ectopic Flashcards
Ectopic Pregnancy rf
PID, IUD, endometriosis
unilateral abdominal pain + vaginal bleeding + amenorrhea
due to pregnancy
Ectopic Pregnancy
if an Ectopic Pregnancy ruptures sxs?
syncope, hemorrhagic shock
Ectopic Pregnancy diag?
HCG (5,000 or less), US
Ectopic Pregnancy tx?
Surgery (if unstable) or MXT (folate and liver issues)
1500-1800 what US?
6000-6500 what us?
TVUS + no yolk sac
Abd US
Gestational trophoblastic disease progresses to?
choriocarcinoma
Painless vaginal bleed, + bHCG (100,000), hyperemesis grav
Gestational trophoblastic disease
Snowstorm/Grapes is
hydatidiform mole
Gestational trophoblastic disease diag is
US - Snowstorm/Grapes
Gestational trophoblastic disease tx is?
Evacuate Uterus, MXT, Chemo
1st trimester bleeding diag?
R/o extopic preg, watchful wait
1st trimester, if Rh -?
Rh checks
When do you give Rhogam?
28 weeks and at birth OR after abortion, ectopic, amniocentesis
Rh- attack can lead to?
Hemolytic anemia, Jaundice, Kernicterus, Hydrops fetalis
placenta previa sxs
painless bright 3rd trimester bleed, no fetal distress
placenta previa diag
US, no pelvic exam
Threaghtend abortion is?
closed os and no passive of tissue
inevitable abortion is?
os dilated and no tissue at os. Offer MXT
incomplete abortion is?
os dilated and tissue is at os. Offer DnC
Complete abortion is?
Closed os, all expelled
Missed abortion is?
closed os, non-viable embory - DnC
Septic abortion is?
Closed os, infected, DnC + Abx
placenta previa tx
bed rest, no sex
placenta previa is
placenta is over the os
Abruptio placenta sxs
dark bleed, fetal distress, PAINFUL,
Abruptio placenta is?
sepatation of placenta to uterus
Abruptio placenta diag?
US, no digital
Abruptio placenta tx?
stabilize mom (MVA, punched at home) Inpatient, watch for DIC, DELIVER BABY
Vasa previa is a complication of
placenta previa - fetal cords cross planceta
Vasa previa diag/tx?
US/ Deliver Baby
Post partum hemorrhage causes?
24 hr after birth, uterine atony/rupture, infection
Post partum hemorrhage is
500 cc after vaginal birth or 1000 cc after C-section
Post partum hemorrhage sxs
hypovolemic shock, boggy uterus, dilated cervix
Post partum hemorrhage tx
massage uterus (bimanual), artery ablation, oxytocin/misoprostol
Cervical insuff is common in what trimester?
2nd - leep procedure
Cervical insuff tx is?
rest, cerclage, progesterone injections
premature labor is under what weeks?
37 weeks
premature labor diag:
sterile pelvic, US, r/o prom & infection
premature labor
Admission, ICS, tocolytics (INMT terbutaline), Abx proff
mag tox is?
cardiac/ hypotonia (reflexes)
PROM vs PPROM
PROM >1 before labor VS PPROM <37 weeks
PROM sxs?
Smoke, gush leak fluid
PROM diag?
sterile speculum, no digital exam, Nitrazine paper, Fern test
PROM tx?
<34 = ICS (lungs),
if infection = deliver and abx
Multiple gestation complication?
PREMATURE, IUGR, TTTS, placental issues
Shoulder dystocia is due what 3 factors
power, passenger (mcRoberts/woods screw), passage
Breech is
legs or butt first
Breech is helped with what maneuver?
Leopold
frank (diver) Breech is?
hip flex and knees ext (50degrees+)
Complete Breech is?
hip and knee flexed
Breech tx?
rotation by week 38, c-sec, cephalic version
first drug of choice in patients with infertility due to anovulation with normal hormone levels
Clomiphene citrate
Proliferation of the mammary ducts is under the influence
Estrogen
Growth of the lobules and alveoli is under the influence of
Progesterone
multinucleated giant cells is what?
Herpes simplex virus
Is a leiomyoma or adenomyosis painful?
adenomyosis
have menorrhagia and/ or metrorrhagia. On examination, the uterus will be larger, and irregularly-shaped. If a mass is present and it moves with the uterus, it is suggestive of a
Fibroid
