Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Step 2 CK > OBGYN > Flashcards

OBGYN Flashcards

1
Q

How to estimate delivery date?

A

LMP - 3 months + 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

DA vs GA

A 
DA = days since fertilization= shorter 
GA= days since LMP= longer than DA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When does first trimester end? second?

A

12 weeks DA or 14 wks GA

24 weeks DA or 26 weeks GA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q 
Define lengths: 
pre- viability:  
pre-term:  
early term: 
full term:
late term:
A 
pre- viability:  before 24 wks 
pre-term: 25-37 
early term: 37-38.6
full term:39-40.6
late term: 41-41.6
postterm: 42+
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When is fetal movement felt?

Whats this called?

A

starts 16-20 wks GA

quickening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When should anatomy scan be done?

A

18-20 wks GA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the following signs?
Goodell sign
Ladin Sign
Chadwick Sign

A

Goodell- softened cervix (first)
Ladin- softened uterine midline
Chadwick- blue discoloration vagina/cervix

all first trimester

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When is “cholasma” seen? linea nigra?

A

second trimester ~16 wks; linea also second trimester

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe BHCG trend?

A

rises and peaks @ 10 wks
drops during 2nd trimester
rises again 3rd trimester to 20-30k

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How often should BHCG double in early pregnancy?

A

q48 hours for first month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

At what BHCG should a gestational sac be seen on scan?

A

10-15k/ or 5 wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Cards changes in pregnancy

A

^HR/CO

lower BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

GI changes in pregnancy

A

GERD and constipation due to LES decreased tone and decreased colonic motility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Renal changes in pregnancy

A

increased GFR, decreased BUN/Cr

increased risk pyelo due to uterine compression of GU tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Heme changes in pregnancy

A

anemia, hypercoagulable (fibrinogen ^ but no PT/PTT, INR change)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Important prenatal testing done:

  • early as possible
  • 11-14 wks
  • 16 wks
  • 15-20 wks:
  • 18-20 wks
A
  • early: blood tests, pap, GC
  • 11-14: gestational age, nuchal translucency
  • 16 wks: fetal heart sounds
  • 15-20 wks: triple or quad screen
  • 18-20 wks: anatomy scan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Third trimester testing done at
27 wks
24-28 wks
36 wks

A

27 wks CBC
24-28 GTT
36 wks repeat GC, GBS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When to give iron supplements in pregnancy

A

Hgb 11 or less

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How often are visits early in pregnancy?
3rd trimester?
36?

A

early- 4-6 wks
3rd trimester- 2-3 weeks
36+- weekly visits w/ cervical cks at each

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When is chorionic villus sampling/amniocentesis a reasonable idea and when can it be done?

A

10-13 wks CVS; 11-14 amnio
advanced maternal age
known genetic disease in parent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

MC location ectopic pregnancy

A

ampulla of fallopian tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How to manage ectopic?

A

ruptured: stabilized –> surgery

not ruptured: medical or surgical treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Medication used to abort ectopic?

A

MTX (folate receptor antagonist)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Important followup for MTX treatment of ectopic?

A

follow BHCG to zero

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Exclusion criteria

A

large or heart beat
liver disease
noncompliant
immune deficient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

surg for ectopic

A

salpingostomy/ectomy

*need rhogam if Rh negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

SAB is inevitable when?

A

bleeding + dilated cervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Abortion is before what GA?

MCC?

A

20 wks
(80% in first 12)
chromosomal abnl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Threatened abortion def

A

bleeding without dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Missed abortion def

A

abortion but all POC in uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Treatment of septic abortion

A

D&C + IV levo or metro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Difference between preterm labor and cervical incompetence?

A

contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Contraindication to tocolytics in preterm labor?

A 
BP ^ 
cardiac disease
dilated more than 4 
DIC 
fetal death 
chorio
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

At what GA is preterm labor not stopped?

A

34-37

earlier give steroids and tocolytics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

MC used tocolytic

A

magnesium sulfate… can also use CCB or terbutaline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Define PROM + risks

A

ruptured more than 24 hours before delivery

= PTL, cord prolapse, abruption, chorio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Management of PROM

A

chorio- always deliver
term- wait 6-12 hours for spontaneous this induce
preterm- abx, steroids, tocolytics,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Abx used in PROM

A

azithro 1 g and ampicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is CI in all cases of third trimester bleeding?

