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Repro Flashcards

(47 cards)

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1
Q

which hormone rises day 0 to day 14 in the menstrual cycle

A

estrogen

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2
Q

which hormone rises day 14 to day 28 in the menstrual cycle

A

progesterone

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3
Q

what hormone spikes on day 14 in the menstrual cycle to trigger ovulation

A

LH

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4
Q

how do you treat cystitis in pregnancy

A

amoxicillin or macrobid x 7-14 days

sulfisoxazole unless the last week of pg

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5
Q

describe the pap screening guidelines

A

start at 21
q3y age 21-29
q5y age 30-65 with hpv
discontinue at 65+

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6
Q

what are 4 reasons you wouldn’t discontinue paps at age 65+

A

hx CIN2
hx CIN3
hx adenocarcinoma in situ
recent + screening

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7
Q

patient is age 21-24
pap comes back + for ASCUS or LSIL
what is the management

A

repeat pap in 12 mos

if negative, repeat pap in another 12 pos
if negative then - routine screening
if positive then - colposcopy

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8
Q

patient is age 21-24
pap comes back + for HSIL, ASC-H, AGC
what is the management

A

colposcopy

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9
Q

patient is age >/ 25
pap is negative
hpv is positive
what is the mgmt

A

repeat pap in 12 mos

if both negative - routine screening
if either are positive - colposcopy

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10
Q

patient is age >/ 25
pap shows ASCUS
hpv is negative
what is the mgmt

A

repeat hpv cotest every 3 years

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11
Q

patient is age >/ 25
pap shows ASCUS
hpv is positive
what is the mgmt

A

colposcopy

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12
Q

patient is age >/ 25
pap shows LSIL
hpv is negative
what is the mgmt

A

repeat hpv cotest every 1 year

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13
Q

patient is age >/25
pap shows LSIL, HSIL, AGC, or ASC-H
hpv is positive
what is the management

A

colposcopy

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14
Q

in ectopic pg what happens to hcg

A

it fails to double every 24-48 hours

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15
Q

at what point in pregnancy does a molar pg occur

A

from 6 weeks to 4-5 months

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16
Q

what are the symptoms are molar pregnancy

A

painless bleeding
uterus size discrepancy
hyperemeis

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17
Q

what does US show with molar pregnancy

A

cluster of grapes
or
snowstorm appearance

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18
Q

how to treat molar pregnancy

A

curettage

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19
Q

what can molar pregnancy lead to?

Study These Flashcards
A

choriocarcinoma

20
Q 
1st trimester bleeding
no POC expelled
os is closed
bloody vaginal discharge
\+/- ctx

what is it, and whats the tx

Study These Flashcards
A

threatened abortion

tx = rest and follow hcg

21
Q

pregnancy bleeding
bleeding is > 7 days with cramping
cervix dilated >3cm, +/- membrane rupture
no POC expelled

what is it and what’s the tx

Study These Flashcards
A

inevitable abortion

tx = D+E

22
Q 
pregnancy bleeding
bleeding is heavy, cramping, with retained tissue
boggy uterus
cervix is dilated
some POC expelled

what is it and what’s the tx

Study These Flashcards
A

incomplete abortion

tx = D+C, pitocin

23
Q

pregnancy bleeding
pain, cramping, bleeding that stops
os is closed
uterus is pre-preg size

what is it and what’s the tx

Study These Flashcards
A

complete abortion

tx = none

24
Q

pregnancy bleeding
brown discharge, no pregnancy sx
os closed, no POC expelled
embryo not viable but is retained

what is it and whats the tx

Study These Flashcards
A

missed abortion

tx = D+C/E

25
as a general rule when do you do D+C versus D+E
D+C is 1st trimester | D+E is 2nd trimester
26
3 causes of 3rd trimester bleeding
placenta previa abruptio placenta vasa previa
27
``` 3rd trim: sudden painless bright red bleeding and soft, nt fetal HR normal pelvis US shows placenta implanted near to os, partially or completely covering fetus' head ``` dx and tx?
placenta previa hospitalize for bedrest stabilize w tocolytics (mag sulfate) to stop ctx perform amniocentesis to check lung maturity then deliver baby
28
when can you give steroids for lung maturity
24-34 weeks
29
``` 3rd trim: continuous, painful, dark red bleeding severe abd pain, rigid uterus +/- sx of shock fetal distress w/ bradycardia pelvis US shows placenta prematurely separated from the uterus ``` dx and tx?
abruptio placenta hospitalize to stabilize immediate delivery
30
what MC causes abruptio placenta? | what can abruptio placenta lead to?
MC cause HTN | can lead to DIC
31
3rd trim: painless vaginal bleeding with rupture of membranes fetal distress with bradycardia US shows fetal vessels crossing over the os dx and tx?
vasa previa immediate C section
32
when is the prenatal screen for gestational DM
24-28 weeks
33
two diagnostic tests for gestational DM and results?
1. Screening 50g oral glucose test Fail test if 140+ after 1 hour ``` 2. Gold standard 3 hour oral glucose tolerance test Fail test if 180+ after 1 hour 155+ after 2 hours 140+ after 3 hours ```
34
management / birth plan of gestational DM
insulin | deliver at 38 weeks
35
when does mom need rhogam
if she is rh negative
36
what are signs of a rh incompatible baby
hemolytic anemia, jaundice, kernicterus, hsm, fetal hydrops
37
where does fluid build up in fetal hydrops
heart - CHF pericardium - pericardial effusion lungs - pleural effusion liver - ascites
38
when do you give RhoGam
at 28 weeks gestation | and within 72 hours p birth of Rh + fetus
39
tests for PROM? (3)
NITRAZINE test to check ph FERN test to check amniotic fluid pattern speculum test
40
management for PROM?
wait for labor and monitor for infx
41
what is premature labor defined as
before 37 weeks
42
patient is before 37 weeks gestation with sx of labor | explain the 3 categories of cervical dilation/effacement and how likely labor is
1. dilated < 2cm, effaced < 80%, labor unlikely 2. dilated 2-3cm, effaced <80%, labor likely 3. dilated > 3cm, effaced >80%, labor definite
43
management of premature labor (3)
1. tocolytics to suppress ctx x 48h 2. steroids for lungs 3. abx maybe - GBS
44
when can you dx gestational HTN
after 20 weeks
45
what is HELLP syndrome
pre-eclampsia can cause HELLP syndrome | Hemolytic Anemia, Elevated Lft's, Low Platelets
46
management of pre-eclampsia
plan for delivery at 34-36 weeks | +/- BP meds
47
management of eclampsia
mag sulfate for seizures deliver as soon as pt is stable definite BP meds

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