OB 3 Flashcards
If pt has allergy to penicillin, what do you give for GBS tx?
Cefazolin- (in syphillis, pt with penicillin allergy is tx with doxycycline UNLESS the pt is PREGNANT, in which case you desensitize)
What are the infants of mothers with Graves disease at risk of?
Thyrotoxicosis - TSH receptor antibodies can cross the placenta, leads to baby who is irritable, tachycardic, poor weight gain. sx mgmt with methimazole and BB
Risk factors for lactational mastitis
breast pumping, poor latch, infrequent feedings, nipple excoriations, rapid weaning from breastfeeding
what do early decelerations look like and what do they reflect
uniform, shallow decelerations with gradual onset that occur symmetrically with contractions; benign, caused by fetal head compression, which leads to physiologic vagal response
best way to reduce maternal fetal HIV transmission
maternal ART during pregnancy and neonatal zidovudine
can wernicke encephalopathy be a complication of HG in pregnancy?
yes - can precipitate thiamine deficiency (encephalopathy, oculomotor dysfunction, gait ataxia)
causes of hyperandrogenism in pregnancy
new acne and hair patterns - may be due to mom (ovarian masses) or fetus (placental aromatase deficiency; expectant mgmg as should resolve with delivery)
abdominal and/or back pain, fetal HR abnormalities, variable amount of vaginal bleeding, HTN in pregnancy
abruptio placentae - puts pt at risk of hypovolemic shock and DIC
two painful genital ulcers
HSV and H Ducreyi (chancroid)
granulosa cell ovarian tumor presentation
large ovarian mass, postmenopausal bleeding
dyspareunia, dysmenorrhea, chronic pelvic pain, infertility, dyschezia
endometriosis
endometrioma US appearance
homogenous cystic appearance
evaluation of atypical glandular cells on pap
colposcopy, endocervical curettage, endometrial biopsy
threshold of endometrial thickness that requires endometrial biopsy for evaluation of post-menopausal bleeding
> 4 mm
what female parts are missing in mullerian agenesis
absent uterus, cervix, and upper 1/3 of the vagina (ovaries and external female anatomy are still there)
when can the first trimester screen be done
9-13 weeks
you have an abnormal first trimester screen, what diagnostic tests do you follow-up with?
amniocentesis (second trimester) or chorionic villus sampling (first trimester - 10 to 13 wks)
Which test can be used to diagnose aneuploidy at 15 weeks?
amniocentesis, available > 13 weeks
fetal complications of pre-eclampsia
oligohydraminos, fetal growth restriction due to uteroplacental insufficiency
how is protraction of the active phase of labor qualified?
< 1 cm cervical change in 2 hrs - causes are CPD, inadequate contractions (measure MVU > 200 in 10 minute), maternal obesity, fetal malposition (occiput posterior)
complications of abruptio placentae
DIC and hypovolemic shock
weakened pelvic floor muscles, urethral hypermobility, reduced bladder support
stress urinary incontinence
continuous dribbling of urine and markedly elevated postvoid residual volume (> 150 ml)
bladder outlet obstruction or a neurogenic bladder
what is a normal PVRV?
< 150 ml
how does PCOS lead to infertility?
failure of follicular maturation
role of hCG
secreted by syncytiothrophoblast and responsible from preservation of corpus luteum in early pregnancy
this hormone inhibits uterine contractions and prepares the endometrium for implantation of fertilized ovum
progesterone
this hormone is responsible for induction of prolactin production
estrogen
should women > 35 be offered cfDNA testing to evaluate fetal aneuploidy
yes
polymicrobial infection with fever > 24 hrs pp, purulent lochia, uterine tenderness
pp endometritis; tx with clinda + gentamicin
emesis with full thickness perforation and associated pneumomediastinum
esophageal perforation (boerhaave); mallory weiss would be mucosal tear with hematemesis
erythematous cervix with punctuate lesions (strawberry cervix), frothy green discharge
Trichomonads - microscopy would show motile organisms; treat pt and partner with metronidazole
evaluation of secondary amennorhea
serum prolactin, TSH, FSH, pregnancy test
chlamydia tx
azithromycin or doxycycline
gonorrhea tx
ceftriaxone + azithromycin
meds for pt in labor < 32 weeks
tocolytic (stop contractions) + corticosteroid (fetal lung matuiry) + mag sulfate (fetal neuoprotection)
evaluation of a palpated adnexal mass
US and CA-125
sinusoidal fetal heart tracing
fetal anemia
can obesity disrupt the HPO axis and result in anovulation and abnormal uterine bleeding?
yep
can vulvar lichen sclerosus occur in prepubertal girls with pruritus and thin, white lesions of the vulva and perianal region
yes
