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Wolfpacc Clues > Ob/Gyn > Flashcards

Ob/Gyn Flashcards

1
Q

Why do pregnant women get Anemia?

A

Due to the dilution effect: RBC rises 30%, but body volume rises 50%

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2
Q

What is Meconium?

A

Green baby poop (first poop)

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3
Q

What are Identical Twins?

A

Eggs split into perfect halves “Monochorionic”

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4
Q

What are Fraternal Twins?

A

Multiple eggs fertilized by different sperm

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5
Q

What is Ovarian Hyperstimulation syndrome?

A

Weight gain and enlarged ovaries after clomiphene use for infertility

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6
Q

Who Makes the Trophoblast?

A

Baby

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7
Q

Who makes the Cytotrophoblast?

A

Mom production of GnRH, CRH, TRH, and Inhibin

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8
Q

Who makes the Syncytiotrophoblast?

A

Mom and baby production of HCG and HPL

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9
Q

When does Implantation occur?

A

1 week after fertilization

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10
Q

When is Beta HCG found in Urine?

A

2 weeks after fertilization

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11
Q

When is B-HCG found in Blood?

A

8-10 days after fertilization

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12
Q

What makes Progesterone in >10 weeks gestation?

A

Placenta

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13
Q

What is the function of B-HCG?

A

Maintains Corpus Luteum, sensitizes TSH receptors to make body hyperthyroid (to raise BMR)

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14
Q

What makes B-HCG?

A

Placenta (synctiotrophoblast)

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15
Q

How fast should B-HCG rise?

A

Shoulde double every 2 days until 10 weeks, stops when placenta is fully formed

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16
Q

What is the function of AFP?

A

Regulates intravascular volume

Made in the liver of fetus

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17
Q

What is the function of HPL?

A

Blocks insulin receptors so the sugar stays high, (baby is stocking up - hibernating)

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18
Q

What is the function of Inhibin?

A

Inhibits FSH so there is no menstruation

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19
Q

What is the function of Cortisol in Pregnancy?

A

Decreases immune rejection of the baby out of mom and for lung maturation

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20
Q

What is the function Oxytocin?

A

Milk and baby ejection

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21
Q

What is the thyroid hormone levels during Pregnancy?

A

Increased TBG - leads to increased total T4 (Bound and free)

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22
Q

When can you first detect fetal heart tones?

A

Week 20

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23
Q

When can you tell the sex of the baby by US?

A

Week 16

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24
Q

What does an AFI <5 indicate?

A

Oligohydramnios (Cord compression)

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25
Q

What does an AFI >20 indicate?

A

Polyhydramnios (DM)

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26
Q

How fast should fundal height change?

A

Uterus grows 1 cm/week

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27
Q

What is the risk of Chorionic Villus Sampling?

A

Fetal limb defects. (Done at 9-12 weeks)

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28
Q

What is the risk of Amniocentesis?

A

Abortion (2% risk)

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29
Q

How much weight should a woman gain during Pregnancy?

A

1 lb/ week

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30
Q

When should Intercourse be avoided during Pregnancy?

A

Cervical dilation, placenta previa, premature labor, vaginal bleeding, ruptured membranes, genital herpes

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31
Q

What are Braxton-Hicks Contractions?

A

Irregular contractions with closed cervix. (preparing for birth)

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32
Q

What is Shoulder Dystocia?

A

Head is out of vagina, shoulder is stuck. (Occurs in late term deliveries and DM in mom)

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33
Q

What are the symptoms of Pre-eclampsia?

A

Headaches, changes in vision, and epigastric pain

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34
Q

What is Pre-Eclampsia?

A

Ischemia to the placenta causes HTN greater than 140/90

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35
Q

What is the Treatment for Pre-Eclampsia?

A

Delivery, MgSO4 (seizures), Hydralazine (BP)

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36
Q

What is HELLP Syndrome?

A

Hepatic injury causing:
H- Hemolysis
EL- Elevated Liver Enzyme
LP- Low Platelets

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37
Q

What is Eclampsia?

A

HTN with seizures

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38
Q

What is the Treatment for Eclampsia?

A

4mg MgSO4 IV (Seizure prophylaxis)

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39
Q

What is Chorioamnionitis?

A

Fever, uterine tenderness, decreased fetal HR

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40
Q

What are the symptoms of Amniotic Fluid Emboli?

