- nitrofurantoin - amoxicillin - cephalexin

- ceftriaxone/cefazolin - ampicillin + genta

OBGYN Flashcards by JOSH WOHL

threatened abortion

closed cervical os

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

How well did you know this?

Not at all

Perfectly

inevitable abortion

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

How well did you know this?

Not at all

Perfectly

incomplete abortion

Cervical os open

Some products of conception (POC) already expelled

How well did you know this?

Not at all

Perfectly

complete abortion

POC completely expelled
Cervix closed
no tx required

How well did you know this?

Not at all

Perfectly

missed abortion

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

How well did you know this?

Not at all

Perfectly

septic abortion

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)

How well did you know this?

Not at all

Perfectly

who gets rhogam

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

How well did you know this?

Not at all

Perfectly

what suggests an incomplete abortion or ectopic

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

How well did you know this?

Not at all

Perfectly

ectopic etiology

Previous episode of PID (from inflammation)

Tubal surgery

Pelvic surgery

Assisted reproductive technology IVF

How well did you know this?

Not at all

Perfectly

ectopic triad

Abdominal pain

Vaginal bleeding

Amenorrhea

How well did you know this?

Not at all

Perfectly

this lab result indicates an ectopic

this lab result is indeterminate

BHCG >6000 mIU/mL w/ empty uterus

BHCG ≤1000 mIU/mL, repeat in 2 days

How well did you know this?

Not at all

Perfectly

hyperemisis gravidum

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

How well did you know this?

Not at all

Perfectly

oral hypoglycemic agents are contraindicated in

pregnant diabetic pts

How well did you know this?

Not at all

Perfectly

how to treat hyperthyroidism in pregnancy

PTU (propthiouracil)

Thyroid storm: fever, volume depletion & cardiac decompensation

How well did you know this?

Not at all

Perfectly

simple cystitis tx

nitrofurantoin
amoxicillin
cephalexin

How well did you know this?

Not at all

Perfectly

pyelo tx

ceftriaxone/cefazolin

- ampicillin + genta

what med to avoid for seizure disorder pts

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

Place patient in left lateral decubitus position to maximize placental oxygenation

HIV + pts should be placed on

zidovudine >14 weeks gestation

in any domestic violence, you must administer

rhogam is pt is Rh -

blunt trauma <20

>20 weeks

reaasurance

get a non-stress test, fetal monitor

when are speculum and pelvic exam C/I?

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

abruptio placentae risk factors

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

how does abruptio placentae present

dark red painful bleeding

- abdominal pain

how does placenta previa present?

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

things to consider with preterm labor

- normal is 40 weeks, anything <37 | - give glucocorticoids to hasten fetal lung maturity

pre-eclampsia | vs eclampsia

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

how to tx pre-eclampsia

- labetalol, hydralazine, nifedipine | - Mg sulfate for severe

HELLP (variant of pre-eclampsia)

Hemolysis Elevated Liver enzymes Low Platelet count presents with abdominal pain

to to tx HELLP

- Mg sulfate - labetalol - definitive tx requires delivery of fetus

postpartum hemorrhage

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

mittleschmerz

"ovulation pain" or "midcycle pain".

m/c noninfectious cause of acute pelvic pain

ovarian cysts

ovarian torsion

surgical emergency | US is test of choice to dx

gold standard dx of PID

laparoscopy

PID definition

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)

how to tx PID inpt

Cefotetan 2 g IV every 12 hours OR | Cefoxitin 2 g IV every 6 hours PLUS Doxycycline 100 mg orally or IV every 12 hours(OR)

how to tx PID outpt

ceftriaxone IM single dose | doxy +- metro

Most frequent benign disorder of breast

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

MCC mastitis

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