Obgyn Flashcards
What kind of exercise is allowed in heathy pregos? What is not allowed?
Moderate exercise- swimming, walking, even cycling. Not allowed are scuba diving, skiing bc risk of fall, distance running
What is it called when a prego in 2nd to 3rd trimester dvlps urticarial papules, plaques surrounding UMBILICUS
Herpes gestationis which is NOT causes by herpes. It is AUTOIMMUNE
Vs PUPPP papules and plaques of preg affects the ABD straie and spares the umbilicus
How do you treat herpes gestationis?
Since it is autoimmune tx with steroids like triamcinolone. If topical not enough may need oral.
How to treat prego with bipolar- mainly depression?
ECT
Avoid SSRI monotherapy like fluoxetine in bipolar bc may induce mania
New palpable mass in 33 yo woman w fam bx of mother w br ca at 62 should receive what imaging?
Mammo and u/s in >30.
Palpable mass in woman in 30s
U/s. If atypical features then mammo too and core needle biopsy. It simple cyst can watch or aspirate
Elevated afp during preg in 16-20 wks due to? And what to do next?
Spina bifida, anenceph, improper fetal date or multiple gestations
Next thing to do is u/s
If u/s abn, amniocentesis and check achE levels
Low afp levels during preg hints at? What to do next?
Down syndrome
Need chromosome analysis next
R sided abd pain , tender adnexal mass, not sexually active
Ovarian torsion
Confirm w doppler pelvic u/s
Does tamoxifen incr risk of dvt
Yes
What level hcg should u see intrauterine preg?
1500 iu/L
If u dont then its an ectopic confirmed on TVUS. Even if the US shows only a cyst- that is the ectopic preg
If hcg less then 1500 then repeat hcg in 2-3 days to make sure rising appropriately >66% every 48 hrs
Subchorionic hematomas assoc with incr risk of
Spontaneous abortions
Hyperkeratotic flesh colored papules on vagina of a pregnant woman are?
Hpv warts. Continue with vaginal delivery since transmission only 1%
After how long is labor considered arrest of labor?
What to do next?
4 hrs with no cervical change but adequate contraction
6 hrs no cervical change with inadequate contractions
Place intrauterine monitor to count montevideo units. Adequate contractions at least 200 mvus.
Treatment of hpv warts on vagina?
Trichloroacetic acid
If multiple recurrences then excise or ablate
How does antiseizure med affect ocp?
Decr ocp effectiveness bc p450
Female atheletes with ammenorrhea bc
Decr lh and gnrh means decr estrogen.
Causing infertility, osteopenia
Gp b strep bacteriuria is checked in rectovag culture at 35-37 wks gestation and tx with intrapartum abx like amp, pcn, cefazolin at least 4 HOURs before delivery.
If term baby (>37 wks, no ROM), then what is management of baby?
Observe for two days.No labs
If not term or ROM, then observe and get blood cx, labs
Pt calls u with vulvovaginitjs symptoms not improvedwith antifungal cream? What could it be? Is it enough to tell her what to do over the phone?
No often physician and pt detail of problem not reliable. Need to get vaginal secretion and test for pseudohyphae in candidiasis, clue cells in bacterial vaginosis, trichimonads in trichimoniasis