treatment?

A

GBS bacteriauria OR UTI during pregnancy

GBS positive within 5 weeks of labor

Prior birth to an infant affected with early onset GBS disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the indications of GBS treatment?part 2

A

Unknown GBS status status with;;
- less than 37 wk of gestation

  • Intra partum fever
  • Rupture of aminotic membrane for more than 24 hours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How to manage unvaccinated pregnant women with confirmed rubella exposure?

A

termination of pregnancy—->if pt do not wish termination—–> treat with IV immuno globulin—benefits unknown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Name the non invasive PRENATAL TESTING FOR FETAL ANEUPLOIDY?

A

First and 2nd trimester markers(9-13)///(15-20) both are non invasive and non dx

2nd trimester US and Cell free fetal DNA (18-20)///(>10wks)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Name the invasive test PRENATAL TESTING FOR FETAL ANEUPLOIDY

A

CVS and aminocentesis (10-30)(15-20wks)

Both test dx karo typic abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the indications for cell free fetal DNA testing?

A

Maternal age more than 35
Abnormal maternal serum screening test

Fetal ANEUPLOIDY on US and past hx
Parental based robertsonian translocation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the uses of Cell free fetal DNA TESTING?

A

Detection of ANEUPLOIDY

Fetal sex determination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Important point of Cell free Fetal DNA testing

A

Abnormal test: confirmed by chorionic villus sampling in 1st trimester and amniocentesis in 2nd trimester

Pts who do not meet high-risk criteria for cffDNA: can undergo 1st trimester combined test or 2nd trimester quadruple screen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When to Do OGTT test in pregnancy?

A

All pregnant women should have OGTT at 24-28 wks—high risk pts (e.g. marked obesity, FH od DM) may receive earlier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Risk Factors of CHORIOAMNIONITIS/INTRAAMNIOTIC INFECTION

A

Prolong labor
Prolong rupture of membrane

Presence of Genital tract pathogen
Internal fetal Or uterine monitoring devices

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Triad of CHORIOAMNIONITIS/INTRAAMNIOTIC INFECTION

A

High grade maternal fever with maternal tachycardia

Malodorous / Purulent AMNIOTIC fluid Or vaginal discharge

Fetal tachycardia with increased WBC count

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q
A

Maternal::
Uterine atony
Endometritis
PPH

-Neonate
Premature birth
Cerebral palsy
Infection encephalopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Name the tests for ANTEPARTUM FETAL SURVEILLANCE

