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Flashcards in SHELF Deck (232)
1

Best screening for trisomy 21

Cell-free DNA testing

2

Preventing Meconium Aspiration Syndrome

Newborn depression with present meconium

=>>Intubate the trachea and suction meconium from beneath the glottis

3

Infant appearance from a maternal Type I Diabetic

Small and hypoglycemic

4

Septic baby appearance

Pale, elevated temperature, and lethargic

5

RFs for babies born to diabetic mothers

Hypoglycemia

Polycythemia

Hyperbilirubinemia

Hypocalcemia

Respiratory distress

6

Safest method to suppress lactation

Breast binding, ice packs, and analgesics

7

Signs of adequate feeding in an infant

3-4 stools/24hrs

6 wet diapers/24hrs

Weight gain

Swallowing sounds

8

First evaluation in suspected ectopic

Repeat B-hCG in 48 hrs

9

Uterine perforation signs

2-3 days post D/C:

N/V

Abdoinal pain

Scant bleeding

Fever

10

Immediate management of unstable spontaneous abortion

D/C

11

Tx for respiratory depression due to Mag therapy

Calcium gluconate

12

Greatest gestational concern for obese women

Development of HTN

13

SLE outbreak tx.

Corticosteroids

14

Teratogenic SSRI

Paroxetine

15

Diagnostic test for appendicitis in pregnant ladies

Graded Compression Ultrasound

16

Hydrops fetalis signs

Can be identified by the collection of fluid in 2 or more body cavities (pleural/pericardial effusion, ascites, cerebral edema)

-Due to failure of liver to produce protein

-Can also see hepatosplenomegaly

17

Prevention of preterm delivery in multifetal gestation

Adequate weight gain

18

Sequelae of TTS in surviving twin

Neurologic sequelae

19

Cytotec

Misoprostol; used to induce labor

20

Terbutaline

B-agonist used to decrease uterine intracellular cAMP and decrease contraction rate

ADRs: Tachycardia
Hypotension
Anxiety
Chest pain

-Do not use this drug for more than 48 hrs

21

Greatest RF for PROM

Genital tract infxns

22

Decreased amniotic glucose in amniocentesis may indicate what?

Chorioamnionitis

23

CI'd drugs after PPH

Ergot alkaloids

24

PPH management

-Uterine massage

-Oxytocin

-If necessary, a Bakri Balloon

25

Most common source of fever on post partum Day 1

Lungs

26

Post term pt. testings

Biweekly NSTs and AFIs

27

Crown-rump length

Measured on transvaginal ultrasound to accurately date a pregnancy within 5-7 days

28

Most likely complication following BTL

Pregnancy

29

Hysteroscopic Tubal Occlusion

Essure

The placement of coils into the fallopian tubes that cause scarring to block the tubes

-must use back OCP for 3 months

-confirm blockage w/ HSG

30

Antiphospholipid antibody syndrome tx

Aspirin + Heparin

31

Lichen planus

Chronic dermatologic disorder manifesting as inflammatory mucocutaneous eruptions characterized by remissions and flare ups

Symptoms: irritation, burning, pruritis, bleeding, dyspareunia

-Pts. may also have extra vulvar lesions such as oral ulcers and alopecia

32

Urge incontinence tx.

Oxybutinin (anticholinergic)

33

RFs for pelvic organ prolapse

Increasing parity

Increasing age

Obesity

CT disorders

Chronic constipation

34

Urethral bulking procedure

Treats intrinsic urethral sphincter deficiencies

35

Tx. of hemorrhagic cyst

Ultrasound monitoring

36

Tx of ovarian torsion

Exploratory surgery

37

Precocious puberty tx

Clomiphene (GnRH agonist)

38

Imperforate hymen

Incomplete genital plate separation

Sx: Abdominal pain worse with periods; amenorrhea

39

Test indicated for amenorrhea

FSH

40

Postpartum Telogen Effusion

High E2 levels following delivery and during pregnancy that can potentially lead to hair loss

41

OCP mechanism of pain reduction in dysmenorrhea

Endometrial atrophy caused by the progestin reduces the amount of prostaglandins produced by the proliferating endometrium

42

Post-menopausal womens daily Ca2+ requirement

1200mg/day

43

Severe menopausal tx.

