Ob/Gyn Flashcards
Mammary Pagets is associated with
Adenocarcinoma
Complex multiloculated adnexal mass with thick walls and internal debris
Tubo-ovarian abscess
Klumpke palsy
C8 and T1
“claw hand”: extended wrist, hyperextended MCP, absent grasp
Horner syndrome
Intact Moro and biceps reflex
Erb-Duchenne palsy
C5-6
“waiters tip”: extended elbow, pronated forearm, flexed wrist & fingers
Intact grasp reflex; decreased morro and biceps
Fx humerus or clavicle during birth
Bony crepitus
Decreased moro reflex d/t pain
Theca lutein cysts
Multilocular, bilateral, ovaries 10-15cm
Due to ovarian hperstimulation from trophoblastic disease or multi gestation
Pudendal nerve injury
During labor
Perianal sensation and wink reflex
Nodules in the recto-vaginal septum, posterior cul-de-sac or uterosacral ligament
Endometriosis
Granulosa cell tumors
Produce estrogen (high estradiol and inhibin); chronic, unopposed estrogen -> endometrial hyperplasia and postmenopausal bleeding OR precocious puberty
Prior HSV infection during pregnancy
Antivirals at 36 weeks
C-section if lesions or prodromal sx during labor
Extremely elevated AFP
NTD, ventral wall defects, multiple gestations
GU syndrome of menopause
Dryness, dyspareunia, bleeding, incontinence, UTIs, pelvic pressure
Looks like lack of estrogen
Give topical estrogen
HPV screening
21-65
Abnml -> colposcopy
Endocervical + -> cone biopsy
ASCUS -> repeat pap q3m or HPV DNA
Endometrial cancer
Estrogen exposure; adeno
- Fat and old
- Young with PCOS
- Thin and old on hormones
- Granulosa-theca tumor
Epithelial ovarian carcinoma
Trauma of ovulation
Presents: renal failure, SBO, ascites cystadenos and Brenner
Solid mass with thick separations
Endodermal sinus tumor
Type of germ cell tumor
Elevated AFP
Vulvar cancer
Most common: SCC
Black lesions: melanoma
Red lesions: pagets
All will have pruritis
Symmetric FGR
Chromosomal anomalies or congenital infections
Asymmetric FGR
Vasculopathy
When to give Rhogam?
28-32 weeks
<72 hours of delivery
Homogenous cystic adnexal mass
Endometriosis
PID
Gonorrhea think the sketch!
Lichen planus
Itching, dyspareunia, vaginal involvement
white lesion, oral ulcers OR purple papules
Biopsy
Treat with corticosteroids
Lichen sclerosis
White lesions, itching
NO vaginal involvement
Mullerian agenesis
No uterus or cervix; otherwise normal secondary sex characteristics
Normal testosterone and FSH
Check the kidneys
5-alpha-reductase deficiency
46,XY that appear female until puberty
Virilization
Androgen insensitivity
X-linked; 46XY
Looks female, breast, no axillary or pubic hair
Female external genitalia; no uterus, cervic and upper 1/3 vagina
Cryptorchid testes
Intraheaptic cholestasis of pregnancy
3rd trimester, pruritic (hands and feet), no rash, RUQ pain
Risks: demise, preterm, meconium, RDS
Deliver at 37 weeks, ursodeoxycholic acid
Placenta previa risks
Prior c-section, prior placenta previa, multiple gestation, advanced maternal age
Risk factors for shoulder dystocia
Macrosomia, maternal obesity, excessive weight gain, GDM, post-term
Bloody nipple discharge
intraductal papilloma
Normal 3-hr glucose tolerance
<140
Melasma
Hyperpigmentation on sun-exposed areas; common in pregnancy
Tamoxifen risks
Hot flashes, DVT, endometrial hyperplasia/carcinoma
Sx of endometriosis
Chronic pelvic pain, dysmenorrhea, deep dyspareunia, dyschezia
Small, non-tender uterus that is immobile
Dx chorioamnionitis
Maternal fever + fetal tachy OR maternal leukocytosis OR purulent amniotic fluid
DCIS
Microcalcifications on mammography
Fibroadenoma
Solitary, painless, firm, mobile mass
Breast pain and diffuse nodularity
Fibrocystic change (usually post menopause)
Inflammatory breast cancer
Diffuse erythema and peau d’orange
Lobular breast carcinoma
fixed, palpable mass with irregular borders
Adenomyosis
Endometrial tissue in the uterine myometrium
Dysmenorrhea, heavy bleeding, pelvic pain, uterine enlargement
Boggy, tender uterus
Aromatase deficiency
Converts androgens into estrogens -> excess androgens but otherwise normal
(Can also have masculinization of mother during pregnancy)
Classic congenital adrenal hyperplasia
Female: ambiguous external genitalia w/ normal internal organs; electrolyte abnormalities
Kallmann
X-linked
Hypogonadrtropic hypogonadism w/ anosmia
LH and FSH low
McCune-Albright
Cafe au lait, polyostoic fibrous dysplasia and autonomous endocrine
Precocious puberty
Primary ovarian insufficiency
Amenorrhea, lack of progesterone with draw bleeding, low estrogen, elevated FSH
Functional hypothalamic amenorrhea
Nutrient deficiency women
No withdraw bleeding after progesterone due to low estrogen
FSH low
Intrauterine adhesions (synechiae)
Asherman syndrome
Risks: infection or intrauterine surgery
Theca lutein cyst
Cystic, bilateral ovarian masses
Virilization risk of mother
Regress after deliver
Optimal fetal presentation
occiput anterior
When do you do oral glucose challange?
24-28 weeks
Hirsutism in women with normal testosterone
5-alpha reductase excess
Risk factors for PPROM
Previous PPROM, GU infection, bleeding
