OB/GYN Flashcards
Down syndrome + UMN findings
AA instability
Definition of urinary retention
Post-catheter void over 150 mL
Fluoroquinolones in pregnancy
QT prolongation
Tendon problems
Avoid Bactrim when?
1st and 3rd trimesters
Treatment options for asymptomatic bacturia or UTI or cystitis
Macrobid
Amoxicillin
Augmentin
Fosfomycin
Treatment for pyelo in pregnancy
Hospitalize, IV abx, then oral abx for 10-14 days after 24 hrs of no fever
Dx and Tx options for stones in pregnancy
Dx - U/S
Tx - conservative, uteroscopy, nephrostomy
Pregnancy + unresponsive fever w/ no apparent cause + pain in pelvis
Septic pelvic thrombophlebitis
How to manage shoulder dystocia
BE CALM
Be calm Elevate legs into McRoberts Call help Apply suprapubic pressure Larger vaginal opening Maneuvers
Goals in gestational DM
Fasting under 95
1 hr under 140
2 hrs under 120
Tx options in gestational DM
- Dietary mod.
2. INSULIN or glyburide/metformin
When are tocolytics contraindicated?
When is magnesium contraindicated?
34 weeks
32 weeks
See Pre-eclampsia workup
?
When is vaginal delivery of dead baby the only option?
24+ weeks
Progression of abortion types
Threatened - alive, bleeding Missed - closed Inevitable - dilated Incomplete - partial out Complete - all out, closed
Placenta previa vs. vasa previa - whose blood? Is baby ok?
PP - mom blood, baby ok
VP - baby blood, baby in trouble
1st trimester, severe vomiting, AMS, ocular dysfunction, ataxia
Tx?
Thiamine deficiency
Thiamine, then glucose
Symmetric SGA - when? Causes?
1st trimester
Chromosomal, infection
Asymmetric SGA - when? Causes?
T2 or T3
Vascular or malnutrition
Eclampsia - tx?
DELIVER
High fetal fibronectin…when normal?
When a problem?
Signifies what?
T1 and term
T2 or T3 before term
Pre-term risk
Painless bleeding in pregnancy…causes?
PP, VP, SAB
Uterus in molar pregnancy
LGA
T3, HTN, elevated liver enzymes, anemia
HELLP
T3, elevated liver enzymes, N/V, jaundice, normotensive, leukocytosis, hypoglycemia, elevated creatinine
Acute fatty liver of pregnancy
Pregnancy, fever, tachycardia (mom or baby), uterine tenderness
Chorio
When does vasa previa bleeding present?
After ROM
Respiration in pregnancy
Increased (progesterone stimulates primary respiratory center)
BP in pregnancy
Decreased (progesterone causes smooth muscle relaxation)
H/H in pregnancy
Decreased (increased plasma volume)
Creatinine in pregnancy
Decreased (increased RBF, etc.)
Pregnant in hospital - Hypotension, bradycardia, respiratory depression
Total spinal anesthesia gone wrong
Woman w/ short cervix - how to prevent pre-term birth
Topical progesterone
Woman w/ prior pre-term birth - how to prevent repeat?
IM progesterone
When to deliver Pre-E in severe vs. not severe
What else to do?
Severe - 34 weeks
Not severe - 37 weeks
Anti-HTN + Mg
Endometriosis Tx options
- NSAIDs or OCPs or Mirena
2. TAH w/ BSO
Hypoplastic thoracic cavity, fetal demise
Osteogenesis imperfect type 2
Red discharge 1-2 days after delivery, composed of blood, fetal membranes, decidua, etc.
Lochia rubra
Brown or pink discharge 3-10 days after delivery, composed of RBCs, WBCs, cervical mucus, BACTERIA
Lochia serosa
Yellow-white discharge 2-6 weeks after delivery
Lochia alba
Prior surgical contraindications for vaginal birth
Vertical C/S
Myomectomy w/ cavity entry
Complete active phase arrest for 4+ hrs…tx?
C/S
Slowed active phase…tx?
Oxytocin
Pre-eclampsia under 20 weeks
Molar pregnancy
Pregnancy…when to give flu vaccine?
Every pregnancy ASAP
When to do DM screening in pregnancy?
24-28 wks unless high risk
When to do G/C screening in pregnancy?
High risk only - under 25, new partners, history of it
When to do Hep C screening in pregnancy?
High risk only
Risk of Mg toxicity when?
Tx?
Renal insufficiency
Calcium gluconate
What does Mg do in premies?
Decreases CP risk
Labor induction/supplementation –> tonic-clonic seizures, H/A, abd pain, lethargy
Lab finding?
Oxytocin OD (similar to ADH –> free water retention)
Hyponatremia
Normal AFI finding
5+ or 1 pocket 2x1
Normal body movement finding
3+ movements
Normal flexion/extension finding
1+ movement
Normal breathing finding
1+ breathing for 30+ sec
CI’s to breast feeding
Rec Drugs HIV Chemo/Rad Active herpes on breast Acute varicella Acute TB
1º treatment for gestational HTN
How to choose?
Labetalol or Hydralazine
No labetalol in bradycardia or hypotension (beta and alpha blocker)
2º treatment option for gestational HTN
Nifedipine (oral, not in emesis)
When is methyldopa used?
Chronic HTN in pregnancy
When is Loop used in pregnancy?
Pulmonary edema
Risk factors for post-partum bladder atony (6)
Nullip C/S Instrumental delivery Prolonged labor Regional analgesia Perineal injury
Risks in poor pregnancy weight gain (3)
Pre-term delivery
Fetal growth restriction
Polycythemia
2 functions of abx after PPROM
- Reduce infxn risk
2. Delay labor
3 risks for HG
- History
- Mole
- Multiple gestations
Lab findings in HG (K, H, Cl, Glc, H/H, urine)
Low K, high H+ (shift) Low Cl (vomiting) Low glc (malnutrition) High H/H (low volume) Ketonuria (malnutrition)
Variable decels - definition
15+ HR drop for 15-120 seconds
Abnormal tri screen in T1…what next?
When to do quad screen?
CVS (11) or amnio (18)
NEVER (no need)
AFP, B-hCG, Est, Inhib A…
Low, low, low normal
Low, high, low, high
Edwards
Downs
Adverse effects of oxytocin
Hyponatremia
HYPOtension
Uterine tachysystole