Lowest effective dose of OCP for the shortest time possible

44

Estrogen Hormone therapy effect on lipid levels

Increased: HDL, TGLs

Decreased: LDL

45

Imipramine

SSRI assoc. w/ hyperprolactinemia

-If pt. desires to be pregnant, they should be weened off this drug

46

Clomiphene Challenge Test

Helps to determine ovarian reserve in perimenopausal pts.

47

Vitamin Deficiencies assoc. w/ PMDD

Vitamin A, E, and B6

48

Most common location of vulvar adenocarcinoma beginning

Bartholin gland

-Be on the lookout for non-tender masses here

49

Multifocal VIN 2 tx.

CO2 laser ablation

50

Most common sx. w/ fibroids

Menorrhagia

51

Biggest RF for endometrial carcinoma

Complex atypical hyperplasia

52

Workup following endometrial cancer diagnosis

CXR

-Lungs are the most common site of metastasis

53

General Stress Incontinence tx.

Retropubic urethopexy (urethral bulking procedure)

-This fixes the urethral hypermobility

54

Tx of thyroid storm in pregnancy

Radioactive iodide

-Only use because it's so dangerous

55

Bleeding in a woman > 40 yrs old

Always get an endometrial biopsy

56

RFs for FGR

CVD

HTN

COPD

Diabetes

57

Late deceleration

Alteration in uteroplacental diffusion that can be caused by any maternal disease that causes vascular damage

-Can progress to placental abruption

58

Tx for secondary arrest of acute phase of labor

Amniotomy

59

Initial tx. for fetal hypoperfusion (signaled by late decels)

Differentiate from maternal heart rate

Assess for umbilical cord prolapse

Change in maternal position to left lateral decubitis
***Also do this first for variable decels

Maternal O2 supplementation

Tx of HTN

Discontinue oxytocin

60

Lichen sclerosis

Chronic inflammatory skin condition presenting w/ extreme vulvar pruritis, burning, pain, resorption of the clitoris, and dyspareunia

-Skin changes include purple, polygonal papules or a waxy sheen on the labia

-Can progress to fissures and erosions secondary to the chronic itching

-Small increased risk for SCC

Tx: Topical corticosteroids

61

Precocious puberty tx

GnRH agonist

-Observation if pt. is nearly 10

62

Tamoxifen ADRs

Hot flashes (MC); works via antiestrogenic activity in the CNS causing anterior hypothalamic dysfnxn

DVTs

Endometrial hyperplasia/carcinoma

63

Hypothyroid pts. in pregnancy

Should have increased dosing of their levothyroxine

-These pts. are unable to adequately increase their prod. of thyroid hormone to meet the new levels of SHBG so they need some help

64

Management of Threatened Abortion

1. US to determine fetal status

2. Reassurance

3. Return US in one week

65

Diagnosing ectopic pregnancies

B-hCG + transvaginal US

66

NAAT testing on gonorrhea and chlamydia

With this test, you only have to treat whatever comes back positive due to its high specificity

67

Placenta previa delivery date

36-37 weeks

68

Endometritis RFs

Prolonged ROM (>24 hrs)

Prolonged labor (>12 hrs)

C-sec

Use of IUPCs or fetal scalp electrodes

69

Endometritis Symptoms

Fever

Uterine tenderness

Foul-smelling lochia

Leukocytosis

70

Endometritis tx.

Clindamycin + Gentamicin

-is usually due to a broad-spectrum infxn

71

Mammary Paget Disease of the Breast

Persistent eczematous or ulcerating rash located around the nipple and areola that indicates an underlying adenocarcinoma

Sx: Bloody discharge
Nipple retraction
Scales
Pain
Itching
Burning

72

Uterine Rupture

Typically occurs in pts. w/ prior uterine surgery @ the site of the scar

Sx prior to rupture: Focal, intense abdominal pain
Hyperventilation
Agitation
Tachycardia

Sx after rupture: Retraction of fetal position (*Pathognomic)
Abnormal FHTs

73

Oxytocin ADRs

Uterine tachysystole ( > 5 contractions in 10 mins) =>> possible fetal hypoxia

Tetanic contractions

Hypotension

Hyponatremia

74

Symmetric IUGR

"Fetal causes"

Genetic disorders (aneuploidy)

Congenital Heart Disease

Intrauterine infxn (CMV, rubella, toxo, malaria, varicella)

75

Intraductal papilloma

Benign breast condition of a single dilated breast duct usually found on biopsy or US

Sx: Unilateral blood discharge w/ no assoc. mass or lymphadenopathy

76

After confirming a benign breast cyst, what should be done?

