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tsomkapQ > Ob/Gyn COPY > Flashcards

Ob/Gyn COPY Flashcards

1
Q

Why do pregnant women get Anemia?

A

Due to the dilution effect: RBC rises 30%, but body volume rises 50%

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2
Q

What are the degrees of Vaginal Lacerations?

A

1st Degree: Skin
2nd Degree: Muscle
3rd Degree: Anus
4th Degree: Rectum

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3
Q

What is Vernix?

A

Cheesy baby skin. (protects the baby’s skin from the outside world and helps with passage through the birth canal)

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4
Q

What is Meconium?

A

Green baby poop (first poop)

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5
Q

What is Lochia?

A

Endometrial slough. (normal discharge and uterus after birth)

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6
Q

What is normal blood loss during a Vaginal Deliver?

A

500 mL

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7
Q

What is normal blood loss during a C-section?

A

1000 mL

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8
Q

How do you treat A1 Gestational DM?

A

Diet

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9
Q

How do you treat A2 Gestational DM?

A

Insulin

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10
Q

What are Identical Twins?

A

Eggs split into perfect halves “Monochorionic”

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11
Q

What are Fraternal Twins?

A

Multiple eggs fertilized by different sperm

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12
Q

What is Ovarian Hyperstimulation syndrome?

A

Weight gain and enlarged ovaries after clomiphene use for infertility

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13
Q

Who Makes the Trophoblast?

A

Baby

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14
Q

Who makes the Cytotrophoblast?

A

Mom production of GnRH, CRH, TRH, and Inhibin

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15
Q

Who makes the Syncytiotrophoblast?

A

Mom and baby production of HCG and HPL

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16
Q

When does Implantation occur?

A

1 week after fertilization

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17
Q

When is Beta HCG found in Urine?

A

2 weeks after fertilization

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18
Q

When is B-HCG found in Blood?

A

8-10 days after fertilization

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19
Q

What makes Progesterone in >10 weeks gestation?

A

Placenta

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20
Q

What is the function of B-HCG?

A

Maintains Corpus Luteum, sensitizes TSH receptors to make body hyperthyroid (to raise BMR)

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21
Q

What makes B-HCG?

A

Placenta (synctiotrophoblast)

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22
Q

How fast should B-HCG rise?

A

Shoulde double every 2 days until 10 weeks, stops when placenta is fully formed

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23
Q

What is the fucntion of AFP?

A

Regulates intravascular volume

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24
Q

What is the function of HPL?

A

Blocks insulin receptors so the sugar stays high, (baby is stocking up - hibernating)

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25
Q

What is the function of Inhibin?

A

Inhibits FSH so there is no menstruation

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26
Q

What is the function of Cortisol in Pregnancy?

A

Decreases immune rejection of the baby out of mom and for lung maturation

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27
Q

What is the function Oxytocin?

A

Milk and baby ejection

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28
Q

What is the thyroid hormone levels during Pregnancy?

A

Increased TBG - leads to increased total T4 (Bound and free)

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29
Q

When can you first detect fetal heart tones?

A

Week 20

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30
Q

When can you tell the sex of the baby by US?

A

Week 16

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31
Q

What does an AFI <5 indicate?

A

Oligohydramnios (Cord compression)

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32
Q

What does an AFI >20 indicate?

A

Polyhydramnios (DM)

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33
Q

How fast should fundal height change?

A

Uterus grows 1 cm/week

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34
Q

What is the Pool Test?

A

Fluid in the vagina

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35
Q

What is Ferning?

A

Estrogen crystallizes on slide. (Amniotic fluid)

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36
Q

What is Nitrazine?

A

Detects presence of amniotic fluid. (pH indicator - strip will turn blue if pH is greater than 6.0)

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37
Q

What is the risk of Chorionic Villus Sampling?

A

Fetal limb defects. (Done at 9-12 weeks)

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38
Q

What is the risk of Amniocentesis?

A

Abortion (2% risk)

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39
Q

What is a Biophysical Profile (BPP)?

A

By US look for:
Non-stress test
AFI
Fetal heart tone
Fetal Activity
Breathing Movement

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40
Q

What is a normal BPP?

