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Block 6 Exam > OBGYN > Flashcards

OBGYN Flashcards

1
Q

What are the indications for use of forceps and a vacuum?

A
  • Maternal exhaustion
  • Prolonged 2nd stage of labor
  • Fetal distress
  • Inadequate maternal expulsion
  • Need to avoid maternal expuslive efforts (cardiac or CNS disease)
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2
Q

What are contraindications to the use of forceps or a vacuum during labor?

A
  • Fetal prematuritin
  • Osteogenesis imperfecta
  • Fetal bleeding disease (e.g., hemophilia)
  • Unengaged head
  • Unknown fetal position
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3
Q

Early decelerations are assoc. w/?

A

Uterine contractions (“mirror images”)

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4
Q

{{BLANK}} decelerations are a result of fetal head compression

A

Early decelerations

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5
Q

{{BLANK}} decelerations follow maternal contractions

A

Late decelerations

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6
Q

Late decelerations are assoc. w/

A

uteroplacental insufficiency

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7
Q

Early onset neonatal encephalopathy after 34 weeks of gestational age and fetal metabolic acidosis are assoc. w/?

A

Cerebral palsy

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8
Q

Preterm labor versus incompetent cervix

A
  • Preterm labor: regular contractions; revival effacement before 37 wks gestation
  • Incompetent cervix: cervix begins to dilate & efface before pregnancy has reached term; absence of contractions
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9
Q

Placental abruption versus placental previa

Both cause bleeding but which one causes pain?

A
  • Placental abruption: Abnormal premature separation of normal placenta in 3rd trimester; painful
  • Placental previa: Placental location close to internal cervical os in 3rd trimester; w/o pain
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10
Q

What are risk factors for placental abruption?

A
  • Chronic HTN
  • Preeclampsia
  • Multiple gestation
  • Advanced maternal age
  • Multiparity
  • Smoking
  • Choroamniotis
  • Trauma
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11
Q

{{BLANK}} placental tissue extends into superficial layer of myometrium

A

Placental accreta

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12
Q

{{BLANK}} placental tissue extends into myometrium

A

Placental increta

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13
Q

{{BLANK}} placental tissue extends completely from myometrium to serosa of uterus

A

Placental percreta

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14
Q

What are you going to see if a patient in labor has uterine rupture?

A
  • Vaginal bleeding, sudden pain between contractions, recession of baby in birth canal, loss of station, slowing of contractions
  • Turtling
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15
Q

What are the laboratory charts show in fetal demise?

A
  • AFP will increase
  • DHEA-S & 16-OH-DS will decline
  • hCG will decline
  • Urinary estriol E3 will decline within 24-48 hours
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16
Q

How do you calculate an APGAR score?

A
  • HR: absent/< 100/>100
  • Tone: limp/mild/active
  • Respiration: absent/slow/good cry
  • Reflex: absent/grimace/crying or coughing
  • Color: blue/blue extremities/pink

0/1/2; 7-10 good; 4-7 mild; < 4 rescucitate

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17
Q

What hormones come from the posterior pituitary?

A
  • Oxytocin
  • ADH
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18
Q

What hormones come from the anterior pituitary?

A
  • GH
  • TSH
  • ACTH
  • LH
  • FSH
  • Prolactin
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19
Q

{{BLANK}} is poor contraction of the uterus (myometrium) following delivery of baby

A

Uterine atony

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20
Q

{{BLANK}} are first line treatments of uterine atony

A
  • Oxytocin
  • Massaging the uterus
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21
Q

If you have a patient with septic pelvic thrombophlebitis, how do you treat?

A

Heparin

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22
Q

If you have a post-op patient that has unrelenting fever no mattery what is wrong with them, what do you think they have?

A

Septic pelvic thrombophlebitis
* Sequela of pelvic infection w/ residual fever & tachycardia

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23
Q

What are the stages of grieving?

A
  1. Shock: disbelief, detachment
  2. Searching: guilt, hostility, empty
  3. Disorientation: depression
  4. Reorganization: gradual adjustment of loss; return to normal activity
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24
Q

How do molar pregnancies present on ultrasound?

