OB/Gyn Flashcards
Which contraceptive has greatest risk of DVT/PE?
patch
pregnant –> positive for syphilis –> PCN allergy –> tx?
desensitize in ICU –> treat w PCN
DEXA scan –> at what age?
65yo
60yo if smoker
menopause –> what happens to FSH and anti-Mullerian hormone (increase/decrease)?
- increase FSH
- decrease AMH
how confirm rupture of membranes?
- vaginal pooling
- nitrazine test
- fern test
what is fetal fibronectin used for?
marker to assess likelihood of preterm labor bw 22-34wk pregnancy
fetal heart tone –> late decel –> indicates what?
uteroplacental insufficiency
fetal heart tone –> early decel –> indicates what?
fetal head compression –> increase vagal tone
fetal heart tone –> variable decel –> indicates what?
umbilical cord compression
pregnant –> DVT –> tx?
SQ LMWH
PID –> inpt tx –> abx?
- cefoxitin + doxy
- clinda + gent
PID –> outpt tx –> abx?
ceftriaxone + doxy + metro
secondary amenorrhea –> preg test negative –> next step?
check FSH, TSH, prolactin
Down synd –> quad screen results
- AFP decreased
- estriol decreased
- Bhcg increased
- inhibin increased
quad screen:
- AFP decreased
- estriol decreased
- Bhcg decreased
- inhibin decreased
what condition?
Trisomy 18
quad screen:
- AFP increased
- estriol normal
- Bhcg normal
- inhibin normal
what condition?
open neural tube defect
quad screen:
- AFP normal
- estriol normal
- Bhcg normal
- inhibin normal
what condition?
- normal fetus
- trisomy 13
quad screen:
- AFP normal
- estriol decreased
- Bhcg normal
- inhibin normal
what condition?
X-linked ichthyoses (steroid sulfatase deficiency)
chorionic villous sampling –> at what gestation can be performed?
9-11wk gestation
at what gestation can amniocentesis be performed?
15-20wk gestation
chorionic villous sampling prior to 9wk gestation increases fetal risk of what?
limb abnormalities
DEXA scan –> Tscore of what diagnoses osteoporosis?
< -2.5
DEXA scan –> Tscore of what diagnoses osteopenia?
-1 to -2.5
gestation diabetes –> when screen for it?
24-28wk gestation (2nd trimester)
pap –> atypical glandular cells –> next step
colposcopy w endocervical curettage
1st trimester –> genetic screen components
- UA nuchal translucency
- PAPP-A
- hCG
2nd trimester –> genetic screen components
triple screen:
- hCG
- AFP
- estriol
quad screen: inhibin-A
AFP –> elevated in what conditions (4)
- neural tube defect
- abdominal wall defect (gastroschisis, omphalocele)
- mult gestation
- error in gestational age
how dx gestational DM?
1hr gtt >140
```
then 3hr gtt:
- fasting >90
- 1hr >180
- 2hr >155
- 3hr >140
any 2
~~~
gestation DM –> tx
insulin (based on post-prandial sugars) <180
20-28wk gestation –> what conditions are screened for (3)
- gestational DM
- Rh Ag status
- maternal anemia
28wk gestation –> under what conditions give rhogam?
- mom is negative for Rh Ag and Rh Ab
- dad is Rh Ag+ or unknown
gestational DM –> goal fasting glucose
<95
3rd trimester –> painless vaginal bleeding –> what condition?
placenta previa
3rd trimester –> painful vaginal bleeding –> what condition?
placental abruption
placenta previa –> RF (3)
- prior C/S
- multiparity
- uterine surgery
3rd trimester –> vaginal bleeding –> next step
fetal ultrasound
placental previa –> pelvic exam is contraindicated –> T/F?
T
hydatidiform mole –> tx
D&C
hydatidiform mole –> tx w D&C –> followup management
monitior hCG –> continued high level can indicate malignancy (commonly mets to lung)
late decel –> uteroplacental insuff –> decreased oxygen delivery to fetus
MCC
excessive uterine contraction
late decel –> uteroplacental insuff – due to excessive uterine contraction
common cause of excessive uterine contraction
oxytocin administration