ob and gyn Flashcards
* master the art of answering questions
what is urge incontinence
It refers to the leakage of urine caused by involuntary bladder contraction
what is the first line management of urge incontinence
behavioral therapy:
pelvic floor exercises
bladder training (frequent voiding q1-2hrs while awake)
the most frequently prescribed medication for urge incontinence is ……
anticholinergic drugs with antimuscarinic effects e.g. oxybutyrin
surgery is an effective treament for urge incontinence. True/False
False
other than abstinence, what is the best method to prevent sexually transmitted disease (STD)
proper use of condom
depo-medroxyprogesterone acetate shot is associated with prolonged and/or irregular vaginal bleeding. T/F
True
what is recommended for a patient who is interested in intrauterine device (IUD) who recently got treated for STD
the patient should wait 3 months before an IUD use
what is fetal scalp sampling (FSS)?
FSS is a method of fetal assessment used in labor and delivery to obtain fetal blood for pH assessment which will help with the management of labor if fetal heart rate tracing isn’t reassuring
what is the management of the fetus with pH >7.25 upon FSS
manage expectantly
what is the management of the fetus with pH7.20-7.25 upon FSS
FSS should be repeated in 15 to 30mins
what is the management of fetus with pH<7.20
delivery is indicated
most commonly used prenatal vitamins contain………IU or …..
5000 IU or less
why is Vitamin A contraindicated during pregnancy?
there is increased risk of neural crest malformation with use
severe variable FHR decelerations are due to ……………………..
umbilical cord compression
Prolonged, severe variable decelerations may result in fetal …………
acidemia
define placenta previa
It is defined as a placenta located over the cervical os
what are the three major types of placenta previa?
- central or total or complete placenta previa
- partial
- marginal or low-lying placenta
what are the three major risk factors of placental previa
maternal age, minority race and previous cesarean delivery
what complication of placenta previa increases in those with repeated cesarean deliveries and h/o placenta previa?
placenta accreta
what is the most likely management of a patient with a previa and accreta at the time of delivery?
hysterectomy
how is hyperthyroidism diagnosed in pregnant women?
it is made when serum results show TSH < 0.1 mU/L and high free T4
for pregnant women with moderate to severe symptoms of hyperthyroidism, what is the drug of choice?
propylthiouracil or methimazole
what is the most common physical symptom of premenstrual dysphoric disorder?
abdominal bloating
what is the treatment of group B streptcoccus in a pregnant woman?
penicillin G
what is the treatment of chlamydia in pregnancy?
a single dose of azithromycin
how do one ensure that the infection of chlamydia is cleared?
treatment of all sexual partners and test of cure 4-6 weeks after treatment
define fetal demise?
fetal demise is defined as death of a fetus after 20 weeks’ gestation and prior to delivery
the ACOG recommends treatment of persistent chronic hypertension when the blood pressure is
persistently >=160mmHg systolic or >=105mmHg diastolic
The NIH and AHA recommend keeping blood pressures below
150/100mmHg
pregnant women who have uncomplicated mild hypertension are at risk for ……………, ………………, ………………, …………………
intrauterine growth restriction, placental abruption, preterm delivery and superimposed preeclampsia
a breast feeding mother presents with a hard, red, tender, swollen area of one breast, fever and chills. what do you suspect?
mastitis
mastitis is most commonly caused by ………………
staphylococcus aureus
what is the treatment of mastitis?
beta-lactamase-resistant drug like dicloxacillin or erythromycin if patient is allergic to penicillin and continue breastfeeding
what is the criteria for the diagnosis of preeclammpsia?
blood pressure > 140/90mmHg after 20 weeks’ gestation with proteinuria >300 mg/24 h or >1+ on urine dipstick
what is the management of mild preeclampsia?
expectantly management
what are the aims of fetal heart monitoring?
to evaluate fetal response to blood volume changes, acidemia and hypoxemia
a fetal heart monitoring shows the baseline to be in the 140s with gradual decrease (15/min) in heart rate that coincide with uterine contraction indicates ……………
early deceleration
what is the most common cause of late deceleration?
uteroplacental innsufficiency
a fetal heart monitoring shows the baseline to be in the 140s with gradual decrease (15/min) in heart rate with onset after a contraction has occured indiates …………
late deceleration
what is the most likely cause of early decleration?
fetal head compression
what is the most likely cause of variable deceleration
umbilical cord compression
what are the circumstances in which pap can be repeated in 6 months?
