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MS3 > OBGYN 9 > Flashcards

OBGYN 9 Flashcards

1
Q

1 hour glucose results positive for GDM

A

> /= 140

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2
Q

Positive results for 3 hour GTT

A
  • Fasting positive > 90
  • 1 hour > 180
  • 2 hour > 155
  • 3 hour > 140
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3
Q

Define arrest of labor

A

• No progress in the active phase of labor (>6 cm) with ruptured membranes for 4 hours without adequate contractions, or 6 hours of inadequate contractions

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4
Q

Managent of PROM

A

GBS status and deliver

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5
Q

Management of PPROM

A

Deliver after 34 weeks

Give steroids

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6
Q

Give the full name of a mono/di twin

A

Monochorionic/diamniotic

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7
Q

Time frame of twinning

A

♣ 0-4 days – dichorionic/diamniotic
♣ 4-8 days – monochorionic/diamniotic
♣ 8-12 days – monochorionic/monoamniotic
♣ >13 days – conjoined twins

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8
Q

Tx of uterine atony

A

♣ First line
• Dilute IV oxytocin + bedside uterine massage
♣ If first line is ineffective:
• Prostaglandin F2-alpha (Hemabate aka Carbaprost)
o Prostaglandin compound that stimulates myometrial contraction
o Contraindicated in asthmatic patients due to potential for bronchoconstriction
• Rectal misoprostol
• Methylergonovine Maleate (Methergine)
o An ergot alkaloid agent that induces myometrial contraction as a treatment of uterine atony
o Contraindicated in hypertension due to risk of stroke

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9
Q

Management of chorioamnionitis

A

♣ Broad spectrum IV antibiotics (e.g. ampicillin, gentamicin, clindamycin)
♣ Induction of labor - Caesarean is not necessary unless indicated

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10
Q

What is a threatened abortion

A

Pregnancy with vaginal spotting during the first half of pregnancy; but fetus is still viable

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11
Q

What is an incomplete abortion

A

Pregnancy <20 weeks associated with cramping, vaginal bleeding, open cervical os, and some passage of tissue but also retained tissue in utero

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12
Q

What is a missed abortion

A

Pregnancy <20 weeks with embryonic or fetal demise but no sx such as bleeding or cramping

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13
Q

What is an inevitable abortion

A

o Bleeding and cramping in the presence of a dilated cervix; indicates that passage of the conceptus is unavoidable

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14
Q

Management of septic abortion

A

Broad spectrum abx + uterine evacuation

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15
Q

What is the disease associated with recurrent pregnancy loss

A

Antiphospholipid syndrome

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16
Q

Tx of antiphospholipid syndrome

A

Anticoagulation = Aspirin + Heparin

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17
Q

What are the drugs used for medical abortion

A

Mifepristone (terminates pregnancy)

Followed by Misoprostol (Uterine cramping + expulsion of POC)

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18
Q

Next step in management of Rh- mom with +antibodies

A

Transcranial doppler - increased flow means that mom is attacking baby and baby is increasing flow to compensate for anemia

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19
Q

Describe the 3 antibodies that you worry about in pregnancy

A

Lewis (lives)
Duffy/Rh(D) (dies)
Kell (kills)

20
Q

At what gestational age do you deliver Rh alloimmunization anemic baby

A

Deliver if > 32 weeks

21
Q

what if baby is <32 weeks

A

transfusion

22
Q

Intrapartum tx of mom with HIV

A

♣ Avoid artificial ROM, fetal scalp electrode, operative vaginal delivery
♣ Viral load <1000 copies = ART + vaginal delivery
♣ Viral load >1000 copies = ART + zidovudine + cesarean section

23
Q

Postpartum tx of baby with HIV+ mom

A

♣ maternal viral load <1000 copies = Zidovudine

♣ maternal viral load >1000 copies = multi-drug ART

24
Q

Most likely diagnosis/organism: vaginal discharge with friable cervix that bleeds with manipulation