A

digital exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Presentation placenta previa

A

painless bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Three types of placental invasion

A

accreta, increta, percreta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Risk assc with placental invasion

A

PPH (type and cross)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Treatment of bleeding assc with placenta accreta

A

hysterectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Define placental abruption

A

Separation of the placenta from the uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Risk factors for abruption

A

smoking, cocaine, HTN, trauma, prior hx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

MC incision type for Csection modern

A

low transverse

47
Q

Two types of abruption

A

concealed vs external

(concealed = bleeding into uterine cavity) * concealed in worse… DIC/hypoxia/ tetany etc

48
Q

Clues to uterine rupture

A

fetus withdraws into abdomen during delivery
bump in abdomen
pain
no contractions

49
Q

Treatment of uterine rupture

A

life threating… always immediate laparotomy

50
Q

Management of future pregnancies after uterine rupture

A

IF uterus can be repaired…. deliver all future pregnancies by cesarean at 36 wks

51
Q

Cause of hemolytic disease of newborn

A

Rh - mom, second pregnancies, develops ab’s to fetal RBCs

52
Q

Result of hemolytic disease newborn

A

erythroblastosis fetalis –> high output CHF

53
Q

Screens for Rh factor (2)

A

Ab SCREEN to see if momma is + or -

Antibody titer to see how many antibodies to Rh+ blood momma has (at initial visit and 28-35 wks)

54
Q

Management of Rh - momma at 28-35 wks

A
  • rhogam if unsensitized and again at birth if babe is acutally Rh+
  • sensitized but less than 1:16- nothing
  • sensitized more than 1:16- serial amnio
55
Q

What if fetal hgb is low and bili is high?.

A

can perform intrauterine transfusion

56
Q

Define pre-eclampsia and eclampsia

A

pre-eclampsia: HTN + proteinuria

eclampsia: ^ + seizures

57
Q

Define chronic HTN of pregnancy

A

above 140/90 before 20 wks GA

58
Q

Define gestational HTN of pregnancy

A

BP above 140/90 after 20 wks GA without proteinuria or edema

59
Q

Treatment of HTN in pregnancy

A

methyldopa, nifedipine, labetalol

60
Q

ACE/ARBs in preggos?

A

no… malformations.

61
Q

Define “severe preeclampsia”

A

more than 160/110; dipstick 3+; more than 5g protein in 24 hrs; generalized edema; mental status/ vision change; impaired LF.

62
Q

Treatment of mild preeclampsia

A

if preterm: steroids + Mag Sulfate

if term: induce delivery

63
Q

Treatment of severe preeclampsia

A

Same as mild but add hydral

64
Q

Maternal risks with pregestational DM

A

preeclampsia, SAB, infection, PPH

65
Q

Fetal risks with pregestational DM

A

heart defects, NTDs, macrosomia, preterm

66
Q

Maternal testing incase of pregestational DM

A

EKG, renal function, a1c, eye exam

67
Q

Fetal testing needed in case of pregestational DM

A

32-26 wks: weekly NST and US
36+: weekly BPP and NST
37+: L/S ratio (can deliver now if mature)
38-39: induce delivery

68
Q

Glucose testing at 24-28 wks…

describe steps

A
  • 50g gluc load test (+ if above 140)
  • if + then ingest 100g while fasting and measure glucs at 1,2,3 hours.
  • load –> tolerance
69
Q

Treatment of GDM

A

diet and exercise (not weight loss) –> metformin/glyburide –> insulin

*pregestational type 2 will likely need insulin

70
Q

Define IUGR

A

less than 10th percentile

71
Q

Two types of IUGR

A

symmetric: brain = rest of body, starts before 20 GA
asymmetric: brain weight better than rest of body, after 20 GA

72
Q

Prevention of IUGR

A

stop smoking, get vaccines (but not live)

73
Q

Define macrosomia

A

babes greater than 4500 grams

74
Q

Appropriate fundal height compared to GA

A

fundal height in cm should equal GA in wks… do US if off by 3 cm or more

75
Q

What are the three STAGES of labor?

How is stage one divided?