A

> 8-10

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41
Q

How much weight should a woman gain during Pregnancy?

A

1 lb/ week

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42
Q

When should Intercourse be avoided during Pregnancy?

A

Cervical dilation, placenta previa, premature labor, vaginal bleeding, ruptured membranes, genital herpes

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43
Q

What are the Leopold Maneuvers?

A

To determine the position of the baby
Feel the fundus
Feel the baby’s neck
Feel the pelvic inlet
Feel the baby’s head

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44
Q

What is Stage 1 of Labor?

A

Starts with the onset of true labor and lasts until the cervix is completely dilated to 10 cm

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45
Q

What is the Stage II of Labor?

A

Continues after the cervix is dilated to 10 cm until the delivery of the baby

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46
Q

What is Stage III of Labor?

A

Delivery of the placenta

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47
Q

How do you monitor Baby’s Heart Rate?

A

Doppler or scalp electrode

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48
Q

How do you monitor the Uterus?

A

Tocodynamics, uterine pressure catheter. (Measure frequency and duration of contractions)

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49
Q

What are Braxton-Hicks Contractions?

A

Irregular contractions with closed cervix. (preparing for birth)

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50
Q

What is a Vertex Presentation?

A

Posterior Fontanel (triangle shape) presents first (normal)

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51
Q

What is a Sinciput Presentation?

A

Anterior Fontanel (Diamond shape) presents first

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52
Q

What is Face Presentation?

A

Mentum Anterior preform forceps delivery

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53
Q

What is a Compound Presentation?

A

Arm or hand on head, vaginal delivery. (Mean’s Prolapse of fetal extremity with presenting part)

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54
Q

What is a Complete Breech?

A

Butt down, thighs, and legs flexed

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55
Q

What is a Frank Breech?

A

Butt down, thigh flexed, legs extended (Pancake)

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56
Q

What is a Footling Breech/Incomplete breech?

A

Butt down. Thigh flexed, one toe is sticking out of the cervical OS

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57
Q

What is a Double Footling Breech?

A

Two feet sticking outside the cervical OS

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58
Q

What is Shoulder Dystocia?

A

Head is out of vagina, shoulder is stuck. (Occurs in late term deliveries and DM in mom)

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59
Q

Can you try a Vaginal Delivery on a woman who has had a Classic Horizontal C-Section previously?

A

No, they must have C-Section for all future pregnancies

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60
Q

Can you try a Vaginal Delivery on a woman who had a LOW Transverse C-Section previously?

A

Yes, 70% are okay, Potential for uterine wall rupture

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61
Q

What is Early Deceleration?

A

Normal due to head compression

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62
Q

What is Late Deceleration?

A

Due to uteroplacental insufficiency because the placenta cannot provide oxygen and nutrients

Late deceleration is defined as a visually apparent, gradual decrease in the fetal heart rate typically following the uterine contraction. The gradual decrease is defined as, from onset to nadir taking 30 seconds or more.

VEAL: CHOP
Late Decelerations: Placental Insufficiency

Variable Decels - Cord Compression
Early decels - Head compression
Accelerations - OK, indicates fetal well being (Increases of the fetal heart rate of at least 15 beats per minute above baseline that start and peak within 30 seconds, but not less than 15 seconds are termed accelerations. These should subside within 2 minutes.)
Late decels - placental insufficiency

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63
Q

What is Variable Deceleration?

A

Cord Compression

variable decelerations are caused by compression of the umbilical cord. Pressure on the cord initially occludes the umbilical vein, which results in an acceleration followed by occlusion of the umbilical artery, which results in a sharp deceleration as the fetal blood supply is suddenly restricted

Variable decelerations are THE MOST COMMON TYPE of fetal deceleration.

They typically occur during the first and second stages of labor (i.e., the initial contractions and dilation of the cervix leading to the delivery of the infant, respectively) and vary in shape, duration, and intensity. They often resemble the letter “U,” “V” or “W” and may not have a constant relationship with uterine contractions.

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64
Q

What is increased beat-to-beat variability?

A

Fetal Hypoxia

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65
Q

What is Decreased beat-to-beat variability?

