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OBGYN Flashcards

1
Q

Day 1-14 of menstrual cycle is called____________

_________ hormone predominates

A

Follicular/Proliferative phase

Estrogen predominates

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2
Q

Occurs after ovulation typically day 14 called_________

Progesterone is produced by the ____________

A

Luteal/Secretory Phase

Corpus Luteum

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3
Q

Normal menstrual cycle begins no earlier than____ days, and no later than____ days

Menstrual cycles lasts

A

21-35 days

3-7 days

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4
Q

Hormone that stimulates follicle growth–> Estrogen production

A

FSH

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5
Q

Hormone that stimulates ovulation secondary to ______ surge

A

LH (secondary to Estrogen surge)

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6
Q

_________ concentration of > 200pg/ml for 50 hours is required for _______ ________ to occur

A

Estrogen

LH surge to occur

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7
Q

Maintains the corpus luteum –> continuous Estrogen/progesterone support of endometrium.

A

HCG

No fertilization–> CL degeneration –> Dec. Est/Prog–> Menses

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8
Q

Menorrhagia is defined as

A

heavy menses

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9
Q

Dysmenorrhea is defined as

A

Menses with cramping

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10
Q

Metrorrhagia is defined as

A

intermenstrual periods

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11
Q

Precocious puberty occurs at what age?

A

< 8 yoa

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12
Q

Delayed Puberty is defined as ?

A

No Thelarche by 13

No menarche by age 16

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13
Q

Type of Amenorrhea where the patient previously had a menses, but stops for six months?

A

Secondary Amenorrhea

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14
Q

Primary amenorrhea is defined as ?

MCC Genetic or anatomic

A

Absence of menses by 16 w 2ndary Sex development.

Absence of 2ndary Sex development by age 14

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15
Q

Primary Amenorrhea MCC “GENETIC”: XO karyotype

Webbed neck, broad chest,

A

Turner’s Syndrome XO

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16
Q

Secondary amenorrhea MCC and 2nd MCC?

A

Pregnancy and weight changes

Other: hypothyroidism, PCOS, Cushing’s

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17
Q

In primary amenorrhea if uterus is absent “Empty Pouch” you associate amenorrhea with what disorders?

A

Mullerien Agenesis (46XX) (Ovaries w Labial fusion)

Androgen Insensitivity (46 XY) (Male w internal Genitals)

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18
Q

Disruption of hypothalamic secretion of GnRH–> Dec. FSH/LH: MCC is anorexia, exercise, celiac disease.

(Secondary Amenorrhea) Tx:

A

Hypothalamic Dysfunction (35%)

Clomiphene (Clomid- Stimulates Gonadotropin H.)

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19
Q

Decreased FSH/LH with Incr. prolactin you associate Secondary Amenorrhea with ?

A

Pituitary Dysfunction (Adenoma)

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20
Q

Increased FSH/LH with decreased estradiol you associate secondary amenorrhea with ?

Insulin resistant, obesity, Incr. testosterone, LH:FSH 3:1

A

PCOS

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21
Q

PCOS patient presentation ?

A

Hirsutism/Hyperandrogenism
Obesity
Ovarian cysts
Amenorrhea/Oligomenorrhea

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22
Q

Definition for prolonged time without menstrual bleeding

A

Oligomenorrhea

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23
Q

Definition for frequent menstrual bleeding

A

Polymenorrhagia

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24
Q

Types of menstrual disorders

A 
Chronic Ovulation (Irregular: extreme ages young/old)
                                "Unopposed estrogen"

Ovulatory (Regular cycles: “Prolonged progesterone”)

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25
Q

Tx: for both Menstrual disorders?

Tx: for severe bleeding?

A

OBC 1st Line (Thins endometrium: Regulates cycle)

Severe bleeding: High dose Estrogen or HD OBC

Sx= Definitive

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26
Q

Menorrhagia (heavy) common causes

A

Leiomyomas
Adenomyomas
Bleeding D/O
Hyperplasia/Carcinoma

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27
Q

Tender boggy enlarged uterus: Accompanied by dysmenorrhea and pelvic pain.

