OB/GYN Flashcards
Menstruation Questions
When was your last menstrual period? Are your periods regular?
*If >2 weeks = Possibility of pregnancy
Was your last period’s flow typical of your regular periods?
*Lighter than usual = Breakthrough bleeding (Possible pregnancy)
Have you had any pain w/ menstruation?
*PID
*Ovarian Cyst
*Mittelschmerz
Sexual HX Questions
Could you be pregnant? When was the last time you had unprotected sex?
*If w/in 12-17 days of last Period = Pregnancy very likely
What forms of contraceptives were used?
Have you had unprotected sex w. multiple partners? (STD’s)
Indications of eminent delivery
- Crowning
- Urge to push
-LUQ ABD pain = Splenomegaly
-Prolonged high fever
-Chills
-Headache
-Malaise
-Extreme fatigue
Cytomegalovirus (CMV)
Member of the herpesvirus family
Complications:
-Can be transmitted to the Baby
-Diffused Bilateral Lower Quadrant Achy ABD Pain
-Cervical, uterine, or adnexal tenderness/Rebound tenderness
-Fever or Chills
-Purulent vaginal discharge (yellow or green)
-Discomfort or pain during sex
-Pain when peeing
-Bleeding between periods and after sex
-Heavy & painful periods
HX:
- Sexually Active/Multiple Partners
- STD’s
- Candidiasis/Bacterial Vaginitis
Pelvic Inflammatory Disease
-Burning
-Itching
-Pain/Soreness during Intercourse
-Vaginal Discharge (cottage cheese)
-Fish Odor
-Inflammation of the labia majora, labia minora, or perineal area
HX:
-Poor Hygiene
-Oral Contraceptives
-Unprotected sex
-Postmenopausal
-Postpartum
-Yeast Infection
-STD trichomoniasis
Vaginitis
Vaginal inflammation caused by a fungal yeast or bacterial infections
-Acute lower ABD pain that can radiate through the entire ABD then back
-Pain during sex or bowel movements
-Menstrual Pain & Irregularities
-Difficulty Urinating
-Heaviness/Bloating in ABD
-Breast Tenderness
-Nausea/Vomiting
HX:
-Previous Cysts
-Hormonal Issues
-Endometriosis
-Pelvic Inflammation
Ovarian Cysts
-Localized, one-sided lower abdominal pain
-Heaviness/Bloating in ABD
-Generalized signs of peritonitis if massive hemorrhage has occurred
-Rebound Tenderness
-Vaginal bleeding or report a late or missed period at the time of rupture
-Heaviness/Bloating in ABD
-Nausea/Vomiting
-Dizziness
Ruptured ovarian cyst
An emergency that may result in significant hemorrhage
-Sudden onset of lower abdominal pain that may radiate to the back, pelvis or thigh
-Pain often begins with exercise (sharp or stabbing)
-Nausea/vomiting
-Fever is usually a late sign
HX:
-Congenital abnormalities
-Ovarian cysts or tumors
-Disease that affects the fallopian tube or ovary
Ovarian torsion
-Frequent urge to pass urine
-Painful urination
-Fever
-Chills
-Lower abdominal pain
HX:
-Bacterial infection (most cases)
-Structural abnormality of the ureters
-Urethra inflammation
-Indwelling urinary catheters
Cystitis
Inflammation of the inner lining of the bladder
-Headache
-Faintness
-Dizziness
-Nausea
-Diarrhea
-Backache and leg pain
HX:
-Sexually inactive
-Childless
Dysmenorrhea
Pain during menstruation caused by muscular contractions of the myometrium
-Pain in the right or left lower quadrant of the abdomen during the normal midcycle of a menstrual period
Mittelschmerz
May occur as a result of the rupture of the graafarian follicle and bleeding from the ovary during the menstrual cycle
-Fever
-Malaise
-Purulent vaginal discharge
-Lower abdominal or pelvic pain (Increased on Palpation)
-Constipation & ABD Distension
-Vaginal bleeding
-Sepsis
HX:
-Sexually Active/Multiple partners
-STD’s
Endometritis
Inflammation of the uterine lining caused by an infection; occurs after childbirth or abortion by retained placental tissue; can affect the uterus and fallopian tubes
Complications:
-Sterility
-Sepsis
-Death
-Pain localized in the lower back, pelvis, and abdomen
-Painful defecation or Intercourse
-Suprapubic soreness
-Heavy vaginal bleeding
-Fatigue
-Escalating menstral cramps
-Infertility
HX:
- Deferred pregnancy
~37 years old
Endometriosis
Fragments of endometrium have been regurgitated backward where they attach and grow as small cystic structures; tissue functions cyclically and undergoes periodic menstrual breakdown
