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PANCE/EOC > OBGYN #3 > Flashcards

OBGYN #3 Flashcards

1
Q

What pregnancies are at risk for Rh Alloimmunization

A

-Rh negative mother + Rh positive father (or unknown)

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2
Q

Explain what happens in Rh alloimmunization

A

When a Rh-negative mother carries a Rh-positive fetus. During subsequent pregnancies, if she carries another Rh positive fetus, antibodies cross placenta and attack the fetal RBC’s, leading to hemolysis of the fetal RBCs

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3
Q

In Rh-negative women, when is Rhogam given? 3 instances

A
  • 28 weeks gestation
  • within 72 hours of delivery of Rh-positive baby
  • After any potential mixing of blood
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4
Q

What is placenta previa?

A

Abnormal placenta placement over or close to internal cervical os

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5
Q

Risk factors for placenta previa

A

-Multiple gestations, previous C-section, previous placenta previa

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6
Q

Symptoms of placenta previa

A
  • Painless vaginal bleeding in third trimester
  • Absence of abdominal pain or uterine tenderness
  • Soft, nontender uterus
  • DO NOT PERFORM PELVIC EXAM (may cause hemorrhage)
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7
Q

How is placenta previa diagnosed?

A

-Transabdominal US performed initially, then confirmed by transvaginal US

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8
Q

Treatment for placenta previa

A
  • Watchful waiting if patient is stable
  • Pelvic rest
  • Delivery if > 36 weeks. C section preferred most times.
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9
Q

Primary Amenorrhea is defined as

A

Primary: failure of menarche onset by 15 (in presence of secondary sexy characteristics) or age 13 (in absence of secondary sex characteristics)

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10
Q

secondary amenorrhea is defined as

A

Absence of menses for > 3 months in a patient with previously normal menstruation (or > 6 months with previous oligomenorrhea)

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11
Q

MCC of secondary amenorrhea

A

Pregnancy

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12
Q

Bacterial vaginosis is due to

A

Overgrowth of Gardnerella Vaginalis

-Decreased Lactobacillus acidophilus

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13
Q

Symptoms of BV

A
  • Malodorous vaginal discharge worse after sex
  • Vaginal itching, burning, dyspareunia
  • May be asymptomatic
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14
Q

Regarding Amsel’s Criteria, what are the 5 criteria for BV

A
  • 1) Clue cells on microscopic saline smear
  • 2) pH > 4.5
  • 3) few WBCs
  • 4) copious, thin, homogenous, gray-white discharge
  • 5) Positive whiff-amine test (fishy odor)
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15
Q

On a saline wet mount, what is seen in BV besides clue cells.

A

-Mobile protozoan trophozoites

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16
Q

Treatment for BV

A
  • Metronidazole 2g oral x 1 dose or Clindamycin

- Partners do not need to be treated

17
Q

MC type of vulvar cancer

A

Squamous Cell Carcinoma

18
Q

Symptoms of vulvar cancer

A
  • Red or white ulcerative or raised crusted lesion

- Vulvar pruritus, bleeding, or pain

19
Q

Diagnostic for vulvar cancer

A

Biopsy - 90% squamous

20
Q

Symptoms of ovarian torsion

A
  • Unilateral pelvic pain (acute)
  • N/V
  • Abdominal tenderness or adnexal mass
21
Q

Diagnostic for ovarian torsion

A
  • US with Doppler (initial): decreased ovarian blood flow

- Surgical exploration: definitive diagnosis

22
Q

Treatment for ovarian torsion

A

-Laparoscopy with detorsion to restore blood flow

23
Q

What is preeclampsia defined as

A

-New onset of hypertension (>140/90) occurring after 20 weeks gestation + proteinuria or end-organ dysfunction in a previously normotensive female

24
Q

Mild preeclampsia is defined as

A

-BP > 140/90 + proteinuria of at least 300 mg in 24-hour urine specimen (or dipstick 1+ to 2+)

25
Q

Severe Preeclampsia is defined as

A
  • Blood pressure 160/110 or greater
  • Proteinuria 5g in 24-hour urine (3+ on dipstick)
  • End organ symptoms (Cerebral or visual symptoms)
  • HELLP (Hemolytic anemia, elevated liver enzymes, low platelets)
26
Q

Management of Mild Preeclampsia

A
  • > 37 weeks: delivery

- < 37 weeks: expectant management

27
Q

Management of severe preeclampsia

A
  • > 37 weeks: prompt delivery, hospitalization, Magnesium sulfate to prevent seizures, BP control
  • < 37 weeks: Hypertensives and delivery
28
Q

Eclampsia is

A

Preeclampsia + seizures or coma

29
Q

Symptoms of Eclampsia

A

Abrupt onset of tonic-clonic seizures

30
Q

Treatment for eclampsia

A
  • IV Mag Sulfate for seizures and BP stabilization

- Delivery of the fetus

31
Q

What medications for BP control should be used in Eclampsia

A

-IV Labetalol or Hydralazine

32
Q

Risk factors for endometrial hyperplasia

A

-Prolonged unopposed estrogen (chronic anovulation, estrogen only therapy, PCOS, obesity, early menarche, late menopause, Tamoxifen use)

33
Q

Diagnostic of endometrial hyperplasia

A

-Transvaginal US screening test - thickened endometrial stripe > 4 mm

34
Q

What is the definitive diagnostic for endometrial hyperplasia?

A

Endometrial biopsy

35
Q

Symptoms of endometrial hyperplasia and endometrial cancer

A

-Abnormal uterine bleeding (postmenopausal bleeding)

36
Q

MC type of endometrial cancer

A

Adenocarcinoma

37
Q

Treatment for Endometrial Cancer

A
  • Stage 1: total abdominal hysterectomy with bilateral salpingo-oophorectomy
  • Stage 2/3: TAH-BSO + lymph node excision w/wo radiation
  • Stage 4: systemic chemotherapy
38
Q

What lab is seen in both endometrial cancer and ovarian cancer

A

CA-125

PANCE/EOC (63 decks)

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