Tx:

A

Adenomyomas

Tx: Hysterectomy

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28
Q

Palpable irregular mass on uterine BM exam. Usually develops >30 y/o: Benign tumor (Non-tender)

Tx:

A

Leiomyoma (Uterine Fibroid)

Tx: Pre-menopause (Leuprolide) Definitive Hysterectomy

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29
Q

Menorrhagia cause by bleeding disorders such as ?

A

Von Willebrand, Thrombocytopenia, or platelet dysfx

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30
Q

Dysmenorrhea due to pelvic pathology: endometriosis or adenomyosis, leiomyomas..

A

Secondary Dysmenorrhea

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31
Q

Primary dysmenorrhea (not due to pathology) is MCC by increased_______–> increased muscle activity

usually starts when?

A

Prostaglandins

1-2 years post menarche in young females

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32
Q

Treatment for dysmenorrhea?

A

NSAIDS

OBC

Laparoscopy if all fail

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33
Q

Cluster of physical, behavioral, and mood changes during the luteal phase (1-2 weeks before menses).

Bloating, breast pain, headache, BM changes, fatigue, muscle aches, depression, hostility, Dec. Libido. TX:?

A

Premenstrual syndrome “Relieved 2-3 days onset of Per”

Tx: SSRIs or OBC (Drosperinone containing)

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34
Q

PCOS Dx: Tx:

A

Progesterone challenge 10mg Medroxyprog. X 10 days
(No withdrawal bleeding= Hypothalamus/Pituitary failure
or imperforated hymen)
Tx: 1.OBC 2.Spironolactone (Hirsutism)
3. Clomiphene (Ovulation) Metformin- Abn. FSH:LH
4. Weight-loss 5. Sx-restores ovulation

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35
Q

term for disorder of acquired scarring of the uterine cavity?

A

Asherman’s Disorder

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36
Q

Ectopic endometrial tissue that responds to cyclical hormones. Usually <35 yoa and nulliparity:

Ovaries MC site: –> infertility 25% Tx: X5 options

A

Endometriosis

Tx- Combined OCPS/NSAIDS
Progesterone- suppresses ovulation
Leuprolide- Suppreses FSH/LH
Danazol- Test induces pseudo-menopause
Laparoscopy ablation/Hysterectomy

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37
Q

C- section is biggest RF: post-partum/abortal:

“Foul smelling Lochia”, tachycardia, abdominal pain:
Tx:

A

Endometritis

Tx: Clindamycin + Gentamycin

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38
Q

Endometriosis Triad?

A

Dyspareunia, Dyschezia, Dysmenorrhea

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39
Q

MC Gynecologic malignancy U.S: MC post- menopausal. Estrogen dependent: combination OBC protective.

Menorrhagia/ Metrorrhagia: post-menopause bleeding:
Dx- Tx-

A

Endometrial Cancer

Dx: Endometrial Bx or TVUS E. Stripe > 4mm
Tx: Hysterectomy (Stage I), LAD excision (III), Chemo IV

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40
Q

Endometrial gland proliferation: Chronic hyperplasia 2T unopposed estrogen: pre-cancerous

Menorrhagia/ Metrorrhagia: post-menopause bleeding:
Dx- Tx-

A

Endometrial Hyperplasia

Dx- TVUS E. Stripe > 4mm Tx: Atypia- Hysterectomy
no Atypia- Progestin

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41
Q

MC type of cancer found in Endometrium

A

Adenocarcinoma 80%

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42
Q

Second MC gynecologic cancer w highest mortality: RF FmHX, nulliparity, infertility, BRCA-1/2, >50 YOA.

OCPs and high parity are protective. rarely s/sx ntil late in disease. Palpable ovary, ascites*, node (sister MJ)

Dx: Tx:

A

Ovarian Cancer

Dx: Biopsy Tx: Early: LAD-ectomy
Sx- CA-125 to monitor progress
Chemo

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43
Q

MC cancer in Ovaries?