Repeat breast exam in 2 months

77

Transverse fetal lie

Transient condition which spontaneously converts to vertex or breech; evaluate w/ US at 37 weeks to be sure

RFs: Prematurity
Uterine anomalies
Placenta previa
Multiple gestation

78

Pts. who have chronic HTN and OCPs

Discontinue OCPs if BPs are elevated on two separate occasions

79

First line test for adnexal mass

Pelvic US

80

Thin, clear cervical mucous around time of ovulation

Normal

81

Assymetric IUGR

"Maternal causes"

Vascular Disease (HTN, Pre-E, Diabetes)

Antiphospholipid antibody syndrome

AI disease

Cyanotic cardiac disease

Substance abuse

82

Endometrial thickness finding alongside a granulosa cell tumor

Biopsy the endometrium first because endometrial cancer is a more grave disease

83

HER-2

Is normally a bad prognostic factor for breast cancer BUT allows for tx. w/ Herceptin

-Can be determined via FISH or immunohistochemical staining

84

OCP ADRs

Breakthrough bleeding (MC; is assoc. w/ lower E2 doses)

Breast tenderness

Nausea

Bloating

Amenorrhea

HTN

DVT

Hepatic adenoma

Increased TGLs

85

Severe Pre-eclamptic features


>160/>110 on 2 occasions at least 4 hrs apart

Thrombocytopenia

Increased serum Creatinine

Increase hepatic transaminases

Pulmonary edema

Visual changes/neurologic symptoms

86

Tx of Maternal Hypertensive Crisis

1. IV hydralazine (vasodilator)

2. IV labetalol (a1, B1, B2 blocker; CI'd w/ bradycardia tho)

3. PO nifedipine (Ca2+ channel blocker)

87

Stress incontinence

Caused by a loss of urethral support and intrabdominal pressure exceeds urethral sphincter pressure causing loss of urine

Sx: Leaking w/ coughing, sneezing, laughing, lifting

88

Urge incontinence

Caused by detrusor muscle overactivity

Sx: Sudden, overwhelming or frequent needs to empty the bladder

89

Overflow incontinence

Impaired detrusor contractility or bladder outlet obstruction

Sx: Constant involuntary dribbling of urine and incomplete emptying of the bladder

90

Pseudocyesis

Conversion disorder where pts. who desire pregnancy present to the office with the signs of pregnancy (amenorrhea, positive test per their statement), however, all in-office testing is negative

-Requires psychiatric consult

91

IUD to use in breast cancer pts. about to start chemo

Copper IUD

-Progesterone is CI'd

92

Menopausal Genitourinary Syndrome

Hypoestrogenemia leads to atrophy of the urethral mucosal epithelium because it also possesses E2 receptors

-Loss of urethral compliance and closure pressure =>> urgency, frequency, UTIs

Tx: 1st line - vaginal moisturizes and lubricant

2nd line- topical vaginal E2

93

Protective Modifiers from Breast Cancer

BSO - not routinely performed due to other consequences but definitely is a biggie

OCPs

Age

94

Bilateral renal agenesis

Condition that is incompatible with life due to the accompanying pulmonary hypoplasia; will see pockets of fluid on ultrasound

95

Quad Screen

AFP

Inhibin A

B-hCG

Conjugated estriol

-If this comes back abnormal, perform US to assess for abnormalities

96

CA-125 screening

Is not routinely recommended due to the large number of things that can cause an increased level

97

Bartholin Cyst

Mobile, soft, non-tender mass located behind the labium majora @ the 4 and 8 oclock positions

-Can caused discomfort during sex or while walking

98

NST

Fetal heart rate is recorded and monitored for spontaneous fetal movement; test is performed routinely on high-risk pregnancies

-Abnormal if

99

Breast engorgement tx

Ice and NSAIDs

100

Tx. of Grade 1 endometrial carcinoma in a woman who still desires pregnancy

High-dose progestin therapy and frequent endometrial sampling

101

Removal of postmenopausal ovaries

Still leads to further decrease in E2 due to loss of androgen prod. from the ovaries that can be converted peripherally to E2

102

Endometriosis pts. w/ infertility tx.

