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Step 2 flashcards > More Ob/gyn 2 > Flashcards

More Ob/gyn 2 Flashcards

1
Q

Hypothyroidism can cause…

A

Amenorrhea
Menorrhagia
Hyperprolactinemia
spontaneous abortion

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2
Q

CI to raloxifene use for osteoporosis

A

Hx of DVT

can also cause hot flashes to get worse

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3
Q

Abx CI in pregnancy

A

Fluoroquinolones (cipro)
Tetracyclines (doxy)
Bactrim (TMP-SMX)

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4
Q

–> asymmetric IUGR

A 
Maternal HTN
preeclampsia
smoking
maternal APLS
collagen vascular disorder
uterine anomalies
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5
Q

–> symmetric IUGR

A

chromosomal anomalies
congenital anomalies
congenital infxns (TORCH)

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6
Q

PEC dx

A

> 20 weeks
140/90
0.3 gm (300 mg) protein/24 hour

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7
Q

Side effect of indomethacin as tocolytic

A
  • closure of ductus arteriosus
  • fetal bradycardia
  • Oligohydramnios*
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8
Q

surgical treatment of early endometrial cancer

A

total abdominal hysterectomy + BSO
pelvic and para-aortic lymphadenectomy
pelvic washings

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9
Q

Risk factors for PMS

A

family hx

deficiency of b6, calcium, magnesium

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10
Q

4th degree laceration

A

rectal sphincter
rectal mucosa*
internal/external anal sphincter

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11
Q

3rd degree laceration

A

rectal partial or complete sphincter tear

no mucosal involvement

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12
Q

2nd degree laceration

A

vaginal fascia

perineum

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13
Q

1st degree laceration

A

vaginal mucosa

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14
Q

protein requirements in pregnancy

A

70 g/day

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15
Q

assoc with retained placenta:

A

prior c-section
uterine fibroids
prior uterine curettage
succenturiate lobe of placenta

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16
Q

discover that baby has IUGR? then…

A

2x weekly: NST
1x weekly: AFI
1x weekly: BPP
1x/2 week: US (more frequent? not helpful)

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17
Q

baby found to be breech

A

most self-correct by 37 weeks

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18
Q

baby born to HIV mother. treat with__ for___

A

Zidovudine, for 6 weeks after birth

  • vaginal delivery: AZT during and after
  • c-section: AZT after
  • can start to check for HIV 24 hrs after delivery
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19
Q

Arrest of dilation (active phase - 1st stage)

A

no cervical dilation >2 hours for nulliparous/multiparous

add an extra hour for an epidural

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20
Q

Arrest of descent (Stage 2)

A

no descent after >2 hrs of pushing in primigravid
>1 hr of pushing for multigravid
(add an extra hr for epidural)

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21
Q

In pregnancy, CO increases by ___

A

33%

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22
Q

What stage of labor can you AROM?

A

active phase

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23
Q

Mag use in PEC delivery

A

Mag during delivery and for 24 hours PP

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24
Q

Smoking puts mom at risk for:

A 
placental abruption
placenta previa
fetal growth restriction
preeclampsia
infection
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25
Q

CI for terbutaline

A

diabetes

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26
Q

Causes of cervicitis (–> post-coital bleeding)

A

gonorrhea
chlamydia
trichomonas
HSV2

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27
Q

Mucopurulent cervical discharge

A

chlamydia >gonorrhea

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28
Q

gram-negative intracellular diplococci

A

gonorrhea

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29
Q

fetal complications from pregestational diabetes

A 
organ defects (cardiac, renal, NTD)
IUGR or macrosomia
Hypocalcemia
polycythemia
hypoglycemia
hyperbilirubinemia
RDS
birth injury
30
Q

Hydrops fetalis

A

fetal hgb <7

31
Q

signs of molar pregnancy

A 
1st trimester uterine bleeding
hyperemesis gravidarum
preeclampsia <24 weeks
uterine size greater than dates
(RF: extremes of age, diet low in folate or beta-carotene)
32
Q

what to do w shoulder dystocia

A 
HELPER
Help reposition
Episiotomy
Leg elevation (McRoberts)
Pressure (suprapubic)
Enter the vagina and attempt rotation (Wood's screw)
Reach for fetal arm
33
Q

Prolonged ROM

A

> 18 hours prior to delivery

34
Q

Fever postpartum

A 
Womb (endomyometritis)
Wind (pna, atelectasis)
Water (UTI)
Walk (DVT, PE)
Wound (incision, episiotomy)
Weaning (breast engorgement, abscess, mastitis)
Wonder drugs (drug fever)
35
Q

Paroxetine (Paxil)

