LEARN Flashcards
Precocious puberty (2ndary sex characteristics <8y), multiple cystic bone lesions, cafe au lait spots
dx?
Polystotic fibrous dysplaisa (McCune Albright)
define variable decels (BPM and etiology)
at least 15/min below baseline with no relationsiph to uterine contractions
etiology: cord compression, polyhydraminos
severe variable decels assoc with?
fetal acidosis –> do NST
renal failure, hypoglycemia, hyperBr, coagulopathy (PT and PTT elevated) in a 34wk woman
acute fatty liver of pregnancy
all cause what: uteroplacental insufficiency caused by uterine hyperactivity or hypertonicity, maternal supine hypotension, epidural or spinal anesthesia, placenta previa, abruptio placente, hypertensive disorders, postmaturity, intrauterine growth restriction, diabetes mellitus, and intraamniotic infection
late decelerations
if meconium is present during labor we should proceed how?
administer amnioinfusion therapy to reduce fetal distress & risk of MAS
Uterine hyperstimulation from oxytocin presents with what in fetus
late decelerations
tx of pp endometritis
clindamycin and gentamycin
define chorioamnionitis/intraamniotic infection
maternal fever (greater than 100.4) and at least one+ of: uterine tenderness, fetal tachycardia, malodorous amniotic fluid, purulent vaginal discharge
transvaginal ultrasound reveals intrauterine gestational sac with yolk sac, but no fetal pole. what happened?
missed abortion
threatened abortion - describe
tv-u/s shows intrauterine gestational sac with yolk sac, and a fetal pole/fetal HR.
BPP: name the 5 parts
NST Amniotic fluid volume fetal movements fetal tone fetal breathing movements
Normal Amniotic Fluid Volume in BPP
slingle fluid pocked more than 2cm x 1cm
OR
AFI greater than five
Normal fetal movements and fetal tone
greater or equal to three fetal mvmts
greater or equal to one F/E of limbs or spine
define chronic HTN v gestational HTN
chronic is mroe than 140/90 BEFORE 20 weeks
gestational is new onset elevated BP at greater than or equal to 20 weeks (without proteinuria or signs of end organ damage)
normal non stress test
2 or more HR accelerations that are 15 or more beats above baseline and 15 or more seconds long in a 20 minute period
syphilis tx
PenG
in a severe preeclamptic with pressures rising, why would you give hydralazine instead of labetalol?
if the woman was bradycardic, wounldn’t give labetalol because its B-blocker property will lower HR.
give hydralazine instead because it is a vasodilator.
MCC of arrest of descent
fetal malposition (nonocciput anterior)
arrest of second stage of labor occurs when no fetal descent after pushing more than 3 or 2hrs nulli/multi
Nitrazine positive fluid in the vagina and closed cervix at 34 weeks. Management how?
this is PPROM 34-37wks:
abx
+/- CS
deliver
Nitrazine positive fluid in vagina and closed cervix at 33 weeks. management how?
sign of infection or fetal compromise?
No: abx, CS, surveilance
Yes: abx, CS, Mg if less than 32 weeks, deliver
definitive karyotype diagnosis: timing for Chorionic Villus sampling v. amniocentesis
CVS 10-13 weeks
amnio 15-20 weeks
what thyroid hormones increase during pregnancy?
TBG
Total T3
most effective screening test for Down Syndrome
Cell-free DNA, from 9wks to brith
is IUGR seen in women with pre-existing diabetes or in women who develop gestational diabetes?
pre-existing
Symptom that distinguishes postpartum depression from blues or normal?
ambivalence toward newborn
side effect of Depot medroxyprogesterone
weight gain
best contraception for postpartum who wants to breastfeed and lose weight
IUD
difference in bleeding between retained products of conception and perforated uterus
retained: profuse vaginal bleeding
perforation: scant (and fever, lower bad tenderness, rebound, guarding,)
thrombocytopenia, need for 3 or more bp meds, LFTs x2 normal, eclampsia, persistent CNS sx - do what?
in this setting of severe preeclamsia, `deliver
Induce labor in a pt with an unfavorable cervix how?
cytotec first, then pitocin induction
foley bulb and AROM cannot be perfomred in a pt with what type of cervix?
closed cervix
give betametasone/CS at what weeks.
associated with what in newborn (hemorrhage)
24-34.
decreased intracerebral hemorrhage
bs abx for endometritis
clindamycin + gentamycin
ROM more than 18hrs, give what abx?
amoxicillin
most likely arisk associated with tubal ligation
future pregnancy
MCC of salpingitis.
think what if pt comes in with fever, and abdominal G/R/T
MCC is G/C
Think b/l tuboovarian abscess (complex masses)
Incontinence type:
pressure, fullness, frequency, small amount of continuous leaking. not associated with positional change or events
overflow
Incontinence type: increased intraabd pressure causes urethral-vesical junction to descned causing detrusor muscle to contract
mixed
Incontinence type: continuous loss of urine
vesicovaginal fistula
Incontinence type: caused by increased itrabd pressure (cough, sneeze) when pt in upright position. caused by overactivity of detrusor mm, resulting in uninhibited contractions, causing increase inbladder pressure over urethral pressure= urine leak
stress
what type of incontinence is associated with cystocele or urethrocele
stress
BRCA mututation carriers, 1st degree relatives of BRCA mutation carriers, li-fraumeni, women with hx of radiation bw 10-30y: offer what?
breast mri and mammo
premature menses before breast and pubic heair developlemtn - what syndrome
mccune albright
Normal TSH, prl, total T, and DHEAS in a young woman with a 1y hx of hirsutism and acne… what next?
17-OHprogesterone test to r/o late onset 21-hydroxylase deficiency
what are these: well circumscribed, non encapsulated myometrial nodules
fibroids
what are these: hyperplastic overgrowth of endometrial glnads/stroma
endometrial polyps
what is this: invasion of endometrial glands into the myometrium
adenomyosis
before performing B/l oophorectomy to alleviate severe PMS, refractory to everything else, do what?
admin GnRH agonist to mimic menopause and see if improvement with this. if so, then b/l ooph will likely be successful treatment
positive endocervical curettage - then what?
cervical conization