A

Non stress test
BPP

Contractions stress test
Doppler US of the umbilical artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
When to call Non stress test "REACTIVE"?
HR 110-160 with moderate variability More than 2 acceleration
26
When to call Non stress.test "Non Reactive "?
Less than 2 acceleration | Recurrent variable Or late deaccleration
27
What are the causes of Non Reactive stress test?
Fetal sleep cycle | Fetal hypoxia due to placental insufficiency fetal cardiac or neurologic abnormalities
28
Important point
FHR accelerations are the product of the fetal sympathetic nervous system, which matures at 26-28 weeks—extremely premature don't demonstrate accelerations
29
Name the causes of Antepartum bleeding
Normal labour Placental abruption / Previa / vasa Uterine rupture
30
How to approach antepartum bleeding?
Start with speculum examination followed by TV.US
31
Triad of Normal labour
Intermittent pain Contractions Small amount of bloody tinged mucus (“bloody show”)
32
What are the risk factors of placental abruption?
Past hx maternal HTN or Pre eclampsia / eclampsia Abdominal trauma Cocaine and tobacco use
33
How to dx placental abruption?
Clinically Or US to rule out P.Previa; would show retroplacental hematoma
34
What are the risk factors for Placental Previa?
Past hx Past hx of C-sec Or any uterine surgery Advance maternal age with multiparity Smoking
35
How to manage Placental Previa?
TA.US followed by TV US Plus NO intercourse OR Digital vaginal Ex Require C-Sec as a t/m
36
Important point
Fetal heart tracing usually unaffected as bleeding is maternal in origin
37
What are the risk factors of uterine rupture?
Past hx of Uterine surgery Protracted Or Induced labour Congenital uterine anomalies Fetal macrosomia
38
Triad of Uterine rupture
Per vaginal bleeding with painful abdominal contraction Loss of fetal station with palpation of fetal parts on abdominal Examination Cessation of uterine contraction
39
Important point of Uterine rupture and P.abruption
No uterine contraction in U.RUPTURE Tachysystole in placental abruption
40
How to prevent fetal and maternal exsanguination due to U.Rupture?
Prevention of fetal and maternal exsanguination: emergency laparotomy to confirm diagnosis and expedite delivery
41
Name type of UTERINE surgery in which trial of labour (vaginal delivery) is not contraindicate
Low transverse (Horizontal) C-section
42
Name type of UTERINE surgery in which trial of labour (vaginal delivery) is contraindicate
Classical C sec(vertical) Abdominal myomectomy with uterine Cavity entry Abdominal myomectomy without uterine Cavity entry
43
How to manage patient with hx of classical cesarean delivery or extensive myomectomy or myomectomy with uterine cavity entry?
Elective C section If present in labor—>perform urgent laparotomy followed by hysterotomy (for fetus delivery if unruptured) or uterine repair (if rupture occurred)
44
Triad of Vasa Previa
Painless per vaginal bleeding with rupture of membrane FHR shows bradycardia Or sinusoidal tracing Bleeding causing fetal distress
45
How to dx and manage Vasa Previa?
Gold standard test is antenatal abdominal and transvaginal Doppler USG Management is C section
46
What are the risk factors of PLACENTA ACCRETA?
Hx of C-Sec Myomectomy h/o dilatation and curettage, maternal age >35
47
US findings of Placental accreta
Antenatal ultrasound: an irregular or absent myometrial-placental interface and intraplacental villous lakes—typically diagnosed antenatally
48
Define Stage 1 ARRESTED of labor?
when dilation is >/=6 cm with ruptured membranes and 1 of the following -No cervical change for >/=4 hours despite adequate contractions OR -No cervical change for >/= 6 hours with inadequate contractions
49
Define ADEQUATE CONTRACTIONS
Contractions summing to >/=200 Montevideo units for >/=2 hours
50
Define Latent Labor
Painful contractions causing cervical size change | Regular and Increase intensity/ frequency of contractions
51
Define false labor
No Or mild painful contractions without causing cervical size change Irregular and weak intensity of contractions
52
How to manage false labor?
reassure and discharge with routine prenatal care
53
Define Precipitous labor
