Repro Flashcards by Elise Wolff

beta-hCG value of 2000 milli-units/mL or more can be indicative of an ____.
What test is gold standard to determine this - and what results indicative?

ectopic pregancy

If no products of conception are detected within the uterine cavity by transvaginal ultrasound (gold standard radiology in this case).

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ACE inhibitors are contraindicated in what type of female?

pregnant

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All are DDx of what?

Ectopic Pregnancy
Aborting uterine pregnancy/hydatidiform mole
Ovarian Torsion
Ovarian cyst
Appendicitis
Urinary tract calculi
Endometriosis
Adhesions/obstruction
PID
IBD (CD)

RLQ abdominal pain in F

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What is the GPA system? GTPAL?

Gravida/Para/Abortus

Gravida/Term/Para/Abortus/Live

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Failure of serum hCG to ____ every two days indicates possibly what?

fails to double, ectopic pregancy

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Abdominal distention and mild paralytic ileus are often present in ___

ectopic pregnancy

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what type of ectopic pt?

3.5 cm in largest dimension and unruptured, with no active bleeding and no fetal heart tones.

stable

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**Tx of stable v. unstable ectopic pregancy pt.

Stable, tx with methotrexate. Unstable = surgery!

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**Methotrexate is CI in what pt?

UNstable ectopic pregnancy!

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Initial surgical procedure in ectopic pregnancy.

diagnostic laparoscopy

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**When should Rho(D) IMMUNE THERAPY be given to pts?

if they are Rh(-)

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OA and AA, S2-S4 pelvic splanchnic are PSNS reflexes for ___ and ___

Ovaries and testes

S2-4 for uterus/prostate/genitalia

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T10-L2 is SNS for __ and __

uterus and cervix

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What is this? 
Chronic anovulation (irregular periods: amenorrhea to menorrhagia)
Hyperandrogenism (hirsutism)
Polycystic ovaries
Obese woman with Hyperlipidemia

PCOS

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Increased risk of what three things if a woman has PCOS.

Increased risk of DM2 (insulin resistance), CVD, and metabolic syndrome

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What drug is beneficial for PCOS?

methotrexate

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PID, IUD, smoking at the time of conception, previous C-section - all are risk factors for…

ectopic pregnancy

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When do you give whole blood?

can consider in trauma, when needs all components including clotting factors

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When do you give PRBC?

Usually the first choice for transfusion due to decreased risk of reaction as compared to whole blood

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What is endometriosis?

Study These Flashcards

ECTOPIC ENDOMETRIAL TISSUE

99% of women with endometriosis associated pelvic pain who report sx before 15 (and before 20.2years) also had what?

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dysmeorrhea

Endometriosis is associated iwth higher incidence of what sensitivity?

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multiple allergic sensitivities

What SD should prompt you to look further into pelvic/endometriosis related dz?

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Extended lumbar type II dysfunctions are frequently the product of segmental muscle contraction that results from a viscerosomatic reflex and should prompt the search for visceral disease and dysfunction

What sx indicate possible endometriosis rupture?

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abrupt increase in severity and radiation

Women who have a sister or mother with endometriosis are more likely to have _____ endometriosis.

severe rather | than mild or moderate

The genetic predisposition for endometriosis is more | consistent with ______ than with a single mutant gene

polygenic and multifactorial inheritance

Ruptured ovarian cysts may mimic ovarian malignancy bc...

