CREOG quizzes Flashcards
Molar Pregnancy
The frequency of molar pregnancy in the US is 1/1000. . Complete moles= 46XX
Partial moles= 69XXX
Sxs: VB, n/v, disproportionately large uterine size
Dx: Ultrasound (look at adnexa for lutein cysts), Hcg and TSH (evaluate for poss thyrotoxicosis)
Tx: suction evacuation of uterus
F/u: Hcg for 6 mos.
Cx: 20% develop persistent gestational trophoblastic dz and require chemo. Recurrence is 1-2%
bacterial vaginosis
Sxs: thin, gray, malodorous discharge; vaginal pH is elevated >4.5
Dx: Microscopy shows clue cells, decrease of lactobacillus, presence of other cocci and bacilli
**In pregnancy BV is assoc. with increased PPROM, preterm delivery, intrapartum and postpartum infection.
Tx: PO metronidazole 250 TID for 7 days; alternative is clinda 300 BID for 7 days
HSV
It is the most common cause of ulcerative genital lesions. -Primary - Initial - Non-primary - Recurrent Dx: viral culture Tx: acyclovir, valacyclovir, famciclovir
Necrotizing Fasciitis
Extensive necrosis of subQ tissue and fascia with sparing of underlying muscle and overlying skin.
RF: diabetes, age>50, peripheral vascular dz, htn, obesity, malnutrition, immunodeficiency, operative trauma, previous irradiation
Mortality 30-60%
Tx: broad spectrum Abx (amp, gent, clinda) + surgical debridement
Ureteral Injuries
Occur in 1% gynecologic procedures
Dx: IVP
Tx: cystoscopy with retrograde pyelography; percutaneous nephrostomy
Mucopurulent cervicitis
most common cause: Chlamydia (Tx: 1 g azithromycin or 7 day courses of doxy or erythro)
Acute abdomen
Etiologies: salpingitis, ectopic pregnancy, ovarian torsion, ruptured ovarian cyst, appendicitis, Crohns dz, cholecystitis, perforated peptic ulcer, pancreatitis, renal calculus, splenic infarct or rupture and diverticulitis
ectopic pregnancy
RF: tubal surgery, prior ectopic pregnancy, STIs, ART, infertility, tobacco use, DES exposure, D&C, increasing age, IUD use
MTX
folic acid antagonist, inhibits dihydrofolic acid reductase. Criteria for MTX:
- Pt is hemodynamically stable
- Pt desires fertility
- Anesthesia poses a significant risk
- Pt is compliant
- no contraindications to MTX
- Unruptured mass <3.5 cm
- No FCA
- Hcg value does not exceed 6,000 to 15000
Contraindications to MTX therapy
- Breastfeeding
- Immunodeficiency
- Alcoholism
- Preexisting blood dyscrasias
- known sensitivity to MTX
- active pulmonary dz
- Peptic ulcer dz
- Renal or hematologic dysfx
Congenital parvovirus
Disseminated petechial rash, hepatosplenomegaly, chorioretinitis and growth restriction.
Lab: elevated LFTs, thrombocytopenia
Velamentous cord insertion
umbilical vessels are surrounded only by a fold of amnion
RF: bilobed or succenturiate placenta, low lying placenta, multiple gestation, IVF pregnancies
Dandy Walker malformation
hypoplasia of the cerebellar vermis and a retrocerebellar cyst
Trisomy 21
Low AFP, Low estriol
High HcG, High Inhibin A
congenital CMV
blueberry muffin baby
Sxs: IUGR, microcephaly, intracranial calcifications, ventriculomegaly, chorioretinitis, hepatosplenomegaly, thrombocytopenia, purpuric skin rash
umbilical artery resistance
falls progressively throughout pregnancy
Amniotic band syndrome
abnormalities resulting from fibrous amniotic bands that entangle and disrupt fetal body parts.
Constrictions are the most common deformities.
Complete breech presentation
risk of cord prolapse 5%
Frank breech presentation
most common breech presentation at term
risk of cord prolapse 0.5%
Femoral hypoplasia unusual facies syndrome
craniofacial anomalies + femoral hypoplasia
Assoc. with maternal pre-existing insulin dependent diabetes
They usually have a normal karyotype
Mono-Mono placentation
result of splitting of the developing embryo after 8 days of gestation
Ovarian vein thrombosis
Dx: CT scan or MRI
Tx: Abx and IV heparin