fetal delivery that occurs within 3 hours of the initiation of the contractions.
54
What causing Precipitous labor
risk factor for precipitous labor is multiparity. | It is spontaneous and not caused by oxytoci infusion
55
What are the S.E of oxytocin?
Low sodium Low BP Excessive Uterine contractions (tachysystole)
56
What are the S.E of EPIDRUAL ANESTHESIA?
Low BP Depression of cervical spinal cord and brainstem activity CSF leakage
57
Triad of CSF leakage due to Epidural ANESTHESIA
Due to dura is inadvertently punctured during epidural postural headaches that are worse with sitting up improved with lying down after delivery
58
Define Preterm labor
regular contractions at <37 wks of gestation that cause cervical dilatation and/or effacement
59
What are the risk factor of Preterm labor?
Past Hx Multiple gestation Short cervical length Surgery of cervical Cigarette use
60
How to Prevent Preterm labor with negative past Hx?
If No Past Hx—>check Cervical length on TVUS—>if normal—>routine pregnancy If short length—>Vaginal progesterone and Check length till 24 weeks
61
How to prevent preterm labor with positive past Hx?
Give Progesterone injections and Do check Cervical length on TVUS If short length—>Cerclage and serial US till 24 weeks If normal cervix—->check length till 24 weeks @What are the predictors of Preterm labor? Short cervix Positive fetal fibronectin test on 24-33 wk
62
Important point
Fetal fibronectin (FFN) in vaginal secretions is usually low from 22-33 weeks gestation an elevated FFN concentration during this period is associated with an increased risk of preterm delivery. Before and after 22-33 weeks gestation, FFN is normally high and therefore not a useful test
63
How to manage Preterm labor?
If before 32wk—>steroid / tocolytics MgSO4 and Abx for GBS If after 32 but before 33 wk—->same as above except MgSO4 If after 33 wks but before 37 wks—->only ABx for GBS and with OR without steroids
64
What are the indications of CESAREAN DELIVERY?
Fetal distress indicated by deceleration Loss of FHR variability (occurs in fetal academia) Breech presentation Multiple prior cesarean deliveries
65
What are the risk factors of Breech presentation? | .
Risk factors: prematurity multiparity multiple gestation uterine anomalies fetal anomalies and abnormal placentation
66
Important point of ECV
It can be performed between 37 weeks gestation and the onset of labor and has been shown to reduce the rate of cesarean deliveries. Before doing ECV, make sure no contraindications of VAGINAL delivery
67
What are the contraindications of ECV?
Indication of C-sec regardless of fetal lie -placental abnormalities - Rupture membrane - Hyperextended neck - Fetal Or uterine anomaly - multiple gestation
68
D/F B/W ECV AND ICV
ECV done in singleton | ICV always in twin baby
69
How to manage PRETERM BREECH PRESENTATION?
Before 37 but after 34 weeks Perform C section only. No use of uterotonic agents
70
What are the risk factors ofTRANSVERSE LIE
prematurity, uterine anomalies, placenta previa multiple gestations
71
How to manage TRANSVERSE LIE?
Give Trial of Labor if baby converts into Vertical position Remain in traverse lie or converts to breech---> ECV (if not CI)--->successful---> trial of labor unsuccessful ECV or ECV CI---> C.sec
72
Define SPONTANEOUS ABORTION (SAB)
fetal loss before the 20th week of gestation
73
How to approach spontaneous abortion?
US of abdomen OR TVUS | Serial B-HCG monitoring
74
Name the types of miscarriage in which cervix is open
Inevitable Incomplete Septic
75
Name the type of miscarriage in which cervix is closed
Threatened | Complete
76
Triad of Threatened miscarriage
Per vaginal bleeding with closed cervical Os No issue in fetal cardiac activity Expectant management if fetus is alive and repeat US
77
Triad of missed miscarriage
No vaginal bleeding closed cervix No fetal cardiac activity Or Empty sac
78
Triad of Inevitable miscarriage
Per vaginal bleeding Open cervix POC seen or felt at Or above cervical Os
79
Triad of Incomplete abortion
Vaginal bleeding Open cervix POC 50% seen in reproductive tract
80
Triad of complete abortion
No vaginal bleeding Or very minimal Closed cervix No POC left
81
How to manage Incomplete/ Inevitable and missed miscarriage?
