OB Emergencies Lecture Powerpoint Flashcards
Causes of abnormal uterine bleeding acronyms (PALM, CONIE)
Polyp
Adenomyosis
Leiomyoma
Malignancy and hyperplasia
Coagulopathy Ovulatory dysfunction Not yet classified Iatrogenic Endometrial
Do not do plain films of abdomen for abdominal pain until ruled out….
….pregnancy and labor
Appendicitis in late term pregnancy patient presentation
Right upper quadrant pain
RU486
Mifepristone (the abortion pill)
Placenta previa increases risk with…
….multiparity
Bright red uterine bleeding (sometimes painless) in pregnant patients is….
….placenta previa until proven otherwise
Abruption risk factors (5)
- maternal hypertension
- increasing maternal age and parity
- prior abruption
- cocaine use
- trauma
Abruption presents as…
Sudden onset painful vaginal bleeding, tenderness on palpation
Classic triad of ectopic pregnancy
Amenorrhea
Abdominal pain
Abnormal vaginal bleeding
Most ectopic pregnancies occur on the___ side
right
Strong associations with ectopic pregnancy (risk factors) (4)
- PID
- endometriosis
- previous tubal surgery
- infertility
Diagnosis of ectopic pregnancy
- hCG and US transvaginal
- laparoscope (diagnostic and therapeutic)
Eclampsia signs and symptoms
- hyperreflexia
- sudden spike in BP
- RUQ or epigastric pain
- visual blurring
- shaking
Treatment of eclampsia (2)
- mag sulfate (dose to retain normal reflexia in the patient
- hydralazine
Management of seizures in obstetric patients (4)
- restraints
- airway
- o2 between seizures
- chest x ray
Abnormal vaginal bleeding in permenopausal women should rule out ___, in post menopausal ____
endometrial cancer, atrophic vaginitis
Premenarchal causes of abnormal vaginal bleeding (7)
- menarche
- abuse
- genital trauma
- foreign body
- precocious puberty
- tumor
- imperforate hymen
Rape kit components
12
- scrape under fingernails
- comb pubic hair
- cut off a few patient’s pubic hairs
- collect any other loose hair and dried blood
- take clothes in separate bags
- examine GU area with woods light
- saline wet mount for sperm # and motility
- collect vaginal aspirate or washings
- GC chlamydia culture
- U/A
- blood for VDRL and HIV
- drug screen for date rape and blood alcohol
Acute PID
Ascending infection from GU to pelvis, most often chlamydeal or GC, clinically diagnosed form lower abdominal tenderness, bilateral uterine and adenexal tenderness, cervical motion tenderness, and signs of lower genital tract infection
PID treatmnent options (1)
-doxy + metronidazole + azithromycin or ciprofloxacin
Once membranes are ruptured, need to deliver within the following…
…24 hours
