Gyn management - Sheet1

Question 1

Antiphospholipid antibodies

pt desire pregnancy

Answer 1

ASA + heparin

Question 2

Post-op endometritis

Answer 2

IV abx immediately

-post CS: cover for anaerobes (clinda/amp + gentamicin)

Question 3

Septic abortion

Answer 3

Broad-spectrum abx + immediate uterine evacuation

Question 4

vulvar vestibulitis

Answer 4

TCA’s, pelvic floor rehab, topical anesthetics

Question 5

Pelvic pain from endometriosis

Answer 5

Hysterectomy + bilateral saplingo-oorphorectomy

definitive treatment

Question 6

Urge incontinence

Answer 6

Oxybutynin

Question 7

ISD

Answer 7

urethral bulking procedure

Question 8

Overflow incontinence

Answer 8

Bethanchol (muscarinc antagonist)

Question 9

SUI

Answer 9

Urethropexy or mid-urethral sling

Question 10

Vaginal dryness

Answer 10

Vaginal topical estrogens

Question 11

thyrotoxicosis

Answer 11

Beta blockers, PTU, corticosteroids

Question 12

When to do c-section in HIV pt

Answer 12

before active labor, >1000 viral copies

Question 13

Fibroids

Answer 13

GnRH agonists x 3 months
Depot provera
hysterectomy
myomectomy(if want future pregnancy)
uterine artery embolization (if pt wants to keep uterus)

Question 14

Rx for complex hyperplasia w/o atypia

Answer 14

cyclic progestins

once hyperplasia has occurred, OCPs are insufficient therapy

Question 15

Pregnant w syphillis

Answer 15

PCN, desensitization to PCN then PCN

Question 16

HTN in pregnancy

Answer 16

Methyldopa
labetalol
hydralazine

Question 17

CI to the IUD

Answer 17

recent STI
risky behaviors for contracting an STI
abnormal size and shape of the uterus

Question 18

Questions to ask before starting someone on OCP

Answer 18

HTN?
Migraines with aura?
hx of DVT?
smoker?
diabetes w vascular ds?
(will decr risk of benign breast ds). may incr risk of breast ca. and incidence of gallstones

Question 19

Copper IUD as emergency contraceptoin

Answer 19

up to 7 days after unprotected intercourse

Question 20

Problems with Depot

Answer 20

weight gain
osteopenia/osteoporosis
irregular bleeding at the beginning
depression

Question 21

Benefits of depot

Answer 21

decr sickle cell crisis

decr epilepsy

Question 22

mastitis

Answer 22

PO abx (dicloxacillin)
continue breast feeding

Question 23

Iron requirements in pregnancy

Answer 23

27mg/day additional

Question 24

1st trimester abortion or medical abortion and bleeding too much?

Answer 24

–> D & C

Question 25

Missed abortion

Answer 25

1st trimester: expectant management

2nd trimester: D&C

Question 26

Renal calculi

Answer 26

double-J ureteral stent

Question 27

Hydrosalpinx (pt wants fertility)

Answer 27

unilateral salpingectomy + lysis of adhesions

Question 28

Interstitial cystitis

Answer 28

elmeron = pentosan polysulfate
anti-histamines
TCAs
dietary modifications