A

Epithelial 90%

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44
Q

Most are asymptomatic: Common in reproductive years: usually unilateral, LLQ/RLQ pain, may rupture or torsion.

Mobile-adnexal mass,Abnormal bleeding, dyspareunia:
Dx: Tx:

A

Functional Ovarian Cyst (CL cyst fails to degenerate)

Dx: Pelvic US Tx: Supportive <8cm resolve
(US repeat in 6 weeks)
> 8cm= Laparoscopy

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45
Q

MC benign Ovarian neoplasm: removed to prevent Torsion or malignant transformation. calcified in Xray

A

Dermoid Cystic Teratoma

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46
Q

3rd MC gynecologic cancer that METS locally. RF incr. sexual activity, multiple partners.

Post coital bleeding/spotting MC sx, pelvic pain, watery DC, metrorrhagia. Dx: Tx

A

Cervical Carcinoma

Dx: Colposcopy w biopsy/PAP/cytology Tx: Dep. Stage

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47
Q

MC cervical cancer?

A

Squamous 90% (Adenocarcinoma-10%)

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48
Q

Cervical cancer MCC?

Prevention?

A

HPV- 16 and 18 (31-33)

Prevention- Gardasil and Gardasil 9 <15 YOA X2 doses
>15 YOA X3 doses

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49
Q

Cervical screening cancer guidelines

A

Start: 21 YOA DC: 65

21-29 YOA: Every 3 years
> 30 YOA: Co-Test Q 5 years

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50
Q

PAP smear cervical cytology results

HPV positive and
Negative for intraepithelial malignancy (no neoplasia)

A

if >25 YOA- Cytology and HPV testing in 12 months

or Genotype for HPV 16 and 18

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51
Q

PAP smear cervical cytology results

Squamous cell Abn.- ASC-US (Undetermined sig.)
HPV Negative? HPV Positive

A

> 25 YOA- HPV Negative- repeat PAP/Co test in 3years
Positive- colposcopy w Bx

Or repeat PAP in 1 year

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52
Q

PAP smear cervical cytology results

ASC-H (cant exclude high intraepithelial lesion) HSIL

A

Colposcopy (Acetic acid accentuation of lesion)

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53
Q

PAP smear cervical cytology results Dx: Tx:

LSIL (Low grade intraepithelial lesion) CIN I
> 30 YOA HPV neg/positive?

A

25-29 YOA- Colposcopy w biopsy

> /= 30 YOA- HPV negative=repeat cytology x1 year
positive= colposcopy w biopsy

Tx: LEEP or Cold Knife conization

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54
Q

PAP smear cervical cytology results Dx: Tx:

HSIL (CIN II, III, carcinoma in situ)

A

Colposcopy w biopsy in all ages

Tx: Tx: LEEP or Ablation (cautery)

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55
Q

inability to maintain pregnancy 2T premature cervical dilation. Vaginal bleeding/DC in 2 trimester. painless

Tx:

A

Cervical Insufficiency (Incompetent cervix

Tx: Cerclage (suture of cervical OS) and bedrest

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56
Q

tender gland enlargement, unilateral vulvar mass (Inferior vulva) may be to E. Coli, staph or gonorrhea.

Non-tender in non-infected

A

Bartholin Cyst/Abcess

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57
Q

MC cancer of the vulva?

MC presentation

A

Squamous 95%

Pruritus (Red-white ulcerative crusted lesions)

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58
Q

Vaginal dryness, dyspareunia, vaginal inflammation, infection, recurrent UTI.

Tx

A

Vulvovaginal Atrophy

Tx: Vaginal Estrogens
Ospemifene- estrogen agonist in vagina and bone

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59
Q

Increased FSH/LH with decreased estrogen–> cessation of menses for > 1year. Dx Tx?

Hot flashes, menses alterations, mood changes, hyperlipidemia, osteoporosis, dyspareunia, incontinence

A

Menopause

Dx- FSH essay most sensitive test > 30 IU/ml
Increased FSH/LH w decreased Estrogen
Tx- Estrogen + Progesterone, Ca2+ vit. D, Hysterectomy

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60
Q

Palpable mass on ovary: associated with endometriosis.

“Chocolate cysts”

A

Endometrioma

61
Q

MC breast D/O: Tender, BL, multiple, mobile. Fluid filled 2T exaggerated response to hormones. 30-50 YOA

Dx: TX:

A

Fibrocystic Breast D/O

DX: US or FNA Tx; Self resolve or FNA

62
Q

2nd MC benign breast D/O: non-tender, mobile, rubbery lump. may enlarge w pregnancy. Gradual growth

Teens to early 20s Dx: Tx:

A

Fibroadenoma of breast

Dx: None Tx: Self resorb (No Sx needed)

63
Q

Inflammation of the breast. Mostly in lactating women. S. Aureus MC. UL breast pain. tender warm + nipple DC

induration and fluctuance. Dx: Tx:

A

Mastitis/ Breast Abscess

Dx: Clinical Tx: Warm compress, nurse, Diclox/Nafcillin
Breast Abscess DC feeding and I/D

64
Q

Breast cancer types

A

Ductal Carcinoma-
Lobular carcinoma-
Medullary, Tubular, Metastatic, Mucinoid

65
Q

Does not penetrate the basement membrane. Associated with lymphatic METS esp. axillary MC 75-80%

A

Ductal Carcinoma In Si Tu

66
Q

may not progress but associated with risk of invasive breast cancer.

A

Lobular Carcinoma

67
Q

Breast cancer clinical manifestations

A

Breast mass- painless, hard, fixed
skin changes- redness, skin retraction, inverted nipple
itchiness, peau de orange

68
Q

MC location of breast cancer?

A

Upper outer quadrant

69
Q

Diagnosis initial SOC < 40?

DX if highly suspicious of malignancy?

A

Initial-US (Best <40 YOA)

Mammogram (High suspicion) and Bx

70
Q

Breast cancer staging

A

Stage 0: DCIS, LCIS, precancerous
Stage I-III: w/I breast/regional lymph node
Stage IV: Metastatic BC

71
Q

Neoadjuvent Hormone therapy

A

Anti-estrogen
Aromatase inhibitor (Decr. Estrogen production)
Monoclonal Ab Tx- HER2 G-factor (+)

72
Q

Adjuvent therapy

A

Lumpectomy-
Mastectomy-
SLND (Sentinel Lymph node dissection)

73
Q

Lower abdominal pain, dyspareunia, fever, purulent DC, Adnexal tenderness, WBC> 10K, (+) chandelier’s

(+) Cervical motion tenderness: Ascending infx of reproductive tract. Dx: Tx:

A

Pelvic nflammatory disease

Dx: HcG R/O Ecto Prego

Tx: OP- Doxy, Ceftr, Metro
IP- IV doxy, Cefotetan, vanc/Gent

74
Q

What is Fitz-Hugh Curtis Syndrome ?

A

RUQ pain associated with hepatic fibrosis and peritoneal involvement of PID. Normal LFTs

“peri-hepatitis”

75
Q

Exotoxin producing S. Aureus. seen with tampon use or diaphragm sponge > 24 hours. Tx:

Sudden onset high fever: diffuse erythematous macular rash, fever 102.2, tachycardia, desquamation. HYTN

A

Toxic Shock Syndrome

Tx: Vancomycin + Gentamycin

76
Q

Frothy yellow green DC: Strawberry cervix: pH > 5
Mobile protozoa;

Dx: Tx:

A

Trichomoniasis

Dx: Wet mount Mobile Tx: Metronidazole 2 G X1
500 mg BID X 7days
(Tinidazole next line)

77
Q

Thin watery Grey white DC: Fishy odor rotten smell: Clue cells bacteria covered: pH >4.5: (____ criteria)

Dx: Tx:

A

Bacterial Vaginosis (Amsel Criteria)

Dx: KOH prep Tx: Metronidazole I-vag X 7days
Vancomycin next line

78
Q

Vaginal vulvar erythema, swelling, itchiness, burning when urine touches. Dysuria/dyspareunia. pH <4. 5

Dx: Tx:

