OBGYN Flashcards
significantly elevated DHEAS support the diagnosis of
an adrenal tumor as the etiology of hirsutism
Hair loss in woman after baby
Postpartum telogen effluvium (hair loss) affects 40-50% of women postpartum.
↑ estrogen levels in pregnancy ↑ the synchrony of hair growth.
hair grows and is shed at the same time (not normal growth pattern)
Rapid onset of hirsutism and virilizing signs are hallmarks of this disease, and include many of the findings in this patient including acne, hirsutism, amenorrhea, clitoral hypertrophy, and deepening of the voice.
Sertoli-Leydig cell tumors
Possible causes of virilization include
PCOS
hypothyroidism,
androgen producing tumors (ovarian, adrenal, or pituitary)
anabolic steroid use.
rare cause may be late onset congenital adrenal hyperplasia.
__________ is a more severe form of polycystic ovarian syndrome (PCOS).
Hyperthecosis
more difficult to treat with oral contraceptive therapy. It is also more challenging to achieve successful ovulation induction.
_______________, can also be used in addition to the oral contraceptives for hirsutism.
Spironolactone, an aldosterone antagonist diuretic
Patients with anovulatory bleeding have ?
predominantly proliferative endometrium from unopposed stimulation by estrogen.
Progestins inhibit further endometrial growth via
converting the proliferative to secretory endometrium.
Withdrawal of the progestin then mimics the effect of the involution of the corpus luteum, creating a normal sloughing of the endometrium.
Disorders of clotting may present with menstrual symptoms in young women, with _______ being most common.
Von Willeberand disease
Leiomyomas typically present in women in their _________ age
30’s and 40’s
The progestin in oral contraceptives causes ____________
endometrial atrophy- Dysmenorrhea should be improved.
Since prostaglandins are produced in the endometrium, there would be less produced.
Endometriosis pathology
endometrial glands/stroma with hemosiderin-laden macrophages
An endometrial biopsy should be performed on all women over age _____with irregular bleeding to rule out endometrial carcinoma.
40
Hyperplastic overgrowth of endometrial glands/stroma is consistent with ?
endometrial polyps.
What is physiologic leukorrhea
non-pathologic copious white vaginal discharge
when do you do the quad screen
2nd trimester
who is good to get cell free dna
women over 35 or high risk for trisomy
can be done > 10 weeks
What cancer is pcos at risk for
endometrial b/c of excess estrogen
what is peripartum cardiomyopathy
rapid onset heart failure > 36 weeks prego
CHF symptoms
In order to remain in zero calcium balance, postmenopausal women require a total of ______ of elemental calcium per day.
1200 mg
Begin treatment with bisphosphonates w/o a bone scan when
Patients who already have had an osteoporotic fracture may be treated on this basis alone.
The World Health Organization (WHO) defines osteopenia (low bone mass) as _______
-1 to -2.5
In all patients with advanced ovarian cancer, post-operative_____________ is considered standard of care in the United States.
chemotherapy with a combination of a taxane and platinum adjunct
________ of the Liley curve indicate the presence of severe hemolytic disease, with hydrops and fetal death likely within 7-10 days
Zone 3
Manual vacuum aspiration is more than 99% effective when?
in early pregnancy (less than eight weeks)
External cephalic version and internal versions are contraindicated in ?
active labor.
__________ is a common complication after vaginal delivery
Acute cystitis- usually e coli
________ is used in pregnancy to treat migraine headaches.
. Amitriptyline
Twin-twin transfusion syndrome most commonly occurs in ?
monochorionic, diamniotic twins
is the result of an intrauterine blood transfusion from one twin to the other. It
Asthma generally worsens in 40% of pregnant patients. One of the indications for moving to the next line of treatment includes ?
the need to use beta agonists more than twice a week.
One SSRI, __________ has been changed to a category D drug because of _____________
paroxetine (Paxil)
↑ risk of fetal cardiac malformations and persistent pulmonary hypertension.
The following are associated with retained placenta:
prior Cesarean delivery, uterine leiomyomas, prior uterine curettage and succenturiate lobe of placenta.
what does estrogen do to cholesterol
HDL levels increase and LDL levels decrease
fetus requirements for methotrexate termination of ectopic
size of ectopic mass <4 cm without a fetal heart rate or <3.5 cm in the presence of a fetal heart rate
Colpocleisis is one option to treat _______
uterine prolapse
best treatment for stress incontinence
sling
aka Retropubic urethropexy
Mifepristone can be effective up to?
nine weeks.
Women with a___________ have up to a 2.5 fold increase in prolapse.
family history of POP
Medical abortion is associated with ____________ vs surgical abortion
higher blood loss
Primary vulvar adenocarcinomas most likely arise from the ?
Bartholin gland
Bone density screening is recommended for women beginning at age ?
65
unless they have pre-existing risk factors which warrant earlier screening. Risk factors for osteoporosis are early menopause, glucocorticoid therapy, sedentary lifestyle, alcohol consumption, hyperthyroidism, hyperparathyroidism, anticonvulsant therapy, vitamin D deficiency, family history of early or severe osteoporosis, or chronic liver or renal disease.
Growth of uterine fibroids is stimulated by ?
estrogen
Systemic diseases such as diabetes mellitus, chronic renal disease and lupus are associated with?
early pregnancy loss
