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%
2
Q
What is Meconium?
A
Green baby poop (first poop)
3
Q
What are Identical Twins?
A
Eggs split into perfect halves “Monochorionic”
4
Q
What are Fraternal Twins?
A
Multiple eggs fertilized by different sperm
5
Q
What is Ovarian Hyperstimulation syndrome?
A
Weight gain and enlarged ovaries after clomiphene use for infertility
6
Q
Who Makes the Trophoblast?
A
Baby
7
Q
Who makes the Cytotrophoblast?
A
Mom production of GnRH, CRH, TRH, and Inhibin
8
Q
Who makes the Syncytiotrophoblast?
A
Mom and baby production of HCG and HPL
9
Q
When does Implantation occur?
A
1 week after fertilization
10
Q
When is Beta HCG found in Urine?
A
2 weeks after fertilization
11
Q
When is B-HCG found in Blood?
A
8-10 days after fertilization
12
Q
What makes Progesterone in >10 weeks gestation?
A
Placenta
13
Q
What is the function of B-HCG?
A
Maintains Corpus Luteum, sensitizes TSH receptors to make body hyperthyroid (to raise BMR)
14
Q
What makes B-HCG?
A
Placenta (synctiotrophoblast)
15
Q
How fast should B-HCG rise?
A
Shoulde double every 2 days until 10 weeks, stops when placenta is fully formed
16
Q
What is the function of AFP?
A
Regulates intravascular volume
Made in the liver of fetus
17
Q
What is the function of HPL?
A
Blocks insulin receptors so the sugar stays high, (baby is stocking up - hibernating)
18
Q
What is the function of Inhibin?
A
Inhibits FSH so there is no menstruation
19
Q
What is the function of Cortisol in Pregnancy?
A
Decreases immune rejection of the baby out of mom and for lung maturation
20
Q
What is the function Oxytocin?
A
Milk and baby ejection
21
Q
What is the thyroid hormone levels during Pregnancy?
A
Increased TBG - leads to increased total T4 (Bound and free)
22
Q
When can you first detect fetal heart tones?
A
Week 20
23
Q
When can you tell the sex of the baby by US?
A
Week 16
24
Q
What does an AFI <5 indicate?
A
Oligohydramnios (Cord compression)
25
What does an AFI >20 indicate?
Polyhydramnios (DM)
26
How fast should fundal height change?
Uterus grows 1 cm/week
27
What is the risk of Chorionic Villus Sampling?
Fetal limb defects. (Done at 9-12 weeks)
28
What is the risk of Amniocentesis?
Abortion (2% risk)
29
How much weight should a woman gain during Pregnancy?
1 lb/ week
30
When should Intercourse be avoided during Pregnancy?
Cervical dilation, placenta previa, premature labor, vaginal bleeding, ruptured membranes, genital herpes
31
What are Braxton-Hicks Contractions?
Irregular contractions with closed cervix. (preparing for birth)
32
What is Shoulder Dystocia?
Head is out of vagina, shoulder is stuck. (Occurs in late term deliveries and DM in mom)
33
What are the symptoms of Pre-eclampsia?
Headaches, changes in vision, and epigastric pain
34
What is Pre-Eclampsia?
Ischemia to the placenta causes HTN greater than 140/90
35
What is the Treatment for Pre-Eclampsia?
Delivery, MgSO4 (seizures), Hydralazine (BP)
36
What is HELLP Syndrome?
Hepatic injury causing:
H- Hemolysis
EL- Elevated Liver Enzyme
LP- Low Platelets
37
What is Eclampsia?
HTN with seizures
38
What is the Treatment for Eclampsia?
4mg MgSO4 IV (Seizure prophylaxis)
39
What is Chorioamnionitis?
Fever, uterine tenderness, decreased fetal HR
40
What are the symptoms of Amniotic Fluid Emboli?
Mom just delivered Baby and mom has SOB, due to PE, leads to death
41
What is Endometritis?
Postpartum uterine tenderness
42
What is an Incomplete Molar Pregnancy?
2 Sperm + 1 egg (69, XXY) mom "cooks the parts" has embryo parts
43
What is a complete molar pregnancy?
2 Sperm and no egg (46, XX) both are paternal, bunch of grapes, dad eats grapes, no embryo
(GROSS!)
44
What is the most common cause of first trimester maternal death?
Ectopic pregnancy
45
What is the most common cause of first trimester spontaneous abortions?
Chromosomal abnormalities
46
What are the most common causes of third trimester spontaneous abortions?
Anti-Cardiolipin Ab, placenta probelms, infection, incompetent cervix
47
What is Placenta Previa?
The placenta is implanted wholly or partially in lower uterine segment
48
What is Vasa Previa?
Babies blood over OS
49
What is Placenta Accreta?
Placenta is attached to the endometrium
50
What is Placenta Percreta?