Clomiphene citrate (to stimulate the ovaries) and possible IUS

103

Lichen simplex chronicus

Result of chronic scratching and rubbing causing skin damage

=>>Increased susceptibility for infxn and further itching

-Labia will appear thick, lichenified, and edematous

Tx: Topical corticosteroids

104

Recent ab therapy and vulvar itching

Candidiasis

105

Pts. w/ PPROM at 36 weeks

Augment labor and deliver

106

Preventing shoulder dystocia

Cant; it's unpredictable but it is more likely in macrosomic infants

-Also, Cesarean delivery is not routinely recommended since it is unpredictable

107

Androgen Insensitivity Syndrome

X-linked mutation of androgen receptors

Findings: Normal breast development
46 XY karyotype
Minimal axillary and pubic hair
Absent uterus and upper vagina
Cryptorchid testes

108

Mullerian Agenesis

Hypoplastic/absent mullerian ductal system

Findings: Normal breast development
46 XX karyotype
Normal axillary and pubic hair
Absent uterus and upper vagina
Normal ovaries

109

IUFD follow-up

Placental and fetal autopsy to prevent reoccurrence

110

External Cephalic Version can be performed at...

>= 37 weeks

111

Tocolytic drugs

Indomethacin

Nifedipine

Terbutaline

112

Delivery at

Mag is also given to prevent neurologic complications in the infant alongside the usual corticosteroids and tocolytics

113

Ruptured Ectopic Pregnancy

Presents as amenorrhea, pelvic pain, and acute vaginal bleeding

Blood in the abdomen =>> hypotension, syncope, tachycardia, diffuse abdominal pain, cervical motion tenderness, shoulder pain, and urge to defecate

114

Klumpke's Palsy

Caused by Excessive traction on C8 and T1 during delivery; possibly due to shoulder dystocia

Sx: Extended wrist
Hyperextended metacarpophalangeal joints
Flexed intercarpalphalangeal joints
Absent grasp reflext
Horner syndrome
Intact macro and biceps reflexes

115

Fractured neonatal clavicle

Complication of shoulder dystocia

Sx: Clavicular crepitus/bony irregularity
Decreased macro reflx (due to pain; usually only on the fractured side)
Intact biceps and grasp reflexes

116

Endometriosis pain

Occurs 1 week before menses and peaks just before

-Also is associated with dysmenorrhea, dyspareunia, and dyschezia

117

UTI tx. in pregnancy

Amoxicillin

Nitrofurantoin

Cephalexin

118

Bactrim teratogenic effect

Kernicterus; due to folic acid antagonism

119

Anorexia and pregnancy complications

Infants: Prematurity
IUGR
Miscarriage
Poor growth
Intellectual disability

Mother: Hyperemesis gravidarum
Cesarean delivery
PPD

120

Genital warts tx.

Trichloroacetic acid
Podophyllin
Imiquimod

121

Women at age >35 should be offer what prenatal screening

Cell-free DNA testing

-If positive, follow-up with chorionic villus sampling or amniocentesis depending on the stage of pregnancy

122

MCC of PPH

Uterine atony; even during a c-sec

123

Most common cause of late postpartum hemorrhage 7-10 days after deliver

Sub involution of the uterus in which the placental i plantations site has not increased in size

124

Endometriosis appearance

Homogenous cystic mass on the adnexae

125

Mag excretion

Kidneys; therefore, dose should be altered for pts. w/ renal insufficiency

126

Modifiable Breast Cancer Risks

Hormone replacement therapy

Nulliparity

Age at first childbirth

Alcohol consumption

127

Chronic retention of products of conception

Consumptive coagulopathy due to chronic release of tissue factor from the placenta

-Fibrinogen levels may be in the low-normal range

-Deliver the stillborn child in any mother with signs of coagulopathy

128

Peripartum cardiomyopathy

Rapid onset of systolic HF @ 36 weeks or later

129

Amniotic fluid embolism

Presents as respiratory failure, cardiac shock, DIC, and coma/seizure

RFs: Advanced maternal age
Gravia >5
Cesarean/Instrumental delivery
Placenta previa/abruption
Preeclampsia

Tx: Respiratory and hemodynamic support

130

Placental abruption tx

IV fluid bolus and left lateral decubitus position

-Packed RBCs if necessary

131

Luteoma of pregnancy

Yellow-brown mass of large lutein cells; often bilateral

-Can be asymptomatic but on a test, likely hyperandrogenic

-Spontaneously regress post-partum

-Female fetus at GREAT risk of virilization

132

Post term pregnancy complications

Fetal: Oligohydramnios
Meconium aspiration
Stillbirth
Macrosomia
Convulsions

Maternal: C-sec
Infxn
PPH
Perineal trauma

133

Neonatal thyrotoxicosis

Transplacental passage of maternal anti-TSH abs causes transient hyperthyroidism in the neonate

