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