A

Acidemia

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66
Q

What are the SYmptoms of Pre-eclampsia?

A

Headaches, changes in vision, and epigastric pain

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67
Q

What is Pre-Eclampsia?

A

Ischemia to the placenta causes HTN greater than 140/90

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68
Q

What is the Treatment for Pre-Eclampsia?

A

Delivery, MgSO4 (seizures), Hydralazine (BP)

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69
Q

What is HELLP Syndrome?

A

Hepatic injury causing:
H- Hemolysis
EL- Elevated Liver Enzyme
LP- Low Platelets

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70
Q

What is Eclampsia?

A

HTN with seizures

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71
Q

What is the Treatment for Eclampsia?

A

4mg MgSO4 IV (Seizure prophylaxis)

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72
Q

What is Chorioamnionitis?

A

Fever, uterine tenderness, decreased fetal HR

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73
Q

What are the symptoms of Amniotic Fluid Emboli?

A

Mom just delivered Baby and mom has SOB, due to PE, leads to death

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74
Q

What is Endometritis?

A

Postpartum uterine tenderness

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75
Q

What is an Incomplete Molar Pregnancy?

A

2 Sperm + 1 egg (69, XXY) mom “cooks the parts” has embryo parts

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76
Q

What is a complete molar pregnancy?

A

2 Sperm and no egg (46, XX) both are paternal, bunch of graps, dad eats grapes, no embryo
(GROSS!)

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77
Q

What is Pseudocyesis

A

Fake pregnancy with all the signs and symptoms

78
Q

What is the most common cause of first trimester maternal death?

A

Ectopic pregnancy

79
Q

What is the most common cause of first trimester spontaneous abortions?

A

Chromosomal abnormalities

80
Q

What are the most common causes of third trimester spontaneous abortions?

A

Anti-Cardiolipin Ab, placenta probelms, infection, incompetent cervix

81
Q

What is a threatened Abortion?

A

Cervix is closed, baby is intact, treat with bed rest

82
Q

What is inevitable Abortion?

A

Cervix is open, baby is intact

83
Q

What is an incomplete Abortion?

A

Cervix is open, fetal remnants
Tx: D&C to prevent placenta infection

84
Q

What is a Complete Abortion?

A

Cervix is closed, no fetal remnants, check B-HCG level

85
Q

What is a Missed Abortion?

A

Cervix is closed, no fetal remnants (“empty sac”)

“Cramping, loss of early pregnancy symptoms. NO BLEEDING. No fetal cardiac activity. products of conception present on US”
Tx. D&C

86
Q

What is a Septic Abortion?

A

Fever greater than 100.4 F, malodorous discharge

87
Q

What is Placenta Previa?

A

The placenta is implanted wholly or partially in lower uterine segment

88
Q

Waht is Vasa Previa?

A

Babies blood over OS

89
Q

What is Placenta Accreta?

A

Placenta is attached to the endometrium

90
Q

What is Placenta Percreta?

A

Placenta perforates through serosa

91
Q

What is Placenta Abruptio?

A

Severe pain due to premature separation of the placenta

92
Q

What is Velamentous Cord Insertion?

A

Fetal vessels insert between chorion and amnion

93
Q

What is Uterus Rupture?

A

Tearing sensation, halt of delivery

94
Q

What is an Apt Test?

A

Detects HbF in the Vagina, detects baby’s hemoglobin (Alkali denaturation test)

95
Q

What is Wright’s Stain?

A

Detects nucleated fetal RBC in mom’s vagina

96
Q

What is a Kleihauer-Betke Test?

A

Detects percentage of fetal blood in maternal circulation (Dilution test)

97
Q

What is Materninty Blues?

A

Postpartum crying and irritability

98
Q

What is Postpartum Depression?

A

Depression post-delivery for more than 2 weeks

99
Q

What is Postpartum Psychosis

A

Hallucinations, suicidal/infaticidal thoughts

100
Q

What does Seminal Vesicle give to Sperm?

A

Food (Fructose) and clothes (semen)

101
Q

What does the Bulbourethral/ Cowper’s Glands secrete?

