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Flashcards in vaginal bleeding Deck (116)
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alternative to doxy for PID

a. Azithromycin alternative to doxy


viollin strings is a classic appearance for

fitz hugh curtis syndrome


MC cystic growth in vagina

Bartholin Gland Cyst/Abscess


tx for Bartholin Gland Cyst/Abscess

depends on size, pain, infxn
i. Home tx
ii. I&D, word catheter placement
iii. Abx if cellulitis is present
iv. Marsupialization if recurrent


PID vs appy

PID: pain is NOT migratory
PID: pain is bilateral
PID: NOT associated with nausea and vomiting


Sudden onset of severe unilateral pelvic pain or dull aching pain w/ sharp exacerbations

and vomiting


get formal U/S to look at flow

ii. Pt w/ ovarian mass
iii. Pt w/ pelvic adhesions


tx of torsin

Adnexal torsion is a SURGICAL EMERGENCY
OR immedeatly


Superficial cellulitis of breast tissue that results in breast pain, swelling warmth, erythema, malaise, fever, chills

Mastitis/Breast Abscess


which populations do we usually see mastitis with

Often in first few wks of breastfeeding
Usually affects lactating women


Caused by a blocked milk duct that didn't empty during nursing

Stap aureus infxn


RF for mastitis

i. Breast feeding
ii. Sore or cracked nipples
iii. Breastfeeding only one position
iv. Wearing tight fitting bra
v. Fatigue
vi. Previous hx of mastitis


tx for mastitis if no response to anbxs

U/S if no response to supportive care or abx (mastitis vs abscess)

systemic emptying, anti-inflammatories, abx
Continue breast feeding!!


what should be on your tray for ED delivery

2 large hemostats
cord clamp

syringe for cord gas


association between hypothermia and mortality

acidosis, respiratory distress, NEC, intraventricular hemorrhage

The smaller you are, the faster you lose heat. BIG problem less than 30 weeks


A ruptured cyst can causes abnormal vital signs and an acute abdomen in sudden unilateral pain think

e. A ruptured cyst can causes abnormal vital signs and an acute abdomen.

Cysts that are >8 cm, multiloculated, or solid are concerning for malignancy


chronic hypertension in pregnancy defined as

Defined HTN present before 20th wk of pregnancy or present before pregnancy

ii. Mild HTN: > 140-180/90-100
iii. Severe HTN: >180/100
iv. Major risk factor: development of preeclampsia or eclampsia later in pregnancy



Preeclampsia is characterized by hypertension, greater than 140/90 mmHg, on two occasions at least 4 hours apart and proteinuria ≥300 mg in 24 hours in patients
at 20 weeks’ gestation until 4 to 6 weeks after delivery.


in the absence of proteinuria in a otherwise preeclampsic woman what can indicate this dx

In the absence of proteinuria, thrombocytopenia with platelet count less than 100,000,

elevation of liver enzymes twice normal,

new renal insufficiency with a creatinine of 1.1 or a doubling of serum creatinine,

pulmonary edema,

or new-onset mental status disturbances or visual disturbances can be used to make the diagnosis of preeclampsia.


what are some sxs of Preeclampsia

1. Facial edema, pulmonary edema, Ascites
a. Unresponsive to rest in supine position
2. BP > 160/110
3. Progressive renal insufficiency (Cr >1.1)
4. Cerebral or visual disturbances --> HA, scotomata
5. Epigastric or RUQ pain
6. Evidence of hepatic dysfunction-->transaminases doubled
7. Thrombocytopenia
8. Rapid weight gain (2lbs/wk)
9. Hyperreflexia or clonus at ankle -->worrisome!


Risks for preeclampsia

1. Placental abruption
2. ARF
3. Cerebral hemorrhage
4. Hepatic failure or rupture
5. Pulmonary edema
6. DIC
7. Progression to eclampsia (one of four leading causes of maternal death)


labs with preeclampsia

1. CBC
2. Platelets --> thrombocytopenia
3. PT, PTT--> coagulopathy
4. LFTS --> hepatocellular dysfunction
5. Serum Cr/ CrCl -->decreased renal function
6. 24hr urine -->protein


in a CBC if you see increased HCT on a pt with preeclampsia what are you worried about

increased Hct signals indicate worsening vasoconstriction & intravascular volume


what is eclampsia

i. Presence of convulsions/ grand mal seizures in a woman w/ preeclampsia NOT explained by a neuro d/o


when is eclampsia most commonly seen

ii. Most cases occur w/I 24hrs of delivery


what are the complications with eclampsia

1. Musculoskeletal injury
2. Hypoxia
3. Aspiration


tx of eclampsia

1. Urgent OBGYN consult!
2. Usually self-limited
a. Not dangerous unless >20min
b. Avoid delivery of baby
3. Tongue blade, gentle restraints, airway, IV access, foley catheter, EKG
4. Tx directed to initiation of Mg sulfate to prevent further studies