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Third Year Shelf > OB Shelf > Flashcards

OB Shelf Flashcards

1
Q

Hyperglycemia leads to increased risk of

A

Macrosomic infant

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2
Q

Excess fluid around infant

  • assoc with
A

Fetal hydrops

  • Rh incompatabilty
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3
Q

Meconium aspiration risks (3)

A

Placental insufficiency
maternal HTN
Preeclampsia

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4
Q

Tx acute bacterial mastitis

  • nonMRSA
  • MRSA
A

NonMRSA= dicloxacillin
- staph aureus

MRSA= Clindamycin

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5
Q

Tx vulvar lichen sclerosis

A

clobetasol propionate (topical corticosteroid)

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6
Q

cryotherapy tx for

A

warts

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7
Q

Tamoxifen

A

Selective estrogen receptor modulator

Increased risk for endometrial carcinoma

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8
Q

Endometriosis risk factor for

diagnostic

Tx

A

ovarian cancer

Ultrasound

NSAIDS –> oral contracept –> laparoscopy

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9
Q

1st pregnancy was preterm

Second pregnancy given

A

Progesterone

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10
Q

Asthma levels

- Mild intermittent

A

Less than 2 days a week

Less than 2 nights/ month

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11
Q

Asthma level

- Mild persistent

A

More than 2 days a week but less than 1x a day

More than 2 nights/ month

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12
Q

Asthma level

- Moderate persistent

A

Daily

More than 1 night per week

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13
Q

Asthma level

- severe persistent

A

Continuous

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14
Q

Mild persistent asthma in pregnancy tx

A

Low dose inhaled corticosteriods (buesonide)

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15
Q

Epinephrine in pregnancy causes

A

Uteroplacental vasoconstriction

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16
Q

Severe presistent asthma tx

A

Prednisone (oral glucocorticoid)

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17
Q

Modersate persistent asthma tx

A

Salmeterol

Long acting inhaled beta agonist

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18
Q

Cancer with history of endometrosis

A

Clear cell carcinoma

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19
Q

Breast cyst with no pain tx

A

observation

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20
Q

Forceps assisted delivery risk of

A

perineal laceration

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21
Q

Medication for pregnant alcoholic

A

Naltrexone

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22
Q

Maculopapular rash on face, trunk and extermities
pinpoint papules
Generalized LAD

  • Causes in infant
A

Rubella (torch)

  • Deafness, cataracts or retinopathy, PDA, encephalitis, hepatosplenomegaly w/ jaundice, petechial purpural rash (blueberry muffin)
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23
Q

Prolonged second stage of labor

A

Failure of fetus to descend after 10 cm dilation for 2 hrs in nulliparious or 3 hrs if epidural

1 hr multiparious or 2 hr w/ epidural

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24
Q

Prolonged second stage of labor risk

A

Chorioamnionitis

- ascending bacterial infection after rupture of membranes

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25
Q

Tx UTI in pregnancy

A

Nitrofurantion (Oral)

Ceftriaxone and gentamicin are IV

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26
Q 
Tx to post partumhemorrhage
- STep 1
- STep 2
- STep 3
- STep 4
Last resort
A

Step 1: bimanual massage of uterus

Step 2: Oxytocin

Step 3:

  • Misoprostol (if HTN and asthma)
  • Carboprost (15-methyl-PGF2-alpha) [Fast acting uterotonic, constrict smooth muscle of uterus to close the bleeding) (CI in asthma)
  • Methylergonovine (ergot alkaloid) directly constrict blood vessels (CI inHTN)

STep 4: balloon tamponade

Last resort: SUrgical exploration

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27
Q

Raynaud syndrome

A

Blood vessels narrow when cold or stressed

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28
Q

5 y.o w/ bleeding and adnexal mass

A

Precocious puberty

Granulosa tumor

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29
Q

Increased inhibin

A

Granulosa tumor

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30
Q

Granulosa tumor increase in

A

Estrogen

Inhibin

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31
Q

Increase in alpha feto protein

A

Yolk sac tumor

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32
Q

Elevated lactate dehydrogenase

Tx

A

dysgerminomas

Sensitive to chemo and radiation

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33
Q

Choriocarcinomas have increased

A

hCG

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34
Q

Chorionic villus sample timeline

A

10-14 weeks

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35
Q

Amniocentesis time line

A

15 weeks

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36
Q

Hyperprolactinemia decreases

A

FSH, LH, Estrogen

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37
Q

Initial assessment of newborn

A 
Heart rate
Respiratory effect
Muscle tone
reflex irritabilty
color
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38
Q

