OBGYN Flashcards
breast abscess etiology
S. aureus
fibroadenoma vs fibrocystic changes
fibroadenoma doesn’t change w/ menstrual cycle
fibroadenoma tx
observation
US Q3-6mo
surgery if mass changes or enlarges
straw colored fluid on FNA bx
fibrocystic changes
1st line fibrocystic changes
OCP
Mild mastalgia: NSAIDS
Severe mastalgia: Tamoxifen or Danazol
galactorrhea tx
Tx underlying
Dopamine (bro/cab): decrease prolactin
levothyroxine: if hypothyroidism
MC med that cause gynecomastia
spironolactone
tx gynecomastia
testosterone replacement
tamoxifen
mastectomy
tx underlying
risk factor breast cancer
BRCA1 BRCA2
FHx, >70yo, never breastfed, OCP use
estrogen exposure (obese, nulliparity, early menarche, late menopause, late 1st pregnancy)
protective against breast cancer
breastfeeding
parity
MC location breast cancer
upper outer quadrant
breast cancer mammogram
microcalcifications
spiculated
guidelines breast cancer prevention
Mammo 50-74 q 2yrs (40-49 if high risk)
tx high risk of breast cancer
tamoxifen or raloxifene
cervical cancer screen
21-65 yo
21-29 Q3yrs
>30 Pap + HPV or Pap Q3yrs
MC cervical cancer
squamous
DES exposure
clear cell cervical cancer
clear cell vaginal cancer
Gardasil
HPV vaccine
start 11-12
<15 (2 doses, 6mo apart)
>15 (day 0, 2mo, 6mo)
cervical dysplasia management
Repeat pap Q6mo, colopscopy, return to routine screening
ASCUS: <30 repeat Q1yr, >30 + HPV colpo, >30 no HPV repeat Q3yrs
LGSIL: mild dysplasia, colpo if HPV, cytology in 1yr
HGSIL: mod/severe, colpo or loop, cytology in 6mo
missed abortion
abnormal US w/ no bleeding
no cervical dilation
threatened abortion
normal US w/ minimal bleeding
no cervical dilation
no POC
inevitable abortion
abnormal US w/ bleeding
dilated cervix, no POC
incomplete abortion
abnormal US w/ bleeding
dilated cervix, loss of some POC but not all
completed abortion
closed cervix
empty contracted uterus
abortion tx
curettage in 1st trimester or D&E in 2nd trimester
misoprostol
rhogam
MC RF placental abruption
HTN
cocaine user
placental abruption tx
stable and <34w: management w/ fetal monitoring
>36w: induction, oxytocin, vaginal delivery preferred
unstable: C section
variable deceleration and bradycardia in fetus
cord prolapse
tx cord prolapse
digital disengatement
knee to chest
C section
MC location of ectopic pregnancy
ampulla
ectopic pregnancy triad
unilateral pelvic pain
vaginal bleeding
amenorrhea
ectopic pregnancy tx
stable: monitor w/ HcG or MTX if identified later (<4cm), rhogam
unstable (hypotensive, tachycardia): laparoscopy
tx endometritis
C section: IV clindamycin w/ gentamicin
Vaginal delivery: ampicillin and gentamicin
prophylaxis 1st gen ceps during c section
gestational diabetes screen
24-28w increased fasting plasma glucose >125
initial: 1h OGTT (>140)
3h OGTT (>180 1h, >155 2h, >140 3h)= confirm
gestational diabetes tx
insulin TOC
metformin/glyburide (refuse insulin)
induce at 38w if uncontrolled, 40w if controlled
molar pregnancy dx
bhcg >100k
transvaginal US: snowstorm, cluster of grapes, honeycomb
molar pregnancy tx
D&C
rhogam
chemo if choriosarcoma (MTX)
do not give misoprostol, risk of incomplete uterine evacuation
1st line hypertensive meds in pregnancy
BB (labetalol)
CCB (nifedipine)
hydralazine
methyldopa
IV magnesium sulfate toxicity
hyporeflexia
tx w/ calcium gluconate
pregnancy induced HTN diagnosis
BP >140/90 after 20wks
tx preeclampsia
definitive: delivery
prophylaxis: ASA
prevention of eclampsia: IV mg sulfate + diazepam
tx eclampsia
IV mg sulfate + diazepam
definitive: delivery
HELLP syndrome
preeclampsia + hemolysis + increased LFT + low plt
tx HELLP
BP management
Mg sulfate
deliver if term
tx cervical insufficiency
No hx: vaginal progesterone (no hx)
hx: PO progesterone a + cerclage
no sex