A

Bicarb to neutralize lactobacilli, if sperm is too acidic. (Infertility until corrected)

102
Q

What does the Prostate Secrete?

A

The prostate HAZ it.
H- Hyaluronidase
A- Acid Phosphatase
Z- Zinc

103
Q

What is the Capacitation reaction?

A

Allow binding btwn sperm & egg

104
Q

What is the Acrosomal reaction?

A

Sperm release enzymes to eat the Corona Radiata

105
Q

What is the Crystallization reaction?

A

Wall formed after one sperm enters to prevent polyspermy

106
Q

Where does Testosterone come from?

A

Adrenal gland and testicles

107
Q

Where does DHT come from?

A

Testicles at puberty

108
Q

What is Pseudohermaphrodite?

A

external genitalia problem

109
Q

What is a True Hermaphrodite?

A

Internal genitalia problem (has both sexes)

110
Q

What is a Female Hermaphrodite?

A

Impossible because female is the default formation

111
Q

Classic congenital adrenal hyperplasia

A

XX with LOW 21-OHase and HIGH Testosterone

112
Q

Androgen insensitive syndrome

A

XY with no MIF

113
Q

congenital adrenal hyperplasia (CAH)

A

congenital adrenal hyperplasia (CAH)

XY with LOW 17-OHase and LOW Testosterone

results from loss-of-function mutations involving the CYP17 gene
.

114
Q

What is Hirsutism?

A

Hairy female (Excess growth in normal male areas)

115
Q

What is Virilization?

A

Female that is Man like

116
Q

What is woman with a blind pouch vagina but an XY karyotype?

A

Androgen Insensitivity Syndrome: males with defective / bad DHT receptor

AKA Testicular Feminization

117
Q

What is McCune-Albright?

A

Precocious sexual development, polyostotic fibrous dysplasia “whorls of connective tissue”, “coast of Maine” pigemented skin macules

118
Q

What is Cryptorchidism?

A

Testes never descended out of abdomen, sterility after 15 months, predisposed to seminomas and CA

119
Q

Which stage of the Menstrual Cycle has the highest Estrogen levels?

A

Follicular stage (Has proliferative endothelium)

120
Q

What stage of the menstrual cycle has the highest Temperature?

A

Ovulatory stage, body temp will rise One degree during ovulation

121
Q

What stage of the Menstrual Cycle has the highest level of Progesterone?

A

Luteal stage (Has secretory endothelium)

122
Q

What form of Estrogen is highest at Menopause?

A

E1: Estrone (Made by Fat)
E2: Estradiol (Made by the ovaries)
E3: Estriol (Made by the placenta)

123
Q

What states have increased Estrogen?

A

Pregnancy, liver failure, P-450 inhibition, and obesity

124
Q

What is Adenomyosis?

A

Growth of the Endometrium, Myometrium, and patients will have an enlarged “boggy” uterus with cystic areas

125
Q

What does DES taken by Mom cause in her Daughter?

A

Adenomyosis, menorrhagia, clear cell CA of the vagina, recurrent abortions

126
Q

What is Kallmann’s Syndrome?

A

No GnRH and Anosmia. (They can’t smell)

127
Q

What is Polycystic Ovarian Syndrome?

A

Increased cysts. No ovulation due to no Progesterone, leads to increased Endometrial CA, they cannot inhibit LH, obese, hairy, acne

128
Q

What is Savage’s Syndrome?

A

Ovarian resistance to LH/FSH

129
Q

What is Turner’s Syndrome (XO)?

A

High FSH, LOW E2, Ovarian Dysgenesis, Webbed Neck, Coarctation of the Aorta, Cystic Hydroma, bicuspid Aortic valve

130
Q

What does the Progesterone Challenge Test tell you?

A

Progesterone withdrawn—> Vaginal bleeding if she has estrogen.

Progesterone withdrawn –> If she does NOT bleed, she has no E2 or ovaries

Increased FSH: Ovary problem
Decreased FSH: Pituitary problem

131
Q

What is SHeehan Syndrome?

A

Postpartum hemorrhage in pituitary, no LH or FSH = no periods, hyperplasia infarcts, no prolactin = no milk

132
Q

What is Asherman’s Syndrome?