If hemodynamic stable with minimal bleeding----->Expectant management/ Prostaglandins Or surgical Evacuation If unstable with heavy bleeding----> D and C
82
Important point
Hospitalization and bed rest—not indicated in 1st trimester abortion spontaneous or threatened abortio Oxytocin infusion—not used in 1st trimester (used in late 2nd or 3rd trimester)
83
How septic abortion occur?
Retained POC after elective abortion with non sterile technique
84
Triad of Septic abortion
Prodromal Sxs Dilated cervix with Purulent Or bloody discharge Boggy and tender uterus
85
Pelvic US finding of septic abortion
Retained POC Increase vascularity Echogenic material in the cavity Thick endometrial stripe
86
How to manage septic abortion?
ABx and IV fluids Suction curettage Removal of uterus if no response to ABX OR develop abscess Or signs of clostridial infection
87
Important point
Misoprostol is a syntheticprostaglandin approved for use with mifepristone to terminate pregnancies of <49 days gestation
88
Triad of INTRAUTERINE FETAL DEMISE (IUFD)
Death of afetus in utero after 20 wks of gestation absence of fetal movement and fetal cardiac activity On US Cause is Unknown in 50% cases
89
Approach to Coagulopathy INTRAUTERINE FETAL DEMISE (IUFD)
Monitoring the coagulation profile: done after USG confirm IUFD suspected coagulation derangement---> delivery without delay coagulation parameters normal: expectant management Or induction of labor (patient preference)
90
What are the t/m options of Still birth delivery in 2nd trimester?
D and C upto 24 weeks Induction of labor Spontaneous vaginal delivery
91
What are the t/m options of Still birth delivery in 3rd trimester?
Do C-sec if past hx of it Spontaneous vaginal delivery Induction of labor with Or without cervical ripening
92
What are the LATE TERM AND POSTTERM PREGNANCY COMPLICATIONS in fetus?
``` C-SOM Convulsion Stillbirth Oligohydramnios Meconium aspiration /macrosomia ```
93
What are the LATE TERM AND POSTTERM PREGNANCY COMPLICATIONS in mother?
PPH Perineal trauma Infection C section
94
Important point
Induction of labor ASAP in late and post term pregnancy as utero placental insufficiency would occur which causes Oligohydramnios
95
What are the causes of Symmetrical fetal growth restriction?
``` Due to fetal factors Viz Genetic disorder CHD TORCHss ```
96
What are the causes of Asymmetric fetal growth restriction?
Due to maternal factors Viz Vascular dis like HTN related and DM APLA Autoimmune dis like SLE Cyanotic cardiac disease Drug abuse
97
Important point of Macrosomia
No change in prognosis whether PPx C-sec or Vaginal delivery
98
What are the risk factors for fetal macrosomia?
Maternal::: Advance age with DM Excessive Wt gain during pregnancy Multiparty Fetal::: Post term pregnancy Male sex African American Or Hispanic
99
What are the complications of Shoulder DYSTOCIA?
Fractured clavicle and humerus Erb Duchene palsy and klumpke palsy Perinatal asphyxia
100
Important point of complications of shoulder DYSTOCIA
In both clavicle and humerus fracture, Moro reflex absent And Grasp reflex present and intact biceps
101
What are the risk factors for the neonatal displaced clavicular fracture?
Fetal macrosomia Instrumental delivery Shoulder dystocia
102
How to t/m Clavicular fracture?
Reassurance and Gentle handling Analgesics Place affected arm in a long sleeve garment and pin sleeve to chest with elbow flexed at 90*degree
103
How to manage ERB-DUCHENNE PALSY?
Fortunately, up to 80% of patients have spontaneous recovery within 3 months No improvement by 3-6 month surgical intervention can be considered but not necessarily curative
104
Complications of 1st trimester Maternal hyperglycaemia
CHD Neural tube defects Small left colon syndrome Spontaneous abortion
105
Complications of 2nd and 3rd trimester of maternal hyperglycaemia
All due to fetal hyperglycaemic which results increase insulin - Polycythemia - Organomegaly - Macrosomia - Neonatal hypoglycaemia
106
How Uterine Inversion occur?
Excessive Fundal pressure Excessive umbilical cord traction
107
Triad of Uterine Inversion
PPH with lower abdominal pain Round mass protrude via cervix Uterine fundus not palpable trans abdominal
108
What are the risk factors for Uterine Inversion?
nulliparity fetal macrosomia placenta accreta rapid labor and delivery
109
What are the risk factor for the uterine atony?
Uterine fatigue from prolong or induce labor Chorioamionitis Over distend uterus Retained placenta
110
What are the contraindications of medicine use in uterine atony?
Methylergonovine in HTN Carboprost in Asthma
111
What are the normal findings in Postpartum period?
Transient rigors and chills Peripheral Edema Lochia rubra Uterine contraction and involution Breast engorgement
112
What routine care to do in postpartum period?
Rooming in /Lactation support serial examination for uterine atony // bleeding Perinatal care voiding trail Pain management
113
Name the Lochia Occur first few days after delivery
lochia rubra which is a red or reddish-brown vaginal
114
Name the Lochia Occur after 3-4 days delivery
(lochia serosa) | discharge becomes thin and pink or brown colored
115
Name the Lochia Occur after 2-3 weeks delivery
lochia alba:: | After 2-3 weeks,the discharge becomes white or yellow
116
Define Postpartum urine retention
inability to void by 6hours after vaginal delivery or 6 hours after removal of indwelling catheter after C. sec.
117
Name the test which confirm the dx of postpartum urine retention
Bladder catheterization more accurate than bladder USG >/=150 mL of urine confirms diagnosis
118
How Postpartum urine retention occur?
Regional anesthesia—->↓ motor and sensory impulses of sacral spinal cord——>suppression of micturition reflex and/or ↓ in bladder tone (↓ detrusor tone), pudendal nerve palsy from injury, or periurethral swelling
119
Triad of POSTPARTUM ENDOMETRITIS
High grade fever outside the first 24 hours postpartum (less than 24 postpartum fever is normal) Uterine tenderness with foul smelling lochia Leukocytosis
120
How to manage postpartum endometritis?
Causes are polymicrobial so IV clindamycin + IV aminoglycoside such as gentamicin
121
What are the risk factor for Endometritis?
Risk factors for endometritis include, Prolonged rupture of membranes (>24 hours) Prolonged labor (>12 hours) C. section Use of intrauterine pressure catheters or fetal scalp electrodes
122
Define Chronic HTN with superimposed Pre eclampsia
PRE EXISTING HTN with new onset proteinuria Or worsening of existing Proteinuria Occur after or at 20wks
123
What risk occur to mother due to HTN? Remember sequence
GDM ——>placental abruption ——>C delivery ——>PPH Superimposed pre eclampsia
124
What risk occur to fetus due to HTN ?
FGR Perinatal mortality Preterm delivery Oligohydraminos
125
What are the risk factors of pre eclampsia?
maternal age <18 or >40 multiple gestation nulliparity preexisting DM chronic kidney disease and prior preeclampsia
126
What features suggest SEVERE PRE ECLAMPSIA?
BP MORE THAN 160/110 Low PLTs with elevated LFT and creatinine Pulmonary Edema New onset visual Or cerebral SXS
127
Important point of medication given in Pre eclampsia
Labetalol can’t be given in low pulse——>Give Hydralazine Oral Nifedipine can’t be given in EMESIS Loop diuretics if pulmonary Edema
128
Name the 2nd line agent given in Eclampsia
diazepam more phenytoin would be indicated as 2nd line
129
How to manage PULMONARY EDEMA IN PRE-ECLAMPSIA OR ECLAMPSIA?
supplemental oxygen fluid restriction diuresis in severe cases. Fluid restriction and diuresis must be used with caution as plasma-volume is effectively ↓ed through third-spacing and placental perfusion can be compromised
130
What are the causes of CAUSES OF HYPERANDROGENISM IN PREGNANCY ?
LUTEOMA KRUKENBERG TUMOR Theca luteum cyst (low Risk of fetal virilization)
131
Triad of KRUKENBERG TUMOR
Mets from GIT cancer US shows B/L ovarian mass High risk of fetal virilization
132
Triad of LUTEOMA
Yellow Or yellow brown masses of large lutein cells B/L solid ovarian mass on US High risk of fetal virilization
133
Triad of Theca lutein cyst
B/L ovarian cyst on US Associated with molar pregnancy And multiple gestation Low risk of virilization
134
How to manage ovarian mass causing hyperandrogenism?
Mostly regress after pregnancy In case of pressure SXS do surgery
135
INDICATIONS FOR PROPHYLACTIC ANTI-D IMMUNE GLOBULIN ADMINISTRATION FOR AN UNSENSITIZED Rh-NEGATIVE PREGNANT PATIENT
At 28 to 32 wk of gestation With 72hrs of RH positive fetus delivery Ectopic pregnancy/ Hydatidform Mole pregnancy / Abortion 2nd Or 3rd trimester bleeding Abdominal Trauma CVS sampling / amnioncentesis ECV
136
Consequences of Anorexic mother in fetus
1.Premature 2. Small for gestational age (due to IUGR) or both 3. Miscarriage 4. Hyperemesis gravidarum 5. C. sec 6. Postpartum depression (not postpartum psychosis)
137
Classified Genital Ulcer on the basis of Pain
If painless---> syphilis / chlamydia / klebsiella If painful--->HSV / H.Ducreyi
138
How the ulcer of HSV presents?
Multiple grouped ulcer | Shallow with erythematous base
139
How the ulcer of h.ducreyi Present?
Single OR Multiple group ulcer With irregular boarder Gray Or yellow exudate Matted lymph nodes (suppurate / rupture)
140
Important point of Chancroid
Organisms clump in long parallel strand (school.of fish)
141
How the ulcer of klebsiella present?
Ulcerative lesion without LAD Beefy appearing lesion with bleeding Base has granulation like tissue
142
How lymphogranuloma venerum Present?
Small shallow ulcer Large painful inguinal LAD Large painful fluctuant buboes Sinus tract
143
How the ulcer of syphilis presents?
Single painless ulcer which is indurated | Clean base
144
Triad Bacterial vaginosis presents?
Thin white discharge with fishy odor pH more than 4.5 with clue cells metronidazole 500mg twice a day for 7 days
145
Triad of TRICHOMONAS VAGINALIS
Thin frothy yellow green malodorous discharge pH more than 4.5 metronidazole and tinidazole
146
Triad of Candida vaginitis
``` Thick cottage cheese discharge Normal PH (3.8-4.5) Fluconazole as a t/m ```
147
Traid of PHYSIOLOGIC LEUKORRHEA
Copious white or yellow discharge non-malodorous squamous cells and polymorphous leukocytes on microscope No treatment needed
148
How to manage PELVIC INFLAMMATORY DISEASE (PID)?
If no response Or unable to oral ABx /fever and pregnancy----->cefoxitin or cefotetan/doxycycline and clindamycin/gentamicin
149
How to manage non hospitalise PID?
non-hospitalized patients: IM cefoxitin + oral probenecid and oral doxycycline or IM ceftriaxone and oral doxycycline.
150
What are the potential Complications of HEPATITIS -C IN PREGNANCY?
Gestational DM Preterm pregnancy Cholestasis of pregnancy
151
How to manage mother if HEPATITIS C IN PREGNANCY?
No ribvairin | Vaccine against HBV AND HAV
152
How to prevent vertical transmission of HCV?
Avoid C-section and scalp electrodes | No contraindications of breastfeeding unless blood present in nipples
153
Antepartum management of HIV
If viral load less than 1k---->ART and vaginal delivery If viral load more than 1k---->ART / zidovudine and C section
154
Important point of HIV management in intrapartum
Avoid rupture of membrane Avoid operative vaginal delivery Avoid fe tal scalp electrode
155
How to manage mother and baby postpartum?
Continue ART in mother If viral load >1k give multi drug ART IF viral load <1k zidovudine
156
What are the risk factors of AMNIOTIC FLUID EMBOLISM? | REMEMBER C--- GAP
C c section or Instrument delivery G gravida more than 5 A advance mother age P placenta previa / abruption / Pre eclampsia
157
How to manage AMNIOTIC FLUID EMBOLISM?
Respiratory Or Hemodynamic support | With Or without transfusion
158
Name the liver disorder in Pregnancy
INTRAHEPATIC CHOLESTASIS OF PREGNANCY ACUTE FATTY LIVER OF PREGNANCY (AFLP) HELLP
159
Traid of INTRAHEPATIC CHOLESTASIS OF PREGNANCY
Intense generalised itching esp at night Direct jaundice pattern in LFT T/m as direct jaundice
160
Triad of ACUTE FATTY LIVER OF PREGNANCY (AFLP)
RUQ pain with N/V Low glucose with deranged LFT Increase bilirubin
161
Traid of PRURITIC URTICARIAL PAPULES AND PLAQUES OF PREGNANCY
Skin manifestation occur in 3rd trimester red papules within striae with sparing around the umbilicus No abnormalities in labs
162
How to approach ACUTE APPENDICITIS IN PREGNANCY?
US>>>>MRI>>>>MRI not available>>>only then CT can be performed>>>diagnostic laparoscopy with last option (lower midline vertical laparotomy)
163
How to dx RENAL STONES in pregnancy?
Renal and pelvic USG is the diagnostic study of choice
164
Important point of Renal stones management in pregnancy
Shockwave lithotripsy—not done in pregnancy. If a pregnant patient fails to improve with conservative measures, ureteroscopy or nephrostomy may be considered.
