OB/Gyn

Question 1

Threatened miscarriage

Answer 1

os is closed
pt stable
mild to moderate pain
EVUS: >5 wks - gestational sac with fetal cardiac activity

Question 2

Complete miscarriage

Answer 2

Os is closed
may have passed POC
+/- abd pain
EVUS: empty uterus

Question 3

Inevitable miscarriage

Answer 3

Os is open 
Possible POC in os
Abd pain 
Declining b-hCG
EVUS w/ retained POC

Question 4

Incomplete miscarriage

Answer 4

Os may be open or closed
May have passed partial POC or going to pass
EVUS retained POC but no fetal cardiac activity

Question 5

Missed abortion

Answer 5

Fetal death <20 wks
Os closed
+/- abd pain, no passage of POC
no fetal cardiac activity

Question 6

Septic abortion

Answer 6

Os open or closed 
abd pain 
fever 
\+CMT 
foul smelling d/c
may be peritoneal 
EVUS: thickened, irregular endometrium, no clear sac

Question 7

What is the MCC of SAB

Answer 7

chromosomal abnormalities (50-60%)

Question 8

Where do ectopic pregnancies MC occur?

Answer 8

fallopian tube

Question 9

Pregnancy Induced Hypertension

Answer 9

HTN that develops after 20 weeks of gestation in the absence of proteinuria and returns to normal postpartum

Question 10

Preeclampsia

Answer 10

new onset of HTN and either proteinuria or end-organ dysfunction after 20 week of gestation in a previously normotensive woman

Question 11

Eclampsia

Answer 11

presence of convulsions in a woman with preeclampsia not explained by neuro disorder

note:  Most cases occur within 24 hours of delivery but approximately 3% of cases diagnosed between 2 and 10 days postpartum

Question 12

HELLP Syndrome

Answer 12

often no HTN/+/- proteinuria

Presence of Hemolysis, Elevated Liver enzymes, and Low Platelet count

initial symptoms may be vague; n/v; viral-like syndrome, malaise, epigastric pain, HA

Question 13

BP tends to decline in 2nd trimester, True or False

Answer 13

True

Question 14

Eclampsia leads to what maternal risks and how do you help prevent these

Answer 14

MSK injury, hypoxia, and aspiration

insert padded tongue blade
restrain gently as needed
maintain adequate airway
gain IV access

Question 15

Fitz Hugh-Curtis Syndrome

Answer 15

late PID that produces pelvic peritonitis and perihepatitis

get a laproscopy

Question 16

PID can be empirically treated without lab evidence if at least what is present

Answer 16

uterine or adnexal tenderness AND CMT

Question 17

What increases the risk for ovarian torsion

Answer 17

those with ovarian masses or those with pelvic adhesions

Question 18

Placental Abruption Complications

Answer 18

Complications include maternal death from hemorrhage or DIC, fetal death, fetomaternal transfusion, amniotic fluid embolism, fetal distress, hypotension.

Question 19

What triad leads you to suspect abruptio placentae

Answer 19

sudden onset of antepartum vaginal bleeding, a tender uterus, and hypertonic/hyperactive uterine contractions

Question 20

What is the MC risk factor for pllacental abruption

Answer 20

HTN

other risk factors: maternal trauma, AMA, multiparity, smoking, cocaine use, previous abruptions

Question 21

Placental Abruption vs. Placental Previa

Answer 21

Placental Abruption = pain and bleeding

Placental Previa = painless and bleeding (bright red)

Question 22

If previa is on the differential do not do what?

Answer 22

do not do a digital or speculum exam