Flashcards in Practice Bulletins Grade A recommendations Deck (75)
What is the recommended amount of folic acid for women of reproductive age?
How long prior to pregnancy should women start folic acid supplementation?
How much folic acid should women at high risk for NTD take? When should they start?
4mg folic acid, started 12 weeks prior to planned pregnancy
What makes a woman high risk for pregnancy with NTD?
1. prior child born with NTD
2. They themselves have NTD
3. Partner has a child with NTD
4. Partner has a NTD
What is the most effective way to repair apical prolapse?
Sacrospinous and uterosacral ligament fixation are equally effective
Does the use of synthetic mesh or grafts in transvaginal repair of posterior vaginal wall prolpase improve outcomes?
Is polypropylene mesh agumentation of anterior vaginal wall prolapse improve outcomes compared to native tissue anterior repair?
Is morbidity lower or higher with polypropylene mesh compared to native tissue anterior repair?
At what point is epidural no longer able to be used during TOLAC?
Epidural can always be offered to someone TOLAC-ing
Can you use misoprostol for inducing someone undergoing TOLAC?
NO! also not for someone who has had major abdominal surgery
Who are candidates for TOLAC?
One prior C/S with low transverse incision
What is a medical contraindication to methergine? What is the dosing?
Hypertension- IM 0.2mg q2-4 hours
What is a medical contraindication to hemabate? What is the dosing?
Asthma- 0.25mg q15-90mins for a maximum of 8 doses
What has a higher risk of ovarian cancer? BRCA1 or BRCA2?
When should ppx bilateral salpingoophorectomy be recommended to those with BRCA1 or 2 mutations?
BRCA 1- age 35-40
BRCA 2- age 40-45
When should Rh neg, unsensitized women get Rhogam?
@ 28 weeks
Within what time frame should women be offered Rhogam is the baby is none to be Rh positive?
within 72 hours of delivery
What is considered first line treatment in women with GDM who fail diet control?
When do you screen for GDM?
At what weight should women without GDM be offered a c/s?
At what weight should women with GDM be offered a c/s?
What is the most appropriate method to screen for fetal anemia?
measuring peak systolic velocity in the middle cerebral artery.
What additional testing should be performed for IUGR fetuses?
NST, BPP, and doppler velocimetry of the umbilical artery
What U/S characteristics are concerning for adnexal masses?
>10cm, solid/papillary components, irregularity, ascites, and high color doppler flow
What is the recommended screening for cervical ca in women 21-29yo?
Cytology only- q3yrs
What is the recommeneded cervical ca screening in women 30-65yo?
Cotesting with cytology and HPV q5yrs -OR- cytology alone q3yrs
What constitutes adequate negative screening tests in order to discontinue screening at age 65?
No history of CIN2 or higher AND either 3 consecutive negative cytology results or 2 consecutive negative co-tests in the last 10 years, with the most recent screening being performed within the last 5 years
When do you restart screening in someone who had a total hysterectomy?
never- as long as they never had a h/o CIN2 or higher
How long after a diagnosis of CIN2 or higher do you need to continue screening for cervical cancer?
20 years after they've received the appropriate treatment