A

Stage 1: labor onset –> full dilation (latent + active starting at 4cm)
Stage 2: full dilation –> delivery
Stage 3: delivery babe –> delivery placenta

76
Q

Upper limit normal stage 1 labor for primip vs multip

A

primip: 18 hours
multip: 10 hours

77
Q

How fast should dilation go during active phase for primp/multip?

A

primip: 1cm/hr
multip: 1.2 cm/hr

78
Q

Upper limit normal stage 2 labor for primip vs multip

A

primip: 3 hours
multip: 30 mins

79
Q

Upper limit normal for stage 3 labor

A

30 mins

80
Q

Stations of fetal head

A

-3 –> 0 –> +3

0 is pelvic brim

81
Q

Chemicals for labor induction

A

oxytocin, PGE2

*avoid PGE in asthmatics

82
Q

3P’s for evaluation of protracted cervical dilation

A

Power (contractions)
Passenger (babys head size)
Passage (pelvis size)
* can give oxytocin if power is the issue

83
Q

Define arrest disorders

A

of cervical dilation: no change x 2 hours

of fetal descent: no change x 1 hour

84
Q

At what age is ECV appropriate

A

after 36 wks GA

85
Q

Define early vs late PPH and what amt of blood constitutes hemorrhage?

A

early first 24 hours; late after

must be more than 500 mL blood

86
Q

Common causes PPH

A

1 atony, then lacs/retained products/ etc

87
Q

Management of PPH

A

massage and oxytocin

88
Q

Dx criteria for PMD

A

2 + cycles
sx absent in follicular phase
sx present in luteal phase
interferes with life

89
Q

Treatment for PMDD

A

SSRIs/ stop caffeine, alcohol, cigarettes chocolate

90
Q

Menopause age + length

A

48-52, must have no periods x 1 year for dx

91
Q

Problem with no estrogen? problem with estrogen replacement?

A

no estrogen- osteoporosis

estrogen- endometrial carcinoma

92
Q

Define menorrhagia? metrorrhagia?

A

meno- too much

metro- irregular

93
Q

Causes of excess bleeding?

A

polyps/cancer/fibroids/estrogen excess/ etc

94
Q

Postcoital bleeding is ____ until proven otherwise

A

cervical cancer

95
Q

Dx tests for menorrhagia/abnormal bleeding

A

CBC, PT/PTT, pelvic US

96
Q

What produces progesterone during normal cycle?

A

corpus luteum, dies when pt does become pregnant, then prog withdraw= bleeding

97
Q

Systemic reasons for anovulation

A

hypothyroid

hyperprolactinoma

98
Q

At what age is abnormal bleeding concerning for cancer?

A

35+

99
Q

What three risks are decreased by OCPs

A

endometrial cancer, ovarian cancer, ectopics

100
Q

Vaginal ring works the same way as? Patches?

A

OCPs same hormones, take out or off for 7 days to bleed

101
Q

Depot medroxyprogesterone is effect for how long?

A

3 months, must get shot q3 months

102
Q

Cause of labial fusion

A

high androgens as in 21 B hydroxylase def

103
Q

Lichen sclerosis vs planus appearance + treatment of both

A

sclerosis is white; planus is purple

both get steroids

104
Q

Appearance of squamous hyperplasia on vagina + treatment

A

RAISED white lesion that itches

treat with sitz bath

105
Q

Treatment of Bartholin gland cyst ?

A

I&D + culture drainage to R/O G&C

106
Q

Normal vaginal pH

A

lower than 4.5

107
Q

Treatment of bacterial vaginosis?

A

metro or clinda

108
Q

Treatment of trich

A

patient and partner with metro

109
Q

Pagets disease appearance and treatment?

A

Rasied red lesion with white coating…. need vulvectomy

110
Q

Common type of vulvar cancer + presentation?

A

squamous cell, often itchy

111
Q

Adenomysosis appearance and treatment

A

endometrial glands grow into myometrium….. large boggy uterus. Treatment is hysterectomy

112
Q

Treatment for severe endometriosis not managed by NSAIDs/ OCPs

A

danazol (test effects), leuprolide (induces reversible menopause)

extreme= surgery

113
Q

Chemical dx of PCOS

A

LH:FSH more than 3:1

114
Q

Drugs to help pt with PCOS conceive

A

metformin and clomiphene

Step 2 CK (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions