OB/Gyn Flashcards
vulvar lesions that resolve with addition of trichloroacetic acid are likely due to…
HPV genital warts (condyloma acuminata)
how do you manage a molar pregnancy
evacuate the uterus (D&C), CXR, give MTX or dactinomycin for malignant disease
low-level homogenous internal echos in a cystic mass of a patient with dyspareunia, infertility and regular cycles is likely
endometriosis; don’t be fooled by the regular cycles, low-level homogenous internal echos on US suggest endometrioma
what is the best way to prevent transmission of genital herpes
CONSISTENT condom use (even when lesions are not present)
how do epidurals sometimes cause maternal hypotension
blocking of sympathetic nerve fibers leads to peripheral vasodilation, which decreases venous return
a patient with persistent cough productive of scant blood following a URI, with normal CXR should be treated with what
supportive care; post-URI bronchitis is self-limited and not dangerous, no further workup needed
when is fetal fibronectin used
to determine if a woman is going into preterm labor when the presentation is equivocal
when is progesterone used in a pregnant woman
to prophylax against preterm labor in a woman with a history of preterm labor; given at 16-36 weeks
when are non-stress tests normally initiated
32-34 weeks; unless there is a decrease in fetal movement to indicate earlier screening
what complications are commonly seen in babies who are small for gestational age
hypoxia (and resultant polycythemia), hypothermia, hypoglycemia, meconium aspiration (due to stress), hypocalcemia
list all the different screening methods for aneuploidy with their associated gestational age ranges
1st trimester combined test (PAPP, b-hCG, nuchal translucency): 9-13 weeks 2nd trimester quad: 15-20 weeks CVS: 10-13 weeks amniocentesis: 15-20 weeks 2nd trimester US: 18-20 weeks cell free DNA: after 10 weeks
define arrest of labor in the first stage
cervix 6cm or more, ruptured membranes and either:
-4 or more hours without change and adequate CTXs
or
-6 or more hours without change and inadequate CTXs
what is tachysystole
abnormal irregular and frequent contractions that can impair bloodflow and hurt the baby (beware of putting mothers on oxytocin who already have adequate contractions for this reason)
retraction of fetal station is alarming for
uterine rupture
up until what point can you do a medical abortion rather than D&C
until 7 weeks
at 10 weeks, all mothers at increased risk for aneuploidy (age, FHx) should be offered
cell free DNA testing (abnormal results can be confirmed via more invasive tests such as CVS or amnio)
OCP’s lower your risk of what cancers
endometrial and ovarian cancer
a woman with low-grade fever, vaginal bleeding, and chills and mild leukocytosis several hours after giving birth should be treated with what
reassurance: chills, low-grade fever, lochia rubra (bloody lochia), and mild leukocytosis is normal in post-partum period
babies born to anorexic mothers are at risk for what complications?
prematurity, SGA, intellectual disability
what is the first line of therapy for PCOS
weight loss to decrease insulin resistance and OCP’s for anti-androgenic therapy
what are the medical options for treatment of abnormal uterine bleeding in the acute setting in a hemodynamically stable patient
high dose estrogen, high dose combination estrogen-progesterone, high dose progesterone, tranexamic acid (anti-fibrinolytic used in patients who can’t take hormones)
what impact does endometriosis have on fertility
endometriosis increases risk of infertility via adhesions and inflammation of the ovaries
what is the treatment for endometritis
clindamycin and gentamicin
define preeclampsia
gestational HTN (BP >140/90 after 20 weeks) + proteinuria OR end-organ damage (creatinine, bilirubin, etc.)