Placenta perforates through serosa
51
What is Placenta Abruptio?
Severe pain due to premature separation of the placenta from myometrium
52
What is Velamentous Cord Insertion?
Fetal vessels insert between chorion and amnion
53
What is Uterus Rupture?
Tearing sensation, halt of delivery
54
What is Materninty Blues?
Postpartum crying and irritability
55
What is Postpartum Depression?
Depression post-delivery for more than 2 weeks
56
What is Postpartum Psychosis
Hallucinations, suicidal/infaticidal thoughts
57
What does Seminal Vesicle give to Sperm?
Food (Fructose) and clothes (semen)
58
What does the Bulbourethral/ Cowper's Glands secrete?
Bicarb to neutralize lactobacilli, if sperm is too acidic. (Infertility until corrected)
59
What does the Prostate Secrete?
The prostate HAZ it.
H- Hyaluronidase
A- Acid Phosphatase
Z- Zinc
60
Where does Testosterone come from?
Adrenal gland and testicles
61
Where does DHT come from?
Testicles at puberty
62
What is Hirsutism?
Hairy female (Excess growth in normal male areas)
63
What is Virilization?
Female that is Man like
64
What is Testicular Feminization (Androgen Insensitivity Syndrome)?
Males with defective / bad DHT receptor, they are XY with a blind pouch vagina
65
What is McCune-Albright?
Precocious sexual development, polyostotic fibrous dysplasia "whorls of connective tissue", "coast of Maine" pigemented skin macules
66
What is Cryptorchidism?
Testes never descended out of abdomen, sterility after 15 months, predisposed to seminomas and CA
67
Which stage of the Menstrual Cycle has the highest Estrogen levels?
Follicular stage (Has proliferative endothelium)
68
What stage of the menstrual cycle has the highest Temperature?
Ovulatory stage, body temp will rise One degree during ovulation
69
What stage of the Menstrual Cycle has the highest level of Progesterone?
Luteal stage (Has secretory endothelium)
70
What form of Estrogen is highest at Menopause?
E1: Estrone (Made by Fat)
E2: Estradiol (Made by the ovaries)
E3: Estriol (Made by the placenta)
71
What states have increased Estrogen?
Pregnancy, liver failure, P-450 inhibition, and obesity
72
What is Adenomyosis?
Growth of the stroma & endometrial glands within Myometrium
Uniformly enlarged "boggy" uterus with cystic areas
Regular, heavy menstrual bleeding
73
What does DES taken by Mom cause in her Daughter?
Adenomyosis, menorrhagia, clear cell CA of the vagina, recurrent abortions
74
What is Kallmann's Syndrome?
No GnRH and Anosmia. (They can't smell)
75
What is Polycystic Ovarian Syndrome?
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
What is Savage's Syndrome?
Ovarian resistance to LH/FSH
77
What is Turner's Syndrome (XO)?
High FSH, LOW E2, Ovarian Dysgenesis, Webbed Neck, Coarctation of the Aorta, Cystic Hydroma, bicuspid Aortic valve
78
What does the Progesterone Challenge Test tell you?
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
What is Sheehan Syndrome?
Postpartum hemorrhage in pituitary, no LH or FSH = no periods, hyperplasia infarcts, no prolactin = no milk
80
What is Asherman's Syndrome?
Uterine scars from multiple D&Cs
81
What is Oligomenorrhea?
Too few periods
82
What is Polymenorrhea?
Too many periods
83
What is the most common cause of post-coital Vaginal Bleeding?
Cervical CA
84
What is the most common cause of post-coital Vaginal Bleeding in Pregnant women?
Placenta previa
85
What is the most common cause of Vaginal Bleeding in Post-menopausal women?
Endometrial CA
86
What is Chronic Pelvic Pain?
Endometriosis until proven otherwise
87
What is Dysfunctional Uterine Bleeding?
Diagnosis of exclusion, usually due to anovulation
88
What is Dysmenorrhea?
PGF causes painful menstrual cramps
| teenagers miss school
89
What is Endometriosis?
Painful cyclical heavy menstrual bleeding
| "Powder burns and chocolate cysts" due to ectopic endometrial tissue. (Endometrial Tissue outside of uterus)
90
What is Menorrhagia?
Heavy menstrual bleeding
91
What are Fibroids (Leiomyoma's)?
Benign uterus smooth muscle tumor
submucosal type: bleeding, reproductive difficulty
subserosal type: pain, uterine irregularity, obstructive sx, bulk-related sx
92
What is Metorrhagia
Bleeding or spotting in btwn periods
93
What is Herpes?
ds DNA virus
94
What is HPV?
ds DNA virus, vaccine out not covers 8-27 year old female to block HPV 6, 11, 18 STD
95
What is Chlamydia?
Obligate intracellular bacteria. Can present asymptomatic or PID Cervicitis (yellow pus) -> salpingitis -> tubal scarring
Conjunctivitis
96
What causes Gonorrhea?
Gram-negative Diplococcus, presents with mucopurulent discharge. Can be present with Palmer Pustule, arthritis/joint pain, urethral discomfort
97
What causes Chancroid?
Haemophilus Ducreyi
98
What causes Granuloma Inguinale?
Klebsiella Granulomatis
99
What is Epididymitis?
Chlamydia Trachomatis.
| Unilateral scrotal pain decreased by support
100
What is the most common cause of Epididymitis?
Chlamydia Trachomatis, N. Gonorrhea, E. Coli
101
What is Condylomata Lata?
Flat fleshy warts, ulcerate = secondary syphilis
102
What is Condyloma Acuminata?
Verrucous "cauliflower" warts, koilocytes, due to HPV 6 and 11
103
How does Herpes present?
Primary: Painful grouped vesicles on red base
Secondary: Painful solitary lesion
104
How does Syphilis present?
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
How does Chancroid present?
Painful with necrotic center, due to Haemophilus Ducreyi (Gram Negative rod)
"School of Fish" pattern
106
How does Lymphogranuloma Venereum present?
Painless Ulcers, Abscessed Nodes, Genital, and Elephantiasis, due to Chlamydia Trachomatis
107
How does Granuloma Inguinale present?
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
How does chlamydia present?
Cervicitis (Yellow pus), conjunctivitis, PID
109
How does Gonorrhea present?
Palmar pustules, arthritis/joint pain, urethral discomfort
110
What is Epididymitis?
Unilateral scrotal pain decreased by support
111
What causes Congenital Blindness?
CMV
112
What causes Neonatal Blindness
Chlamydia
113
What is Lichen Simplex Chronicus?
Raised white lesions, chronic scratching
114
What is Lichen Sclerosis?
Paper like vulva, itching, CA risk
115
What is Hidradenoma?
Sweat gland cysts
116
What causes non-bacterial Fetal infections?
```
"TORCHS
T- Toxoplasma
O - Others (HIV, Measles, B-19)
R - Rubella
C - CMV
H - HSV-2
S - Syphilis
```
117
What is Toxoplasmosis?
Multiple ring enhancing lesions, loves parietal love, from cat urine and feces
118
What happens with Rubella infections in utero?
Cataracts, hearing loss, PDA, "blueberry muffin" rash (Rash on face that spreads to trunk)
119
What do you see in CMV in utero infections?
Spastic diplegia of legs, hepatosplenomegaly, blindness, central calcifications
120
What is seen in newborn with HSV-2 in utero infections?
Temporal Lobe encephalitis, must offer C-section to mom with active lesions
121
What is seen in newborns with Syphilis in utero infection?
Rhages (lip fissue), Saber shin legs (anterior bowing of the tibia), Hutchinson's Razor teeth,Mulberry Molars
122
What is Paget's disease of the Breast?
Rash and ulcer around the nipple, breast CA
123
What is Lobular Carcinoma?
Cells line up single file, contralateral breast is primary site of CA
124
What is Comedocarcinoma?
Multiple focal areas of necrosis (blackheads) DCIS
125
What is Inflammatory Carcinoma?
Infiltrates Lymphatics, pulls on Cooper's Ligaments "Peau d'Orange"
126
What is Cystosarcoma Phylloides?
Exploding Mushroom
127
What is Intraductal Papilloma?
Bleeding from the nipple
| Most common Breast CA
128
What is Ductal Carcinoma?
Worst prognosis Breast CA.
Firm, fixed, irregular borders.
Upper outer quadrant of breast.
Post-menopausal women, BRCA mutation.
129
What is Sarcoma Botryoides?
Vaginal CA, looks like a ball of grapes
130
What is a Sister Mary Joseph Nodule?
Ovarian CA that has spread to the umbilicus
(Also GI cancers can cause)
(Indicates metastasis)
131
What is Meig's Syndrome?
Pleural effusion, ovarian fibroma, ascites
132
What are the side effects of Estrogen?
Weight gain, breast tenderness, nausea, headaches, muscle relaxant, causes constipation, increased protein production, irritability, and varicose veins
133
What are the side effects of Progesterone?
Acne, depression, HTN, increase appetite, acne causes dilution anemia, quiescent uterus, PICA, hypotension, melasma (AKA Chloasma)
134
What makes Progesterone <10 week gestation?
Corpus Luteum
135
What are the four Painful Genital Lesions?
Herpes
Chancroid (It makes you cry... H. Ducreyi) Lymphogranuloma Venereum
Lymphogranuloma Inguinale
136
How do you predict a due date with Nagele's rule?
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
Why is Nagele's Rule Inaccurate?
Because it does not start from Ovulation date