Kleihauer-Betke (KB test)

A

measures amount of fetal blood passed into maternal circulation
tells amount of Rh immunoglobulin to be given in Rh (-) mothers

Detects fetomaternal hemorrhage

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39
Q

PROM risks

A 
smoking
Substance abuse
Maternal age less than 18 or greater than 40
PPROM in prior pregnancy
insuffiecent prenatal care
infection
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40
Q

Fetal biophysical profile

A 
Amniotic fluid vol
Fetal breathing
Fetal movements
Fetal tone
non stress test

(NOT size)

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41
Q 
Lower abdominal pain bilateral
Fever
Diffuse abdominal tenderness in lower quadrant
rebound tenderness
Adnexal tenderness
A

PID

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42
Q

PID tx

A

Ceftrixone and doxycycline (outpatient)

Cefoxitin and doxycycline (inpatient) or clindamycin or gentamicin

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43
Q

Chlamydia tx

A

azithromycin

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44
Q

Urethritis tx

A

cover chlamydia and gonorrhea

ceftriaxone + azithromycin

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45
Q

Gonorrhea tx

A

Ceftriaxone

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46
Q

Tichomonas vaginalis tx

A

Ceftriaxone, doxycycline, metronidazole

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47
Q

Asymptomatic bacteriuria tx

A

Cephalexin

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48
Q

Baby w/ neonatal abstience syndrome of heroin

A

Sleep wake disturbanes
hyperactive reflexes
difficulty feeding

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49
Q

Cocaine in baby

A

Tremors

Episodes of apnea or tachypnea

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50
Q

First line tx prolonged heavy bleeding

A

ORal estrogen

D& C if unstable

NSAID if cant take estrogen

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51
Q

Depression in pregnancy or breast feeding

A

Sertraline (SSRI)

Second line= bupropion or venlafaxine
3rd norttiptyline

Paroxetine CI

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52
Q

Seizure prophylaxis

A

Magnesium sulfate

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53
Q

Anti HTN therapy

A

hydralize

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54
Q

Pregnancy values that increase

A 
CO
HR
SV
Plasma volume
Red blood cell mass
Thyroid binding globulin
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55
Q

Pregnancy values that decrease

A 
Systemic vascular resistance
Hemoglobin
Hematocrit
Residual volume
Functional residual capacity
Mean arterial pressure
Serum creatinine

TSH in first trimester

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56
Q

Menopause + hx of pulm embolism

A

Estrogen contraindicated

Tx= SSRI (paroxetine)

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57
Q

Sterile fashion

A

Iodine/ betadine

Shell fish allergy

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58
Q

Hellp syndrome

A

Hemolysis ( burr cell, bilirubin > 1.2)
Elevated liver enzymes
Low platelets <100

No HTN or proteinuria

59
Q

Recurrent pregnancy loss

A

3 or more consecutive spontaneous abortions in first trimester with same partner

  • SOnohysterography for anatomy
    Immunology workup
    anticardiolipin and lupus Ab
    Karyotype
60
Q

Induces ovulation

A

Clomiphene citrate

61
Q

Flu vaccine give

A

in fall and winter

62
Q

Condyloma acuminate tx in pregnancy (warts

A

Trichloroacetic acid

Cryoblastion if fails

63
Q

Mullerian agenesis

A

congenital abence of both the uterus and vagina

Normal ovaries

Normal secondary sexual characteristics

64
Q

Order of developemnt

A

Thelarche
Pubarche
Growth spurt
Menarche

65
Q

D & C done at

A

before or at 16 weeks

66
Q

Abnormal uterine bleeding
Uterus enlarged
Boggy (soft) and tender

A

Adenomyosis

67
Q

Breasts, no pubic hair, vagina with blind pouch, no uterus or ovaries

A

Androgen insensitivity

68
Q

Papp-a test

A

11- 14 weeks

69
Q

Alpha fetoprotein test

A

15-22 weeks

70
Q 
Maculopapular rash over body
Multiple partnrs
Muscle aches
Fever
Night sweats
A

Acute HIV infection

71
Q

DHEA-S

A

marker for adrenal dysfunction

72
Q 
Lower abdominal pain
Pain w/ intercourse
Fever before onset of pain
Abdominal distension
Guarding and severe tenderness
A

tuboovarian abscess

Rupture (hypotension, tachhycardia, fever)