A

Candidiasis

Dx: Yeast/spores KOH Tx: I- vag Clotri/Mico or nystatin

79
Q

Long Acting progestins that last 3 years: least failure rate: –>osteoporosis;

A

Etonogestrel (Implanon)

80
Q

Long Acting progestins that last 3 months: least failure rate: –>osteoporosis; Infertility up to 2 years

A

Medroxyprogesterone (Depo-Provera) Injectable

81
Q

applied every week X3 weeks not used x1 week. Better compliance. less effective is patient is underweight

A

Ethinyl Estradiol/ Norelgestromin (Ortho-Evra Patch)

82
Q

applied X3 weeks with 1 week off; removed during intercourse but must be replaced within 3 hours

A

Etonogestrel /Estradiol (Nuva-ring)

83
Q

Progestin only: safe during lactation: Decreases endometrial cancer: less PID. Incr ectopic prego

A

“Mini-Pill”

84
Q

Most effective form of contraception: 5 year duration: increased risk of PID

A

Levonorgestrel (Mirena) IUD

85
Q

10 year duration of action. no hormonal use: Increased risk of PID

A

Copper (Paragard)

86
Q

Beneficial if taken w/I 72 hours of unprotected sex

A

Levonorgestrel X2 0.75mg 12 hours apart or

Levonorgestrel X1 1.5mg dose

87
Q

Emergency contraception of up to 120 hrs within intercourse?

A

Ulipristal Acetate (Ella)

88
Q

Emergency contraception within 5 days of intercourse?

A

Copper IUD ( Paragard)

89
Q

In obstetrics, what is Ladin’s sign?

A

Uterus softening after 6 weeks

90
Q

What is Hegar’s sign ?

A

uterus isthmus softening after 6-8 weeks

91
Q

What is Goodell’s sign

A

Cervical softening due to incr. vascularization 4-5 weeks gestation

92
Q

what is chadwick’s sign ?

A

bluish coloration of the cervix and vulva 8-12 weeks

93
Q

Fetal hart tones will be heard at how many weeks ?

What is the normal rate?

A

10-12 weeks EGA

120-160

94
Q

At what EGA will the patient feel fetal movements?

A

16-20 weeks

95
Q

heart beat with US can be seen at what EGA?

96
Q

Rhogam testing is conducted when?

A

@ 28 weeks and within 72 hours of birth

97
Q

Highest risk factors for Ectopic pregnancy?

A

History of prior ectopic pregnancy

Previous Abdominal/ Tubal surgery or PID (adhesions)

98
Q

Ectopic Pregnancy triad?

A
  1. Unilateral pelv/abd pain
  2. Vaginal bleeding
  3. Amenorrhea
99
Q

severe abdominal pain, dizziness, NV, signs of shock, syncope, tachycardia, and hypotension are assoc. with?

A

Ectopic Pregnancy Rupture

100
Q

How is the diagnosis and what is the treatment of Ectopic pregnancy?

A

Dx: 1. Serial HcGs q 2-3 days
2. TVUS- empty Gestational sac, Non- IUP, HcG > 2K

Tx: Unruptured: Methotrexate: Stable, <4cm, HcG < 5K
(+ leucovorin= Multi dose)
Rutured: Salpingostomy 1st choice

101
Q

Type of abortion where- Some Products of conception expelled, some retained and presence of Dilation?

A

Incomplete Spontaneous Abortion

Dilation and Evacuation with all retained abortions
(Also- Rhogam if mom is Rh - )

102
Q

Type of abortion where- NO Products of conception expelled, some retained and presence of progressive Dilation?

A

Inevitable Spontaneous Abortion

103
Q

Type of abortion where- NO Products of conception expelled and the cervical OS is closed?

A

Threatened Spontaneous Abortion

104
Q

Type of abortion where- All Products of conception expelled and cervical OS is closed?

A

Complete Spontaneous Abortion

105
Q

Type of abortion where- NO Products of conception expelled and cervical OS is closed?

A

Missed Spontaneous Abortion

106
Q

Foul brownish discharge, fevers, chills. Some POC retained Cervical OS closed with cervical motion T.?

