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Emed 1 > OBGYN > Flashcards

OBGYN Flashcards

1
Q

threatened abortion

A
  • closed cervical os

- Threat but nothing is happening yet, no treatment unless condition worsens and return to ER

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2
Q

inevitable abortion

A

open cervix
Sac low w/in uterus
Sac surrounded by perigestational hemorrhage
Dilated cervix

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3
Q

incomplete abortion

A

Cervical os open

Some products of conception (POC) already expelled

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4
Q

complete abortion

A

POC completely expelled
Cervix closed
no tx required

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5
Q

missed abortion

A

No fetal heart beat after 8 weeks w/ minimal or no symptoms

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6
Q

septic abortion

A

Any type of abortion in presence of endometritis

S&S:
↑ temperature & WBC count, Lower abdominal pain
Cervical motion tenderness
Foul uterine discharge

Txt: Evacuate pregnancy, IV antibiotics (ampicillin,-sulbactam, clindamycin)

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7
Q

who gets rhogam

A

Rh- negative women should receive Rh (D) immune globulin 300 micrograms IM

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8
Q

what suggests an incomplete abortion or ectopic

A

Absence of gestational sac w/ a B-hCG>1000mIU/mL suggests incomplete abortion/ectopic pregnancy

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9
Q

ectopic etiology

A

Previous episode of PID (from inflammation)

Tubal surgery

Pelvic surgery

Assisted reproductive technology IVF

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10
Q

ectopic triad

A

Abdominal pain

Vaginal bleeding

Amenorrhea

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11
Q

this lab result indicates an ectopic

this lab result is indeterminate

A

BHCG >6000 mIU/mL w/ empty uterus

BHCG ≤1000 mIU/mL, repeat in 2 days

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12
Q

hyperemisis gravidum

A 
Intractable nausea & vomiting w/out  significant abdominal pain 
IV fluids (D5NS or D5LR)  
Anti-emetics
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13
Q

oral hypoglycemic agents are contraindicated in

A

pregnant diabetic pts

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14
Q

how to treat hyperthyroidism in pregnancy

A

PTU (propthiouracil)

Thyroid storm: fever, volume depletion & cardiac decompensation

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15
Q

simple cystitis tx

A
  • nitrofurantoin
  • amoxicillin
  • cephalexin
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16
Q

pyelo tx

A
  • ceftriaxone/cefazolin

- ampicillin + genta

17
Q

what med to avoid for seizure disorder pts

A

Valproic acid avoided b/c association w/ neural tube defects

Place patient in left lateral decubitus position to maximize placental oxygenation

18
Q

HIV + pts should be placed on

A

zidovudine >14 weeks gestation

19
Q

in any domestic violence, you must administer

A

rhogam is pt is Rh -

20
Q

blunt trauma <20

>20 weeks

A

reaasurance

get a non-stress test, fetal monitor

21
Q

when are speculum and pelvic exam C/I?

A

2nd half of pregnancy, don’t do till US obtained

22
Q

abruptio placentae risk factors

A 
HTN, DM, Chronic renal Dx
Advanced maternal age
Multiparity, 
Smoking
Cocaine use,
Previous abruption
 Abdominal trauma
23
Q

how does abruptio placentae present

A
  • dark red painful bleeding

- abdominal pain

24
Q

how does placenta previa present?

A

Painless bright red vaginal bleeding after 28 weeks gestation
avoid pelvic exam

25
Q

things to consider with preterm labor

A
  • normal is 40 weeks, anything <37

- give glucocorticoids to hasten fetal lung maturity

26
Q

pre-eclampsia

vs eclampsia

A

BP >140/90 or >20 rise in systolic or >10 in diastolic
proteinuria
generalized/pedal edema or weight gain >5 lbs in 1 week
typically > 20 weeks gestation
all of above + seizures

27
Q

how to tx pre-eclampsia

A
  • labetalol, hydralazine, nifedipine

- Mg sulfate for severe

28
Q

HELLP (variant of pre-eclampsia)

A

Hemolysis
Elevated Liver enzymes
Low Platelet count
presents with abdominal pain

29
Q

to to tx HELLP

A
  • Mg sulfate
  • labetalol
  • definitive tx requires delivery of fetus
30
Q

postpartum hemorrhage

A

Uterus is enlarged & “doughy” w/ uterine atony
Vaginal mass is suggestive of inverted uterus
Bleeding inspite of good uterine tone & size may indicate retained products of conception

31
Q

mittleschmerz

A

“ovulation pain” or “midcycle pain”.

32
Q

m/c noninfectious cause of acute pelvic pain

A

ovarian cysts

33
Q

ovarian torsion

A

surgical emergency

US is test of choice to dx

34
Q

gold standard dx of PID

A

laparoscopy

35
Q

PID definition

A

clinical syndrome in which microorganisms present in the cervix & vagina ascend into the normally sterile areas of the upper genital tract & causes an inflammatory reaction in the uterus (endometritis), FT (salpingitis) & adjacent structures (pelvic peritonitis)

36
Q

how to tx PID inpt

A

Cefotetan2 g IV every 12 hours OR

Cefoxitin2 g IV every 6 hours PLUS Doxycycline100 mg orally or IV every 12 hours(OR)

37
Q

how to tx PID outpt

A

ceftriaxone IM single dose

doxy +- metro

38
Q

Most frequent benign disorder of breast

A

fibrocystic changes

Symptoms most prominent pre-menstrually, pain and lumpiness tends clear up once your menstrual period begins

39
Q

MCC mastitis

A
  • s. aureus
  • Cephalexin or dicloxacillin
  • IMPORTANT - R/O inflammatory breast CA if no response to antibiotics

Emed 1 (8 decks)

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