A

Mom just delivered Baby and mom has SOB, due to PE, leads to death

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41
Q

What is Endometritis?

A

Postpartum uterine tenderness

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42
Q

What is an Incomplete Molar Pregnancy?

A

2 Sperm + 1 egg (69, XXY) mom “cooks the parts” has embryo parts

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43
Q

What is a complete molar pregnancy?

A

2 Sperm and no egg (46, XX) both are paternal, bunch of grapes, dad eats grapes, no embryo
(GROSS!)

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44
Q

What is the most common cause of first trimester maternal death?

A

Ectopic pregnancy

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45
Q

What is the most common cause of first trimester spontaneous abortions?

A

Chromosomal abnormalities

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46
Q

What are the most common causes of third trimester spontaneous abortions?

A

Anti-Cardiolipin Ab, placenta probelms, infection, incompetent cervix

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47
Q

What is Placenta Previa?

A

The placenta is implanted wholly or partially in lower uterine segment

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48
Q

What is Vasa Previa?

A

Babies blood over OS

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49
Q

What is Placenta Accreta?

A

Placenta is attached to the endometrium

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50
Q

What is Placenta Percreta?

A

Placenta perforates through serosa

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51
Q

What is Placenta Abruptio?

A

Severe pain due to premature separation of the placenta from myometrium

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52
Q

What is Velamentous Cord Insertion?

A

Fetal vessels insert between chorion and amnion

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53
Q

What is Uterus Rupture?

A

Tearing sensation, halt of delivery

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54
Q

What is Materninty Blues?

A

Postpartum crying and irritability

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55
Q

What is Postpartum Depression?

A

Depression post-delivery for more than 2 weeks

56
Q

What is Postpartum Psychosis

A

Hallucinations, suicidal/infaticidal thoughts

57
Q

What does Seminal Vesicle give to Sperm?

A

Food (Fructose) and clothes (semen)

58
Q

What does the Bulbourethral/ Cowper’s Glands secrete?

A

Bicarb to neutralize lactobacilli, if sperm is too acidic. (Infertility until corrected)

59
Q

What does the Prostate Secrete?

A

The prostate HAZ it.
H- Hyaluronidase
A- Acid Phosphatase
Z- Zinc

60
Q

Where does Testosterone come from?

A

Adrenal gland and testicles

61
Q

Where does DHT come from?

A

Testicles at puberty

62
Q

What is Hirsutism?

A

Hairy female (Excess growth in normal male areas)

63
Q

What is Virilization?

A

Female that is Man like

64
Q

What is Testicular Feminization (Androgen Insensitivity Syndrome)?

A

Males with defective / bad DHT receptor, they are XY with a blind pouch vagina

65
Q

What is McCune-Albright?

A

Precocious sexual development, polyostotic fibrous dysplasia “whorls of connective tissue”, “coast of Maine” pigemented skin macules

66
Q

What is Cryptorchidism?

A

Testes never descended out of abdomen, sterility after 15 months, predisposed to seminomas and CA

67
Q

Which stage of the Menstrual Cycle has the highest Estrogen levels?

A

Follicular stage (Has proliferative endothelium)

68
Q

What stage of the menstrual cycle has the highest Temperature?

A

Ovulatory stage, body temp will rise One degree during ovulation

69
Q

What stage of the Menstrual Cycle has the highest level of Progesterone?

A

Luteal stage (Has secretory endothelium)

70
Q

What form of Estrogen is highest at Menopause?

A

E1: Estrone (Made by Fat)
E2: Estradiol (Made by the ovaries)
E3: Estriol (Made by the placenta)

71
Q

What states have increased Estrogen?

A

Pregnancy, liver failure, P-450 inhibition, and obesity

72
Q

What is Adenomyosis?

A

Growth of the stroma & endometrial glands within Myometrium
Uniformly enlarged “boggy” uterus with cystic areas
Regular, heavy menstrual bleeding

73
Q

What does DES taken by Mom cause in her Daughter?

A

Adenomyosis, menorrhagia, clear cell CA of the vagina, recurrent abortions

74
Q

What is Kallmann’s Syndrome?

A

No GnRH and Anosmia. (They can’t smell)

75
Q

What is Polycystic Ovarian Syndrome?

