OB/GYN Flashcards
PID
most common causes in order (3)
empiric treatment?
Inpatient treatment meds(2)
IUD?
Chlamydia, GC, poly microbial
yes
–Cefotetan or cefoxitin; plus doxycycline
–Clindamycin plus gentamicin
remove IUD
Pictured entity
labs?
cause of strawberry cervix
associated symptom
treatment
category of important complications
Fitz Hugh Curtis sydrome - bacterial perihepatitis spread from PID/TOA
LFTs normal; violin string adhesions near liver pictured
trichomonas
abdominal pain
metronidazole
pregnancy related: PROM, LBW, preterm delivery
Most common cause of vaginal discharge
etiologic agent
CDC criteria for diagnosis
treatment
Bacterial vaginosis
lactobacilli replaced by gardenerella and anaerobes
three out of four criteria
copious thin white discharge
clue cells
pH greater than 4.5
fishy odor with KOH - whiff test
treatment: metronidazole
also has pregnancy complications
Candidal vaginitis
risk factors (4)
dx
treatment (2)
Diabetes, antibiotics, oral contraceptives, pregnancy
dx: pseudohyphae on wet mount
fluconazole 150 x1 or topical imidazole x 7 days
Bartholin Cyst/Abscess - treatment for recurrent
pictured entity + etiologic agent
risk for?
Painful?
TX (3)
Marsupialization
condyloma accuminata - HPV
cervical cancer
not painful
–Condylox (podofilox topical)
–Aldara (imiquimod topical)
–Cryotherapy
Physiologic cyst nomenclature - follicular versus corpus luteal
torsion-major risk factor/subtype
endometriosis treatments (2)
fibroids - complication, tx (2)
First two weeks versus last two weeks
benign cyst, Dermoid cyst most common
endometriosis treatments
hormonal vs surgery
fibroids - rapid growth->degeneration during pregnancy
hormonal and surgery
Most common GYN cancer
risk factors (7)
other major GYN cancer and common presentation
Endometrial - think of for ANY post-menopausal vaginal bleeding
Risk factors: Continuous estrogen, obesity, diabetes, hypertension, nulliparity, early menses, late menopause
ovarian cancer, often presents an advanced stage with ascites
Cervical cancer risk factors
prevention
risks: same as STDs
- Early coitus, multiple partners, smoking, HPV, high-risk male partners
- In HIV patients is an AIDS-defining illness
vaccine covers 2 types responsible for 70% (and 2 that cause 90% of warts)
Abnormal vaginal bleeding-nonpregnant
Cause categories
•Non-uterine: Cervix, vagina, urinary, GI, coagulation disorders
•Ovulatory: Menorrhagia (heavy bleeding), metrorrhagia (outside cycle); polyps, tumors, cancer, infection, fibroids, endometriosis, dyscrasias
•Anovulatory (DUB): Prolonged amenorrhea with intermittent menorrhagia; endocrine disorders, OCPs, liver/renal diseases, polycystic ovary, extremes of reproductive age, eating disorders. Treatment: OCP, NSAIDs or D&C
•Peri- & postmenopausal: Cancer should be considered
HCG
increases by *** for *** weeks
positive *** days after ovulation
detectable *** following delivery for Ab
SAB inevitable versus incomplete and associated tx
x2 for 8 weeks
8 days after ovulation
three weeks after delivery
inevitable: bleeding<20 weeks with open os -> D&C
incomplete: bleeding with fetal demise and retained products -> D&C
Ectopic pregnancy
risk factors (5) and most common
most common location
ultrasound evidence of IUP (3)
Risk: no risk factor (most common) previous ectopic, PID, infertility treatment, IUD, tubal ligation
distal fallopian tube
double ring sign (gestational sac), yolk sac or fetal pole, fetal heart tones
HCG level - US visibility for
transvaginal ultrasound
trans abdominal ultrasound
heterotopic pregnancy risk factor
diagnosis categories/definitions
TV: 1500- 3000 TA: 6000
risk: fertility treatments
definitive: empty uterus plus FHT outside uterus or bHCG > 1500
probable: adnexal mass, free fluid in pelvis, no IUP, +HCG
indeterminate: neither of the above; serial beta hCG and ultrasound
Ectopic pregnancy - criteria for methotrexate (2), side effect
RhoGAM mechanism/purpose/indication (5)
dose cut off point
Ectopic: size less than 4 cm, no FHT; abdominal pain, failure rate 1/3
mechanism: destroys fetal RBCs in maternal circulation
purpose: prevent maternal antibodies which could cause hemolytic anemia in future pregnancy
mother Rh negative + abortion, minor trauma, abruption, ectopic, antepartum hemorrhage
50mcg < 12 weeks, then 300 mcg
Pictured entity
AKA, what
findings (2)
complications (3)
Molar pregnancy = Gestational trophoblastic disease-proliferation of chorionic villi w/o fetus
passage of grape like clusters, virginal bleeding, size > dates, markedly elevated hcg
complications: neoplasm, preeclampsia, PE