A

contraindicated in pregnancy

–> fetal cardiac malformation, persistent pulm HTN

36
Q

Apt test

A

distinguishes maternal blood vs. fetal

e.g. use to dx vasa previa

37
Q

before doing epidural…

A

must confirm Fetal Heart rate

-baby moving a lot? do an fetal scalp electrode

38
Q

Apgars

A 
heart rate: 2
respiratory rate: 2
activity: 2
reflexes: 2
color: 1
(total of 9)
39
Q

CI to expectant management of severe PEC <32 weeks

A

thrombocytopenia (2x upper limit of normal (liver damage)
unrelenting CNS sxs
non-reassuring fetal signs
inability to control bp w 2 meds

40
Q

feto-maternal hemorrhage after vaginal delivery

A

<0.1cc

41
Q

HTN
APLS
factor 5 leiden

A

–> IUGR + OLIGO

42
Q

Fresh frozen plasma

A

fibrinogen, factors 5 and 8

43
Q

RF for uterine inversion (things that stretch it out!)

A

polyhydramnios
macrosomia
multiple gestations
multiparity (girl you got a loose uterus!)

44
Q

RF for uterine atony

A

chorioamnionitis
oxytocin use in labor
prolonged labor (the muscle is tired!)
and things that stretch it out

45
Q

Post-term pregnancy assoc w

A

placental sulfatase deficiency*
anencephaly*
inaccurate dates
fetal adrenal hypoplasia*

46
Q

complications of post-term pregnancy

A 
meconium aspiration
macrosomia
oligohydramnios***
dysmaturity (baby looks old!)
uteroplacental insufficiency
47
Q

fetal growth restriction, screws you in adulthood:

A

diabetes
COPD
HTN
cardiovascular disease

48
Q

who should not use progestin-only pills?

A

those who are depressed!!

they should avoid depot provera too!

49
Q

“recurrent pregnancy loss”

A

> 2 consecutive losses (stillbirth)

>3 spontaneous losses before 20 wks gestation

50
Q

D&C vs D&E

A

D&C: <16 weeks

51
Q

Medical abortion vs surgical

A

more blood less, less effective

52
Q

Lichen planus

A

involves: oral membranes, vulva, hair-bearing skin
-vaginal obliteration
lacy, reticulated pattern of labia and perineum
alopecia, oral ulcers, extragenital rashes

53
Q

LSIL on colpo–>

A

repeat pap in 6 and 12 months

OR do HPV testing at 12 months

54
Q

Indications for CKC

A 
positive endocervical curettage
lesion extends into the canal
HSIL on pap, benign on colpo
HSIL too large for LEEP
to rule out invasive cancer
55
Q

Pseudophedrine for SUI

A

has alpha-adrenergic properties

may improve urethral tone

56
Q

Danazol

A

for endometriosis!
prevents ovulation
suppresses mid-cycle LH and FSH surge**
ADE: masculinization

57
Q

greatest risk factors for breast cancer

A

age

gender

58
Q

Things that incr prolactin levels

A

prolactin tumor
hypothyroidism
chest lesions (breast implants, thoractomy scars, herpes zoster)**
renal failure
Imipramine (TCA - the one you use for child bedwetting)

59
Q

See bloody nipple discharge, do –>

A

ductogram

60
Q

increases fibrocystic breast changes pain

A

caffeine

61
Q

Breast mammography guidelines

A

40 yrs+: yearly clinical breast exam, 50 yrs+: annual mammogram

35+ w pos Fhx: annual mammogram

62
Q

Most significant impact on pts breast cancer prognosis?

A

Lymph node status

hormone receptor status plays some role, but not as significantly as the lymph node condition

63
Q

Most common cause of unilateral serosanguineous nipple discharge

A

intraductal papilloma

64
Q

Most common histological type of breast cancer

A

Infiltrating ductal carcinoma

65
Q

Risks of forceps delivery

A
  • Mom: perineal trauma, hematoma, pelvic floor injury

- Baby: brain and spine injury, musculoskeletal injury, corneal abration

66
Q

Risks of vaccum extraction

A

-Baby: intracranial hemorrhage, scalp lacerations (if torsion is excessive), cephalohematoma

67
Q

Non-maleficence

A

duty to protect the patient from harm

68
Q

Beneficiance

A

duty to act for the benefit of others

69
Q

Deliver at 34 weeks…

A

severe preeclampsia
placenta previa
PPROM
HELLP

70
Q

Deliver at 37 weeks…

A

preelampsia
chronic HTN
intrahepatic cholestasis of pregnancy
IUGR

Step 2 flashcards (7 decks)

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