A

Septic Spontaneous Abortion (BS ABX)

107
Q

defined as HTN without proteinuria after 20 weeks EGA resolving w/I 12 weeks PP?

A

Transitional (Gestational) HTN

108
Q

defined as HTN + proteinuria +/- edema >20 wks EGA. Thrombocytopenia

Proteinuria >300mg (> 5G=severe): BP >140/90 twice 6 hours apart but not over week. Tx: ?

A

Pre-eclampsia

Tx: Mild- Delivery >/= 37 weeks: < 34= bed rest daily BP
Severe- Prompt Delivery only cure

109
Q

HTN + Thrombocytopenia + Proteinuria + Seizures or Coma

Tx:?

A

Eclampsia

Tx:Magnesium Sulfate
Lorazepam (2nd Line) “Delivery once stable”

110
Q

Treatment of HTN for Pre-eclampsia/Eclampsia?

A

Hydralazine, Labetalol ( or Nifedipine for Pre-)

111
Q

Treatment of HTN for pregnancy with BP 150/100?

A

Methyldopa (TOC)

Labetalol ( Hydralazine or Nifedipine)

112
Q

3rd trimester sudden onset of painless bright red bleeding. No abd. pain or uterine tenderness.

No fetal distress: Dx: Tx?

A

Placenta Previa

Dx: US localizes placenta
Tx: Admit 1. Mag Sulfate inhibits contractions
2. CS given between 24-34 weeks (Lungs)
3. Delivery when stable

113
Q

3rd trimester sudden onset of painful dark red bleeding. Severe abd. pain or uterine tenderness/ rigidity:

Fetal distress (Bradycardia) Dx: TX:

A

Abruptio Placenta

Dx: US ( NO pelvic exam)
Tx: Stabilize (hemodynamically) Immediate Delivery

114
Q

What is the MCC of Abruptio Placenta ?

A

Maternal HTN

115
Q

how do you diagnose Gestational Diabetes?

How do you confirm Gestational Diabetes?

A

50 G Oral Glucose challenge test @ 24-28 EGA Confirm: 100G 3 hours Oral GTT (GS) fasting @ a.m (>140 in 1 hour)–>

1 hour= >180 3 hours> 140 fasting> 95

116
Q

What is the treatment of choice for Gestational Diabetes?

A

Insulin (0.8 IU/kg 1st Tri.) then 1.0, then 1.2 IU

Labor induction @ 38 weeks

117
Q

Post-Partum depression occurs within______ PP?

A

2 weeks-2months PP

118
Q

Post-Partum blues occurs within _______ PP?

A

2-4 days PP

119
Q

Major-Depression occurs > ______ PP?

A

2 months (2 weeks- 12 months)

120
Q

Painless vaginal bleeding, uterine size/date mismatch, Hyperemesis gravidarum.

B-HcG markedly elevated > 100K: US- snowstorm “Cluster of grapes” Tx:

A

Gestational Trophoblastic Disease (Molar Pregnancy)

Tx: Surgical Uterine evacuation (Suction Curettage)
METS- Chemotherapy (Methotrexate)
“No pregnancy for a year”

121
Q

Neoplasm due to abnormal placental development with trophoblastic tissue from gestational tissue? 80% benign

A

Hydatidiform Mole

122
Q

What are the two types of Hydatidiform Mole?

A

Complete- 46 XX all paternal

Incomplete- Eggs fertilized by 2 sperm

123
Q

What does Dizygotic gestation mean?

A

Fertilization of two Ova by 2 different sperm (Fraternal)

124
Q

What does Monozygotic gestation mean?

A

Fertilization of one ovum (Identical)

125
Q

Hemolytic anemia, jaundice, kernicterus, hepatosplenomegaly that can lead to Hydrops Fetalis?

A

Rh alloimmunization

126
Q

Preventive management of Rh alloimmunization?

