Jan 2 2020 Flashcards
why are estrogen containing contraceptives contraindicated in the first month post partum?
increased risk of thromboembolism
what birth control methods can be used in someone within 1 month post partum?
non-hormonal (copper IUD), or progestin-only
what is seen on histology of a granulosa cell tumour?
call-exner bodies
a granulosa cell tumour is which type of ovarian tumour?
stromal
what is elevated in a granulosa cell tumour?
- estrogen
- inhibin
when should Mg sulfate be given (how many weeks gestation)?
<32 weeks
prophylactic latency antibiotics should be given to pregnant women with…
PPROM
are NSAIDs given in pregnancy?
no generally avoided
is acetominophen given during pregnancy?
yes - considered safe
what is pseudocyesis?
the false belief that one is pregnancy, associated with somatic signs and reported symptoms of pregnancy
what causes pseudocyesis?
somatization of stress effects the hypothalamic-pituitary axis causing symptoms of pregnancy
management of pseudocyesis?
psychiatric evaluation
patients with polyhydarmios who have a sudden rupture of membranes are at increased risk for what?
placental abruption
normal internal genitalia, external virilization and undetectable serum estrogen levels =
aromatase deficiency
how does aromatase deficiency FIRST present?
In uteruo - mother will experience transient hirsuitism. Baby may have ambigious external genitalia
liver complication of PID?
perihepatitis- infection spreads and causes liver capsule inflammation
minimally rugated vagina is a sign of?
estrogen deficiency
which roots are damaged in klumpke palsy?
C8, T1
infants with klumpke palsy may have associated…
horners syndrome
which nerve roots are damaged in erbs palsy?
C5, C6
presentaiton of lichen planus?
pruritic, purple-hued plaques that may have associated thin, white striae
clinical features of vulvar carcinoma?
pruritic, plaque or ulcer with abnormal bleeding
an elevated FSH suggests
ovarian failure
carriers of the fragile X premutation (FMR1) gene are at increased risk for …
primary ovarian insufficiency
Women who have primary ovarian failure <40 years old with no other cause should be tested for…
FMR1 mutation
treatment of asymptomatic uterine leiomyomas?
observation
what causes non-classic congenital adrenal hyperplasia?
a PARTIAL deficiency of 21-hydroxylase
presentation of non-classic congenital adrenal hyperplasia?
non-classic presents in adolescence instead of at birth. - irregular menses, hirsuitism, severe acne,
do females with NON-classic CAH have electrolyte abnormalities?
no - usually sufficient mineralcorticoids and glucocorticoids are produced
difference between dyspnea of pregnancy and asthma?
Asthma has associated cough and chest tightness
what is fetal dysmaturity syndrome?
Complication or post-term pregnancy - due to age-related placental changes -> SGA, thin neonate with loose skin and meconium stained amniotic fluid
what causes aspiration (chemical) pneumonitis?
-the aspiration of gastric acid leading to direct tissue injury & lung parenchymal injury
risk factors for chemical (aspiration) pneumonitis?
- increased intraabdominal pressure
- delayed gastric emptying
- altered consciousness or sedation
- endotracheal intubtion, nasogastric tube
- gastric reflux
presentation of chemical pneumonitis?
- occurs within hours of the aspiration event
- acute-onset dyspnea, low grade fever, hypoxemia
- diffuse crackles on exam
- chest xray infiltrates
does chemical pneumonitis require antibiotics?
no - usually self resolves
why is hypotension common after an epidural?
sympathetic fibers responsible for vascular tone may be blocked -> vasodilation and pooling
how to treat hyptoension from an epidural?
IV fluids, putting woman in left lateral position to increase venous return, vasopressors if needed
what treatments are given to a woman in preterm labour at <32 weeks?
- tocolysis
- betamethasone
- MgSulfate
- penicillin
what is indomethicin used for in preterm labour?
tocolysis
adverse effect of indomethicin for tocolysis?
oligohydramnios (decreases prostaglandin production leading to fetal vasoconstriction which can lead to decreased fetal renal perfusion and oligouria)
which antibiotics are given for asymptomatic bacteruria in pregnancy?
- cephalexin
- amoxicillin-claluvonate
- nitrofurantoin
- fosfomycin
can you give fluoroquinolones in pregnancy?
NO - teratogenic effects on fetal bone/tooth development
what causes HIT?
heparin forms a complex with platelet factor 4
clinical features of HIT?
drop in platelet count >50%
- arterial or venous clots
- necrosis at site
- anaphylactoid reaction after heparin
