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Genitourinary Women > MDT's Part 4 > Flashcards

MDT's Part 4 Flashcards

1
Q

Signs and symptoms of intrauterine pregnancy?

A
  • Amenorrhea
  • Nausea/Vomiting
  • Breast tenderness/tingling
  • Urinary frequency/urgency
  • “Quickening”
  • Weight gain
  • Softening of cervix around 7 wks
  • Uterine fundus palpable above pubic symphysis by 12-15 weeks
  • Fetal heart tones on doppler by 8-10 weeks gestation
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2
Q

Imaging and referral for intrauterine pregnancy?

A
  • Transvaginal US
  • Obstetrics
  • MEDEVAC
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3
Q

Pt education for pregnancy?

A
  • Prenatal vitamins
  • Avoid supplements
  • Decrease caffeine intake
  • Avoid eating raw/rare meat and fish high in mercury
  • Eat fresh fruits and vegetables
  • Only take medication prescribed by OB
  • Encourage to abstain from alcohol, tobacco, and drugs
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4
Q

Signs and symptoms of threatened abortion (increased risk of miscarriage) pregnancy loss?

A
  • Bleeding/cramping occurs

- Cervix not dilated

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5
Q

Signs and symptoms of complete abortion (complete miscarriage) pregnancy loss

A
  • Products of contraception are completely expelled
  • Pain ceases but spotting may persist
  • Cervical os is closed, some blood on vaginal vault
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6
Q

Signs and symptoms of incomplete abortion?

A
  • Cervix dilated
  • Some portions of products of conception remains in uterus
  • Only mild cramps reported
  • Bleeding is persistent and often excessive
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7
Q

Signs and symptoms of missed abortion?

A
  • Pregnancy ceased to develop but conceptus has not been expelled
  • Symptoms of pregnancy disappear
  • May be brownish vaginal discharge but no active bleeding
  • Pain does not develop
  • Uterus becomes smaller and irregularly softened
  • Adnexa are normal
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8
Q

Treatment of pregnancy loss?

A
  • Stabilize and resuscitate Pt
  • MEDEVAC
  • Gently remove visible products of conception
  • Analgesics
  • Follow up determined by obstetrics
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9
Q

A female with what is assumed to have ectopic pregnancy until proven otherwise with what symptoms?

A
  • Vaginal bleeding
  • Positive hCG
  • Abdominal pain
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10
Q

What are risk factors of ectopic pregnancy?

A
  • Infertility
  • PID
  • Ruptured appendix
  • Prior tubal surgery
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11
Q

What is the most common cause of maternal death during the first trimester?

A

Undiagnosed or undetected ectopic pregnancy

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12
Q

What are signs and symptoms of ectopic pregnancy?

A
  • Severe lower quadrant pain
  • sudden onset, stabbing, intermittent, does not radiate
  • Backache may be present during attacks
  • Adnexal tenderness on exam
  • At least 2/3’s have Hx:
  • abnormal menstruation
  • infertile
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13
Q

Treatment of ectopic pregnancy?

A
  • MEDEVAC to OB
  • Surgical Laparoscopy (unstable/rupture)
  • Methotrexate IM IF stable with early ectopic
  • Complications (shock, anemia)
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14
Q

General considerations for mastitis?

A
  • Staph aureus most common

- Infecting non-lactating breast is rare

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15
Q

Signs and symptoms of mastitis?

A
  • Frequently beings 3 months after delivery
  • Starts with engorged breasts and sore or fissured nipple
  • Cellulitis typically unilateral
  • Fever and chills common
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16
Q

Lab findings mastitis?

A
  • CBC - leukocytosis
17
Q

Imaging mastitis?

A

Breast US

18
Q

Antibiotic treatment for mastitis?

A
  • MSSA:
  • Cephalexin or clindamycin
  • MRSA:
  • Bactrim or clindamycin
  • Regular emptying of breast
  • Pain and inflammation management
19
Q

Follow up for mastitis?

A
  • Follow up within 48 hours

- Refer physician supervisor or gyno for absent improvement within 72 hours

20
Q

General considerations for primary amenorrhea?

A
  • Failure of menarche to appear

- Menarche generally occurs between 11-15 years

21
Q

What is secondary amenorrhea?

A

Absence of menses for 3 months in woman who have passed menarche

22
Q

What is menopause?

A
  • Terminal episode of naturally occurring menses
  • Retrospective Dx
  • Usually after 6 months of amenorrhea
23
Q

What is the most common cause of secondary amenorrhea in premenopausal women?

A

Pregnancy

24
Q

What is the normal age of menopause? Early? Premature?

A
  • Early: <45
  • Premature: <40
  • Normal 48-55
25
Q

Imaging for amenorrhea?

A
  • Transvaginal US

- MRI if pituitary tumor suspected

26
Q

Treatment of amenorrhea?

A

Depends on underlying cause

  • non-estrogen therapy
  • estrogen therapy
27
Q

Complications amenorrhea?

A

Women with premature menopause have:

  • 50% increase risk of coronary disease
  • 23% increase risk of stroke
  • 12% increase of overall mortality
28
Q

General considerations for Ovarian torsion (adnexal torsion)?

A
  • Surgical emergency
  • Ischemic condition
  • generally due to ovarian cyst or mass
29
Q

Risk factors of ovarian torsion?

A
  • Pregnancy
  • Enlarged luteum
  • Presence of large ovarian cysts or tumors
  • Chemical induction of ovulation
  • Tubal ligation
30
Q

What causes ovarian torsion and where does it most frequently happen?

A
  • Ovarian enlargement causes ovary to twist
  • Process may involve ovary alone, but generally involves both ovary and oviduct
  • Most common on right side due to increased ligament length
31
Q

Classic signs and symptoms of ovarian torsion?

A
  • Sudden onset
  • Severe unilateral lower abdominal pain
  • May develop after episodes of exertion or athletics
32
Q

Atypical signs and symptoms of ovarian torsion?

A
  • Half of patients
  • Gradual onset intermittent pain
  • Nausea and vomiting - 70% of cases
33
Q

Physical pain signs and symptoms ovarian torsion?

A
  • Unilateral lower abdominal tenderness with guarding
  • Unilateral adnexal tenderness on bimanual exam
  • Possible palpable adnexal mass
34
Q

Imaging ovarian torsion?

A

Transvaginal US with doppler

35
Q

Treatment ovarian torsion?

A
  • Prompt gynecological surgical procedure
  • Ovarian conservation with cystectomy
  • MEDEVAC

Genitourinary Women (7 decks)

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