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OB/GYN Clerkship > Medical Disease, Third Trimester Bleeding, Prenatal Infections, Contraception > Flashcards

Medical Disease, Third Trimester Bleeding, Prenatal Infections, Contraception Flashcards

1
Q

Why would a Ua or UCX be done to work up UTI

A

On asymptomatic screen, for frequency/dysuria/urgency, or for UFD with chills, fever, and CVA

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2
Q

What are the possible outcomes of UA and UCX

A

Positive UA, positive symptoms, positive casts
Positive UA, positive symptoms, no casts
Positive UA, no symptoms

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3
Q

What does Positive UA, positive symptoms, positive casts mean? How to work it up?

A

Pyelonephritis. If pregnant, admit and start zosyn.
Rescreen after dose. If pyelo is improved, it’s pyelo. If not improved then there’s an abscess. Diagnose with ultrasound and treat with I+D.

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4
Q

What does Positive UA, positive symptoms, positive casts

Positive UA, positive symptoms, no casts mean? How to work it up?

A

UTI. Treat with nitro, ceftriaxone

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5
Q

What does positive UA, no symptoms mean? How to work it up?

A

Asymptomatic bacteriuria. MUST treat in pregnancy with nitro or ceftriaxone. Then rescreen to make sure negative. If still positive, keep treating.

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6
Q

What drugs should and should not be used to treat chronic hypertension?

A

Use methyldopa, hydralazine, labetalol. DO NOT USE acei, arbs, diuretics.

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7
Q

What does fetal hyperthyroidism cause? Fetal hypothyroidism?

A

Demise

Cretinism

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8
Q

Can RAIU be done in pregnancY?

A

NO

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9
Q

How to treat maternal hyperthyroidism?

A

PTU is safe in pregnancy. Do surgery during second trimester. DO NOT iodine ablate.

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10
Q

How to treat maternal hypothyroidism?

A

Levothyroxine.

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11
Q

How to diagnose/treat lichen sclerosis?

A

Punch biopsy necessary, followed by treatment with steroids if positive

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12
Q

How to treat maternal seizures?

A

Tricky because all anti-seizure medications are teratogens. Best one to use is phenobarbital. The least bad.

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13
Q

How to supplement phenobarbital?

A

Give folate

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14
Q

Placenta previa pathogenesis

A

Placenta implants across the os. As os dilates the placenta tears.

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15
Q

How does patient with placenta previa present?

A

Presents with painless third trimester bleeding with signs of struggling baby.

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16
Q

How to diagnose placenta previa?

A

Ultrasound. Can show baby in transverse lie.

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17
Q

How to treat placenta previa?

A

Do a c/s

18
Q

Risk factors for placenta previa?

A

Multiple gestations, multiparity.

19
Q

Pathogenesis of placental abruption

A

Placenta tears off wall and bleeds (can be concealed too)

20
Q

What types of things cause placental abruption?

A

Hypertension, cocaine use, huge trauma

21
Q

How does a patient with placental abruption present?

A

With painful, sudden onset, heavy vaginal bleeding. Fetal distress

22
Q

How to diagnose placental abruption?

A

With ultrasound showing a tear

23
Q

How to treat placental abruption?

A

C/s

24
Q

Uterine rupture pathogenesis

A

Uterus ruptures with big contraction along c/s scar, or after pitocin use. Baby is birthed into peritoneum

25
Q

How does uterine rupture present?

A

HUGE pain, may or may not bleed. Fetal heart rate abnormalities

26
Q

How to diagnose uterine rupture?

A

No need for diagnosis, move straight to crash section

27
Q

How to treat uterine rupture

A

Crash C-section

28
Q

Vasa previa pathogenesis

A

Accessory lobe across the oss, there are bridging blood vessels. Os dilates and vessels tear.

29
Q

How does vasa previa present?

A

With painless fetal distress and third trimester bleeding.

30
Q

How to treat vasa previa?

A

C section.

31
Q

Pathogenesis of neonatal GBS infection

A

Benign colonization of vagina, exposure during delivery

32
Q

Patient presentation with GBS

A

Found on ASX screen at week 35-38. Or found on normal delivery with fetal crash within 12 hours

33
Q

How to treat GBS

A

Ampicillin. Also give penicillin for asx bacteriuria, gbs+ status, prolonged ROM, or third trimester delivery with GBS.

34
Q

How does baby get hepatitis B

A

Vertical transmission, can become chronic carrier

35
Q

How to treat to make sure baby doesn’t get hep B

A

C/section with hep B IVIG and hep B vaccine

36
Q

How does maternal HSV infection affect baby?

A

Primary viremia definitely affects baby, secondary reactivation affects baby only if exposed during delivery

37
Q

How to treat secondary reactivation of HSV in pregnancy?

A

Treat with acyclovir and c/s baby

38
Q

How to prevent maternal chickenpox infection

A

Vaccinate before pregnancy or if pregnant already, isolate mom from children.

39
Q

How does baby with neonatal chicken pox present?

A

Zig zag lesions with small eyes and small extremities.

40
Q

Which method of contraception has highest risk of DVT/PE

A

Orthoevra patch, risk increases with increased age and smoking

41
Q

Can you do ECV in active labor?

A

No.

OB/GYN Clerkship (9 decks)

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