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OBGYN Flashcards

1
Q

round ligament

A

anteverts uterus; travels in inguinal canal

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2
Q

broad ligament

A

contains uterine vessels; lateral uterus to pelvic sidewalls

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3
Q

infundibular ligament “suspensory ligaments”

A

contains ovarian aa, nerve, and vein

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4
Q

cardinal ligament

A

holds cervix and vagina

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5
Q

ectopic preg mgmt

A

methotrexate or salpingotomy - STABLE
salpingetomy - UNSTABLE

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6
Q

mittelschmerz what ruptures

A

graafian follicle

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7
Q

risk factor clear cell ca of vagina

A

DES diethylstilbestrol

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8
Q

mgmt vaginal SCC

A

RADIATION

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9
Q

vulvular intraepithelial neoplasms

A

VIN = premalignant (HPV)

HSIL - WLE 0.5-1cm, laser, or TOPICAL IMIQUIMOD with annual surveillance

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10
Q

vulvar SCC ca <2cm (stage I) mgmt

A

WLE 2 cm margin, ipsilateral inguinal node dissection

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11
Q

vulvar SCC ca >2cm (II+ stage) mgmt

A

radical vulvectomy (b/l labia) with b/l inguinal dissection and postop XRT if close margins <1cm

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12
Q

ovarian cyst concerning features

A

thick septation
solid + vascularity
papillary projections
>10 cm

if there, oophorectomy with intraop sections

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13
Q

ovarian cyst mgmt

A

US surveillance if no high risk features

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14
Q

ovarian torsion risk factors

A

5cm cyst

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15
Q

ovarian ca risk factors

A

nulliparity
late menopause
early menarche
PCOS
endometriosis
smoking
family hx
BRCA, Lynch

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16
Q

protective factors for ovarian ca

A

OCPs
bilateral tubal ligation
previous pregnancies
breastfeeding

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17
Q

ovarian ca types

A

teratoma
granulosa-theca (ESTROGEN- early puberty)
Sertoli Leydig (ANDROGEN - manly)
struma ovarii (thyroid)
chorio (B-HCG)
mucinous
serous
papillary
clear cell type = worst prognosis

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18
Q

staging ovarian ca

A

I: 1 or 2 ovaries
II; limited to pelvis
III; spread throughout abdomen
IV: distant mets

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19
Q

indication for omentectomy for survival

A

met from ovary

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20
Q

mgmt ovarian ca

A

TAH BSO + pelvic/paraaortic LN dissection, omentectomy, 4 quadrant washes, cytology of diaphragm, and CHEMOt

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21
Q

what Is chemo for ovarian ca

A

cisplatin and paclitaxol

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22
Q

Meiges syndrome

A

pelvic ovarian fibroma causing ascites and hydrothorax (just excise primary)

23
Q

Krukenberg

A

gastric met to ovary (path: signet ring cells)

24
Q

MC gyn ca

A

endometrial ca

25
risk factors endometrial ca
unopposed E... nulliparity, later in life first pregnancy, obesity, use of tamoxifen
26
endometrial ca staging
I: endometrium II: cervix III: vagina/peritoneum/ovary IV: bladder/rectum
27
mgmt endometrial ca
TAH and BSO (add XRT once extends beyond cervix)
28
cervical ca staging
I: cervix II: upper 2/3 vagina III: pelvis/side wall/lower 1/3 vagina/hydronpehrosis IV: bladder/rectum
29
where does cervical ca spread
obturator nodes
30
mgmt cervical ca
cone bx if only CIS TAH (I and IIA) chemoXRT (IIB to IV) cisplatin/paclitaxel like ovarian
31
mgmt fibroids
GnRH agonis (leuprolide)
32
mgmt anovulation
clomiphene citrate
33
tocolytic contraindication
>34 wks, nonreassuring fetal HR
34
severe fetal bradycardia
<80 bpm causes: cord compression, cord prolapse, tetanic uterine contractions, maternal seizure, anesthesia effects
35
stat C section indication
nonreassuring fetal heart rate prolapsed cord placental abruption uterine rutpure maternal cardiac arrest
36
Rh alloimmunization concept
if mom is Rh-: give mom Rh IgG within 72 hours and at delivery (if confirmed baby is Rh-positive)
37
what fetal monitoring to for EGS
< 24 wks: pre & post op fetal herat tones >24 wks: continuous intraop fetal HR monitoring +/- tocodynamometry
38
physiologic changes to CV system in pregnancy
dilutional anemia leukocytosis thrombocytosis increased fibrinogen and 7, 8, 9, 10
39
physiologic changes to Pulm system in pregnancy
increased tidal volume decreased functional residual capacity O2 consumption chronic compensated respiratory alkalosis
40
physiologic changes to GI system in pregnancy
decreased motility decreased esophageal sphincter competency increased aspiration risk
41
nonoperative ectopic indications
HD normal B-hcg < 5000 no fetal cardiac activity give methotrexate: follow up with B-hcg monitoring until undetectable CI: if hemodynamically abnormal, simultaneous pregnancy, active pulmonary disease, renal insufficiency, peptic ulcer disease, immunosuppression, actively breast feeding
42
operative ectopic indcations
salpingostomy: if want pregnancy in future salpingectomy: if ruptured, tubal damage, uncontrolled bleeding, gestation is >3-5cm (too large for salpingostomy)
43
CT scan A/P risk
2.5 rad 5 is organogenesis risk
44
ACOG and ASA for GA
no risk to in utero developmentrime
45
trimester restrictions to laparoscopcy
NONE
46
laparoscopic port insertion in pregant patient
Hasson 6cm above most gravid part 1st tri: normal
47
fetal fast
of fetuses position placenta location placenta amniotic fluid volume fetal cardiac activity fetal femur length
48
kleinhauser Bekte test
positive = abruption and is an indicator for preterm labor do prompt Rh Ig administration
49
mgmt TOA
clindamycin + aminoglycoside then PO
50
missed abortion
bleeding, closed os, positive sac, NO HEARTBEAT
51
threatened abortion
1st trimester bleeding, positive heartbeat
52
incomplete abortion
tissue protrudes through os
53
PID tx
doxycycline and ceftriaxone
54
hydatidiform mole
partial is malignant risk complete: paternal origin chemo = methotrexate

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