- previous abnormal pap without interval normal screening
- previous glandular abnormality
- insufficient previous screening
- inability to visualize/sample the endocervical canal
- positive high-risk HPV testing in the last 12 months
when should pap smear begin and how often should it be done?
begin at 21yrs, done q3y
one of the most important risk factors for developing uncomplicated UTI in postmenopausal women who are not taking hormone replacement therapy is …………..
hypoestrogenemia
how can uncomplicated UTI be prevented in a postmenopausal woman
estrogen administration
what is the treatment of endometrial cancer
surgical staging
for those with endometrial cancer who are not surgical candidates, what is the management?
radiation therapy
an infertility workup for a couple should start with ……………
semen analysis
normal semen findings include
- pH 7.2-7.8
- volume >1.5mL
- sperm density >15million/mL
- total motility >40%
- morphology >4% normal forms
what should be done after a single abnormal semen analysis
there should be a repeat semen analysis 4-6 weeks after the first one
how many semen analyses are required before male factor fertility can be diagnosed?
two
what is the rate of vertical HIV transmission during pregnancy in a patient on no antiretroviral therapy?
25%
what is the rate of vertical HIV transmission during pregnancy in a patient on antiretroviral therapy
8%
what is the rate of vertical HIV transmission during pregnancy in a patient on antiretroviral therapy and scheduled C. delivery at 38weeks
2% or less
what is the rate of vertical HIV transmission during pregnancy in a patient on antiretroviral therapy and vaginal delivery with viral load <1000copies?
2% or less
What are the malformations seen in congenital rubella syndrome?
Microcephaly, intellectual disability, cataracts, deafness, congenital heart disease
What is the vaccine risk for a pregnant woman given MMR?
Low risk
What can be given to help prevent aspiration pneumonitis?
Antacid
What is a major cause of anesthesia-related death in obstetrics?
Aspiration pneumonitis
Why are pregnant patients at greater risk of aspiration?
This is because of delayed gastric emptying that occurs with pregnancy and labor
What are the criteria needed for the diagnosis of polycystic ovary syndrome?
- oligomenorrhea/amenorrhea
- clinical or biochemical hyperandrogenism
- polycystic ovaries
bone mineral density T-score ……… is diagnostic of osteoporosis
-2.5
Abdominal pain, amenorrhea and vaginal bleeding are classic symptoms of ………
Ectopic pregnancy
How is ectopic pregnancy evaluated?
- Transvaginal ultrasound examination
- Quantitative human chorionic gonadotropin (hCG) level
Between 18-34 weeks, intrauterine growth restriction (IUGR) should be suspected when the fundal height is …………………..
> 3cm below the gestational age in weeks
…………… is defined as an estimated fetal weight of <10th percentile confirmed by ………..
Intrauterine growth restriction
Obstetrical ultrasound
Clinical diagnosis of PID requires the presence of the following signs and symptoms:
- …………………..
- …………………..
- ……………………
- cervical tenderness
- adnexal tenderness
- abdominal pain and tenderness
Ovarian torsion is a surgical emergency. True or false
True
prophylactic cerclage is placed in the _____ and removed at _________ when _____
early second trimester
36-38 weeks gestation when the fetal lungs is fully matured
What is the test of choice to confirm tubo-ovarian abscess?
Transvaginal ultrasound
What is the treatment of tubo-ovarian abscess?
Intravenous antibiotics :
Clindamycin and gentamicin in penicillin allergic patients
Cefoxitin and doxycycline
the diagnosis of preeclampsia is confirmed by a _____________ or ___________________
urine protein/creatinine ratio >/0.3 or 24-hour urine collection showing
