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OB/gyn > Clinical pearls > Flashcards

Clinical pearls Flashcards

1
Q

How do you calculate day of delivery?

A

Nagele rule: LMP - 3 months + 7 days

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2
Q

At what B-hcg level can you see pregnancy on US?

A

Beta-HCG > 1500 = 5 weeks

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3
Q

When is digital vaginal exam contraindicated?

A

third trimester bleeding because it may lead to increase separation between placenta and uterus resulting in severe hemorrhage

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4
Q

In what types of patients are prostaglandins contraindicated?

A

asthmatics because it may provoke bronchospasm

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5
Q

How does Sheehan syndrome present?

A

Inability to breastfeed

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6
Q

What defines adequate uterine contractions?

A

greater than 200 Montevideo units

contractions every 2-3 mins lasting 40-60 secs

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7
Q

What drugs induce hemolysis in patients with G6PD deficiency?

A

sulfonamides, nitrofurantoin or antimalarial agents

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8
Q

What is the most common cause of inverted uterus?

A

undue traction on the cord when the placenta has not yet separated

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9
Q

What is the most common complication of inverted uterus?

A

hemorrhage due to uterine atony

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10
Q

What is McRoberts manuever and when do you use it?

A

flex maternal thighs against abdomen. this rotates the symphysis pubis anteriorly toward maternal head.
use for shoulder dystocia

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11
Q

What are the causes of elevated AFP?

A 
underestimation of gestational age
multiple gestations
neural tube defects
cystic hygroma
fetal skin defects
sacrococcygeal teratoma
decreased materal weight
oligohydramnios
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12
Q

What are the causes of low AFP?

A 
Overestimation of gestational age
chromosomal trisomies
molar pregnancy
fetal death
increase materal AFP
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13
Q

Trisomy 21

A 
low AFP
low uE3
high hcg
high inhibin A
low PAPP-A
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14
Q

Trisomy 18

A

low AFP
low uE3
low hcg
low PAPP-A

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15
Q

Trisomy 13

A

low PAPP-A

low B-hcg

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16
Q

What kind of pain is typical of ovarian torsion?

A

Acute onset of colicky abdominal pain that is episodic at 14 wks or after delivery

17
Q

If corpus luteum is excised less than 10-12 was what should be supplemented?

A

Progesterone

18
Q

What causes pruritis with or without jaundice and no skin rash? When does it begin? What is the complication?

A

Intrahepatic cholestasis of pregnancy (ICP)
Begins in third trimester
Perinatal mortality

19
Q

what is the earliest sign of chorioamnionitis?

A

fetal tachycardia

20
Q

what does a negative cervical fetal fibronectin assay indicate?

A

guarantees no delivery within 1 week

21
Q

what is the first sign of mag toxicity?

A

loss of deep tendon reflexes

22
Q

what is the difference between chronic htn and gestational htn?

A

chronic: htn prior to 20 wks gestation or if htn persists beyond 12 wks postpartum
gestational: htn after 20 weeks without proteinuria

23
Q

what medications are used to treat chlamydia in pregnancy?

A

oral erythromycin, azithromycin or amoxicillin.

doxycycline is contraindicated because it can cause teeth staining

24
Q

What is the cause of post partum hyperthyroidism?

A

lymphocytic thyroiditis due to flare of autoimmune antibodies after corticosteroid levels drop post partum. check antimicrosomal and antiperoxidase antibodies

25
Q

What are the TSH, free thyroixine, TBG, and total thyroixine levels in hypothyroidism?

A

TSH - increased
free thyroixine - decreased
TBG - increased
total thyroixine - unchanged

26
Q

How does pregnancy affect thyroid levels?

A 
due to increase estrogens
TSH - unchanged
free thyroixine - unchanged
TBG - increased
total thyroixine - increased
27
Q

What is the difference between cause of symmetric and asymmetric IUGR?

A

symmetric is caused by aneuploidy or early transplacental infection.
asymmetric reflects a more recent insult to fetal growth like htn

28
Q

What is diagnostic criteria for diabetes in pregnancy?

A

ph 200

Bicarbonate

29
Q

what does fluctuance in the breast indicate?

A

abscess

30
Q

What is the treatment for post partum mastitis?

A

dicloxacillin and cont breast feeding

31
Q

what is the most common cause of fever after cs? What is the organism that causes it?

A

endomymometritis

Bacteroides

32
Q

what is pregestational diabetes associated with?

A

congential anomalies and miscarriages

33
Q

What hormones in pregnancy cause insulin resistant state?

A

CRH, hPL, progesterone

OB/gyn (11 decks)

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