Mehl. OBGYN bullet point in general nr 4 Flashcards
Definitive Tx of preeclampsia?
definitive Tx is delivery.
Tx for preeclampsia? drugs
HTN Mx (labetalol, methyldopa, etc.);
Definitive Tx of Eclampsia?
definitive Tx is delivery.
Tx for eclampsia? drugs
Mg for seizures
Tx for HTN emergencies in pregnancy? drug
just know hydralazine can be used for this purpose.
Female at 8 weeks’ gestation + cysts visualized bilaterally on pelvic USS; Dx?
Theca-lutein cysts -> benign finding in pregnancy + will almost always naturally regress -> increased occurrence in high
beta-hCG states like multiple gestation pregnancy, moles, choriocarcinoma.
Complete vs partial mole?
complete mole = karyotype of 46; empty egg fertilized by a sperm that duplicates; bunches of grapes / snowstorm appearance on USS; chance of progression to choriocarcinoma higher than partial;
partial mole = karyotype of 69; fetal parts visible on USS; lesser chance of progression to choriocarcinoma.
Anovulation; mechanism USMLE wants?
insulin resistance -> causes abnormal GnRH pulsation -> high LH/FSH -> LH high enough to precipitate ovulation but follicle not yet adequately primed -> no ovulation (anovulation) -> follicle retained as cyst.
Why hirsutism in anovulation?
higher relative LH -> more androgen production by theca interna cells.
What’s LH do?
Stimulates theca interna cells (females) and Leydig cells (males) to make androgens.
What’s FSH do?
Stimulates granulosa cells (females) and Sertoli cells (males) to make aromatase;
also primes follicles.
Beta-hCG in mole vs ectopic?
super-high in mole; low in ectopic (and slow rate of increase).
32F + presentation similar to stroke + beta-hCG hundreds of thousands; Dx?
choriocarcinoma (brain mets); chorio loves to metastasize to lungs.
postpartum endometriti Tx?
ampicillin + gentamicin + clindamycin.
32F + rupture of membranes (ROM) >18 hours + abdo pain + fever; Dx + Tx?
Chorioamnionitis;
Tx = ampicillin + gentamicin + clindamycin (amp + gent alone seen as answer on one Obgyn shelf Q).
SCC of perineum in diabetic; biggest risk factor in this patient?
answer = HPV, not dysglycemia.
37F + Bartholin gland abscess + Q asks “most serious complication of this condition?”
necrotizing fasciitis; wrong answer = “gram positive sepsis” (polymicrobial; need not be gram +).
Grey/whitish patchy/rough area on the vulva or perineum; Dx + Tx?
lichen sclerosus -> must do punch biopsy first to rule out SCC;
if confirmed LS, do topical steroids;
if SCC, surgically excision