A
  1. Rhogam @ 28 weeks EGA
  2. Rhogam within 72 hours of delivery
  3. Rhogam if any potential cross mix blood (Trauma)
127
Q

Severe, excessive morning sickness (with NV) associated with weight loss or electrolyte imbalance

Persists >16 weeks EGA Tx:

A

Hyperemesis Gravidarum

Tx: High protein foods: small frequent meals: Parenteral nutrition if severe: Pyridoxine (B6)+ Doxylamine 1st
(Promethazine dimenhydrinate)

128
Q

Stages of Labor

A

Stage I- Cervix dilation (Latent-effacement Active- 3-4cm dilation)
Stage II- Cervical dilation to delivery of fetus
Stage III- Delivery of placenta and after birth

129
Q

Stages of Delivery

A

Delivery of Fetus

Passive phase- complete dilation to mother expulse efforts
Active phase- Mother expulse efforts to fetal delivery

130
Q

Three signs of placental separation? (0-30 minutes)

A
  1. Gush of blood
  2. Lengthening of Umbilicus
  3. Firm Fundus
131
Q

MCC of post-partum hemorrhage >500ml

Tx:

A

Uterine Atony (Non contracting- soft boggy uterus)

Tx: Uterine massage: Oxytocin: Misoprostol: Methylergonovine

132
Q

Premature Rupture of membranes Diagnosis?

A
  • Nitrazine (Blue paper test)- pH >6.5
  • Fern Test: Crystallization of Estrogen/Amniotic fluid
  • US
  • Fetal Fibronectin present (pre-term)
133
Q

Causes of Premature Rupture of membranes

A

prior preterm delivery, STDs, smoking

134
Q

Premature labor is defined as ?

What dilation and effacement?

A

Regular contractions (>4-6 hours) w progressive cercival changes before 37 weeks.

> 3cm dilation > 80 effacement

135
Q

Tocolytics that suppress uterine contractions?

A
  • Indomethacin
  • Nifedipine (CCBs)
  • Magnesium sulfate
  • Beta2 agonist Terbutaline
136
Q

Group B strep ABX prophylaxis?

A

Ampicillin –> then Amoxicillin and Azytrhomycin

PCN- Cephazolin –> cephalexin and Azytrhomycin

137
Q

Dystocia causes 3 Ps

A

Power- weak/absent contraction
Passenger- size/position
Passage- uterus/ soft tissue abnormalities

138
Q

Nonmanipulative management that increases pelvic opening with hyperflexion

A

Mc Robert’s maneuver

139
Q

Manipulative management that requires fetal 180 shoulder rotation

A

Corkscrew maneuver

140
Q

Induction of labor management? (Early and late)

A

Early- Cervidil- Prostaglandin Gel: Balloon (Laminaria)– cervical ripening

Late- <1 cm : IV Oxytocin: Amniotomy (Rupture) cervix partially dilated

141
Q

Daily recommended Vitamin D and calcium

A

Calcium: 1000 mg/day for women up to 50 and men up to 70, (1200 mg/day for older adult)

Vit. D: Adults: 800-2000 IU/day (400 kids/adolescent)

142
Q

Dexa scan normal limits? Osteoporosis Dexa scan?

A
  • Normal – T score of +1.0 to -1.0
  • Osteopenia – T score of -1.0 to -2.5

-Osteoporosis – T score of

143
Q

End Due Date Nagele’s ?

A

add 7 days and subtract 3 months to 1st day of LMP

144
Q

Thought to be a form of severe pre-eclampsia that occurs in 10% of pre-eclamptic patients

can occur in the absence of elevated BP

A

HELLP Syndrome

145
Q

What does HELLP syndrome stand for?

A

Hemolysis, Elevated Liver enzymes and Low Platelets

146
Q

summation of the largest cord-free vertical pockets in each of the four quadrants of an equally divided uterus

A

Amniotic Fluid Index

147
Q

Greatest Breast cancer RFs?

A

Age: BRCA1/2 1st relative: Nulliparity: Menarchy <12:

148
Q

USPTF recommendations for Breast cancer screening?

A

> 50-74 : Biennial Mammography

BRCA1/2: @ 25 Annual

PANCE (13 decks)

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