It causes extremely high serum CA-125

In a patient suffering from hemoperitoneum, active bleeding as depicted on CT by the active ____ with a measured attenuation value higher than that of free or clotted blood is indicative _____.

arterial extravasation of intravenous contrast of the need for prompt surgical intervention

``` Sx for... DYSMENORRHEA - PELVIC PAIN o DUE TO INTRAPELVIC BLEEDING AND PERIUTERINE ADHESIONS - MENORRHAGIA - HORMONE DEPENDENT - DYSPAREUNIA - LUMBAGO - RECTAL PAIN - DYSCHEZIA - INFERTILITY - INCREASED ALLERGIC REACTIONS - POSITIVE FAMILY HISTORY ```

endometriosis

exam findings for endometriosis

``` BEST PERFORMED DURING EARLY MENSES - PELVIC TENDERNESS - NODULES FOUND ON BIMANUAL EXAM o ON UTEROSACRAL LIGAMENT o IN POSTERIOR CUL-DE-SAC - DECREASED UTERINE MOBILITY/RETROVERSION - TENDER/FIXED NODULAR ADNEXAL MASSES - OSTEOPATHIC FINDINGS o SOMATIC DYSFUNCTION LUMBAR SPINE o CHAPMAN’S POINTS - LESS COMMON - HEMORRHAGIC CYSTS OBSERVED ON CERVIX ```

Endometriomas look like what on transvaginal sono?

homogenous cysts

Best way to dx endometriosis

surgical confirmation - laparoscopic biospy and visual lesions.

what are the classic visual and biopsy findings in endometriosis?

Biopsy - endometrial glands and stroma | Visual - black powder burns

Potential complications of endometriosis

PROGRESSIVELY WORSENING COURSE | o IMPLANTS SPREAD TO PELVIS, GI TRACT, URINARY TRACT, ILIOPSOAS MUSCLES, LUMBAR SPINE

What is the coelom?

CAVITY BETWEEN SPLANIC AND SOMATIC MESODERM IN THE EMBRYO FORMS THE LINING OF THE GENERAL BODY CAVITY IN THE ADULT DERIVES FROM MESOTHELIUM

how is coelomic metaplasia of multipotential cells in the peritoneal cavity a possible etiology of endometriosis?

* A single layer of flattened cells forming an epithelium that lines serous cavities; e.g., peritoneum, pleura, pericardium * From which Mullerian ducts and endometrium originate

How is metaplasia a possible etiology of endometriosis? **Most common etiology of etiology is retrograde flow***

MESONEPHRIC REMNANTS MAY UNDERGO ENDOMETRIAL DIFFERENTIATION AND GIVE RISE TO ECTOPIC ENDOMETRIAL TISSUE - mesoephros or mullerian ducts

two cancers with increased incidence with endometriosis

Clear cell ovarian cancer, endometrioid cancer.

Significant genetic mutations in endometriosis

PTEN, ARID1A

Sx of? Lower abd pain, pain during or shortly after menses, new vaginal discharge, dyspareunia, abnormal bleeding, pain with jarring movement.

PID

2 most important sexually transmitted organisms associated with acute PID

Chlamydia trachomatis, Neisseria gonorrhoeae

Indications for hospitalization in PID

Pregnancy, lack of response to tx, nonadherence, inability to take oral meds due to N/V, severe clinical illness (fever, severe pain, vomiting), complication with abscess, possible need for surgical intervention or exploration.

What is this? infection of liver capsule and peritoneal surfaces of the RUQ, minimal stromal hepatic involvement. Patchy purulent fibrinous exudate – “violin string” adhesions

Fitz-Hugh Curtis Syndrome - a complication of PID, 10% of PID pts have perihepatitis

Long term sequelae of PID

infertility, ectopic pregnancy, chronic pain

STD risk factors that increase risk of developing PID

young age at first sex, nonbarrier contraception, multiple sexual partners

What do these factors do? | Previous PID, Sex during menses, vaginal douching, BV, IUD

potentially facilitate PID

Tx of PID

Second generation cephalosporin and doxycycline (Azithromycin also has activity against C. Tracomatis and is sometimes used in place of doxycycline). Other options include: clindamycin and gentamicin combination.

Buzzword: IUD - think what bug?

anaerobic actinomyces

What complication of PID has to be tx inpatient with clindamycin or metronidazole(anaerobic coverage: “below the diaphragm”) OR outpatient tx - anaerobic coverage.

pelvic abscess

Repro Flashcards

(49 cards)