A
  • cluster of grapes
  • Snowstrom
  • Honeycombed uterus
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25
Q

If you have a couple trying to have a baby but fail to do so, what do you check?

A
  • Woman, if she is fertile
  • Then check male
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26
Q

What is supposed to be normal on hysterosplaningography?

A
  • Smooth symmetrical endometrial cavity
  • Slender proximal tubes w/ dilation at the ends
  • Constrast media easily spilling out of fimbriae
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27
Q

What are ABSOLUTE contraindications to hormonal birth control?

A
  • Thrombophlebitis/Thromboembolic disease
  • Cerebral vascular disease
  • Coronary artery occlusion
  • Impaired liver function or hepatic necrosis
  • Known or suspected breast cancer or pregnancy
  • Undiagnosed abnormal vaginal bleeding
  • Smokers over 35 yo
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28
Q

What are the (2) best treatments for PCOS?

A
  • Weight loss
  • Hormonal birth control
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29
Q

What medications are given for preterm labor?

A
  • Atobsian
  • Magnesium sulfate
  • Nifedipine
30
Q

What medications induce labor?

A

Oxytocin analogs

31
Q

Autonomic dysreflexia is an uncoordinated response to demands of heart and vascular tone due to a lesion below T6. This can induce labor. What is the treatment?

A

Epidural to T10

32
Q

When is MTX repeated in the case of ectopic pregnancy?

A
  • To ensure fetus has been aborted
  • Measure hCG on day 4, if not below > 15%, continue w/ more MTX

MTX is initiated IM x 2 doses (1 in ea. cheek)

33
Q

What are the most common places for ectopic pregnancy?

A
  • Fallopian tubes (esp. ampulla)
34
Q

Absence of menses is not an issue unless?

A
  • Pt ≥15 yo w/ 2° sex characteristics
  • Pt is 13 ≥w/o 2° sex characteristics
35
Q

Why/how do you perform percutaneous umbilical cord blood sampling?

A
  • Transabdominal needle w/ aspiration of umbilical cord
  • > 20 wks

Looking for abnormality

36
Q

Why/How do you perform chorionic villus sampling?

A
  • Reserved for pts w/ > 0.5% chance of abnormality
  • Women > 35 yo or w/ probable genetic predisposition
  • Can be done earlier (versus percutaneous umbilical cord sampling)
37
Q

What are causes of primary amenorrhea?

A
  • Turner syndrome 45,X (most common)
  • Pregnancy
  • Alterations in genital outflow tract
  • Premature ovarian failure
  • Hypogonadotrophic hypogonadism
  • Kallman’s syndrome
  • Marijuana use
38
Q

{{BLANK}} is the most common cause of primary amenorrhea

Hint: 45, X

A

Turner syndrome

39
Q

{{BLANK}} syndrome is assoc. w/ primary amenorrhea, absence of GnRH and hypoplasia of olfactory tracts

A

Kallman syndrome

40
Q

Marijuana use blocks the release of {{BLANK}} so it can cause primary amenorrhea

A

Blocks release of GnRH

41
Q

Why do you treat early menarche?

A
  • Early closure of bone epiphysis
  • Short stature
42
Q

When do you give Rhogam to a pregnant patient?

A
  • Exposure of RBCs –> anti-RBC Abs
  • Rh- mother can develop Rh antibodies
  • therefore, in f/u pregnancy, give rhogam

Specifically, if < 1:8

43
Q

{{BLANK}} can cross the placenta and cause hydrops fetalis. To prevent this, you give Rhogam

A

IgG

44
Q

Macrocytic versus microcytic anemia

A
  • Macrocytic: MCV > 100
  • Microcytic: MCV < 80
45
Q

How is hypothyroidism treated in pregnancy?

A

Increase the dose of levothyroxine

46
Q

How is hyperthyroidism treated in pregnancy?

A
  • 1st trimester: PTU
  • 2nd/3rd: MMI
47
Q

HbS trait is assoc. w/ increased {{BLANK}} during pregnancy

A

UTI

48
Q

Explain the difference regarding dichorionic/diamniotic, monochorionic/diamniotic, and monochorionic/monamniotic.