A

Increased cysts
No ovulation due to no progesterone??
In granulosa cells, androgens converted to estrogen by aromatase
Increased ovarian estrogen inhibits LH, FSH, and ovulation
s/s obese, hairy, acne
increased risk for endometrial CA

76
Q

What is Savage’s Syndrome?

A

Ovarian resistance to LH/FSH

77
Q

What is Turner’s Syndrome (XO)?

A

High FSH, LOW E2, Ovarian Dysgenesis, Webbed Neck, Coarctation of the Aorta, Cystic Hydroma, bicuspid Aortic valve

78
Q

What does the Progesterone Challenge Test tell you?

A

Vaginal bleeding if she has estrogen. If she does not bleed, she has no E2 or ovaries
Increased FSH: Ovary problem
Decreased FSH: Pituitary problem

79
Q

What is Sheehan Syndrome?

A

Postpartum hemorrhage in pituitary, no LH or FSH = no periods, hyperplasia infarcts, no prolactin = no milk

80
Q

What is Asherman’s Syndrome?

A

Uterine scars from multiple D&Cs

81
Q

What is Oligomenorrhea?

A

Too few periods

82
Q

What is Polymenorrhea?

A

Too many periods

83
Q

What is the most common cause of post-coital Vaginal Bleeding?

A

Cervical CA

84
Q

What is the most common cause of post-coital Vaginal Bleeding in Pregnant women?

A

Placenta previa

85
Q

What is the most common cause of Vaginal Bleeding in Post-menopausal women?

A

Endometrial CA

86
Q

What is Chronic Pelvic Pain?

A

Endometriosis until proven otherwise

87
Q

What is Dysfunctional Uterine Bleeding?

A

Diagnosis of exclusion, usually due to anovulation

88
Q

What is Dysmenorrhea?

A

PGF causes painful menstrual cramps

teenagers miss school

89
Q

What is Endometriosis?

A

Painful cyclical heavy menstrual bleeding

“Powder burns and chocolate cysts” due to ectopic endometrial tissue. (Endometrial Tissue outside of uterus)

90
Q

What is Menorrhagia?

A

Heavy menstrual bleeding

91
Q

What are Fibroids (Leiomyoma’s)?

A

Benign uterus smooth muscle tumor
submucosal type: bleeding, reproductive difficulty
subserosal type: pain, uterine irregularity, obstructive sx, bulk-related sx

92
Q

What is Metorrhagia

A

Bleeding or spotting in btwn periods

93
Q

What is Herpes?

A

ds DNA virus

94
Q

What is HPV?

A

ds DNA virus, vaccine out not covers 8-27 year old female to block HPV 6, 11, 18 STD

95
Q

What is Chlamydia?

A

Obligate intracellular bacteria. Can present asymptomatic or PID Cervicitis (yellow pus) -> salpingitis -> tubal scarring
Conjunctivitis

96
Q

What causes Gonorrhea?

A

Gram-negative Diplococcus, presents with mucopurulent discharge. Can be present with Palmer Pustule, arthritis/joint pain, urethral discomfort

97
Q

What causes Chancroid?

A

Haemophilus Ducreyi

98
Q

What causes Granuloma Inguinale?

A

Klebsiella Granulomatis

99
Q

What is Epididymitis?

A

Chlamydia Trachomatis.

Unilateral scrotal pain decreased by support

100
Q

What is the most common cause of Epididymitis?

A

Chlamydia Trachomatis, N. Gonorrhea, E. Coli

101
Q

What is Condylomata Lata?

A

Flat fleshy warts, ulcerate = secondary syphilis

102
Q

What is Condyloma Acuminata?

A

Verrucous “cauliflower” warts, koilocytes, due to HPV 6 and 11

103
Q

How does Herpes present?

A

Primary: Painful grouped vesicles on red base
Secondary: Painful solitary lesion

104
Q

How does Syphilis present?

A

Primary: Painless Chancre (1-6 weeks)
Secondary: Rash and Condyloma Lata (After 6 weeks)
Tertiary: Neurological and Cardiac issues, in Bone (after 6 years)

105
Q

How does Chancroid present?

A

Painful with necrotic center, due to Haemophilus Ducreyi (Gram Negative rod)
“School of Fish” pattern

106
Q

How does Lymphogranuloma Venereum present?

A

Painless Ulcers, Abscessed Nodes, Genital, and Elephantiasis, due to Chlamydia Trachomatis

107
Q

How does Granuloma Inguinale present?

A

Spreading ulcer, Donovan bodies, due to Klebsiella Granulomatis (rod shaped), oval organism that can be seen in the Cytoplasms of Phagocytes or in tissue of people with grauloma inguinale

108
Q

How does chlamydia present?

A

Cervicitis (Yellow pus), conjunctivitis, PID

109
Q

How does Gonorrhea present?

A

Palmar pustules, arthritis/joint pain, urethral discomfort

110
Q

What is Epididymitis?

A

Unilateral scrotal pain decreased by support

111
Q

What causes Congenital Blindness?

A

CMV

112
Q

What causes Neonatal Blindness

A

Chlamydia

113
Q

What is Lichen Simplex Chronicus?

A

Raised white lesions, chronic scratching

114
Q

What is Lichen Sclerosis?

A

Paper like vulva, itching, CA risk

115
Q

What is Hidradenoma?

A

Sweat gland cysts

116
Q

What causes non-bacterial Fetal infections?

A 
"TORCHS
T- Toxoplasma
O - Others (HIV, Measles, B-19)
R - Rubella
C - CMV
H - HSV-2
S - Syphilis
117
Q

What is Toxoplasmosis?

A

Multiple ring enhancing lesions, loves parietal love, from cat urine and feces

118
Q

What happens with Rubella infections in utero?

A

Cataracts, hearing loss, PDA, “blueberry muffin” rash (Rash on face that spreads to trunk)

119
Q

What do you see in CMV in utero infections?

A

Spastic diplegia of legs, hepatosplenomegaly, blindness, central calcifications

120
Q

What is seen in newborn with HSV-2 in utero infections?

A

Temporal Lobe encephalitis, must offer C-section to mom with active lesions

121
Q

What is seen in newborns with Syphilis in utero infection?

A

Rhages (lip fissue), Saber shin legs (anterior bowing of the tibia), Hutchinson’s Razor teeth,Mulberry Molars

122
Q

What is Paget’s disease of the Breast?

A

Rash and ulcer around the nipple, breast CA

123
Q

What is Lobular Carcinoma?

A

Cells line up single file, contralateral breast is primary site of CA

124
Q

What is Comedocarcinoma?

A

Multiple focal areas of necrosis (blackheads) DCIS

125
Q

What is Inflammatory Carcinoma?

A

Infiltrates Lymphatics, pulls on Cooper’s Ligaments “Peau d’Orange”

126
Q

What is Cystosarcoma Phylloides?

A

Exploding Mushroom

127
Q

What is Intraductal Papilloma?

A

Bleeding from the nipple

Most common Breast CA

128
Q

What is Ductal Carcinoma?

A

Worst prognosis Breast CA.
Firm, fixed, irregular borders.
Upper outer quadrant of breast.
Post-menopausal women, BRCA mutation.

129
Q

What is Sarcoma Botryoides?

A

Vaginal CA, looks like a ball of grapes

130
Q

What is a Sister Mary Joseph Nodule?

A

Ovarian CA that has spread to the umbilicus
(Also GI cancers can cause)
(Indicates metastasis)

131
Q

What is Meig’s Syndrome?

A

Pleural effusion, ovarian fibroma, ascites

132
Q

What are the side effects of Estrogen?

A

Weight gain, breast tenderness, nausea, headaches, muscle relaxant, causes constipation, increased protein production, irritability, and varicose veins

133
Q

What are the side effects of Progesterone?

A

Acne, depression, HTN, increase appetite, acne causes dilution anemia, quiescent uterus, PICA, hypotension, melasma (AKA Chloasma)

134
Q

What makes Progesterone <10 week gestation?

A

Corpus Luteum

135
Q

What are the four Painful Genital Lesions?

A

Herpes
Chancroid (It makes you cry… H. Ducreyi) Lymphogranuloma Venereum
Lymphogranuloma Inguinale

136
Q

How do you predict a due date with Nagele’s rule?

A

Subtract 3 mo. from LMP (last menstrual period)
Add 7 days, if her cycle is 28 days (i.e: LMP Jan 7, 2016 would have an estimated date of Oct. 14, 2016)
If her cycle is more than 28 days add 1 day for each extra day of the cycle

137
Q

Why is Nagele’s Rule Inaccurate?

A

Because it does not start from Ovulation date

Wolfpacc Clues (17 decks)

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