14 Flashcards
when is MVA most effective
less than 8 weeks
why would postmenopausal woman get hot flashes again after THBSO?
because menopausal ovaries still make androgens (not estrogen), and circulating androgens get converted to estrogen
what test would you get if older woman has problems getting pregnant?
anti mullerian hormone to indicate ovarian reserve
friable cervix, think…
cervicitis (chlaymdia and gonorrhea)
what type of mass can lead to ovarian torsion
any mass but especially teratomas
what type of murmur is normal in pregnancy
systolic ejection murmur
major risk factors for osteoporosis
advanced age, postmenopausal, low body weight
modifiable–alcohol, sedentary, smoke
prior history of fragility fracture!!
septic pelvic thrombophlebitis
postoperative or postpartum infected thrombosis of deep pelvic or ovarian veins
persistent fever
tx: broad spectrum antibiotics plus anticoagulants
why does epidural anesthesia give side effect of hypotension?
sympathetic blockade –> vasodilation –> decreased VR and venous pooling
postpartum urinary retention
due to bladder atony from prolonged labor or perineal injury or regional anesthesia
unable to void >6 hrs post delivery, dribbling
temporary and reversible
most accurate way of getting gestational age
first trimester US with crown-rump measurement
contraindications to breastfeeding
HIV active TB herpes breast infections active varicella chemo/radiation substance abuse (even mary jane)
what is impaired in posterior shoulder dislocation
external rotation
when asymptomatic patients have incidental finding of endometriosis, whats best management?
observe
decreasing bHCG indicates…
fetal demise
if dead fetus is in breech, whats best way to deliveR?
still vaginal
adverse effects of oxytocin
tachysystole
hypotension
hyponatremia –> seizure
causes of hyperandrogegism in pregnancy
- luteoma
- theca luteum cyst
- krukenberg tumor
first step in treating uterine inversion
- manual replacement of uterus
how to prevent HIV transmission to fetus during pregnancy
- test mom for HIV VL until undetectable then every 3 mo
- test CD4 count every 3 mo
- avoid amniocentesis, artificial ROM, fetal scalp electrode
- **continue HAART
whats best way to deliver fetus with HIV mom
if VL<1000 –> HAART + vaginal delivery
if VL>1000–> zidovudine + c-sect
how to prevent HIV transmission post partum
infant should take zidovudine for 6 weeks plus serial HIV testing
what should you do for mom with urinary retention and overflow incontinence
urethral catheterization
SLE in pregnancy
edema, malar rash, arthritis, hematuria, proteinuria with hypertension (don't confuse with preeclampsia!)
normal changes right after delivery
shivering
uterine contraction
red-brown discharge
postpartum fever starts at…
38 C or 100.4 F
modifiable risk factors for breast cancer
HRT
nulliparity
increased age at first live birth
ALCOHOL
guidelines for arrest of active labor
cervix dilated >6 cm
no cervical change for >4 hrs with adequate contractions or for >6 hrs with inadequate