Tx: Short term methimazole and BBs if necessary

-Resolves after 3 months

134

Mittelschmerz

Pain on ovulation

-Occurs due to the small amount of blood released into the peritonem w/ follicle rupture

135

Ovarian cancer diagnosis follow-up

Exploratory laparotomy

-Biopsy would cause seeding

136

Postpartum urinary retention

Presents as inability to void bladder w/ a sensation of fullness and dribbling

RFs: Nulliparity
Prolonged labor
Perineal injury
C-sec
Instrumental delivery
Regional injury =>> decreased sensory impulse =>> decreased microtuition reflex and detrusor tone

Tx: Analgesics
Ambulation
***Urinary catheterization

137

Pt. w/ spontaneous abortion who desires prompt treatment

D/C

138

HSV (+) pt at 36 weeks

Give prophylactic acyclovir

139

Palpable breast mass

> US

>30 years old =>> Mammogram

140

Intrahepatic cholestasis of pregnancy

Benign condition caused by idiopathic increased production of bile acids

-Presents w/ unbearable pruritis

Labs: Increased bile acids and bilirubin
Increased liver aminotransferases

141

MC ADR of epidural anesthesia

Hypotension; due to blockage of sympathetic nerve fibers

***Can lead to fetal acidemia from hypoxia

Tx: Left lateral decubitus position; IV fluids; vasopressors

142

Hyperemesis gravidarum pH

Metabolic alkalosis due to volume contraction

143

Placenta accreta tx.

Hysterectomy

144

Defect in the decidua basalis

Possible placenta accreta

145

Ectopic pregnancies needing surgical treatment

Unstable maternal vital signs, cardiac activity, or B-hCG > 5,000

146

Fetal manifestations of gestational diabetes

Congenital anomalies (cardiac/limb, sacral agenesis)

Increased risk of stillbirth

Macrosomia

Pulmonary hypoplasia

Polyhydramnios

147

Labor treatment of gestational diabetic

Begin IV dextrose; also do this if glucose

148

Chlamydia screening

All women under 25 and older women w/ risk factors, like a new sexual partner

149

C-sec viral load if mother is HIV pos

>1,000

150

Pap smears post-hysterectomy

Only continue if the pt. Had a subtotal hysterectomy

151

ASC-US follow up

Repeat paps every 4-6 months until 2 consecutive negatives

152

Luteal phase defect

Insufficient amounts of progesterone produced by the corpus luteum =>> early endometrial shedding

-However, ovulation is still occurring

153

Mild preeclampsia management

2x weekly NSTs and BPPs if suspected oligohydramnios or IUGR

US for fetal growth and amniotic fluid q3 weeks

Be on the lookout for rapid weight gain

154

Severe preeclampsia management

-Inpatient monitoring w/ daily lab values and fetal monitoring

-Stabilize w/ Mag and antihypertensives

155

Sclerosing adenosis

Firm, indurated, and ILL-DEFINED mass that is due to excessive tissue growth in the breast tissue lobules

-Painful, especially with the cycle

Dx: FNA; looks similar to carcinoma on mammogram

156

Duct ectasia

Inflammatory dilation of the breast ducts that may present w/ BILATERAL green or brown discharge

-Requires biopsy but once confirmed, management is conservative

157

Cystosarcoma phyllodes

Most common non-epithelial mass in the breast; is usually nontender and unilateral

-Presents pretty similar to a fibroadenoma with more rapid growth

-Slight chance for malignancy so removal is standard of care with monitor of recurrence

158

Tests at first pregnancy visit

CBC

UA

G/C

TB

VDRL/RPR

HIV

Rh status

Rubella titer and HBsAg test

159

Cardinal movments of labor

Engagement

Descent

Flexion

Internal rotation

Extension

External rotation

Expulsion

160

Pathogenesis of endometriosis

1. Retrograde menstruation

2. Lymphatic dissemination

3. Coelomic metaplasia (explains endometriosis in pre-pubertal girls)

161

Infant of a mother with HBsAg (+) test

Receive vaccine within 12 hours of birth

162

Risks of hormone replacement therapy

***BREAST CANCER

Stroke

Blood clots

Heart disease

163

Thyroid Storm Treatment

B-blocker, PTU, and corticosteroids

164

Postpartum thyroiditis

Transient hyperthyroidism following delivery and is associated with anti-microsomal and TSO antibodies (just like w/ Hashimotos)

