Clinical Flashcards
How do you prevent or treat osetoporosis in a menopausal woman?
- Vitamin D and Calcium supplement
- Exercice
- Diet, alcohol, smoking…
- Selective estrogen-receptor modulators
What are the risk factors of Gestational Diabetes?
- Maternal obesity
- Ethnicity
- Previous gestational diabetes
- Family history of diabetes
- Excessive weight gain
- PCOS
What are the main causes of female infertility?
- 80-90% have polycystic ovary syndrome (PCOS)
- 5% ovarian failure
- 10% hypothalamic/pituitary disorders
- UNEXPLAINED
What are the indications for In vitro fertilization (IVF) ?
- Tubal disease
- Male factor infertility (ICSI)
- Endometriosis
- Unexplained infertility
- Anovulatory infertility (non-responsive)
- Congenital disease (PGD)
What are the non-hormonal contraceptive options?
- Sterilization
- Spermicides
- Withdrawal
- Vaginal sponge
- Diaphragm with spermicides
- Cervical cap
- Condom (male)
- Condom (female)
- Calendar
Is apnea of prematurity normal?
NOT ALWAYS –> NEED TO INVESTIGATE
You have a patient with Atypical Squamous Cells (ASC-H) pap test, what do you do?
A colposcopy
When do you recommend Rhogam (Anti-Rh D Antibodies) if Rh Neg for a pregnant woman?
28 weeks
What is the management of Post partum Hemorrhage (PPH)?
- Use of uterotonics:
Oxytocin 5 IU IV or 10 IU IM after delivery of anterior shoulder
Carbetocin 100 mcg IV after cord clamping at C/S
- Clamping of the umbilical cord
- Controlled traction of the cord
- Uterine compression (bimanual)
- Repair tears
What is the most common affective or behavioral symptom of PMS?
Mood swings
How do we manage preterm labor?
- Corticosteroids for lung maturation
- Antibiotics for GBS prophylaxis
- Tocolysis
- Calcium channel blocker
- MgSO4 for neuroprotection if <32 weeks
What is the BASIC investigation for infertility?
- Seminal analysis
- D21 (mid-luteal) serum progesterone
- Pelvic ultrasound
- Hysterosalpingogram
You have a patient with Atypical Squamous Cells of Unknown Significance (ASCUS) pap test, what do you do?
- < 30 yo: repeat pap at 6 and 12 months, refer if persists (have ASCUS repeatedly during that interval)
- > 30 yo: Do HPV, if + = colposcopy; if – = repeat pap test in 1 year
What can cause Primary Ovarian Failure (POF)?
- Fragile X syndrome
- Turner syndrome
- Mullerian Agenesis
What are the causes of Post partum Hemorrhage (PPH)?
- Tone: uterine atony, distended bladder
- Tissue: retained placenta and clots
- Trauma: vaginal, cervical, or uterine injury
- Thrombin: coagulopathy (pre-existing or acquired)
When do we investigate Amenorrhea or Oligomenorrhea?
- No onset of menses at age 13 and no other signs of pubertal development
- No onset of menses at age 15 with normal pubertal development
- No onset of menses within 3 years of completion of telarche (breast)
- Absence of menses for 3 months
- Less than 9 menstrual cycles per year
What is the treatment of Umbilical Cord Prolapse?
C-Section
What is the treatment of most placental abnormalities?
C-section
How do you treat PCOS?
IT DEPENDS IF WANNA GET PREGGY:
- Ovulation medication
- Anovulation medication
+ Weight loss and all that jazz
Production of surfactant in premature newborn lungs increases with which conditions?
Corticosteroid production (ex. labor)
What are the WHO 2010 criteria for seminal analysis?
- 15 x 106/ml
- 39 x 106 total per ejaculate
- 40% total motile (progessive 32%)
- 4% normal morphology (Kruger)
- Volume
- Leucocytospermia
- Antibodies
What is the treatment of Labor dystocia?
- Oxytocin
- Rupture the membrane artificially
- Instrumental delivery
What are the causes of postmenopausal bleeding?
- Vaginal atrophy >50%
- Polyps 20-30%
- Hormone replacement therapy
- Endometrial Hyperplasia 5-10%
- Endometrial Cancer 5-10%
- Other
You have a patient with Atypical glandular cells, not otherwise specified (AGC-NOS) or Atypical glandular cells, favour neoplasia (AGC-N), what do you do?
A colposcopy
What are the indications for Intra-Uterine Insemination (IUI)?
- Unexplained infertility
- Coital dysfunction
- Mild male factor infertility (over 5 million/ml)
- Donor sperm
What is the classic diagnosis triad of Amniotic Fluid Embolism?
- Abrupt hemodynamic compromise
- Abrupt respiratory compromise
- DIC
What is Metrorrhagia?
Irregular cycles or bleeding between periods
What are the structural causes of abdormal uterine bleeding?
- Polyp (AUB-P)
- Adenomyosis (AUB-A)
- Leiomyoma (AUB-L)
- Submucous myoma (AUB-LSM)
- Other myoma (AUB-LO)
- Malignancy and hyperplasia (AUB-M)
How do you diagnose ectopic pregnancy?
- Rule-out other causes of abdominal pain
- Serial bhgc: plateau or abnormal rise
- Transvaginal ultrasound
How is the diagnosis of adenomyosis made?
Usually pelvic MRI but definitivediagnosis is made by histologic findings in surgical specimens
What are the signs of respiratory distress in a newborn?
- Tachypnea
- Intercostal or subcostal retractions
- Nasal flaring
- Tracheal tugging
- Grunting
What is placenta abruptio?
Partial or complete separation of placenta from the inner wall of the uterus before delivery
What is the most common physical manifestations of PMS
Abdominal bloating and an extreme sense of fatigue
You have a patient with Adenocarcinoma in situ (AIS), what do you do?
A colposcopy
Other than cytologic abnormalities, what are the indications for colposcopy?
- Gross or palpable cervical ulcer, mass, or growth
- Concern for cancer on visual examination
- Unexplained lower genital tract bleeding
- History of in utero DES exposure
- Post-surgical follow-up examination
- Vulvar or vaginal HPV-associated lesion
What are the indications for Operative vaginal delivery?
- Fetal atypical/abnormal heart rate tracing
- Aftercoming head in breech delivery
- Maternal exhaustion
- Prolonged second stage
If a women going through menopause has no uterus, can you give hormonal therapy?
yes but ONLY ESTROGEN
How do you diagnose PCOS?
- WITH US:
- ≥12 follicles on one ovary (≥20)
- Ovarian volume >10 cc
- “pearl of strings” appearance
- Amenorrhea or Oligomenorrhea
- Hyperandrogenism