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Flashcards in vaginal bleeding Deck (116)
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91

alternative to doxy for PID

a. Azithromycin alternative to doxy

92

viollin strings is a classic appearance for

fitz hugh curtis syndrome

93

MC cystic growth in vagina

Bartholin Gland Cyst/Abscess

94

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

95

PID vs appy

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

96

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

and vomiting

torsion

get formal U/S to look at flow

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

97

tx of torsin

Adnexal torsion is a SURGICAL EMERGENCY
OR immedeatly

98

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

Mastitis/Breast Abscess

99

which populations do we usually see mastitis with

Often in first few wks of breastfeeding
Usually affects lactating women

100

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

Stap aureus infxn

101

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

102

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!!

103

what should be on your tray for ED delivery

2 large hemostats
scissors
cord clamp
towels

syringe for cord gas

104

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

105

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

106

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

107

preeclampsia

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.

108

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.

109

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!

110

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)

111

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

112

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

113

what is eclampsia

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

114

when is eclampsia most commonly seen

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

115

what are the complications with eclampsia

1. Musculoskeletal injury
2. Hypoxia
3. Aspiration

116

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