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*****ObGYN > uWise > Flashcards

uWise Flashcards

(50 cards)

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1
Q

Pt with poorly controlled HTN. what method of contraception is not recommended?

A

OCPs

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2
Q

best contraception to decrease risk of ovarian cancer?

A

OCPs

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3
Q

What does levonogestrel IUD protect against?

A

endometrial cancer

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4
Q

char. of septic abortion

A

fever + bleed + dilated cervix

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5
Q

char. of threatened abortion

A

bleed + pos preg test + closed/uneffaced cervix

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6
Q

tx for APLA syndrome when pt wants to become preg?

A

ASA + heparin

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7
Q

What is 17-OH progesterone used for?

A

prevention of preterm labor in pts with recurrent pregnancy loss

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8
Q

What complication is worse with medical abortion than surgical?

A

blood loss (worse with MEDICAL abortion(

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9
Q

mifepristone MOA

A

antiprogestin used for pregnancy termination

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10
Q

misoprostol MOA

A

prostaglandin

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11
Q

Up to what gestational age can manual vacuum aspiration be used?

A

less than 8 weeks

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12
Q

what is the least invasive treatment for a missed abortion?

A

expectant management with misoprostol (PG E1)

administered orally or vaginally to induce uterine cramping with expulsion of products of conception

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13
Q

likely dx and best management for heavy bleeding after medical abortion?

A

retained products of conception. perform D&C

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14
Q

Criteria for dx of BV

A

3 out of 4:

1) thin, gray, homogenous vaginal discharge
2) positive whiff test (KOH -> amine odor)
3) clue cells on saline microscopy
4) elevated vaginal pH > 4.5

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15
Q

what can occur with severe lichen sclerosis?

A

introital stenosis, resorption of clitoris (phimosis) and labia minora

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16
Q

inflammatory mucocutaneous eruptions characterized by remissions and flares involving hair-bearing skin/scalp, nails, oral mucous membranes & vulva

A

lichen planus

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17
Q

tx options for vestibulodynia

A

TCA, pelvic floor rehab, biofeedback, topical anesthetics; last resort: vestibulectomy

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18
Q

condition results from chronic scratching and rubbing of vulva

A

lichen simplex chronicus

tx: short course topical corticosteroids and antihistamines

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19
Q

parental abx options for GC?

A

cefotetan or cefoxitin
PLUS doxy or clinda
PLUS gentamicin

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20
Q

outpt abx options for GC?

A

ceftriaxone, cefoxitin, or other 3rd gen cephalosporin PLUS doxy WITH or WITHOUT flagyl

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21
Q

what is a normal PVR?

22
Q

what PVR is seen w/ overflow incontinence

Study These Flashcards
A

usually >300 cc

23
Q

risk factors for development of pelvic organ prolapse?

Study These Flashcards
A

increasing parity, increasing age, obesity, Ehlers-Danlos, chronic constipation, family history

24
Q

best surgical treatment for genuine stress incontinence?

Study These Flashcards
A

retropubic urethropexy (tension-free vaginal tape or other sling procedures)

25
what is colpocleisis used to treat?
uterine prolapse; can be performed without need for general anesthesia
26
what is the treatment for intrinsic sphincteric deficiency?
urethral bulking procedure
27
what condition is repaired by fixing defects in pubocervical fascia/reattaching to sidewall?
cystocele
28
pt has elevated serum prolactin level. next step?
FASTING prolactin; stimulation of breast during physical exam can give rise to elevated prolactin; if still elevated -> get TSH level and brain MRI
29
what activity can worsen the pain associated with fibrocystic breast changes/cyclic mastalgia?
caffeine intake
30
54 year old woman. mass with bloody discharge. next step?
excisional biopsy to rule out breast cancer
31
54 year old woman. mass with clear discharge on aspiration, mass resolves. next step?
reexamination in 2 months to check for cyst recurrence
32
pt with puerperal mastitis. still having pain with acetaminophen. started oral abx. what else to do?
add ibuprofen for add'l pain management
33
most appropriate abx for mastitis?
dicloxacillin (most is caused by S. aureus); use erythromycin in PCN allergic
34
42 year old woman with 2cm mass. FNA negative, mass persists. next step?
excisional biopsy
35
why is breast ultrasound useful?
distinguishes between cyst and a solid mass
36
what dx does uterosacral ligament nodularity suggest?
endometriosis
37
What are the treatment options for endometriosis?
- OCPS (first line. - along with NSAIDS. decreased estrogen production, decreased stim of endometrial tissue) - GnRH agonists (short term use only; have side effects) - danazol (synthetic androgen, but SE: wt gain, body hair/acne, adverse lipids) - laparoscopy (if failed medical tx/planning pregnancy)
38
best tx of infertility of pt with known history of endometriosis and otherwise negative work up?
ovarian stimulation with clomiphene citrate
39
imaging study for chronic pelvic pain?
laparoscopy
40
what is interstitial cystitis?
chronic inflamm condition of bladder w/ recurrent urgency and frequency in absence of another cause; often have pelvic pain, may have dyspareunia
41
how does danazol work?
testosterone derivative; suppresses the mid-cycle surges of LH and FSH
42
what social factor is chronic pelvic pain often associated with?
physical/sexual abuse
43
what is pelvic congestion syndrome?
pelvic veins -> chronic dilation with stasis -> vascular congestion "pelvic fullness/heaviness"
44
What nerves are at risk with a low transverse incision?
iliohypogastric (T12L1) | ilioinguinal (T12, L1)
45
next step after diagnosis of cervical dysplasia?
LEEP or cold knife cone
46
50 year old with onset of heavy periods. next step?
endometrial bx; ddx = endometritis, endometrial polyp, endometrial hyperplasia, fibroid, cancer
47
complications from LEEP?
infxn, bleed, CERVICAL STENOSIS, persistent disease, risk preterm delivery
48
CIN 1 diagnosed. benign cells on ECC. next step?
no tx; f/u pap in 1 year
49
What are the indications for cold knife conization?
positive endocervical curettage; HSIL lesion too large for LEEP, pt not tolerant of exam in office; lesion extending into endocervical canal beyond vision; rule out invasive cancer
50
best initial step for work up of incidental adnexal mass finding?
pelvic ultrasound

*****ObGYN (3 decks)

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