-Temporary management w/ antithyroid medications during the hyperthyroid phase

165

Hyperparathyroidism treatment in pregnancy

1 or 2nd trimester= surgery

3rd trimester= oral phosphates and a low calcium diet

166

Reverse doppler flow

Assoc. w/ fetal death in 48 hrs

=>>DELIVER

167

Pt. w/ suspected pyelonephritis and no improvement after 48 hrs of antibiotics

Suspect urinary tract obstruction

-Getting a US will be helpful in this case

168

Dyspnea in a pregnant woman being treated for pyelonephritis

Possible ARDS

-Due to endotoxin release from gram negative bacteria

169

Septic pelvic thrombophlebitis

Bacterial infection at the placental implantation site spreads to thrombosed veins at the ovarian venous plexus or the common iliac veins

Sx: Recurrent high fever
Pelvic mass

Tx: Antibiotics + heparin

170

Most common organisms causing postpartum endometritis

Anaerobic bacteria

171

Treatment for breast engorgement

Wear a comfortable bra

Avoid nipple stimulation

Ice packs

NSAIDs

*DO NOT USE BREAST BINDING FOR LACTATION SUPPRESSION
-may lead to infection or plugged ducts

172

Test done to confirm ectopic pregnancy

Transvaginal US

173

Delivery of woman with previous abruption

36-37 weeks

174

TdAP vaccine and pregnancy

Give after 28 weeks regardless of when they last had it

175

Pap smears in HIV women

Annual

176

Most common location of a. Osteoporotic fracture

Thoracic spine

177

Most common STIs after sexual assault

Gonorrhea, chlamydia, Trichomonas, and HBV

-Go ahead and treat for these right off the bat

-Also screen for HIV and Syphilis

178

Woman complaining of flank pain and abdominal tenderness following a pelvic surgery

Probably ureteral damage, most likely at the cardinal ligament

-CT or IVP to confirm

179

RFs for fascial dehiscence

Obesity

Diabetes

Cancer

Vertical incision

-Usually will occur 7-10 days following surgery

180

Most common cause for suture dehiscence

Fascial disruption/breakdown by the suture

181

Diagnostic tests for Stress incontinence

Physical examination

Loss of bladder angle

Cystocele

Hypermobile urethra


Tx: Urethropexy (sling)

182

Pessary

Device that treats pelvic support problems and urinary incontinence; support the pelvic structures

-useful for women who do not want surgery for stress incontinence

183

Diabetes and the bladder

Can cause a nuerogenic bladder =>> overflow incontinence

-Basically because of neuropathy

184

Most common cause of acute salpingitis

Multibacterial infxn

185

Fitz-hugh-curtis cause

Purulent tubal discharge which ascends to the RUQ

-Patients will complain of pain here

186

Most common cause of septic arthritis in young women

Gonorrhea; classically presents as migratory

187

Signs and symptoms of acute salpingitis

Abdominal tenderness

Cervical motion tenderness

Adnexal tenderness

Vaginal discharge

Fever

Pelvic mass on physical examination or US

188

IUD effect on PID

Increases risk

OCPs =>> Lower

189

Adnexal mass w/ PID

Possible tubo-ovarian abscess

-US follow-up recommended

-Treated w/ IV antibiotics

190

Most common ADRs from metronidazole

N/V, abdominal bloating, diarrhea

-DO NOT CONFUSE W/ DISULFARIM RXN
=>>headache, flushing, tachycardia, dizziness, N/V

191

Bartholin gland abscess

On the vestibule of the labium majora

-Significant problem could be Cancer; especially in women > 40

192

Greatest RF of multiple gestation

Premature or preterm labor

193

Tx of polyhydramnios

Amniocentesis; even if vitals are stable and baby looks good at the moment

194

Workup for Hyperemesis gravidarum

Work up for urine ketones

195

Medical management of an inevitable abortion

Prostaglandins for ️Bleeding control

196

Common history with cervical ectopic a

History of D/C

197

DD of PPH

Atony (can be due to twins, fibroids, polyhydramnios, macrosomia)

Lacerations

PLACENTAL RETENTION

DIC

Hematomas

Coagulopathy

198

Other drugs for uterine atony

Prostaglandin (Hemabate); don't give to asthmatics

Ergot alkaloids; don't give to HTN Pts.

