Week 4 Uworld Flashcards by Luke Hayek

what is coccydynia?

tail bone pain at coccyx that is worse with sitting

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when does coccydynia get worse?

with sitting

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what is an OB cause of coccydynia?

vaginal assisted delivery

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what is rx for coccydynia?

analgesics

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what is rash associated with maternal toxoplasmosis?

non pruritic diffuse maculopapular rash

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in preterm labor when do you stop giving tocolytics?

34 weeks

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what sx of dysmenorrhea are concerning for a secondary cause?

unilateral pain, minimal constitutional symptoms, symptoms start past 25 yo

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what are symptoms of acute hemolytic transfusion reaction?

hemoglobinuria, flank pain, fever chiils and hypotension

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what is test for acute hemolytic transfusion reaction?

direct coombs test

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what are two complications of acute hemolytic transfusion reaction?

DIC and renal failure

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what type of pain can occur with imperforate hymen?

low back pain, pelvic pressure and defecatory pain

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what is postpartum management of baby from HIV+ mom with viral load less than 1000?

zidovudine

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what is postpartum management of baby from HIV+ mom with viral load more than 1000?

combo ART

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what are indications for HIGH risk STI qualifications in pregnancy?

age less than 25, prior STI multiple partners, sex worker,

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what testing is done at initial prenatal visit in high risk STI patients?

RPR, chlamydia, gonorrhea, Hep B and HIV

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what testing is done at 3rd trimester prenatal visit in high risk STI patients?

RPR, chlamydia, gonorrhea, Hep B and HIV

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anyone that is high risk for STIs in pregnancy gets testing when?

1st prenatal visit and 3rd trimester

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aside from obstetric trauma and pelvic surgery, what are four other risk factors for rectovaginal trauma?

crohns, diverticulitis, colon cancer, pelvic radiation

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how does a rectovaginal fistula appear in vagina?

dark red velvety lesion

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patient has cyclic breast pain and exam totally normal, what should be done/

NSAIDs and supportive bra

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patient has cyclic breast pain and exam finds a mass, what should be done?

imaging

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what is a common symptom of type 2 perineal tear?

pain with urination

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what bug can be found on pap smear and is not very specific?

actinomyces

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why is actinomyces found in women?

often part of the GI/GU flora

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what is a risk for actinomyces infection in upper GU area?

IUDs

what can actinomyces cause in GU tracts?

pelvic inflammatory disease

if patient has actinomyces on pap testing and is asymptomatic what do you do?

nothing...unlikely she has PID

if patient has actinomyces on pap testing and is symptomatic what do you do?

remove IUD and treat with penicillin

how does uterus feel on examination of abruptio placentae?

rigid and diffusely tender uterus

3 teratogenic anti epileptics

carbamazapine, phenytoin and valproate

teratogenic anti epileptics can cause what issues in fetuses?

fetal hydantoin syndrome

what is fetal hydantoin syndrome?

after exposure to anti epileptic fetus has cleft lip and palate, wide anterior fontanelle, distal phalange hypoplasia and cardiac anomalies

what are the signs of fetal hydantoin syndrome?

cleft lip and palate wide anterior fontanelle distal phalange hypoplasia cardiac anomalies

an abdominal mass that increases with valsava maneuver is concerning for what?

incisional hernia

when do incisional hernias usually present | /

can be months to years post op

what type of incision increases risk for incisional hernias?

vertical or midline

what are symptoms of incisional hernia?

usually asymptomatic actually `

ABO disease of newborn is what severity level?

usually pretty mild

what is cause of hemolytic disease of newborn?

