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reproductive system > LA OB/GYNE > Flashcards

LA OB/GYNE Flashcards

1
Q

HPV types that cause genital warts

A

6 and 11

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2
Q

1st, 2nd, 3rd most common gyne malignancies

A

endometrial, ovarian, cervical

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3
Q

high risk HPV

A

16 and 18

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4
Q

MC kind of cervical cancer and endometrial

A

squamous cervical

adenocarcinoma endometrial

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5
Q

screening for cervical cancer is at what age

A

21 yo

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6
Q

endometrial stripe is how many mm

A

4 mm. worry if larger

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7
Q

abn uterine bleeding most likely what cancer

A

endometrial

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8
Q

which cancer most commonly mets to local areas

A

cervical

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9
Q

CA 125 is mainly a marker for what?

A

epithelial cancer

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10
Q

MC of ovarian cancer and vaginal/vulvar cancer

A

epithelial ovarian

squamous vagina/vulvar

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11
Q

FH of which cancer is strong

A

ovarian

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12
Q

OCA use and breastfeeding protect in what cancer

A

ovarian

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13
Q

ascites can point to what cancer

A

ovarian

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14
Q

what % of ovarian neoplasms are benign

A

90

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15
Q

what has a 0.2-2% malignancy potential

A

dermoid ovarian neoplasm

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16
Q

vaginal bleeding(post coital), watery discharge, and pruritis

A

think vaginal/vulvar cancer

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17
Q

red/white crusted ulcerative lesions noted

A

think vulvar cancer

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18
Q

BRCA gene, watch for what 2 cancers

A

breast and ovarian

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19
Q

MC kind of breast cancer

A

infiltrative ductal carcinoma

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20
Q

which of the breast cancers has the worse prognosis

A

inflammatory breast cancer

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21
Q

eczematous itchy, scaley, rash on nipples/areola, bloody discharge

A

paget ds of breast

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22
Q

which part of the breast are cancers commonly found

A

upper outer quadrant

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23
Q

where do breast cancer mets to

A

bone, lung, liver, brain

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24
Q

what age to start screening for breast cancer

A

40/ brca then at 25

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25
Q

peau d’orange

A

inflam breast cancer

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26
Q

which breast cancer has no lump

A

inflam breast cancer

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27
Q

Differential dx for breast mass in order

A
  1. fibrocystic disease
  2. fibroadenoma
  3. carcinoma
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28
Q

what kind of med is bromocriptine and cabergoline

A

dopamine agonist

cabergoline decreases prolactin too

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29
Q

MC benign breast tumor

A

fibroadenoma

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30
Q

breast mass is rubbery, well circumferential, mobile mass, 2-3cm, usually nontender

A

fibroadenoma

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31
Q

MC benign breast disorder

A

fibrocystic disease

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32
Q

spironolactone, ketoconazole, theophylline, verapamil, thiazides,

A

can all cause gynecomastia

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33
Q

which phase is estrogen dominant and progesterone dominent

A

follicular is estrogen
luteal phase is progesterone

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34
Q

describe the FSH/LH surge

A

in follicular phase and it induces ovulation, ruptures follicle and releases oocyte

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35
Q

FSH>40 , low estrogen in secondary amenorrhea

A

ovarian failure

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36
Q

when to do a progesterone challenge

A

workup of secondary amenorrhea

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37
Q

amenorrhea in a female athlete

A

functional hypothalmic

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38
Q

decreased estrogen, decreased FSH/LH

A

pituitary dysfunction

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39
Q

asherman syndrome

A

acquired scarring, causes uterine dysfunction.

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40
Q

progesterone challenge and there is withdrawal bleeding

A

she is not ovulating. outflow tract and endometrium nml

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41
Q

what is primary dysmenorrhea

A

due to high prostaglandins, not a pelvic pathology

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42
Q

menorrhagia vs metorrhagia

A

menorrhagia: prolonged heavy bleeding, regular intervals, no spotting
metorrhagia: uterine bleeding that occurs frequently and irregular between menses

