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PANCE > OB GYN > Flashcards

OB GYN Flashcards

1
Q

Preeclampsia

- RF

A
  • > 40 yo
  • nulliparity
  • fam hx
  • oesity
  • twins
  • hx HTN, DM, renal dz
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2
Q

Preeclampsia

- dx

A
  • new onset HTN >140/90
  • proteinuria >300 mg/24 hour
  • > 20 weeks gestation
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3
Q

Preeclampsia

- mgmt

A
  • > 37 weeks: deliver
  • 34-37 weeks: induced if severe dz
  • <34 weeks: steroids
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4
Q

Mifepristone

- CI

A
  • chronic adrenal failure
  • long term steroid use
  • drug is glucocorticoid receptor antagonist
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5
Q

Medical abortion

- meds

A
  • Mifepristone followed by misoprostol

- copper IUD

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6
Q

Cyclical breast pain

- mgmt

A
  • Reassurance, physical support (bra) and NSAID/tylenol

- second line: tamoxifen, danazol for 1-3 months only

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7
Q

APGAR
score range
details

A 
0-10
- Appearance: 
0 blue/pale 
1 body pink extremities blue
2 pink all over
- Pulse:
0 absent
1 <100
2 >100
- Grimace
0 Flaccid
1 grimace with stimulation
2 active motion - sneeze, cough, pulls away
- Activity / m tone
0 absent
1 arms/legs flexed
2 active movement
- Respiration
0 absent
1 slow, irregular
2 vigorous cry
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8
Q

Fetal station

A

Position of presenting part (usu head) in centimeters relative to line across ischial spines

  • superior = negative station (negative numbers 1-5)
  • inferior = positive station (pos numbers 1-5)
  • at the line: 0 station
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9
Q

Best way to dx herpes simplex

A

PCR

- Tzanck less sensitive/specific

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10
Q

Placental abruption

- biggest RF

A

prior placental abruption

also HTN, cigs, cocaine, multiparty

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11
Q

Ovarian torsion

- definitive dx

A

laparoscopy

- pelvic US first line

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12
Q

Labor induction

A
  • ripen cervix (Bishop <6): prostaglandin E2 or E1 (dinoprostin/misoprostol)
  • oxytocin
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13
Q

Bishop score

A

Higher = greater chance of successful vag delivery

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14
Q

Cord prolapse

- mgmt

A
  • elevate presenting part of fetus
  • trendelenburg position
  • tocolytic
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15
Q

Infertility

- dx best test

A
  • anti-mullerian hormone: decline steadily with age, undetectable at menopause
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16
Q

Fetal non stress test

- overview

A

measures

  • fetal heart rate
  • uterine contractions

Reactive (nl) if
- 2+ fetal HR accelerations 15 bpm for 15 second in 20 min

Nonreactive (abnl)
- no sig acceleration of HR, repeat in 30 min (sleeping?)

17
Q

Fetal biophysical profile

- measure what

A
  1. fetal tone
  2. fetal breathing
  3. fetal movement
  4. amniotic fluid volume
18
Q

Early vs. late decelerations

A

Early: fetal head compression
Late: fetal hypoxemia - placental insufficiency or cord compression

19
Q

Ovarian cancer

A

MCC gyn cancer death

  • MC epithelial cell origin
  • pelvic US to start
20
Q

Ovarian cancer tumor marker

A

CA 125

21
Q

Placenta accreta spectrum

A
  • accreta: attaches to myometrium
  • increta: into myometrium
  • percreta: penetrates through myometrium
22
Q

Lymphogranuloma venereum

  • bug
  • location
A
  • chlamydia trachomatis

- Africa, SE Asia, Caribbean, S. America

23
Q

Lymphogranuloma venereum

- clinical

A
  • painless vesicle or ulcer, resolves spontaneously
  • inguinal buboes bilaterally > multiple draining sinuses
  • proctitis with tenesmus, bloody purulent drainage from anal region, scarring of perirectal tissue
24
Q

Lymphogranuloma venereum

- mgmt

A
  • doxy 100 mg BID X 21 D

- I&D inguinal buboes

25
Q

Anterior fontanelle

- composed of what sutures

A
  • coronal
  • frontal
  • sagittal
26
Q

Best fetal presentation

A
  • longitudinal
  • cephalic
  • vertex
  • occiput anterior
27
Q

Adenomyosis

- overview

A
  • endometrial tissue is in myometrium
28
Q

Adenomyosis

- clinical

A
  • abnl uterine bleeding
  • painful menses
  • uterine enlargement
  • globular, boggy, symmetric uterus on palpation
29
Q

Adenomyosis

- mgmt

A
  • NSAIDs
  • OCPs
  • endometrial ablation, resection if conservative fails
  • definitive: hysterectomy
30
Q

First line dx for dysfunctional uterine bleeding

A
  • transvaginal US
31
Q

Abnormal Uterine Bleeding

- causes

A

PALM COEIN

  • Polyp
  • Adenomyosis
  • Leiomyoma
  • Malignancy/hyperplasia
  • Coagulopathy
  • Ovulatory dysfunction
  • Endometrial
  • Iatrogenic
  • Not yet classified
32
Q

Hypermg

- sx

A
  • Loss of DTR
  • Decr respirations
  • Impaired urinary output
33
Q

Endometrial Hyperplasia

- RF

A
  • increased exposure to estrogen: obesity, PCOS, exogenous E
34
Q

Endometrial Hyperplasia

- clinical

A
  • abnormal uterine bleeding
35
Q

Endometrial Hyperplasia

- dx

A
  • endometrial bx

- pelvic US to ro other causes of AUB

36
Q

Endometrial Hyperplasia

- mgmt

A
  • no atypia: Progestins (IUD)

- atypia: Hysterectomy (keep the eggs)

PANCE (14 decks)

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