A

Uterine scars from multiple D&Cs

133
Q

What is Oligomenorrhea?

A

Too few periods

134
Q

What is Polymenorrhea?

A

Too many periods

135
Q

What is the most common cause of post-coital Vaginal Bleeding?

A

Cervical CA

136
Q

What is the most common cause of post-coital Vaginal Bleeding in Pregnant women?

A

Placenta previa

137
Q

What is the most common cause of Vaginal Bleeding in Post-menopausal women?

A

Endometrial CA

138
Q

What is Chronic Pelvic Pain?

A

Endometriosis until proven otherwise

139
Q

What is Dysfunctional Uterine Bleeding?

A

Diagnosis of exclusion, usually due to anovulation

CAUSES of abnormal bleeding- PALM COEIN

Polyp
Adenomyosis
Leiomyoma
Malignancy

Coagulopathy
Ovarian dysfunction
Endometrial causes
Iatrogenic
Non identified

140
Q

What is Dysmenorrhea?

A

PG-F causes painful menstrual cramps. (Teenagers miss school / work)

141
Q

What is Endometriosis?

A

Painful cyclical heavy menstrual bleeding
“Powder burns and chocolate cysts” due to ectopic endometrial tissue. (Endometrial Tissue outside of uterus)

142
Q

What is Kleine Rechnung?

A

Scant bleeding at ovulation

143
Q

What is Menorrhagia?

A

Heavy menstrual bleeding

144
Q

What are Fibroids (Leiomyoma’s)?

A

Benign uterus smooth muscle tumor
submucosal type: they bleed
Subserosal type: they cause pain

145
Q

What is Metorrhagia

A

Bleeding or spotting in btwn periods

146
Q

What is Mittelschmerz

A

Pain with ovulation

147
Q

What causes Syphilis?

A

Treponema Pallidum (Spirochete)

148
Q

What is Herpes?

A

ds DNA virus

149
Q

What is HPV?

A

ds DNA virus, vaccine out not covers 8-27 year old female to block HPV 6, 11, 18 STD

150
Q

What is Chlamydia?

A

Obligate intracellular bacteria. Can present asymptomatic or PID Cervicitis (yellow pus)
Conjunctivitis

151
Q

What causes Gonorrhea?

A

Gram-negative Diplococcus, presents with mucopurulent discharge. Can be present with Palmer Pustule, arthritis/joint pain, urethral discomfort

152
Q

What causes Chancroid?

A

Haemophilus Ducreyi

153
Q

What causes Granuloma Inguinale?

A

Calymmatobacterium
Granulomatosis
Klebsiella Granulomatis

154
Q

What is Epididymitis?

A

Chlamydia Trachomatis. Unilateral scrotal pain decreased by support

155
Q

What is the most common cause of Epididymitis?

A

Chlamydia Trachomatis, N. Gonorrhea, E. Coli

156
Q

What is Condylomata Lata?

A

Flat fleshy warts, ulcerate = secondary syphilis

157
Q

What is Condyloma Acuminata?

A

Verrucous “cauliflower” warts, koilocytes, due to HPV 6 and 11

158
Q

How does Herpes present?

A

Primary: Painful grouped vesicles on red base
Secondary: Painful solitary lesion

159
Q

How does Syphilis present?

A

Primary: Painless Chancre (1-6 weeks)
Secondary: Rash and Condyloma Lata (After 6 weeks)
Tertiary: Neurological and Cardiac issues, in Bone (after 6 years)

160
Q

How does Chancroid present?

A

Painful with necrotic center, due to Haemophilus Ducreyi (Gram Negative rod)
“School of Fish” pattern

161
Q

How does Lymphogranuloma Venereum present?

A

Painless Ulcers, Abscessed Nodes, Genital, and Elephantiasis, due to Chlamydia Trachomatis

162
Q

How does Granuloma Inguinale present?

A

Spreading ulcer, Donovan bodies, due to Klebsiella Granulomatis (rod shaped, oval organism that can be seen in the Cytoplasms of Phagocytes or in tissue of grauloma inguinale)

163
Q

How does chlamydia present?