73
Q

Tuboovarian abscess

A

CLindamycin, metronidazole, cefoxitin

74
Q

Varicella zoster infxn can cause

Tx

A

Limb hypoplasia, IUGR, cicatricial (scarred) skin lesions, chorioretinitis

Tx: varicella zoster immune globulin (last 10 days)

75
Q

Acyclovir

A

Minimize risk of vertical transmission of herpes simplex

76
Q

Tx toxoplasmosis

A

Spiramycin

77
Q

Fever
Uterine tenderness
Purulent lochia after postpartum
Increased neutrophil

A

Postpartum endometritis

- Clindamycin and gentamicin

78
Q

PMS tx

A

SSRI (sertraline)

79
Q

Buproprion

A

tx depression plus want to stop smoking

80
Q

Preeclampsia occurs as a result of

A

Hypoperfusion to the placenta due to abnormal remodeling of spiral arteries with fail to expand as expected causing hypoperfusion and ischemia

81
Q

Amorphic calcifications in unilateral breast

A

Ductal carcinoma in situ

82
Q

Unilateral breast discharge

A

Intraductal papilloma

83
Q

Heavy vaginal bleeding
pelvic pressure
N/V
hCG > 100,000

A

hydatidiform moles

84
Q

Post partum hemorrhage =

risk factor

A

> 500 ml during vaginal

> 1000 during c-section

Fetal macrosomia

85
Q

Irregular menstrual bleedign w/ lighter periods > 6 months after D&C or endomyometritis with previous nromal menses

A 
uterine synechiae (asherman syndrome) 
- intrauterine adhesions
86
Q

Cause methotrexate to fail

A

hCG > 5000,
gestational sac larger tahn 3 to 4 cm
fetal heart tones

87
Q

Poorly controlled blood sugars leads to in baby

A

Hyperinsulinemia
Hyperglycemia
Macrosomia

88
Q

Low grade squamous lesions over 25 y.o

A

Colposcopy

89
Q

Turners risk of

A

constipation

90
Q

Tx precocious puberty

A

GnRH agonist (leuprolide)

91
Q

Most common complication of c section

A

Post op ileus

92
Q

Mittelschmerz

A

Middle pain

Lower abdominal or pelvic pain that occur midway during menstrual cyclat at time of ovulation

93
Q

Bacterial vaginosis tx

- character

A

Thin grey white malodorous discharge, ph 4.5-5, clue cells

Metronidazole

94
Q

Condition that only occurs in pregnant diabetics

A

Sacral agenesis

95
Q 
White classification
A
B
C
D
R
F
H
T
A 
A: Gestational
B: > 20 y.o for less than 10 yr
C: 10-19 y.o, for 10-19 years
D: < 10 y.o, for 20 years
F: Nephrolopathy, proteinuria **
H:Heart
R: retinopathy
T: renal transplant
96
Q

Chronic HTN if present how long after

A

> 12 weeks

97
Q

Dont give magnesium sulfate in

A

myasthenia gravis

98
Q

Betamethasone increases what in mother

A

Glucose

STeroid therapy

99
Q

Preeclampsia

A 
New onset HTN
Proteinuria > 300 mg
Edema
Headache
Visual disturbances
Abdominal pain
100
Q

Fever nausea
Anorexia
Abdominal pain periumbilicus –> RLQ or upper abdomen

A

Appendicitis

101
Q

Upper abdominal pain to back
Fever
N/V
Elevated amylase and lipase

A

Pancreatitis

102
Q

Hair bearing skin, scalp, anils, oral mucous membranes, vulva
Inflammation, mucocutaneous eruptions and blisters that flare and remission

Burning itching

Lacy reticulated lesions on labia
No scarring or fibrosis

A

Lichen planus

Corticosteroids

103
Q

Trisomy 21 labs

A

AFP down
Estriol down
hCG up
Inhibin up

104
Q

growth rate

  • 15 weeks
  • 20 weeks
  • 20-32 weeks
  • 32-34
A
  • 15 weeks= 5 grams
  • 20 weeks= 10 grams
  • 20-32 weeks= 20 grams
  • 32-34= 30 grams
105
Q

