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PANCE Questions > OB/Gyn > Flashcards

OB/Gyn Flashcards

1
Q

Chadwhick’s sign

A

Bluish/ purple vagina/cervix

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2
Q

Chandelier sign

A

Cervical motion tenderness, seen with PID

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3
Q

McDonald’s sign

A

Uterus is flexible at uterocervical junction at 7-8 weeks

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4
Q

Hegar’s sign or Goodell’s

A

softening of the cervix

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5
Q

Antibiotics to avoid in pregnancy

A

Floroquinolones

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6
Q

When to administer Rhogam

A 
28 weeks gestation in Rh- mom
abortion
ectopic pregnancy
invasive procedure: AVS, CVS
Hydatidiform mole
trauma
cephalic version (breech)
antepartum hemorrhage
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7
Q

Maternal Serum Alpha Fetal Protien in down syndrome

A

Levels will be LOW

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8
Q

Fundal Height at 20 weeks

A

umbilicus

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9
Q

Braxton Hicks contractions

A

Contractions without a change in cervical dilation or effacement

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10
Q

Fetal Heart tones

A

Variable decelerations : Cord compression
Early decelerations: Head compression
Accelerations: Ok
Late decelerations: Placental insufficiency

*WANT variable acclerations

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11
Q

Fibroadenoma

A

Seen in young females (25)

rubbery, painless mobile mass that does not change with the menstrural cycle like a fibrocystic mass will

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12
Q

Mastitis

A

Pain and swelling of breast usually after breast feeding
from STAPH aureus
treat with Dicloxacillin or Keflex, continue breast feeding while on antibiotics

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13
Q

Spontaneous abortion types (must occur before 20 weeks or else its a still birth)

A

Threatened: Os closed, No products passed TX: bed rest 1-2 days
Inevitable: Os Open, No products passed
Incomplete: Os Open, Some products passed
Complete: Os Closed, Products have passed
Missed: Os Closed, no pregnancy developed

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14
Q

Ectopic pregnancy labs

A

Beta Hcg will be lower than expected for normal pregnancy (don’t get doubling like with normal pregnancy)
Hcg of 6500 with empty uterine cavity on US is diagnostic, Laparoscopy is definitive

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15
Q

Ectopic pregnancy treatment

A

Methotrexate in STABLE patient
if hemodynamically unstable surgical management is needed with blood type and cross (only tx if ruptured ectopic pregnancy)

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16
Q

Hydatidiform Mole

A 
benign neoplasm of chorion 
s/s: vaginal bleeding, enlarged uterus, pelvic pain
B-hCg is EXTREMELY high! above 40,000
us shows snowy uterus
treat: D&C
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17
Q

Choriocarcinoma

A

Highly malignant gestasional trophoblastic disease

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18
Q

PAINLESS bleeding in 3rd trimester

A

Placenta Previa

NO vaginal or speculum exam

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19
Q

Risk factors for placental abruption

A

Trauma, cocaine, smoking, previous abruption

IS PAINFUL

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20
Q

Placenta Accreata

A

placenta attaches too deeply in the uterine wall

21
Q

McRobert’s maneuver

A

suprapubic pressure on anterior shoulder with legs fully flexed

22
Q

Primary cause of post partum hemorrhage

A

uterine atony

tx. with fundal massage 1st then fluid/blood products and oxytocin

23
Q

Preeclampsia Triad

A

Hypertension (>140/90), protienuria, edema

24
Q

Eclampsia Treatment

A

Deliver baby and give mom betamethasone for fetal lungs
Give Oxytocin to induce contractions
Magnesium Sulfate, if toxicity (decreased reflexes) then reverse with Calcium Gluconate

25
Q

Biggest risk factors for preterm birth

A

Multiple gestation
prior preterm birth
treat with tocolytics to stop preterm labor ( CCB’s if 32-34 wks, Indocin if 24-32 wks, Terbutaline, Mag Sulfate)

26
Q

Group B strep prophylaxis

A

Screen at 35-37 weeks

administer Penicillin G if positive or with PROM, if PCN allergy five clindamycin or Ancef

27
Q

Leading indication for a C-section

A

shoulder dystocia (Failure to profess during labor)
non reassuring fetal status
fetal malpresentation

28
Q

role of progesterone in ovulation

A

during luteal phase of cycle if no conception occurs the corpus luteum secretes progesterone and as levels fall, menstrual period is triggered
If implantation occurs, HCG is released from zygote and sustains the corpus luteum for 6-7 weeks until placenta takes over

29
Q

Midcycle pelvic pain

A

Middleschmerz

30
Q

Diagnosis of endometriosis confirmed with…

A

Laparoscpy, can see chocolate cysts in uterus

31
Q

Pelvic Inflammatory disease presents with

A

lower abdominal pain
adnexal tenderness
cervical motion tenderness on bimanual exam (Chandelier sign)
usually from gonorrhea or chlamydia trachomatis

32
Q

PCOS symptoms

A

oligomenorrhea or amenorrhea, obesity, hirsutism, androgen excess (testosterone), insulin resistance (acanthosis nigricans)

33
Q

What hormone spikes at ovulation

A

LH

Body temp also increases during luteal phase

34
Q

symptoms of ovarian cancer

A

abdominal/pelvic pain, bowel changes, gas/bloating
RARELY symptomatic
screen with CA-125

35
Q

Strawberry cervix consistant with

A

Trichomonas

36
Q

Nabothian Cysts

A

Mucous filled cyst on cervix

benign and usually resolve on their own

37
Q

HPV types for cervical cancer and genital warts

A

16 and 18= cancer

6 and 11= warts (condylomata)

38
Q

Cervical cancer screening

A

Start pap at age 21 for every 3 years
age 30-65 pap with HPV screening every 5 years
stop at age 65 as long as never above CIN 1

39
Q

Endometrial cancer # 1 sign

A

painless bleeding post menopaus

40
Q

Risks of endometrial cancer

A

Unopposed estrogen (PCOS, obesity), nulliparity, estrogen use WITHOUT progesterone (Tamoxifen)

41
Q

Uterine Fibroids

A

benign tumor of myometrium, usually shrink after menopause
Present with menorrhagia and pelvic pain
PE: enlarged asymmetric uterus
Treat with IUD or myomectomy

42
Q

Drugs that interact with OCP’s

A

Ritnavir, Rifampin, phenobarbitol, carbamazepine, phenytoin, St Johns wart

43
Q

OCPs to use during lactation

A

Progesterone only

44
Q

Trichomoniasis

A

pH: 5-6
frothy green/yellow discharge, post-coital bleeding from strawberry cervix
Tx one time dose PO Flagyl

45
Q

Bacterial Vaginosis

A

pH: >4.5
Clue cells on wet mount
fishy odor with white/grey discharge
Treat with FLAGYL (NO ALCOHOL on flagyl)

46
Q

Candidiasis

A 
pH: 4-4.5
KOH prep with hyphae and budding yeast
cottage cheese discharge
antibiotic use, pregnant, immunocompromised, DM
Tx PO Diflucan and topical Miconazole
47
Q

***Diagnosis of Herpes

A

Tzank Smear

48
Q

What to suspect if palpate ovaries in a postmenopausal women

A

ovarian cancer

49
Q

Hormone elevated in menopaus

A

FSH (low estrogen, low progesterone)

PANCE Questions (10 decks)

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