OB Flashcards
At what week breech presentation will self-correct?
37th week of gestation
When should external cephalic version be attempted?
After the 37th week without any contraindications; if unsuccessful, consider C-section
What is the cutoff for distinguishing gestational HTN vs chronic HTN
20 weeks
What are the signs of preeclampsia?
elevated BP after 20 weeks AND proteinuria or signs of end-organ damage
What are signs of eclampsia?
preeclampsia AND grand mal seizures
What are signs of chronic HTN with superimposed preeclampsia?
Chronic HTN AND 1 of the following: proteinuria or worsening of existing proteinuria after 20 weeks, sudden worsening of HTN, or signs of end-organ damage
Pregnant patient of 38 weeks comes in with HTN, 340 mg of protein, and facial edema. What is the next step of management?
Induce labor with IV oxytocin
True or False: ACE-I or diuretics are the best drug to control BP during pregnancy
False: ACEIs are known to lead to uterine ischemia and diuretics can aggravate low plasma volume to the point of uterine ischemia
What is HELLP?
hemolysis, elevated LFTs, and low platelets
What hormone causes uterine involution during the postpartum period and help with the expulsion of milk from lactiferous glands
oxytocin
What role does hPL play during pregnancy
it has an insulin antagonist effect and provides nutrition of fetus by causing maternal lipolysis and insulin resistance thus increasing delivery of fatty acids and glucose to fetus
What’s the next management for 12 week pregnant woman with urine culture of 100,000 CFUs of E coli
Amoxicillin or Nitrofurantoin x 3-7 days
*disclaimer: no fluoroquinolones becuz of potential association with bone deformities and arthropathy in unborn fetus
What are some contraindications for treating UTIs in pregnancy?
- fluoroquin’s (bone deformities)
- tetracycline (fetal bone and tooth deform; gray discoloration of teeth)
- TMX-SMX (1st trimester with folic acid metabolism; 3rd with kernicterus in newborn)
This type of tumor can present in a perimens. woman with intermittent blood staining her bra.
Intraductal papilloma
This is the worse malignant breast cancer to have and it’s firm, fibrous, and rock hard with stellate morphology
Invasive ductal
This is the most common cause of postpartum hemorrhage within 24 hours of delivery
uterine atony
This type of illness has profuse frothy vaginal discharge with vaginal erythema, showing flagellates under wet mount. This is used to treat it.
Trichomonas; metronidazole for patient and partner
This is used to treat a patient with thick cottage cheese discharge and vaginal inflammation
fluconazole
This represents the initial workup for an adnexal mass.
CA125 and Transvag US
These are features that would cause suspicion for malignant adnexal mass
elevated CA125, greater than 10 cm in size, nodular or fixed pelvic mass, ascites, metastasis
These are the indications for GBS prophylaxis when GBS is unknown
Delivery less than 37 w (preterm premature ROM), duration of memb ruture greater than 18 hr, GBS bacteruria, prior hx of infant with GBS sepsis
These are the painless vaginal bleeds during pregnancy
Placenta previa and vasa previa
A pregnant lady who has painless bleeding with rapid fetal deterioration and preceded by ROM should be dx then tx this way.
transvag Doppler; cesarean delivery
This test is used to differentiate maternal and fetal blood during vag bleed
Apt test or Kleihauer-Betke test (for vasa previa)
This has painless bleeding but not rapid deterioration to fetus.
Placenta previa
This is used for infertility and PCOS by being a partial agonist at estrogen receptors in hypothalamus, thus prevent negative feedback and increase LH and FSH
clomiphene
A patient who has anovulation and galactorrhea has an increase of this.
prolactin
This should not be taken while taking metronidazole.
alcohol
This is the week range where you check for quad screen.
15-22 w
This is the week range where you do a gestational DM screen
24-28 w
