OB/GYN uWISE Flashcards

1
Q

causes of breech presentation

A

prematurity multiple gestation genetic disorders hydrocephalus polyhydro fibroids anencephaly uterine anomalies

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2
Q

time frames of “prolong latent phase” When should you artificially rupture membranes?

A

nullip >20 hours multip >14 hours tx: rest or augmentation do no rupture in latent phase because increased risk of infection

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3
Q

how does cervical change typically prgoress in the active phase?

A

1 cm for nullips 1-2cm for multips

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4
Q

LOTS of bleeding and disproportionate cervical exam change during active phase, think…

A

abruption

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5
Q

whats in FFP?

A

fibrinogen, V, VIII

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6
Q

chorioamnionitis association

A

PROM **also think of any bacterial infection for this, like BV

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7
Q

causes of preterm labor

A

IDEOPATHIC uterine distortion dehydration

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8
Q

list three major drugs that should be given in preterm labor before 32 weeks

A

bethamesasone nifedipine –> give time for steroids to work ampicillin –> for GBS

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9
Q

if fetal heart tones are baseline 150 with a category 1 tracing do you need to do a contraction stress test for preterm labor?

A

NO, category I means they are contracting with variability and accels

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10
Q

contraindications for: -terbutaline -mag sulfate -indomethacin

A

-terbutaline in diabetics, or over 48 hours -mag sulfate in myastehnia gravis (resp depression) -indo after 33 weeks for closure of ductus

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11
Q

effects of bethasmesasone

A

-lung development/ decreased RDS -decreased ICH -decreased NEC

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12
Q

do you test vaginal mucus or cervical mucus for ferning?

A

VAGINAL cervix has higher false positive rates

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13
Q

whats the benefits in tocolytics before 32 weeks?

A

time to administer steroids NOT necessarily to wait for fetal lung maturity, because don’t wan tto use for >48hours

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14
Q

what antibiotic regimen has been shown to increase latency 5-7 days in PPROM?

A

amp + erythro

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15
Q

use of 17-a-hydroxyprogesterone

A

prevent PROM fom 16-36 weeks

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16
Q

postpartum fever differential

A

mastitis cystitis endometritis infection

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17
Q

most common site of fever on postpartum day 1?

A

LUNGS, esp if patient had anesthesia for csection, think aspiration PNA

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18
Q

associations for postterm pregnancy

A

placental sulfatase deficiency anencephaly fetal adrenal hypoplasia inaccurate dates

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19
Q

late term preg associations?

A

macrosomia oligohydramnios meconium aspiration ureteroplacental insufficiency

20
Q

fetal dysmaturity

A

seen over 43 weeks withered, meconium stained, long fingernails, small placenta

21
Q

antibiotics for mastitis

A

dicloxacillin, cephalexin

22
Q

why would you think candida mastitis?

A

nipple pain out of proportion to physical exam burning, shotting pain

23
Q

things to think about with uterus small for gestational age

A

oligo IUGR IUFD

24
Q

pharm for hyperemesis gravidarum? vs pharm for NVP?

A

zofran (odansetron) reglan (metoclopramide) pyridoxine (B6) and doxylamine

25
Q

maternal risk factors assoc with ASSYMETRIC IUGR? When in pregnancy does this occur?

A

think of DISEASE states: dm,htn,sle,cvd smoking/cocaine this tends to occur LATER in pregnancy 80% of IUGR is ASSYM.

26
Q

twins from 4-8 day splits? 13?

A

Mo, Di 4x2=8 13= unlucky= conjoined

27
Q

what murmur on PE are you concerned about, what are you not?

A

systolic is not concerning diastolic (think mitral stenosis) can be sign of heart failure

28
Q

most common defects seen in women with diabetes before pregnancy?

A

problems with organogenesis –> mostly cardiac or NTD

29
Q

how do you manage a patient who fails GTTs?

A

diet and exercise.

30
Q

do you see IUGR with gestational diabetes?

A

no, generally pre-existing

31
Q

potential lab finding indicative of contractions due to dehydration?

A

ketones in the urine

32
Q

therapuetic range of mag? resp depression range?

A

4-7mEq/L 11-14

33
Q

definition of hydrops

A

fluid accumulation in two or more body cavities -ascites -pleural effu -pericardial effu -scalp edema

34
Q

what should you look for on exam of high AFP before jumping to NTD?

A

high fundal height –> think twins!

35
Q

what should you look for on exam of high AFP before jumping to NTD?

A

high fundal height –> think twins!

36
Q

most proven way to prevent preterm birth in twin gestation?

A

good weightgain early, 20-24 weeks. This will help to grow the placentas

37
Q

whats a b-lynch suture?

A

technique for ligating uterine vessels surgically in PPH when pharm has failed

38
Q

nerves at risk from low transverse incision? decribe their course

A

ilioinguinal, iliohypogastric –> both exit T12/L1, through psoas, laterally through transversus abd, courses on anterior abd wall to ASIS, then medially between internal/external oblique. Becomes CUTANEOUS 1cm sup to inguinal ring

hypogastric does sensation of groin/skin overlying pubis

inguinal does sensation of symphysis, groin, labium, UPPER THIGH

39
Q

pain with adduction indicative of what nerves? inability to adduct indicative of what nerve?

A

iliohypogastric, ilioinguinal obturator

40
Q

if OCPs are not adequately controlling hirsituism, what can youadd?

A

spirinolactone

41
Q

physiology of increased free T in PCOS?

A

inc LH–>inc androgen production –> dec sex hormone binding globulin –> increase free T

42
Q

how do combo OCPs help with dysmen?

A

progestin causes endometrial atrophy –> endometrium produces prostaglandins which causecramping

43
Q

how can BSO after menopause “recreate” menopausal symptoms?

A

ovaries continue to produce androgens which get peripherally converted to estrogen

44
Q

how long to wait to attempt pregnancy after mole?

A

6 months AFTER last negative bhCG

45
Q

how does HPV/pap screening workfor women ages 30-65?

A

HPV testing every FIVE years, but acceptable to do pap alone every three years

46
Q

CT or US for evaluting female pelvic anatomy?

A

US!!

47
Q

salpingectomy vs salpingostomy. Which one needs bhCG f/u?

A

salpinectomy removes entire chunk of tube with pregnancy and does not require f/u

salpingostomy just remove pregnancy via hole intueb and DOES REQ F/U