✅Ob/GYN Flashcards
Guidelines for PAP Smear Cervical CA Screening - 3
[PAP Cervical Screening starts at 21 yo]
- [Age 21 - 65 PAP every 3 years (cytology only)] ≥ 3x consecutively before stopping after 65
________________
OR
- [Age 30-65 can PAP every 5 years if they add HPV testing] ≥ 2x consecutively before stopping after 65
________________
BUT
- Risk Groups (immunocompro/CIN2, 3 or CA hx) need more frequent PAP screening = voids out #1 and 2 if present
What are the main side effects of Levonorgestrel progestin IUD - 2
- Breast tenderness
- HA
When does [Fetal Postmaturity Syndrome] occur?
g42WG
[fetal Postmaturity syndrome]
________________
s\s -4
- occurs GOE 42WG*
1. long fingernails
2. meconium-stained placenta
3. [wrinkled peeling skin]
4. small for gestational age
[Transient Tachypnea of Newborn]
cp -4
- lung hyperinflation
- cardiomegaly
- [Interlobar fissure fluid] ➜ prominence
- [Tachypnea (retractions/nasal flaring) with clear breath sounds]
Cause of [Transient Tachypnea of Newborn]
[CESAREAN/PREMATURITY/MATERNAL DM] ➜ [Retained Fetal Lung Fluid]
Tx for [transient tachypnea of newborn]
SPONTANEOUSLY RESOLVES IN 1-3d
risk factors for [transient tachypnea of newborn] -3
- Cesarean
- Maternal DM
- Prematurity
* caused by Retained fetal lung fluid*
Clinical criteria for diagnosing PMS (PreMenstrualSyndrome) relies on PMS sx
What is the mngmt for PMS? - 5
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
What are the causes of Functional Hypothalamic Amenorrhea?-6
Functional hypOthalamic amenorrhea ; these pts have low FSH and therefore NO postmenopausal sx
- Excessive Exercise
- Very low calorie diet/starvation
- low BMI/Anorexia/Wt loss
- Stress
- Depression
- Chronic illness
; Osteoporosis from lack of estrogen
note: these pts will NOT have normal mentrual cycles
Explain how Functional Hypothalamic Amenorrhea causes amenorrhea
Functional hypOthalamic amenorrhea ; these pts have low FSH and therefore NO postmenopausal sx
- Excessive Exercise
- Very low calorie diet/starvation
- low BMI/Anorexia/Wt loss
- Stress
- Depression
- Chronic illness
; Osteoporosis from lack of estrogen
note: these pts will NOT have normal mentrual cycles
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?
Functional hypOthalamic amenorrhea ; these pts have low FSH and therefore NO postmenopausal sx
- Excessive Exercise
- Very low calorie diet/starvation
- low BMI/Anorexia/Wt loss
- Stress
- Depression
- Chronic illness
; Osteoporosis from lack of estrogen
note: these pts will NOT have normal mentrual cycles
Differentiate the following spontaneous abortions:
Inevitable abortion
Threatened abortion
Missed abortion
Complete abortion
spontaneous abortion = occurs < 20 WG
- INEVITABLE = vaginal bleeding < 20 WG with cervical os dilated –>abortion will inevitably happen soon
- THREATENED = early vaginal bleeding < 20 WG with cervical os closed is clearly a threat to a STILL LIVING FETUS
- 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)
- COMPLETE = ALL PRODUCTS OF CONCEPTION COMPLETELY EXPEL AND THEN CERVIX CLOSES BACK UP
spontaneous = occurs < 20 WG
What are the options for Mngmt of Spontaneous Abortion - 4
- Expectant: Watchful Waiting for products of conception to expel naturally in 2-6 weeks
- Surgical: [Dilitation & Curettage (D&C) (cant be done during infection)] or [Manual Vacuum Aspiration]
- Medical: 800mcg Vaginal Misoprostol - takes up to 2 weeks for expel
ALL REQUIRE 1 WEEK FOLLOW UP
How do you anticoagulate a pregnant patient? -4
<1st trimester = [LMW Enoxaparin] >
<2nd trimester = WARFARIN>
<3rd trimester = WARFARIN>
Clinical criteria for diagnosing PMS (PreMenstrualSyndrome) relies on PMS sx
What is the Clinical Criteria for PMS? ; Name some of the PMS sx
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
Clinical criteria for diagnosing PMS (PreMenstrualSyndrome) relies on PMS sx
What is the mngmt for PMS? - 5
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
What are the risk factors for Polyhydraminos? - 2
Polyhydraminos ( ≥24 cm AFI) is a risk factor for Placenta Abruptio
- Maternal DM - poorly controlled
- swallowing fetal anomalieis (esophageal atresia)
What are the risk factors for Polyhydraminos? - 2
Polyhydraminos ( ≥24 cm AFI) is a risk factor for Placenta Abruptio
- Maternal DM - poorly controlled
- swallowing fetal anomalieis (esophageal atresia)
Amniotic Fluid Index for Polyhydramnios
≥ 24cm
RF = Maternal DM, congenital swallowing malformation
Polyhydramnios can –> placenta Abruptio
Amniotic Fluid Index for Polyhydramnios
≥ 24cm
RF = Maternal DM, congenital swallowing malformation
Polyhydramnios can –> placenta Abruptio
patients who are high risk for preeclampsia should receive what prophylaxis?
[12 WG ASA low dose]
risk factors for preeclampsia -4
- prior severe preeclampsia
- chronic HTN
- DM
- CKD
* px = [12 WG ASA low dose]*
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?
reactive = appropriate [fetal cerebral oxygenation]
- within a 20 min period there are
- at least two HR acclerations that are
- 15 bpm over baseline
- 1.5 small boxes long (15 sec)
THIS IS NOT REQUIRED FOR PTS IN LABOR
Criteria for PreEclampsia is Gestational HTN + [Proteinuria or End Organ Damage]
How do you clinically diagnose Gestational HTN? - 6
- NO previous HTN
- ≥ 20 WG (2nd trimester)
- Systolic > 140
- Diastolic > 90
- At least 2 readings taken > 6 hrs apart
- BP taken in seated or semi-reclined position
FYI: PreEclampsia can still occur superimposed on Chronic HTN
Criteria for PreEclampsia is Gestational HTN + [Proteinuria or End Organ Damage]
How do you clinically diagnose Proteinuria for pregnant women - 4
- ≥300 mg protein on 24 hr urine
OR
- ≥ 30 mg/dL on dipstick
OR - At least 1+ on dipstick
OR
-
Protein:Creatinine ratio > 0.3
* Must occur at least 2 times at least 6 hours apart*
What are the primary components for the Mechanisms of Disease in Preeclampsia? - 3
Ab complex mediated endovascular damage –>
- Hemolytic Anemia
- Platelet aggregation from ⬆︎Thromboxane
- Vascular constriction pervasively from ⬆︎Thromboxane
Full term infant = 37- 42WG
How do you manage Preterm Labor 34 to 36+6 WG - 2
Pregnant Bitches
Full term infant = 37 -42WG
How do you manage Preterm Labor 32 to 33+6 WG - 3
Pregnant Bitches Take
Full term infant = 37 - 42WG
How do you manage Preterm Labor < 32WG - 4
Pregnant Bitches Take Money