-Severe abdominal pain that may radiate to the shoulder and vaginal spotting
-Rebound Tenderness
-Cullen or Grey Turner Sign (Internal hemorrhage)
-Sepsis
-Shock may develop
HX:
- Sexually Active
- <20 weeks pregnant
- 35 to 44 years
- Intrauterine device (IUD) use
- Conceiving after having a tubal ligation
- HX of pelvic inflammatory disease (PID)
- Endometriosis or induced abortions
- Smoking
Ectopic Pregnancy
-Feeling like sitting on a small ball
-Heaviness in the vaginal area
-Abd palpation often reveals rigidity and pain, and in some cases, fetal parts
-Low back pain
-Painful intercourse
-Vaginal bleeding
-Shock
HX:
-Previous C sections
-Large babies and difficult vaginal delivery
-Loss of muscle tone associated with aging
-Menopause
-Pelvic cavity tumors
-Trauma during vaginal birth
Uterine prolapse
Falling or sliding of the uterus from its normal position into the vaginal canal
-Acute ABD Pain w/out contractions
-Weaker contractions
-Shoulder Tip Pain
-Vaginal bleeding
-Undetectable Fetal heartbeat
-Loss of Baby movement/Fetal distress
-Baby felt through abdomen
-Shock
Uterine Rupture
Can allow a part of the baby, amniotic fluid, or the umbilical cord to enter the peritoneal cavity or broad ligament
Complications:
-Inability to deliver Baby
-Excessive hemorrhage from Uterus or Placenta
-Shock
- Profuse, painful itching of the hands & hand
- Fatigue or Depression
- Nausea
- RUQ Abd pain
- Dark Urine
- Abnormally colored stool (Light Grey, Yellow, Light Brown, or White)
HX:
- Carrying multiple babies @ once
- Family hx of Cholestasis
- Previous liver damage
Cholestasis
Liver disease that occurs during pregnancy in which hormones affect the gallbladder by slowing down or blocking the normal flow of bile from the liver, which leads to bile acids to build up in the liver then spill over into the bloodstream.
- Fever
- Achy muscles
- Fatigue
- Headache
- Sore Throat
- Swollen Glands
HX:
-Cleans cat litter
-Ate contaminated food
Toxoplasmosis
Infection caused by a parasite from handling/eating contaminated food or through exposure from handling cat litter, can be transmitted to the baby
- SBP 140>, DBP 90>
- Headache
- Edema
- Visual Disturbances
HX:
-Usually >20 weeks Pregnant
Preeclampsia
- Acute onset vaginal bleeding & Abd pain (3rd trimester)
- Bleeding unproportionate to shock
- Uterine rigidity
HX:
- Multiparity
- Maternal Trauma
- Maternal Cocaine use
- Maternal Hypertension
Abruptio Placenta
Partial or complete detachment of the placenta beyond the 20th week of gestation.
- Hypertension & Proteinuria
- Edema
- Headache
- Bruising/Bleeding
- RUQ Pain (Liver Distension)
- Shoulder pain
- Visual disturbances
HX:
-Late stages of pregnancy
HELLP syndrome
(Hemolysis, Elevated Liver enzymes, and Low Platelet count)
A life-threatening complication that typically occurs in the later stages of pregnancy; A variant of preeclampsia because it generally occurs in conjunction with hypertension and proteinuria
Complications:
-Liver Rupture
-Stroke
Baby w/:
- Lethargy
- Jaundice
- Reddish Brown spots on skin
- Hepatosplenomegaly
- Congenital Heart Disease
- Microcephaly
- Low Birth weight
- Hearing Loss
- Blueberry muffin rash
TORCH Syndrome
(Toxoplasmosis, Other agents, Rubella (German measles), Cytomegalovirus, and Herpes simplex)
An infection of the developing fetus or newborn by any of a group of infectious agents. Transmission can occur through placenta, while passing through birth canal, & through breast milk
Complications:
- Preterm Birth
- Delayed Developments of Baby
- Physical malformations
- Loss of pregnancy
- Prolapsed Umbilical Cord
- Abruptio Placenta
- Postpartum Hemorrhage
HX:
- Multiple Babies (twins, triplets, ect.)
- Fetal Anemia
- Maternal Diabetes
- Fetal conditions in where the babies don’t swallow the fluid
Polyhydraminos
Condition in which there is too much amniotic fluid
-Swelling and inflammation and a visible bump on one side of the vaginal opening
-Fever is possible
-Any activity that puts pressure on the vulva can cause severe pain
Bartholin abscess
Accumulation of pus that forms a lump in one of the Bartholin glands; can take years to form, may develop quickly, or over several days