ABO incompatibility...O mom

what are symptoms of hemolytic disease of newborn

jaundice only minimal though

2 concerning signs for sepsis in a neonate?

respiratory distress and poor peripheral perfusion

what should be screened for at post partum visit that is social issue?

intimate partner violence

what effect does indomethacin have on fetus?

decrease prostaglandin so leads to vasoconstriction

what does indomethacin cause in fetus if vasoconstriction bad?

can lead to oligohydramnios from constriction of renal artery

three drugs that can cause minimal variability on a Fetal heart tracing?

opioids, alcohol, illicit drugs

with persistent pyelonephritis what can happen to the kidney?

renal abscess

what is a risk factor for renal abscesses?

pregnancy

what is rx for renal abscess in pregnancy?

kidney ultrasound then broad spectrum abx

if baby is not latching well and is using improper technique, what symptoms can mom experience?

nipple pain even between feedings and breast engorgement

what can happen to the skin with improper latching technique in breastfeeding?

linear abrasions,,bloody

what does in utero DES exposure increase womens risk for?

clear cell adenocarcinoma of vagina

what two meds should be used in severe preeclampsia acutely?

hydralazine or labetalol

what is a rare complication of ovulation stimulation with hCG?

ovulation hyperstimulation syndrome

what are the symptoms of ovulation hyperstimulation syndrome?

ascites, hemoconcentration, DIC and multiorgan failure | nausea and vomiting

when does ovulation hyperstimulation syndrome onset?

1-2 weeks after stimulation

what tests should be done if you see atypical glandular cells on pap smear?

endo biopsy, colposcopy, and endocervical curettage

define uterine tachysystole

more than 5 contractions in 10 minutes

what type of bladder pain is common in interstitial cystitis?

pain with filling that is relieved with voiding

is dysuria common in interstitial cystitis?

what is rx for interstitial cystitis?

amitryptiline

why do girls right after menarche often not have consistent bleeding?

lack of GnRH and minimal progesterone so endometrium doesnt slough off

what can you give to determine if no gnrh is reason for abnormal bleeding in menarchal female?

progesterone `

3 causes of stress urinary incontinence in women

obesity, multiparity and exercise

when does post partum psychosis generally onset?

usually 1-2 weeks post partum

prenatal US signs of placenta accreta?

multiple lacunae and thin myometrium

severe hyperemesis gravidum can lead to what other disorder?

thiamine deficieny

what are the features of thiamine deficiency?

occulomotor changes, gait ataxia, and encephalopathy

what is rx for patient with chorioamnionitis and PPROM?

immediate delivery and abx

aside from hyst what is an rx option for fibroid?

uterine artery embolization

what sx do patients have after uterine artery embolization? why

pelvic pain from fibroid necrosis

what is a physical exam sign of endometriosis?

cervical motion tenderness and lateral cervical displacement

4 infections that are contraindications to breast feeding

TB HIV, varicella and breast herpes

what are symptoms of choriocarcinoma?

vaginal bleeding, enlarged uterus and pelvic pain

when can choriocarcinoma occur?

molar pregnancy, regular pregnancy and abortion

where does choriocarcinoma spread?

lung and vagina

what test can you do to confirm choriocarcinoma?

hcg

what point post delivery does symptoms from chroiocarcinoma ccour?

6 months

if pregnant patient has risk factors for gestational diabetes when do you screen?

at 1st visit

what is rx for MVP in pregnancy?

beta blockers

pregnant patient with myasthenia gravis has preeclampsia with severe features, what can you not give her?

Mg sulfate

pregnant patient with myasthenia gravis has preeclampsia with severe features, what can you not give her? what can you give instead?

mg sulfate...give valproic acid

what two places can lichen planus effect

mouth and vagina

who gets lichen planus?

women age 50-60

what do lichen planus lesions look like?

erosive lesions with white border

how do you diagnose lichen planus?

biopsy

how do you treat lichen planus?

strong topical steroids

four characteristics of hydatiform mole that mom can experience

theca lutein cyst uterine larger than expected abnormal bleeding high HCG

three emergency contraception options

ulipristal levonogestrel copper IUD

what is management of vasa previa?

usually admitted in week 34-35 and c sxned

what are signs of vasa previa?

ROM with blood following fluid

what are the symptoms of pubic symphysis diastasis?

suprapubic pain that radiates to the back and legs

what makes pubic symphysis diastasis worse?

walking!

two complications of inadequate maternal weight gain in pregnancy

preterm birth and low birth weight

what hormone causes slowed emptying of gallbladder in pregnancy?

progesterone

what hormone causes increased bile in pregnancy?

increased estrogen

what is the main symptom of cholelithiasis in pregnancy?

intermittent RUQ pain

how do you dx cholelithiasis in pregnancy?