165
D/F categories of URINARY TRACT INFECTION (UTI) IN PREGNANCY
Asymptomatic bacteriuria Acute cystitis Acute pyelonephritis
166
Profile of thyroid hormone in pregnancy
Total T4 and Free T4 increase | TSH decrease
167
At what week screening of GDM is conducted?
24-28 weeks
168
How to screen for GDM?
Give 1hour 50g glucose and check after 1 hour---->if less than 140 No GDM If more than 140----->give 100g glucose and take 4 readings
169
What is the target level of blood glucose in GDM?
Fasting should be less than 95 1 hours post meal should be less than 140 2 hours post meal should be less than 120
170
Important Point of GDM
Usually screen test is done in 3rd trimester but if patient has risk factors for GDM, do screening test in first Trimester or First prenatal visit
171
lmportant point
Small left colon syndrome----->transient inability to pass meconium and resolves spontaneously. Not related to intussusception
172
Triad of Post Partum blues
Occur after 2-3 of pregnancy and resolve within 10 days Mild depression with tearfulness Reassurance and monitoring
173
Triad of Post Partum depression
Occur within 4weeks after pregnancy Sxs like Major depression disorders Antidepressants and pyschotherapy
174
Triad of Post Partum psychosis
Occur day to weeks after pregnancy Sxs of pyschosis Start anti psychotic and anti depressants without leaving infant with mother
175
What are the complications of INAPPROPRIATE WT GAIN?
EXCESSIVE WT GAIN--> GDM / C-SEC / Fetal macrosomia low wt gain-->FGR / Preterm delivery
176
What are the consequences of mono placenta mono amniotic membrane?
Twin twin transfusion umbilical cord enlargement IU fetal demise *stat preterm c-sec
177
-Important point
single placenta with two amnion---> T-SIGN | two placenta with two amnion--->lamda sign
178
What are the components of BPP?
Non stress test Fetal movement Fetal breathing movement Fetal tone Amniotic fluid volume
179
What exactly BPP is assessing?
BPP is performed to assess fetal oxygenation which low in placental insufficiency
180
What is the normal amniotic fluid volume?
Single fluid pocket more than 2*1cm Or Amniotic fluid index more than 5
181
Name the conditions in which BPP is normal?
BPP is normal in: fetal malpresentation (causes fetal growth restriction or chronic fetal hypoxia but not abnormal BPP) anterior placental location
182
When to consider Contractions stress test normal?
No Late Or recurrent variable deceleration
183
@ When to consider Contractions stress test abnormal?
Late deceleration even with more than 50 percent contractions
184
What are the cause of fetal Tachycardia?
FHR >160 beats/min. Common causes: chorioamnionitis maternal fever ``` maternal hyperthyroidism medication use (e.g. terbutaline) ``` abruptio placenta
185
Name the causes of Early fetal deceleration
Fetal head compression | But sometime this type of tracing considered normal
186
How to manage early fetal deceleration due to head compression?
No treatment needed if normal baseline rate, moderate variability, no late or variable decelerations present as does not indicate fetal hypoxemia
187
Triad of Post dural puncture headache
Occur after epidural anaesthesia Headache increase increase with upright and decrease on supine N/V and neck stiffness
188
Triad of Congenital Zika virus
Fits with hypertonicity Microcephaly with craniofacial disproportion Ocular abnormalities
189
Neuroimage finding of Zika virus
Calcification Ventriculomegaly Cortical thinning
190
Name the Abx given for GBS if patient has allergy to penicillin
Cefazolin
191
What are the warning signs of shoulder dystocia?
Prolonged labor | Turtle sign-----> Retraction of fetal head into perineum after delivery
192
What are the cause of Fetal hydrops?
Immune---> Rh negative ``` Non immune---> Parvo virus Fetal aneuploidy CVS abnormalities Thalassemia ```
193
What breech position in which vaginal delivery possible and impossible?
Possible in ---->Frank and complete | Impossible---->incomplete and footling
194
What is the MCC cause 2nd stage arrest?
Fetal malposition (non occpitant
195
How round ligament pain occur?
Sharp pain radiates to vagina
196
