OBGYN Flashcards
Endometriosis
pain a couple days before period and lasts throughout dyspareunia chocolate cysts most common spot is ovaries Gold standard diagnostic- Laparoscopy Tx- Nsaids 1st, oral contraceptives 2nd
Asherman syndrome
adhesions within the uterus
usually caused by D&C
can be due to endometritis or past OB problem
could cause secondary ammenorhea
Bacterial Vaginosis
caused by Gardnerella Change in vaginal flora (not an sti) Fishy odor (KOH prep) Clue cells Positive amine test PH >4.5 Thin, grey/white discharge Tx Metronidazole (Flagyl) 500 mg bid 7 days If nursing/pregnant women then Clindamycin
Candidiasis (yeast infection)
Thick/ white/cottage cheese
satellite lesions
PH 4-4.5
Tx Fluconazole (Diflucan) 150 mg x 1 dose
Trichomonas
Most common STI PH 5-6 Strawberry cervix Punctate hemorrhages on cervix frothy, green/ yellow discharge Tx metronidazole
HPV subtypes
Cervical cancer 16 and 18
Genital warts 6 and 11
Atrophic Vaginitis
decrease in estrogen
vaginal dryness
pale, smooth shiny vagina
loss of elasticity, narrowing of introitus
dyspareunia
uti sxs
tx first is vaginal moisturizers, 2nd topical estrogen
Lichen sclerosis
main symptom is pruritus of vulva and anus
Bartholin cyst
first tx- word catheter
if fail word 2-3 times then marsupilization
Dysfunctional uterine bleeding
problem with adolescents girls or perimenopause women
hormonal problem and bleed too much or too often
tx- hormone (OCP) and nsaids (nsaids decrease bleeding in uterus)
primary amenorrhea
by 13 without secondary sexual characteristics
or 16 with sexual characteristics
secondary amenorrhea
cessation of period for 3 months if previous cycles normal
cessation of 6 months if irregular menses
FSH to diagnose menopause
FSH >30 is diagnostic
HRT for menopause side effects
increase cardiovascular disease
breast cancer
can’t use if unexplained vaginal bleeding, h/o dvt or PE, gynecology cancers
fibrocystic vs fibroadenoma in breasts
fibrocystic are painful (fluctuating size)
fibroadenoma are painless (round, firm, mobile, non tender)
mastitis tx
penicillinase resistant abx- naficillin or dicloxacillin or cephalosporin with hot compress
mastitis is usually staph (especially lactating mothers-continue to breast feed or pump and dump)
most common breast cancer
invasive ductal cancer
what does US show on PCOS
string of pearls
oyster ovaries
Physical exam sign in PID
chandler sign- cervical motion tenderness
infertility
haven’t got pregnant within a year of having unprotected sex
How to calculate due date
subtract 3 months and add 7 days
Where is pregnancy at 20 week
umbilicus
When should you get quickening (movement)
18 weeks
normal fetal HR
120-160
what do contractions do to fetal hr
deceleration (decrease flow to placenta)
compress head
Stages of labor
1st- from contractions to full dilation
2nd- full dilation to delivery of baby
3rd delivery of placenta
late decelerations
bad
uteroplacental insufficiency
(early decels are ok and are due to contraction)
APGAR
1 and 5 min
appearance (blue, pink trunk/blue extremities, pink)
pulse (absent, 100)
grimnance (absent, facial movement, sneeze/cough)
activity (absent, some flexion, full)
respiration (absent, slow irregular, good crying)
variable decelerations
cord compression
when is the uterus first palpable (above pelvis)
12 weeks
HCG in ectopic pregnancy
less then expected
HCG should double every 48 hours
should see intra uterine pregnancy if HCG >1500 (discriminatory zone)
TX for ectopic
methotrexate (folic acid antagonist)- if stable
if unstable surgery
must follow HCG to make sure it returns to normal
Hydatidaform moles
complete more common then partial
choronic villi that has grown like tumor
US shows grape like clusters or snowstorm
Signs- Uterine size greater then expected
HCG greater then expected
Hyperemesis gravidarum (extreme nausea from high HCG)
Tx chemo
Highblood pressure in pregnancy
20 weeks (up to 6 weeks post partum)- If no symptoms- pregnancy induced HTN
If asymptomatic- preeclampsia/eclampsiaPreeclampsia triad
HTN
proteinuria
edema
mild preeclampsia
140/90 w/ >3 g proteinuria (
severe preeclampsia
160/110 w/ >5 g proteinuria
HELLP syndrome
severe pre eclampsia
hemolysis
elevated liver enzymes
low platelets
most common risk factor for preeclampsia
null parity
Fetal hydrops
when mom makes antibodies to RH factor and causes fetal anemia
abx of choice for pregnant ladies w/ uti
macrobid (nitrofurantoin)
amoxicillin
cephalexin (beta lactams- ceftriaxone)