Metoclopramide causes

A

hyperprolactinemia

106
Q

Vasectomy not effective for

107
Q

Text for uterine leiomyomas (fibroids)

A

Transvaginal ultrasonography

108
Q

+ BRCA test

A

Mammography + MRI every 6 months alternating

109
Q

Primary dysmenorrhea cuases by

tx

A

excess of protstaglandins

Tx : NSAID (COX1/2 inhbitor)

110
Q

Threatened miscarriage time

A

< 20 weeks

111
Q

Vaccum assisted delivery risk

A

Cephalohematoma –> hyperbilirubinemia

112
Q

Heavy menstrual bleeding check

A

PT and PTT

113
Q

Pencillin allergy

A

Clindamycin + gentamicin

114
Q

Early term

A

37 weeks 0 days to 38 weeks 6 days

115
Q

Full term

A

39 weeks 0 days –> 40 weeks 6 days

116
Q

Post term

A

after 42 weeks

117
Q

Cardinal movements of labor

A 
Engagement
Descent
Flexion
Internal rotation
Extension
External rotation
Explusion
118
Q

What other organ system at risk w/ menopause

A

Cardiovascular disease

Estrogen cardioprotective and decreases LDL

119
Q

Dia Dia twin time line

A

first 72 hours

120
Q

Mono dia twin separation

A

4 to 8 days

121
Q

Mono mono twins sep

122
Q

Conjoined twins sep

123
Q

Sonohysterogram:

A

imaging of uterus

fluids into uterus via cervix to examine lining

124
Q

Hystosalpingogram

A

xray of uterus and fallopian tubes (infertility)

125
Q

Hyperemesis –>

A

Ketouria and weight loss

126
Q

Reduce post op infection for c section

A

Prophlaxis cefaxolin

127
Q

Painless, erythematous round firm ulcer with raised edges

Tx

A

Syphillis

Pencillin G

128
Q

Painful vesicles

tx

A

Herpes

Oral acyclovir

129
Q

Ppaule or shallow ulcer w/o raised border, painless

A

Lymphogranuloma venereum

Oral doxycycline

130
Q

Painful demarcated non indurated ulcer

A

Chancroid

IM ceftrixone

131
Q

CMV infection

A

hearing impairment

Amniocentesis test

132
Q

Fetal growth resistriction < 10 % –>

A

cerebral palsy

hypoxic damage to brain

133
Q

Increasing branching of the ductular trees and increased secretory gland formation

A

1st trimester

134
Q

Breast changes

  • Initial stages
  • First trimester
  • 2nd trimester
  • 2nd/3rd trimester
  • 3rd trimestser (36 wk)
  • Time of labor
A

Initial stages

  • Increased bud branching
  • Increased secretory glands on each bud

First trimester

  • Increasing branching of ductular tree
  • Increase secretory gland formation

2nd trimester
- glandular tissue proliferation w/ ductal homogrenization

2nd/3rd trimester
- Lobular formation and enlargement
- ELiminating fat and stroma for glandular tissue and ductal trees
(enlargement and tenderness)

3rd trimestser (36 wk)
- Distension of lumens by accumulation of secretory material

Time of labor
- glandular proliferation and mitosis

135
Q
  • glandular tissue proliferation w/ ductal homogrenization
A

2nd trimester

136
Q

Increased bud branching

A

Initial stages

137
Q
  • Distension of lumens by accumulation of secretory material
A

3rd trimestser (36 wk)

138
Q
  • Increasing branching of ductular tree

- Increase secretory gland formation

A

First trimester

139
Q

Increased secretory glands on each bud

A

Initial stages

140
Q
  • glandular proliferation and mitosis
A

Time of labor

141
Q

Febrile illness w/ myalgia, arthralgias, LAD, lacy erythematous rash

A

Parvovirus B 19

142
Q

Infant w/ anemia
High output congestive heart failure
Cardiomyopathy

A

Parvovirus B 19

143
Q

Antiviral for Hep B

144
Q

Pregnancy weight gain

A

BMI less tahn 18.5 = 28 to 40
25- 29.9 –> 15 to 25 lbs
> 30 gain 11 to 20

Third Year Shelf (7 decks)

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