OB/GYN Flashcards
Causes of ovarian torsion and when does it usually occur?
Ovarian cyst
14 weeks or right after delivery
Dx of placenta abruption?
clinical
How long does corpus luteum produce progesterone during gestation?
Till 10th to 12th weeks of gestation
What are category III fetal heart abnormality?
Recurrent late and variable deceleration
Bradycardia
Sinusoidal pattern
What symp would you see if a pt has pregnancy associated fatty liver disease?
Hypoglycemia
What are the complication of intrahepatic cholistasis in pregnancy, PUPP and herpes gestationis
fetal preterm/demise for ICP
and none for PUPP
Neonate might get skin lesion from herpes gestationis
What respiratory symp would you see with HELLP syndrome (aka severe preeclampsia)? and tx?
Pul edema
100% O2
What is Posterior Reversible encephalopathy syndrome and how to tx it?
Headache/encephalopathy/seizure/visual problems
Tx: antiHTN. anti seizure and ICU
Pt who has chronic HTN now develops proteinuria, what is it?
Superimposed preeclampsia
Protein/Cr ratio in preeclampsia pt
> or = 0.3
Pathophysiology of preeclampsia
Vasospasm and leaky vessels
When does preeclampsia pt start to have HTN? and what drug should be avoided postpartum for these pts?
after 20 weeks GA so does gestational HTN
NSAIDS—>might increase BP
What is the one complication of severe preeclampsia that necessitate delivery?
DIC
See severe preeclampsia, aka HELLP, do?
Meg sulfate and deliver
MC cause of death in woman with eclampsia
Intracerebral hemorrhage
What to do with pt with mild preeclampsia at preterm and term?
Preterm —>expectant management
Term —>deliver
What symp indicate preterm delivery with severe preeclampsia?
Pul edema and DIC
What test is used to monitor prego with chronic HTN?
Biophysical profile
First sign of Meg sulfate toxicity?
Hyporeflexia
What test can you do to dx preterm labor, and what drugs to give to the mother
Fibronectin assay
Terbutaline, IV steroid and Meg Sulfate (prevent cerebral palsy)
What are tocolytics?
Drugs that suppress preterm labor
like beta 2 agonist like terbutaline or indomethacin and nifedipine
What anatomical features indicate high risk for preterm labor?
Short cervix or funneling
Which infxn is strongly associated with preterm delivery
Gonococcal cervicitis
Tocolytics would increase what post delivery?
Hemorrhage, since the uterus can’t contract, thus it is contraindicated in placenta abruption
What does PPROM and what are the fetal symptoms? How do you dx it?
Chorioaminoitis
Fetal tachycardia
Gram stain via amniocentesis
What should be give to pt with PPROM
Antibiotics
What organism causes chorioaminoitis without PPROM?
Listeria
What is the fetal sign of parvovirus infection?
Fetal hydrops–polyhydramnios
What is the indication of severe fetal anemia on FHR?
Sinusoidal pattern
What would you see on MCA Doppler with fetal anemia?
Increase flow
Common causes of polyhydramnios ?
Fetal duodenal atresia
Isoimmunization
When to deliver via C action vs vaginal for HIV or? And should the mother breast feed?
Viral load under 1000—vaginal
Viral load over 1000—c section (before ROM)
No breast feed
What to give fetus once delivered with mother having hep B?
Hep B Ig and vaccination
Tx for chlamydia infection during pregnancy?
PO azithromycin or amoxicillin
Does c section effect transmission of hep C?
Nah
Tx for hyperthyroidism during pregnancy
PTU in first trimester and then switch to methimazole
What happens to the thyroid level during pregnancy?
Increase thyroid binding globulin and total T4
What study helps to dx IUGR? And what finding on the study is worrisome?
Umbilical artery Doppler
Reverse end diastolic flow
What can pyelonephritis cause in pregnant women?
Preterm labor or ARDS
Pt presents with fever after c section, MC cause? And MC bacteria?
Endomyometritis
Anaerobic
What would you give the pt before c section?
PPX abx
Mastitis pt with persistent fever after 48 hours of abx
Abscess
Tender mass in afebrile postpartum woman
Galactocele
What hormones cause insulin resistance during pregnancy?
hPL
Progesterone
Cortisol
What changes happens to CO, tidal volume and acid base during pregnancy?
Increased CO and tidal volume
Respiratory alkalosis
When should pregnant mothers receive TdaP vaccine?
At 28-36 weeks regardless of prior vaccination
How often do you do cervical cytology on HIV pt?
Every year
Pathology of amenorrhea of athletes
Hypothalamic dysfunction—>low estrogen
Pyelonephritis after hysterectomy, what is it and how to dx?
Urethral injury
CT
MC site for ureteral injury
Cardinal ligament
What to give before pt undergoes hysterectomy
First gen cephalosporin
Continuous blood tinged drainage from incision site, diagnosis? And what if bowel protrude through it?
Fascial disruption
Evisceration
Dx and risk factors of PID?
Laparoscopy
Nulliparity/IUD
What’s the more common cause of mucopurulent cervical discharge, chlamydia or gonnorrhea?
Chlamydia
Period pain following menarche
Primary dysmenorrhea
Too much prostaglandins
What’s behind the groove sign?
LGV
What drug to give pt before fibroid surgery?
GnRH agonist like leuprolide
What level of B-hCG would you start see anything on u/s?
1500-2000