What are the complications of Excessive weight gain and Inappropriate weight gain?
Excessive causes GDM + macrosomia + C sec Inappropriate weight gain: Fetal growth restriction + Preterm delivery
197
Triad of Anembryonic gestation
No embryonic development | No uterine size discrepancy
198
Important point
Down syndrome associated with VACTERAL Diaphragmatic hernia associated with Edward syndrome holoprosencephaly associated with pataue syndrome
199
what are the causes of oligohydramnios in first Trimester?
Mostly due to fetal causes
200
what are the causes of oligohydramnios in 2nd and 3rd Trimester?
Utero placental insufficiency | Rupture of membranes
201
Name the medicine for bipolar disorder in pregnancy
Lamotrigine
202
What are the consequence of short interpregnancy interval? | LAP
L LBW A anemia P PPROM / Preterm delivery
203
US doppler finding of Ectopic pregnancy
Ring of fire around the ectopic pregnancy
204
How to manage PPROM after 34 week but before 37 weeks?
Delivery Abx like penicillin for GBS ±steriods
205
How to manage uncomplicated PPROM before 34 weeks?
Steroid with ABx for GBS Expectant management If before 32 wk give magnesium
206
What does mean by Complicated PPROM?
Infection | Fetal or maternal compromise
207
How to managed Complicated PPROM before 34 weeks?
Magnesium if before 32 wk Delivery Abx like ampicillin and Gentamicin Steroid
208
What are the causes of Oligohydramnios in first trimester?
In first Trimester mostly due to fetal causes---> Posterior uretheral valve Renal agenesis Aneuploidy
209
What are the causes of Oligohydramnios in 2nd or 3rd trimester?
Utero placental insufficiency (With FGR) Maternal dehydration or Rupture of membranes (normal fetal growth)
210
How thyroid hormone production increase to meet metabolic demand in pregnancy?
Estrogen increase TBG result increase only in bound hormones B-HCG stimulates TSH receptor increase thryoid hormones Both these suppress TSH
211
TFT Pattern in Pregnancy
Increase Total 4 Mild Increase or unchanged free T3 Deceased TSH
212
How to managed Perineal laceration after pregnancy?
If uncomplicated viz no fever or purulence---> NASIDS / Sitz bath If fever or purulence or wound breakdown or non intact repair ---->Abx / suture removal and surgical debridement
213
What are the causes of Minimal Variability <5 Or absent Undetectable amplitude?
Prematurity Fetal hypoxia or Sleep CNS depressants like alcohol, narcotics and drugs
214
What changes occur in Pulmonary patterns in Pregnancy?
Resp-alkalosis Normal VC and FEV1 Increase Minute ventilation due to Tidal volume increase Decrease RV and FRC
215
Triad of Degenerating Uterine fibroid
Fundal tenderness with palpable mass Increase WBCs count Conservative management
216
Important point of Cerclage
Patient with past hx of 2nd term pregnancy loss manage with prophylactic Cerclage placement ((doesn't matter if cervical length is short or normal)) Procedure also done if patient has short cervical length
217
Triad of Intrahepatic choletasis of pregnancy
RUQ pain Whole body pruritis but more on hand and feet Only LFT deranged without rash
218
How to manage Intrahepatic choletasis of pregnancy?
1) Ursodeoxcholic acid 2) Antihistamine 3) delivery at 37th week of gestation
219
What are the complications of Intrahepatic choletasis of pregnancy? M-PIN
M. Meconium stained aminotic fluid P preterm delivery I intrauterine fetal demise N Neonatal RDS
220
How to Prevent and abort Migraine? Abortive (TANE) Preventive ABA
Abortive:: (Triptans, Antiemetic, Acetaminophen, NSAIDs, Ergotamine) Prevent:: Anticonvulsant like topiramate Or Valproate B BB (given in pregnancy unlike others ) A antidepressants ( TCA or Venlafaxine)
221
What are the causes of Late (Secondary) PPH?
1) Placental Endometritis 2) Retained POC which present as boggy or tense uterus with heavy bleeding ± uterine atony Rx via dilation and curettage 3) Placental site Sub involution which present as present as heavy bleeding with uterine atony Rx via Uterotonics
222
What are the CVS condition which are CI to pregnancy?
Symptomatic MS and AS PAH Symptomatic HF with LVeF less than 30% Bicuspid AV with ascending aorta enlargement >50mm

Gynae obs And Male Reproductive (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions