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[1b] a- step 3 > ✅Ob/GYN > Flashcards

✅Ob/GYN Flashcards

1
Q

Guidelines for PAP Smear Cervical CA Screening - 3

A

[PAP Cervical Screening starts at 21 yo]

  1. [Age 21 - 65 PAP every 3 years (cytology only)] ≥ 3x consecutively before stopping after 65

________________

OR

  1. [Age 30-65 can PAP every 5 years if they add HPV testing] ≥ 2x consecutively before stopping after 65

________________

BUT

  1. Risk Groups (immunocompro/CIN2, 3 or CA hx) need more frequent PAP screening = voids out #1 and 2 if present
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2
Q

What are the main side effects of Levonorgestrel progestin IUD - 2

A
  1. Breast tenderness
  2. HA
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3
Q

When does [Fetal Postmaturity Syndrome] occur?

A

g42WG

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4
Q

[fetal Postmaturity syndrome]
________________

s\s -4

A
  • occurs GOE 42WG*
    1. long fingernails
    2. meconium-stained placenta
    3. [wrinkled peeling skin]
    4. small for gestational age
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5
Q

[Transient Tachypnea of Newborn]

cp -4

A
  1. lung hyperinflation
  2. cardiomegaly
  3. [Interlobar fissure fluid] ➜ prominence
  4. [Tachypnea (retractions/nasal flaring) with clear breath sounds]
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6
Q

Cause of [Transient Tachypnea of Newborn]

A

[CESAREAN/PREMATURITY/MATERNAL DM] ➜ [Retained Fetal Lung Fluid]

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7
Q

Tx for [transient tachypnea of newborn]

A

SPONTANEOUSLY RESOLVES IN 1-3d

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8
Q

risk factors for [transient tachypnea of newborn] -3

A
  1. Cesarean
  2. Maternal DM
  3. Prematurity
    * caused by Retained fetal lung fluid*
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9
Q

Clinical criteria for diagnosing PMS (PreMenstrualSyndrome) relies on PMS sx

What is the mngmt for PMS? - 5

A

PMS sx begin 1 week before menses (luteal phase) and resolves during week after menses (follicular phase)

1st: Sx Diary reveal PMS sx timing occured over ≥ 2 menstrual cycles
2nd: Order TSH to r/o hypOthyroidism as cause
3rd: Exercise w/NSAIDs
4th: SSRI
5th: Combined OCP if SSRI don’t work and there’s no ctd

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10
Q

What are the causes of Functional Hypothalamic Amenorrhea?-6

A

Functional hypOthalamic amenorrhea ; these pts have low FSH and therefore NO postmenopausal sx

  1. Excessive Exercise
  2. Very low calorie diet/starvation
  3. low BMI/Anorexia/Wt loss
  4. Stress
  5. Depression
  6. Chronic illness

; Osteoporosis from lack of estrogen

note: these pts will NOT have normal mentrual cycles

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11
Q

Explain how Functional Hypothalamic Amenorrhea causes amenorrhea

A

Functional hypOthalamic amenorrhea ; these pts have low FSH and therefore NO postmenopausal sx

  1. Excessive Exercise
  2. Very low calorie diet/starvation
  3. low BMI/Anorexia/Wt loss
  4. Stress
  5. Depression
  6. Chronic illness

; Osteoporosis from lack of estrogen

note: these pts will NOT have normal mentrual cycles

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12
Q

What are the causes of Functional Hypothalamic Amenorrhea?-6 ; Explain how they cause amenorrhea ; What’s the most common long term complication for these pts?

A

Functional hypOthalamic amenorrhea ; these pts have low FSH and therefore NO postmenopausal sx

  1. Excessive Exercise
  2. Very low calorie diet/starvation
  3. low BMI/Anorexia/Wt loss
  4. Stress
  5. Depression
  6. Chronic illness

; Osteoporosis from lack of estrogen

note: these pts will NOT have normal mentrual cycles

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13
Q

Differentiate the following spontaneous abortions:

Inevitable abortion

Threatened abortion

Missed abortion

Complete abortion

spontaneous abortion = occurs < 20 WG

A
  1. INEVITABLE = vaginal bleeding < 20 WG with cervical os dilated –>abortion will inevitably happen soon
  2. THREATENED = early vaginal bleeding < 20 WG with cervical os closed is clearly a threat to a STILL LIVING FETUS
  3. MISSED = Fetal death with cervical os closed…which is why we Missed it - (pt will have pregnancy sx that just suddenly disappear out of nowhere)
  4. COMPLETE = ALL PRODUCTS OF CONCEPTION COMPLETELY EXPEL AND THEN CERVIX CLOSES BACK UP

spontaneous = occurs < 20 WG

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14
Q

What are the options for Mngmt of Spontaneous Abortion - 4

A
  1. Expectant: Watchful Waiting for products of conception to expel naturally in 2-6 weeks
  2. Surgical: [Dilitation & Curettage (D&C) (cant be done during infection)] or [Manual Vacuum Aspiration]
  3. Medical: 800mcg Vaginal Misoprostol - takes up to 2 weeks for expel

ALL REQUIRE 1 WEEK FOLLOW UP

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15
Q

How do you anticoagulate a pregnant patient? -4

A

<1st trimester = [LMW Enoxaparin] >

<2nd trimester = WARFARIN>

<3rd trimester = WARFARIN>

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16
Q

Clinical criteria for diagnosing PMS (PreMenstrualSyndrome) relies on PMS sx

What is the Clinical Criteria for PMS? ; Name some of the PMS sx

A

PMS sx begin 1 week before menses (luteal phase) and resolves during week after menses (follicular phase) for ≥ 2 menstrual cycles

Sx:

  • Bloating
  • Fatigue
  • HA
  • Hot Flashes
  • Breast Tenderness
  • Irritability/Mood Swings
  • ⬇︎Concentration
17
Q

Clinical criteria for diagnosing PMS (PreMenstrualSyndrome) relies on PMS sx

What is the mngmt for PMS? - 5

A

PMS sx begin 1 week before menses (luteal phase) and resolves during week after menses (follicular phase)

1st: Sx Diary reveal PMS sx timing occured over ≥ 2 menstrual cycles
2nd: Order TSH to r/o hypOthyroidism as cause
3rd: Exercise w/NSAIDs
4th: SSRI
5th: Combined OCP if SSRI don’t work and there’s no ctd

18
Q

What are the risk factors for Polyhydraminos? - 2

Polyhydraminos ( ≥24 cm AFI) is a risk factor for Placenta Abruptio

A
  1. Maternal DM - poorly controlled
  2. swallowing fetal anomalieis (esophageal atresia)
19
Q

What are the risk factors for Polyhydraminos? - 2

Polyhydraminos ( ≥24 cm AFI) is a risk factor for Placenta Abruptio

A
  1. Maternal DM - poorly controlled
  2. swallowing fetal anomalieis (esophageal atresia)
20
Q

Amniotic Fluid Index for Polyhydramnios

A

≥ 24cm

RF = Maternal DM, congenital swallowing malformation

Polyhydramnios can –> placenta Abruptio

21
Q

Amniotic Fluid Index for Polyhydramnios

A

≥ 24cm

RF = Maternal DM, congenital swallowing malformation

Polyhydramnios can –> placenta Abruptio

22
Q

patients who are high risk for preeclampsia should receive what prophylaxis?

A

[12 WG ASA low dose]

23
Q

risk factors for preeclampsia -4

A
  1. prior severe preeclampsia
  2. chronic HTN
  3. DM
  4. CKD
    * px = [12 WG ASA low dose]*
24
Q

For Antepartum patients, their NST (Non Stress Test) should be reactive

What is the Fetal Heart Tracing criteria for this?-4 Does this happen in pts in labor?

A

reactive = appropriate [fetal cerebral oxygenation]

  1. within a 20 min period there are
  2. at least two HR acclerations that are
  3. 15 bpm over baseline
  4. 1.5 small boxes long (15 sec)

THIS IS NOT REQUIRED FOR PTS IN LABOR

25
Q

Criteria for PreEclampsia is Gestational HTN + [Proteinuria or End Organ Damage]

How do you clinically diagnose Gestational HTN? - 6

A
  1. NO previous HTN
  2. ≥ 20 WG (2nd trimester)
  3. Systolic > 140
  4. Diastolic > 90
  5. At least 2 readings taken > 6 hrs apart
  6. BP taken in seated or semi-reclined position

FYI: PreEclampsia can still occur superimposed on Chronic HTN

26
Q

Criteria for PreEclampsia is Gestational HTN + [Proteinuria or End Organ Damage]

How do you clinically diagnose Proteinuria for pregnant women - 4

A
  1. ≥300 mg protein on 24 hr urine

OR

  1. ≥ 30 mg/dL on dipstick
    OR
  2. At least 1+ on dipstick

OR

  1. Protein:Creatinine ratio > 0.3
    * Must occur at least 2 times at least 6 hours apart*
27
Q

What are the primary components for the Mechanisms of Disease in Preeclampsia? - 3

A

Ab complex mediated endovascular damage –>

  1. Hemolytic Anemia
  2. Platelet aggregation from ⬆︎Thromboxane
  3. Vascular constriction pervasively from ⬆︎Thromboxane
28
Q

Full term infant = 37- 42WG

How do you manage Preterm Labor 34 to 36+6 WG - 2

A

Pregnant Bitches

29
Q

Full term infant = 37 -42WG

How do you manage Preterm Labor 32 to 33+6 WG - 3

A

Pregnant Bitches Take

30
Q

Full term infant = 37 - 42WG

How do you manage Preterm Labor < 32WG - 4

A

Pregnant Bitches Take Money

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