Ob/Gyn UWorld Flashcards
what should you be concerned about in a baby with shoulder dystocia
clavicular fractures may result in C8-T1 brachial plexus injury that may result in Horner syndrome, Erb-Duchenne palsy, or Klumpke palsy
-usually resolve spontaneously
cystocele
rectocele
enterocele
apical prolapse
bladder prolapse
rectum prolapse
small intestine prolapse
uterus or vaginal valt prolapse
what can cause sharp groin pain in a pregnant woman
round ligament pain
what increases risk of uterine rupture the most during pregnancy/labor
past uterine surgeries (like a classical/vertical c-section or a uterine myomectomy)
-if these pts are giving birth again do a laparotomy and delivery
what do amphetamines do to a baby in utero
fetal growth restriction
second line to oxytocin (ptosin) in a pt with postpartum hemorrhage and why would each of these be contraindicated
Methylergonovine (contraindicated in hypertension)
Carboprost (contraindicated in asthma)
risks of combined OCPs
- venous thromboembolism
- hypertension
- hepatic adenoma
- stroke/MI (both rare)
- cervical cancer
pt with breast dimpling, peau d’orange, edematous, erythematous, and painful breast with nipple flattening/retraction
inflammatory breast carcinoma
-if pt also has axillary lymphadenopathy you can assume its likely spread
unilateral bloody nipple discharge
intraductal papilloma
management of intrauterine fetal demise
20-23 weeks –> dilation and evacuation OR vaginal delivery
24+ weeks –> vaginal delivery (induce labor)
*Note: retention of the fetus for several weeks can lead to coagulopathy in the mom
cervical insufficiency and whatre the risk factors
painless dilation of the cervix that can lead to second trimester pregnancy loss
risk factors
- cervical conization or LEEP
- mechanical cervical dilation
- obstetric cervical laceration
- uterine anomalies
modifiable breast cancer risk factors
hormone replacement therapy
nulliparity
increased age at first live birth
alcohol consumption
lifetime risk of breast cancer for every woman
1/8
melasma
- acquired hyperpigmentation disorder that commonly occurs during pregnancy
- usually involves sun-exposed areas on the face
- diagnosed clinically and resolves postpartum
- tell pt to avoid sun exposure and use sunscreen
what is a major contraindication of any estrogen containing contraceptives
hypertension
what to lookout for when given pap smear data on a postmenopausal woman
endometrial cells seen after the age of 45 is an abnormal finding (this is normal on women less than 45yo)
- endometrial shedding may be due to endometrial hyperplasia/cancer
- do endometrial biopsy if this finding is seen
intermenstrual spotting without uterine enlargement (no prolonged menses)
endometrial polyps
pt seems like a girl then during puberty is more like a boy and you find clitoromegaly and bilateral labial masses
5-alpha reductase deficiency
-virilization during puberty due to increased levels of testosterone
how does androgen insensitivity present
normal female with no uterus or fallopian tubes, rudimentary vagina
–possibly with bilateral labial masses
patient postop from hysterectomy with unilateral nonradiating costovertebral angle pain, nausea, and vomiting
-normal renal function
hydronephrosis from ureteral injury during surgery
steps in dealing with a uterine inversion
- manual replacement of the uterus
- placental removal
- administer uterotonics
what is a leiomyoma
proliferation of smooth muscle cells within myometrium
what is the acid-base normal for a pregnant woman
respiratory alkalosis
what is a main cause of stress incontinence
weak pelvic floor muscles
-urethral hypermobility and reduced bladder support