Deck 3 Flashcards
pagets disease of the breast appearance
flaky, crusty with yellow exudate, breast tenderness
signs of urethral diverticulum
painful anterior vaginal wall mass, purulent exudate when palpated
can you have actinomyces as normal vag flora
yace
if a pregnant person does not want to have a csection but need one do you do it
nope
what do you do if a patient doesnt haven cervicle change
c section
management of placenta previa
no sex, no digital cervical exam, csection at 37 wks
initial eval of a premenopausal women with an adnexal mass
pregnancy test and ultrasound
clinical signs of intrahepatic cholestasis
intense pruritis, RUQ pain, hands and feet itchy, no rash, deveIops in third trimester
lab signs of intrahepatic cholestasis
significantly elevated liver enzymes and increased total bile acids
pathophys behind intrahepatic cholestasis
progesterone delays bile acid secretion causing backup
dx of a person with heavy menstrual bleeding and normal coag studies
von willebrands
what is the material if breast discharge is guiac negative and brown/white or gray
galactorrhea
signs of 5alpha reductase def
palpable undescended testes, virulization,
genotype of a 5alpha reductase person
46XY
contraindications for ablation
future desire for fertility, high suscpision of endometrial cancer (makes it harder to biopsy)
normal finding of endometrial tisue post abortion
2cm heterogeneous
hydrops fetalis maternal coombs test and blood type
coombs positive and blood type Rh negative
what to do for superficial wound dehiscence
regular dressing changes only
signs of superficial wound dehiscence from c/s
serosanguinous drainage but rectus fascia in tact
if a patient with mastitis has no improvement in systemic sx what is giong on
likely breast abscess
dx of breast abscess
ultrasound
complications of placental abruption
hemorrhage, DIC
how do you treat antiphospholipid syndrome
low molecular weight heparin
contraindications to vaginal delivery
placenta previa, prior classical cesarean, prior extensive uterine myomectomy
what should you put patients on that have short cervix at <20 wks
progesterone
very preterm medications to administer to mom
mag, penicillin, betamethasone, indamethicin
when do we use nifedipine for tocolysis
32-34 weeks
types of incontinence
urge (neurogenic bladder), overflow (obstruction), stress
what test should be ran with a Rh factor to see if there will be Rh incompatibility
indirect coombs
what do you see on the ovaries of a person with choriocarcinoma
they will often have theca lutein cysts bilaterally due to hyperstimulation from all the b-hcg
does a mature cystic teratoma have b-hcg
nor
complications of labor trial with breech delivery
cord prolapse, asphyxiation of baby
do you have to do a c section for chorioamnionitis
no as long as the pt is progressing and baby is okay
when to remove a demised fetus vs. letting the body induce labor
you need to remove the fetus in a hemodynamically unstable person
trt of migraine in preg
acetominophen
signs of a galactocele
painful breast mass right as lactation starts or ends, no infection
bugs that cause post partum endometritis
polymicrobial; gut and skin normal flora
test for BV
wet mount and see clue cels
bugs that cause bartholin gland cysts/abscesses
mixed enteric and skin flora
which two bugs cause painFUL genital lesions
h ducreyi and herpes simplex
risk factors for uterine sarcoma
tamoxifen use, previous pelvic radiation, hx of retinoblastoma
do you still do paps after total hysterectomy
yes bc of risk of vaginal lesions but no if they didnt get the hysterectomy for CIN
what hormone causes the increase in basal body temp during ovulation
progesterone
how do OCPs help AUB
they synchronize the endometrium
mortality causes of TSS
ARDS, DIC, Seizures, etc
sudden onset RLQ pain with hematuria dx
kidney stone
how to dx kidney stone in a pregnant person
renal and pelvic U/S
treatment of menopause for pts. without a uterus
estrogen only
treatment of menopause for pts. with a uterus
combo estrogen-progesterone
if a patient has confirmed chlamydia only do you still treat for gonorrhea
nope only chlamydia
if a patient has adequate contractions and does not progress to 10cm what do you do
section that baby out of there asap
active phase arrest definition
> 6cm dilated with no cervical change for 4 hours WITH adequate contractions or 6 hours with inadequate contractions
AEs of tamoxifen
hot flashes, uterine sarcoma, endometiral hyperplasia, VTE
do you have to deliver for asymptomatic poly
nope if theyre at term
can hepB + moms breastfeed
yes as long as the infant received prophylaxis immune globulin
what is the cause of early decels
fetal head compression
if a patient has active HSV lesions can they deliver vag
nor
hepatitis like signs in a nonpregnant sexually active female dx
perihepatitis from PID
do OCPs cause weight gain
nope
signs of asthma in pregnancy
cough, wheezing, SOB, chest tightness
what do you do if a pt has an asymptomatic adnexal mass (postmenopausal)
do a CA-125 level
lupus flare vs. preeclampsia labs
lupus flare will have RBC casts and nephrotic range proteinuria vs. preeclampsia will have eIevated P:Cr ratio but no associated sx
best way to reduce shoulder dystocia complications
perform simulations
what is ulipristal acetate
an emergency contraceptive option that has no contradinications, blocks progesterone receptors to delay ovulation
when can you prx antibiotics for recurrent UTI
> 2 in 6mo or >3 in a year
if you dont know GBS status when do you still do prophylaxis
prior neonatal sepsis // <37wks // maternal fever // rupture of membranes for >18hrs
trtment for adolescent heavy uterine bleeding in ER setting
IV estrogen or high dose OCPs
trt of recurrent UTI for postmenopausal poeple
vaginal estrogen
drugs for uncomplicated UTIs
nitrofurantoin, TMP-SMX, fosfomycin
when is too close to use the same antibiotic for UTI
must be >3mo to reuse a similar antibiotic I
trt of hyaditiform mole
Dilation and suction curretage, serial HCG mesurements, contraception for 6 mo
treatment of endometritis post delivery
clinda +gent
signs of endometritis post delivery
fever, fundal tenderness, purulent lochia
risk factors for endometritis
c section, prolonged ROM, GBS +, operative vaginal delivery, hx chorio
what can you give for preeclampsia prevention
low dose aspirin
fetal complication of lupus SLE
AV block
signs of AV block in the fetus
low HR, and minimal variablity
physio of HIT
antibodies against platelets that cause clumping which can cause thrombi and therefor PE
what is the normal pH of urine
6-7.5
what is lichen planus
this is a chronic inflammatory condition that affects post menopausal women, desquamative erosion of the vulvar mucosa
difference between lichen planus and lichen sclerosis
planus has erythematous vulvar erosions with white borders but sclerosis is white plaques that are intensely itchy
do you use PTU in post partum thyrotoxicosis
nope never
management of post partum thyrotoxicosis
beta blocker during hyperthyroid phase and levo during hypothyroid phase if they are sx positive
ovarian torsion blood pressures
likely high from pain, not low (no blood loss)
causes of protracted active phase of labor
pelvis disproportion, baby is too large, poorly strength of contractions
where is round ligament pain
lower abdomen and ipsilateral labia
