OB/GYN Flashcards
Early Decels =
Fetal Head Compressions
Variable Decels =
Cord Compression
Late Decels =
Uteroplacental Insufficiency (hypoxia)
Pathophysiology of Hemorrhage S/P Inverted Uterus
Inverted uterus leads to inability for an adequate myometrial contraction effect –> myometrial fibers do not exert their normal tourniquet effect on the spiral arteries
Most common reason for hemorrhage in inverted uterus =
uterine atony
Atypical glandular cells =
cervical or endometrial adenocarcinoma
Patient with ppx hemorrhage, prolonged bleeding time, normal coag studies…
vWF
Pathophysiology of vWF
vWF assists in platelet adhesion and aggregation, acts as a carrier protein for factor 8
vaginal bleeding + lower abdominal pain + adnexal tenderness
ectopic pregnancy
_____ can cause hyponatremia and subsequent seizures.
Oxytocin
`Dx test for hyperemesis gravisdum
U/A for ketones
S/E of preeclampsia for newborn
small for gestational age
FHR = tachycardia is most likely due to…
maternal fever
Boggy uterus + symmetrically enlarged + long, heavy periods + >40
Adenomyosis
Heavy, long periods + pelvic pain + age b/w 25-35 =
Endometriosis
Major R/F for placenta previa
Hx of C/S
Active phase arrest is defined as:
no cervical change in > 4 hours with adequate contractions OR no change in 6 hours with inadequate contractions; managed with c/s
Mothers with O+ blood are at high risk for…
ABO incompatibility; neonates will have mild jaundice
Sheehan Syndrome
complication of massive obstetrical hemorrhage, results = amenorrhea, lactational failure, persistent hypotension
Anovulatory cycles in adolescents are…
characterized by heavy, irregular menstrual bleeding due to an immature HP axis; can stabilize with progesterone therapy
Thinning of vulvar skin + narrowing of vaginal introitus + loss of natural lubrication + clitoral shrinkage =
atrophic vaginitis
Green, frothy, malodorous d/c
Trich
secondary amenorrhea + elevated FSH + younger than 40 =
primary ovarian insufficiency
TX for stress urinary incontinence
- Pelvic floor muscle exercises (Kegels)
- Lifestyle modifications (weight loss)
- Continence pessary
- Midurethral sling procedure
Contraindication for mag sulfate…
Renal Insufficiency (dx: creatinine)
Mag sulfate is used for (2):
- prevention of eclamptic seizures
2. fetal neuroprotection against CP
Tx for mag toxicity =
calcium gluconate
Charcot’s Triad for acute cholangitis
fever + RUQ + jaundice
abdominal pain + bleeding + loss of fetal station =
uterine rupture
Pathophys for epithelial ovarian carcinoma:
abnormal proliferation of tubal epithelium
TSS Sx (3)
fever
hypotension
diffuse red macular rash
shallow ulcers + mild lymphadenopathy
HSV
Pregnant patient with fever, N/V, R-sided abdominal pain =
acute appy
Fever + any evidence of PROM =
chorioamnionitis
Tx for intra-amniotic infections
broad spectrum IV abx
expedited delivery
Tx for HPV warts
podophyllin
trichloroacetic acid
imiquimod
Patients with PID and unstable VS should…
be admitted and given 1) cefotetan/cefoxitin and 2) doxycycline
Tx regimen for preventing preterm labor
- progesterone (maintain uterine quiescence)
2. cerclage
Pathophys for uterine fibroids
Proliferation of smooth muscle cells within the myometrium
Postpartum endometritis tx
clindamycin + gentamycin
Women with mullerian agenesis should be screened with…
renal u/s
Patients with new onset Afib w/ RVR and PMH of sore throat…
Rheumatic Fever, Mitral Stenosis
Workup for secondary amenorrhea
- b-hcg
2. prolactin, fsh, testosterone, tsh
The elevated ______ during pregnancy stimulates the respiratory centers in the brain to cause increased _____ _____, increased minute ventilation, increased _____, and a physiological chronic compensated ______ _______.
progesterone
tidal volume
PaO2
respiratory alkalosis
Uterus adherent to the right with tenderness on mobilization…
endometriosis
Early signs of primary metabolic alkalosis…
hyperemesis gravidarum
Best contraception for patient with breast cancer…
copper IUD
Retrosternal crunching sound…
esophageal perforation
Greatest risk for placental abruption…
DIC
Most common cause of active labor delay…
cephalopelvic disproportion
45 X
Turner Syndrome
46 XX
Muellerian agenesis
46 XY
Androgen insensitivity (genotypically male, phenotypically female)
47 XXY
Klinefelter Syndrome
47 XYY
Angry Man Syndrome
Risk for babies born to moms with preeclampsia…
fetal growth restriction
Klumpke Palsy
“claw hand”
Horner syndrome
Contraindications to external cephalic version
Prior classical c/s
Prior extensive uterine myomectomy
Placenta previa
Complete vs. partial mole
Complete – no fetal parts; 46 XY (two sperms and broken egg)
Partial – fetal parts; 69 XXY/XXX (two sperms on one egg)
Call-Exner bodies
Granulosa Cell Tumor
Condyloma =
koilocytes
Turner’s Lab Finding =
high FSH
Increased 5 alpha reductase =
normal presentation + hairy
Decreased 5 alpha reductase =
no breasts, + hair, 46XY