B8.062 Prework 2-3: Random Shit That Might Be Relevant From The YouTube Videos Flashcards
at what tanner stage does menarche occur
stage 4
what is primary amenorrhea
no menarche at 14 without pubertal development
OR
no menarche at 16 regardless of pubertal development
what is secondary amenorrhea
absence of menses for > 6 mo in previously menstruating females often due to disruption in HPO axis -inadequate GnRH -inadequate LH, FSH -inadequate E
features of ectopic pregnancy presentation
unilateral pelvic/abdominal pain
amenorrhea
vaginal bleeding
if ruptured: signs of peritoneal irritation and shock
locations of ectopic pregnancy
most common: ampulla of fallopian tube (80%)
other fallopian tube sections can happen also
rarely:
-cervix
-abdominal cavity
-ovary
risk factors for ectopic pregnancy
PID (most common) -tubal scarring -loss of cilia -luminal narrowing history of tubal surgery history of curettage prior ectopic -15% recurrence after first -30% recurrence after second smoking prenatal exposure to DES increased maternal age IUD
classic clinical triad of ectopic
amenorrhea
abdominal pain
vaginal bleeding
clinical signs of ectopic pregnancy rupture
severe pain peritoneal irritation cervical motion tenderness bleeding -internally in abdominal or pelvic cavities -externally through vagina -hypovolemia and shock if severe
diagnostic tests for ectopic pregnancy
b-HCG (qualitative)
US after positive b-HCG (transvaginal better)
culdocentesis
medical ttx of ectopic
indication: unruptured with a b-hCG <6000
methotrexate
follow b-HCG weekly, surgery indicated if levels rise, stay unchanged, or if ectopic ruptures
surgical ttx of ectopic
laparoscopy with salpingostomy
salpingectomy is required when the fallopian tube ruptures
stages of miscarriage
missed
inevitable
incomplete
complete
missed misscarriage
cervix: closed
POC passage: retained
inevitable miscarriage
cervix: open
POC passage: retained
incomplete miscarriage
cervix: open
POC passage: partially