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43
Q

anovulation

A

no corpus luteum formation, increased unopposed estrogen

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44
Q

duration of postpartum depression

A

2 weeks to 12 months, give SSRI

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45
Q

no colposcopy for which lesions of cervix

A

ASC-US and LSIL in young pt, HPV neg

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46
Q

woman over 45 yo, 12 months amenorrhea, FSH >40, low estradiol

A

menopause

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47
Q

cancer type in postmenopausal bleeding

A

adenocarcinoma, endometrial cancer 10%

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48
Q

biggest risk of HRT

A

75% chance of breast cancer risk

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49
Q

MC metabolic bone disease in US

A

osteoporosis

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50
Q

recommended CA, Vit D daily

A

Calcium 1200 mg/day
vit d 800-2000 mg/day

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51
Q

when to screen for osteoporosis

A

female 50-74 if there is fx risk

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52
Q

dexa in osteoporosis and osteopenia

A

osteoporosis <-2.5
osteopenia -1 to -2.5

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53
Q

most effective birth control methods

A

IUD and nexplanon

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54
Q

birth control safe in lactation

A

progestin mini pill, IUD, nexplanon

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55
Q

avoid estrogen products how long after delivery

A

6 months

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56
Q

how much % is female and male the cause of infertility

A

female 65%, male 20-40%

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57
Q

luteal phase is what day when progesterone level < 3 and no ovulation

A

21

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58
Q

what can hyperstimulate ovulaion

A

clomiphene citrate

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59
Q

what treats hyperprolactinemia

A

bromocriptine

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60
Q

GTPAL

A
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61
Q

of weeks

abortion
premature
full term

A

abortion under 20 weeks
premature 20-36
full term 37-42

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62
Q

quickening

A

fetal movement
nullipara 18-20
multi 14-16

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63
Q

chadwicks sign

A

bluish discoloration of vagina/cervix

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64
Q

hegars sign

A

softening between fundus and cervix

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65
Q

uterine growth
12 wks
20 wks
38 wks

A

12: symphysis pubis
20: umbilicus
38: 2-3 cm below xiphoid process

66
Q

fetal heart tones

A

10-12 weeks

TV u/s at 5-6 weeks

67
Q

nml heart rate

A

120-160

68
Q

recommended wt gain and calories

A

20-35 lbs for average woman

increase calories 300 kcal/day

69
Q

prenatal folic acid and iron

A

folic acid 0.4 mg
iron 30mg/day

70
Q

pathogen in unpasteurized food/drinks

A

listeria

71
Q

beta HCG in pg

A

doubles every 48 hours

72
Q

naegels rule

A

1st day of last menstrual period+ 7 days - 3 months + 1 year

73
Q

nml BP in PG

A

140/90

74
Q

PAPP-A

A

PG assoc plasma protein-A low: trisomy 21

75
Q

nuchael translucency screening test done when

A

10-13 weeks

76
Q

amniocentesis can be done when

A

15-20 weeks

77
Q

triple screen
and
quad screen

A

APF, estriol, HCG

quad: inhibin A

78
Q

Glucose tolerance test done when

A

26-28 weeks

79
Q

GBS cultures done when

A

36-37 weeks

80
Q

rhogam done when

A

28-30 weeks

81
Q

monthly prenatal visits what weeks

A

weeks 4-28

month 1-7

82
Q

twice monthly prenatal visits when

A

weeks 28-36

month 7-9

83
Q

safe antibx

A

PCN, ceph, augmentin, clinda, flagyl

84
Q

antibx to avoid

A

FQ, fluconazole, bactrim, macrolides

85
Q

lightening

A

fetal head descending into the pelvis

86
Q

stage 1 of labor

A

onset of contractions to full dilation
* primi 6-20 hours
* multi 2-14 hours

87
Q

stage 2 of labor

A

full dilation to baby delivery
* primi 30 min to 3 hrs
* multi 5-6 min

88
Q

effacement

A

softening of cervix
100% means thin

89
Q

station

A

babys head at level of ischial spine
-3 to 3

90
Q

when to get Tdap shot

A

1 dose during later 2nd or 3rd trimester (after 20 weeks)

91
Q

high fever, erythroderma(sunburn) desquamation

A

toxic shock syndrome

replace fluids

vanco(or linezoid) plus clinda

92
Q

painful vag bleeding and abd pain, dark red 3rd trimester

A

abruption placenta

93
Q

when to avoid digital exam and speculaum

A

placenta previa and abruption placenta, PROM

94
Q

hypertonic uterus

A

abruption placenta

95
Q

painless bright red bleeding, no abd pain

A

placenta previa

96
Q

waiter’s deformity

A

shoulder dystocia

97
Q

termination of PG due to medical or elective reason called what

A

induced abortion

98
Q

termination of PG due to mother endangerment or fetus dead called what

A

therapeutic abortion

99
Q

which abortion has a chance of being viable

A

threatened abortion

100
Q

vaginal bleeding occuring before 20 week without cervical dilation and indicating spontaneous abortion occured

