OB Emergencies Lecture Powerpoint COPY

Question 1

Causes of abnormal uterine bleeding acronyms (PALM, CONIE)

Answer 1

Polyp
Adenomyosis
Leiomyoma
Malignancy and hyperplasia

Coagulopathy
Ovulatory dysfunction
Not yet classified
Iatrogenic
Endometrial

Question 2

Do not do plain films of abdomen for abdominal pain until ruled out….

Answer 2

….pregnancy and labor

Question 3

Appendicitis in late term pregnancy patient presentation

Answer 3

Right upper quadrant pain

Question 4

RU486

Answer 4

Mifepristone (the abortion pill)

Question 5

Placenta previa increases risk with…

Answer 5

….multiparity

Question 6

Bright red uterine bleeding (sometimes painless) in pregnant patients is….

Answer 6

….placenta previa until proven otherwise

Question 7

Abruption risk factors (5)

Answer 7

• maternal hypertension
• increasing maternal age and parity
• prior abruption
• cocaine use
• trauma

Question 8

Abruption presents as…

Answer 8

Sudden onset painful vaginal bleeding, tenderness on palpation

Question 9

Classic triad of ectopic pregnancy

Answer 9

Amenorrhea
Abdominal pain
Abnormal vaginal bleeding

Question 10

Most ectopic pregnancies occur on the___ side

Answer 10

right

Question 11

Strong associations with ectopic pregnancy (risk factors) (4)

Answer 11

• PID
• endometriosis
• previous tubal surgery
• infertility

Question 12

Diagnosis of ectopic pregnancy

Answer 12

• hCG and US transvaginal

- laparoscope (diagnostic and therapeutic)

Question 13

Eclampsia signs and symptoms

Answer 13

• hyperreflexia
• sudden spike in BP
• RUQ or epigastric pain
• visual blurring
• shaking

Question 14

Treatment of eclampsia (2)

Answer 14

• mag sulfate (dose to retain normal reflexia in the patient

- hydralazine

Question 15

Management of seizures in obstetric patients (4)

Answer 15

• restraints
• airway
• o2 between seizures
• chest x ray

Question 16

Abnormal vaginal bleeding in permenopausal women should rule out ___, in post menopausal ____

Answer 16

endometrial cancer, atrophic vaginitis

Question 17

Premenarchal causes of abnormal vaginal bleeding (7)

Answer 17

• menarche
• abuse
• genital trauma
• foreign body
• precocious puberty
• tumor
• imperforate hymen

Question 18

Rape kit components

12

Answer 18

• 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

Question 19

Acute PID

Answer 19

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

Question 20

PID treatmnent options (1)

Answer 20

-doxy + metronidazole + azithromycin or ciprofloxacin

Question 21

Once membranes are ruptured, need to deliver within the following…

Answer 21

…24 hours