A
  • Dichorionic/Diamniotic: 2 distinct amniotic cavities w/ their own placenta & chorionic sac
  • Monochorionic/Diamniotic: Identical twins who each share a placenta but not chorionic sac
  • Monochorionic/Monamniotic: Identical twins who share placenta & amniotic sacs (separate umbilical cords)
49
Q

What measurements do you suspect in a fetus with IUGR?

A
  • Fundal height ≤4 cm
  • Fetus est. weight < 10th percentile for age
  • Fetus abdominal circumference < 2.5 percentile for age
  • Birth weight for IUGR is < 2.5 kg
50
Q

What qualifies as macrosomnia?

A
  • Fetus > 90% percentile at gestational age
  • Weights > 4 kg
51
Q

How long does Rhogam last? When do you give it?

A
  • T1/2 ~16 days
  • within 72-hours post-delivery
52
Q

Symmetric IUGR versus Asymmetric

A
  • Symmetric: early onset, decreased cell #; irreversible diminution of organ size & function; BPD/HC small & HC/AC normal (
  • Asymmetric: late onset; decrease cell size; amenable to adequate nutrition; BPD/HC normal & HC/AC increased
53
Q

1st & 2nd line Tx fr post-partum hemorrhage?

A
  • 1st: massage
  • 2nd: oxytocin analog
54
Q

If a patient comes in Hx of fetal demise & O- blood type. What do you give?

A

Rhogam

55
Q

If a patient comes in full-term after MVC and have a port-wine vaginal bleeding. Both her & the baby are O-. Do you need to use Rhogam?

A

No

56
Q

If a patient comes in w/ low fundal height, what in her hx would cause IUGR?

A

HTN

57
Q

What are the maternal factors that increase IUGR?

A
  • Preeclampsia
  • Eclampsia
  • Smoking
  • Malnurishment
  • Connective tissue dx

Fibroids are NOT a risk factor

58
Q

What do you do for a patient who is 34 weeks gestation and her water broke?

A

Induce labor

59
Q

Which trocolytic medicine has data that it can prevent preterm labor?

A

Atobisan

60
Q

When does the splitting of monozygotic twins occur?

A

Within 0-3 days

61
Q

What are the complications of increased risk w/ twins/triplets?

A
  • High incidence of congenital malformations
  • Higher risk of miscarriage
  • Increased risk of IUGR
  • Higher risk of pre-eclampsia
  • Higher risk of placental or umbilical cord issues
62
Q

{{BLANK}} is the removal of the uterus

A

Hysterectomy

63
Q

{{BLANK}} placement of occlusive device in tubal ostia bilaterally

A

Hysteroscopy

64
Q

{{BLANK}} is the surgical cutting of vas deferens

A

Vasectomy

65
Q

What is the best choice for teenagers who have never had a baby and may not remember to take pill everyday?

A
  • Implant in arm
  • Nuvaring
  • Dep-provera
66
Q

What is the MOA of clomiphene?

A

Binds to ERs in hypothalamus & increases FSH production

67
Q

Why do you perform a semen analysis?

A

40% of infertility cases are due to defects in spermatogenesis

68
Q

What are cardiac problems that it is okay for them to get pregnant?

A
  • Septal defect
  • PDA
  • mild mitral & aortic valve disorders
  • Grades 1/2 CHF
69
Q

What are the cardiac problems that it is NOT okay to get pregnant?

A
  • Primary PHTN
  • Tetralogy of Fallot
  • Eisenmenger syndrome
  • Marfan syndrome w/ aortic root dilation
  • Grades 3/4 CHF
70
Q

If a pregnant patient comes in w/ flank pain, what do you worry about?

A

Pyelonephritis or kidney stone

71
Q

{{BLANK}} deficiency is more common in people w/ multiple gestations & people taking phenytoin.

Def. = increased risk of neural tube defects

A

Folate deficiencies

72
Q
A

Block 6 Exam (3 decks)

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