A

threatened abortion

101
Q

MOA of progesterone receptor antagonist

A

leads to dilation and softening of cervis, causes placenta separation

102
Q

what is a prostagladin E analog

A

misoprostol, causes uterine contraction

103
Q

all RH ___ should receive anti D RH immunoglobulin at the time of abortion

A

negative

104
Q

which abortions is the cervix open

A

inevitable and
complete

105
Q

which abortion has no vaginal bleeding

A

missed

106
Q

anembryonic PG

A

blighted ovum

107
Q

% of spontaneous abortions due to chromosomal abnormalities

A

60

108
Q

components of umbilical cord

A

2 veins and an artery

109
Q

vein fx in cord

A

carries oxygenated blood/nutrients from placenta to fetus

110
Q

artery fx in cord

A

carries deoxgenated blood/waste from uterus to placenta

111
Q

no fetal heart rate

A

uterine rupture, bradycardic fetus

112
Q

% of breech babies

A

3-5

113
Q

% #s as PG goes forward
<28 weeks
32 week
at birth

A

<28 weeks 25%
32 weeks 7-16%
at birth 3%

114
Q

MC breech position

A

frank, both hips flexed and knees extended

115
Q

when to move a breech baby

A

at 37 weeks

116
Q

% of c sections

A

32

117
Q

anti prophylaxis in c sections

A

cefazolin

alternative: clinda, genta

118
Q

nml length of uterus

A

30cm

119
Q

transvaginal u/s shows funneling of cervix, <25mm

A

cervical insufficiency

120
Q

cerclage can be done when

A

`36 weeks

121
Q

cervical insufficiency has difficulty maintaining gestation at what week gestation

A

20

122
Q

MC characteristics of ectopic population

A

age over 35 and non white

123
Q

ectopic MC location

A

ampulla of fallopian tube

124
Q

abd pain, vag bleeding, amenorrhea

A

ectopic PG

125
Q

transvaginal u/s: ring of fire, sperical mas

A

ectopic PG

126
Q

pre-eclampsia before 20 weeks is what

A

molar PG

127
Q

non stress testing >2 accelerations in 20 minutes and HR increase at least 15 bpm from baseline lasting >15 seconds

A

good, fetus well being

128
Q

non stress testing is nonreactive, no fetal HR accelerations or <15 bpm increase lasting <15 seconds.

A

bad result, get a contraction test

129
Q

contraction shows no late decels in presence of 2 contractions in 10 min

A

negative test. good result

130
Q

contraction test shows repetitive late decels

A

bad, prompt delivery

131
Q

RH incompatibility occurs when

(mom/baby)

A

Rh NEG mom carries a Rh POSITIVE baby

132
Q

RH incompatibility occurs when

(mom/dad)

A

Rh NEG mom and Rh POSITIVE dad

133
Q

Rh

AB titer is unsensitized

A

No Rh antibodies

134
Q

Rh

AB titer is sensitized

A

Rh antibodes present

135
Q

prevention in Rh AB mom

A

Rh immunoglobulin at 28 weeks and within 72 hours of delivery

136
Q

when to do the 3 hour glucose tolerance gest

A

if FBS >130 with 1st test at 24-28 weeks

137
Q

when to need insulin when PG

A

if FBS >105 or 2 hr post prandial >120

138
Q

what insulin for gestational dm

A

NPH/regular

139
Q

PG vomiting ok up to how many weeks

A

16

140
Q

what ABG to expect with hyperemesis gravidum

A

metabolic alkalosis

141
Q

HELLP

A

hemolysis
elevated liver enzymes
low platelets

142
Q

moderate and severe gestional HTN

A

moderate: 150-159/100-109
severe: Over 160/110

143
Q

concerning proteinuria, platelets, serum creatinine

A

preeclampsia
protein >0.3 or 2+ on dipstick
platelets <100,000
creatinine >1.1

144
Q

other symptoms to be concerning with preeclampsia

A

severe HA, visual problems, pulm edema

145
Q

RUQ pain, blurred vision, photophobia, hyperreflexia

A

watch for eclampsia

146
Q

when to deliver with HELLP

A

34 week

147
Q

magnesium sulfate for what

A

protect CNS, prevent seizures

148
Q

aspirin ok for PG when

A

eclampsia, …

149
Q

identical twins called what

A

monzygotic
splitting of one zygote

150
Q

increased AFP, fundal height > gestation date, extra fetal heart tones

A

multiple gestations

151
Q

1 cause of maternal deaths worldwide

A

postpartum hemorrhage

152
Q

___ ml for postpartum hemorrhage

A

at least 1000

153
Q

1 reason for postpartum hemorrhage

A

uterine atony

154
Q

severe preeclampsia, amniotic fluid embolism, placental abruption

A

DIC

155
Q

uterus soft and boggy, signs of shock

A

postpartum hemorrhage

156
Q

tx for uterine atony

A

fundal massage, meds(Iv oxytocin, misoprostol), replenish IV fluids

157
Q

menses returns to nml when if not breastfeeding

A

6-8 weeks

158
Q

what is Chorioamnionitis

A

Chorioamnionitis, also known as amnionitis and intra-amniotic infection, is inflammation of the fetal membranes, usually due to bacterial infection.

159
Q

pooling after 37 weeks

A

PROM

160
Q

PROM does what to nitrazine paper? + what test

A

blue

fern test

161
Q

preterm labor occurs when

A

before 37 weeks

162
Q

findings on exam with preterm labor

A

> 3 cm dilated and >80% effacement

reproductive system (11 decks)

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