A

Acute cervicitis - usually caused by gonorrhea/chlamydia

25
Q

When (timing) is chorionic villus sampling vs. amniocentesis indicated

A

Chorionic villus sampling = 10-13 weeks

Amniocentesis = 15-20 weeks

26
Q

Describe likely complication of baby born to mom with preeclampsia with severe features

A

Fetal growth restriction/low birth weight

Preeclampsia is caused by abnormal placental development which puts the fetus at risk for chronic uteroplacental insufficiency

27
Q

Describe the difference in management of PPROM based on gestational age, signs of infection/fetal distress

A

34-37 weeks:
o Antibiotics
o +/- corticosteroids
o Delivery

<34 weeks:
-- No signs of infection or fetal compromise
♣	Antibiotics
♣	Corticosteroids
-- Signs of infection or fetal compromise
♣	Antibiotics
♣	Corticosteroids
♣	Magnesium if <32 weeks
♣	Delivery
28
Q

Describe the pathogenesis of hypotension secondary to epidural

A

Hypotension occurs when the sympathetic nerve fibers responsible for vascular tone are blocked, resulting in vasodilation (venous pooling), decreased venous return, and decreased cardiac output

29
Q

Prevention and tx of hypotension secondary to epidural

A

Prevention = IV fluid expansion prior to epidural

Tx = IV fluid bolus, L uterine displacement (mom on L side) to improve venous return, or vasopressor

30
Q

What happens to pH, PCO2, and HCO3 in normal pregnancy

A

Primary respiratory alkalosis with partial metabolic compensation

(pH increased - 7.45; PCO2 decreased, HCO3 decreased)

31
Q

What happen kidney function in pregnancy

A

Increased GFR leads to lower Creatinine

32
Q

Management of ASCUS in pregnancy

A

re-Pap postpartum

33
Q

Management of HSIL in pregnancy

A

Colposcopy

34
Q

What are risks of hormone replacement therapy in menopausal women

A

o Venous thrombosis
o Stroke
o CHD (combined therapy)
o Breast cancer (combined therapy)

35
Q

What are contraindications to OCPs

A 
o	Uncontrolled HTN
o	DM with end organ disease
o	Smokers 
o	Age > 35
o	Migraine HA with aura
36
Q

Describe interstitial cystitis

A

A chronic inflammatory condition of the bladder, clinically characterized by recurrent irritative voiding sx of urgency and frequency. Etiology is unknown

37
Q

How often should mammograms be perfomed

A

Bi-annually

Or annually according to ACOG

38
Q

How often should colonoscopies be performed

A

q10 years

39
Q

What is a common exacerbating factor of cyclic mastalgia

A

caffeine

40
Q

Next step in managment of breast lump with bloody needle aspiration

A

Mammogram + excisional biopsy

41
Q

Next step in management of breast lump with clear needle aspiration

A

Reexamination in 2 months

42
Q

Order of pubertal events

A 
(Think: Tits, pits, mits, and lips) 
♣	Thelarche (Breasts) (8)
♣	Pubarche (Axillary and pubic hair) (9)
♣	Growth (10) 
♣	Menarche (11)
43
Q

What are the components of McCune Albright

A

o Precocious puberty
o Café-au-lait spots
o Polyostotic fibrous dysplasia

44
Q

Diagnose: Normal ovaries with absent uterus and fallopian tubes

A

Mullerian agenesis

45
Q

Describe GnRH, LH, FSH, Prolactin, and TSH in hypothalamic amenorrhea

A 
o	Functional hypothalamic amenorrhea (aka low GnRH)
♣	FSH  low
♣	LH  low
♣	Prolactin  normal
♣	TSH  normal
46
Q

Most common locations for ureteral injury during hysterectomy

A
  1. Cardinal ligament - when ligating the uterine arteries
  2. During ligation of ovarian vessels
  3. At uterovesicular junction (where ureters enter the bladder) - when vaginal cuff is ligated

MS3 (88 decks)

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