A

Cervicitis (Yellow pus), conjunctivitis, PID

164
Q

How does Gonorrhea present?

A

Palmar pustules, arthritis/joint pain, urethral discomfor

165
Q

What is Epididymitis?

A

Unilateral scrotal pain decreased by support

166
Q

What causes Congenital Blindness?

A

CMV

167
Q

What causes Neonatal Blindness

A

Chlamydia

168
Q

What is Lichen Simplex Chronicus?

A

Raised white (VIOLET) lesions, chronic scratching

169
Q

What is Lichen Sclerosis?

A

Paper like vulva, itching, CA risk

170
Q

What is Hidradenoma?

A

Sweat gland cysts

“Hidradenitis suppurativa is a chronic inflammatory skin disease involving the hair follicles and sweat glands”

171
Q

What causes non-bacterial Fetal infections?

A

“TORCHS
T- Toxoplasma
O - Others (HIV, Measles, B-19)
R - Rubella
C - CMV
H - HSV-2
S - Syphilis

172
Q

What is Toxoplasmosis?

A

Multiple ring enhancing lesions, loves parietal love, from cat urine and feces

173
Q

What happens with Rubella infections in utero?

A

Cataracts, hearing loss, PDA, “blueberry muffin” rash (Rash on face that spreads to trunk)

174
Q

What do you see in CMV in utero infections?

A

Spastic diplegia of legs, hepatosplenomegaly, blindness, central calcifications

175
Q

What is seen in newborn with HSV-2 in utero infections?

A

Temporal Lobe encephalitis, must offer C-section to mom with active lesions

176
Q

What is seen in newborns with Syphilis in utero infection?

A

Rhages (lip fissue), Saber shin legs (anterior bowing of the tibia), Hutchinson’s Razor teeth,Mulberry Molars

177
Q

What is Paget’s disease of the Breast?

A

Rash and ulcer around the nipple, breast CA

178
Q

What is Lobular Carcinoma?

A

Cells line up single file, contralateral breast is primary site of CA

179
Q

What is Comedocarcinoma?

A

Multiple focal areas of necrosis (blackheads) DCIS

180
Q

What is Inflammatory Carcinoma?

A

Infiltrates Lymphatics, pulls on Cooper’s Ligaments “Peau d’Orange”

181
Q

What is Cystosarcoma Phylloides?

A

Exploding Mushroom

182
Q

What is Intraductal Papilloma?

A

Bleeding from the nipple
Most common Breast CA

183
Q

What is Ductal Carcinoma?

A

Worst prognosis Breast CA

184
Q

What is Sarcoma Botryoides?

A

Vaginal CA, looks like a ball of grapes

185
Q

What is a Sister Mary Joseph Nodule?

A

Ovarian CA that has spread to the umbilicus
(Also GI cancers can cause)
(Indicates metastasis)

186
Q

What is Meig’s Syndrome?

A

Pleural effusion, ovarian fibroma, ascites

187
Q

What are the side effects of Estrogen?

A

Weight gain, breast tenderness, nausea, headaches, muscle relaxant, causes constipation, increased protein production, irritability, and varicose veins

188
Q

What are the side effects of Progesterone?

A

Acne, depression, HTN, increase appetite, acne causes dilution anemia, quiescent uterus, PICA, hypotension, melisma (AKA Chloasma)

189
Q

What makes Progesteron <10 week gestation?

A

Corpus Luteum

190
Q

What are the four Painful Genital Lesions?

A

Herpes
Chancroid (It makes you cry… H. Ducreyi) Lymphogranuloma Venereum
Lymphogranuloma Inguinale

191
Q

How do you predict a due date with Nagele’s rule?

A

Subtract 3 mo. from LMP (last menstrual period)
Add 7 days, if her cycle is 28 days (i.e: LMP Jan 7, 2016 would have an estimated date of Oct. 14, 2016)
If her cycle is more than 28 days add 1 day for each extra day of the cycle

192
Q

Why is Nagele’s Rule Inaccurate?

A

Because it does not start from Ovulation date

tsomkapQ (117 decks)

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