199

Target glucose levels in gestational diabetes

Fasting:

200

RFs for placenta Previa

Previous PV

Previous c-sec

Uterine surgeries

Multiparity

Smoking

Cocaine

AMA

201

Assessment of HDN severity

Bilirubin in the amniotic fluid

Usually between 1:8-1:32

Increase in Doppler flow

202

Tx of HDN

Direct blood transfusion into the umbilical cord

203

Swelling lateral to the insertion of e round ligament and no intrauterine pregnancy but a positive test

Cornu ectopic pregnancy

204

Testes in Androgen Insensitivity Syndrome

Removed to prevent cancer development

205

Positive withdrawal bleeding after progesterone challenge test in secondary amenorrhea work up...what next?

Prolactin and TSH levels

Pts. May wind up needing Clomiphene treatment

206

Benefits to OCPS

Less heavy periods

Decreased risk of endometrial and ovarian cancer, PID, and benign Breast disease

207

Contraindications to IUD placement

Recent PID

STDs

Uterine tract malignancies

Breast cancer (preogesterone IUDs)

Fibroids

208

Rapid growth of a uterine fibroid

Possible Leiomyosarcoma; take that motherfucker out

209

Cervical cancer Tx.

Stages I and II = Hysterectomy

Stages III and IV = radiation therapy

210

Abnormal uterine bleeding unresponsive to OCP Tx.

Endometrial ablation or hysterectomy

211

Tx of fibrocystic changes in the breast

OCPs

Vitamin E

Decrease caffeine

FNA if you want I guess

212

Breast cancer treatments

Depends on its receptor positivity

Radiation given after simple lumpectomy

Chemo give with hormone therapy

213

Congenital syphilis

10 days after delivery: Maculopapular rash, snuffles, mucous patches on the pharynx, Hepatosplenomegaly,

Later in life: Hutchinson teeth, saddle nose, saber shin

214

Gestational CMV

Transmitted via saliva, secretions, Breast milk, semen

-can see IUGR, petechiae, Hepatosplenomegaly, Microcephaly, seizure, chorioretinitis, hydrops,

IgG in mom does not confer immunity and baby is still susceptible

215

Tx for congenital varicella

Give varicella Ig and check tigers

216

Delivery date for a gestational diabetic

38-39 weeks

217

Theory behind progesterone treatment for early endometrial changes

Converts estradiol to estrone and also decreases the number of E2 receptors on endometrial cells

218

MCCo prenatal death

Preterm labor

219

Antibiotics in PROM

Decrease likelihood of neonatal infection and also prolong the latent phase of labor

220

Postpartum fever with no uterine or Breast tenderness

Consider pelvic thrombophlebitis; is a diagnosis of exclusion

-Can sometimes see thrombosis on CT

221

Risk of HIV transmission without HAART

25%

222

Drug to give prior to administration of epidural

Antacids

If these were not given and a patient has the signs of respiratory distress, consider aspiration pneumonitis

223

Most common neonatal endocrine cause of death

Congenital adrenal hyperplasia

224

Management goals for delayed puberty

Intimate sexual maturation, prevent osteoporosis from Hypoestrogenemia, and promote full height potential

Start on unopposed estrogen first to promote normal
Breast development

225

Uterine septum

Incomplete dissolution of the fused midline septum of the Müllerian ducts; often presents with recurrent miscarriage

Dx: HSG, saline infusion sonohysterogram

Tx: Resection


226

What follow up should be performed on a woman with blocked tubes on HSG?

Laparoscopy; tubal spasm can cause this finding so we should identify the exact blockage

-Plus, it can also provide treatment

227

Persistent postmenopausal bleeding after a normal endometrial sampling

Perform hysteroscopy

-Even though the sample was negative, we gotta figure this shit out dont give up bruh

228

Granulosa cell and Sertoli-Leydig tumors on US

Completely solid mass

229

Pseudomyomaperitonei

Rupture of a large mucinous cystadenoma (can get VERY LARGE and can produce chronic pelvic symptoms (pain, constipation, bowel obstruction)

230

Tx for epithelial ovarian cancer

Debulking of the tumor with follow-up chemo

231

Follicular cyst size

Usually 5cm or less

-If bigger mass seen, follow-up is needed

232

Exercise-induced hypothalamic amenorrhea lab finding

Decreased estrogen w/ lower end normal FSH