Brainscape's Knowledge GenomeTM

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


See full index

Emergency Medicine > OBGYN Emergencies > Flashcards

OBGYN Emergencies Flashcards

1
Q

Common causes of premenarcheal abnormal vaginal bleeding

A
  1. Genital Trauma and/or sexual abuse
  2. Vaginitis
  3. Tumors (vaginal, uterine)
  4. FB
  5. Menarche
  6. Precocious puberty
  7. Hematuria
  8. Coagulopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

common causes of abnml vaginal bleeding of reproductive age

A
  1. Coagulopathy
  2. Anovulatory cycles
  3. Pregnancy (including ectopic, abortion)
  4. Endocrine abnormality
  5. Uterine leiomyomas
  6. Cervical and endometrial polyps
  7. Pelvic infections (salpingitis, cervicitis)
  8. Trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

common causes of abnml vaginal bleeding during postmenopausal?

A
  1. Exogenous hormones
  2. Atrophic vaginitis
  3. Endometrial lesions (including cervical or uterine cancer/tumors)
  4. Cervical/endometrial polyps
  5. Trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

w/u to get for abnml vaginal bleeding

A
  1. hcg, CBC, PT/INR, thyroid, STI
  2. US
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

mgmt for unstable abnml vaginal bleeding

A

resuscitation and GYN consult

  1. Uterine compression
  2. D&C/laparoscopy/laparotomy
  3. IV estrogen
  4. Admission
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

mgmt for stable abnml vaginal bleeding

A
  1. oral short-term hormonal therapy vs TXA
  2. Discharge and follow up gynecologist
  3. NSAIDs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

RF for ectopic pregnancy

A
  1. H/o ectopic pregnancy
  2. h/o fallopian tube, pelvic, or abd surgery
  3. STI
  4. PID
  5. Endometriosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

classic triad presentation of ectopic pregnancy

A

abdominal pain, vaginal bleeding, amenorrhea

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

w/u for ectopic pregnancy?
what r/o ectopic?

A
  1. HCG, CBC, progesterone, type & screen, CMP
  2. US
    - Transabdominal may be first
    - Transvaginal if transabdominal nondiagnostic
    - Visualization of unequivocal IUP w/o abnormalities excludes ectopic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

mgmt for ectopic pregnancy

A
  1. ABC
  2. Bedside urine HCG
  3. Rh immune globulin as needed
  4. OB consult
  5. Expectant tx
  6. Definitive - Surgery, Medication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

w/u for vaginal bleeding during early pregnancy

A
  1. quantitative HCG, CBC, STI testing, type & screen, urinalysis
  2. US
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

mgmt for vaginal bleeding in early pregnancy

A
  1. Unstable: resuscitation and emergent OB consultation
  2. Rh (-): anti-Rho (D) IG
  3. Further tx dependent upon US findings:
    - Expectant management
    - Ectopic pregnancy
    - IUP w/ vaginal bleeding
    - Incomplete abortion
    - Gestational trophoblastic disease
    - Inevitable abortion

DC: instructions and follow up

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

premature separation of the placenta from the uterine wall

A

placental abruption

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

the implantation of the placenta over the cervical os

A

placenta previa

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

what is considered preterm labor?

A

labor < 37 wks

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

w/u for vaginal bleeding in late pregnancy

A
  1. CBC, type & cross, cervical fluid eval, STI, coags, lytes, DIC profile, UA
  2. US
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

late pregnancy pt presenting with vaginal bleeding - what should you be cautious about when doing your PE?

A

ddx of placental abruption or placenta previa - don’t want to introduce more risk of infection when doing a pelvic exam so do a sterile speculum test
don’t do a bimanual!

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

mgmt for vaginal bleeding in late pregnancy?

A
  1. Unstable: ABC, emergent OB consultation
  2. Rh negative: anti-Rho (D) immunoglobulin
  3. Further tx dependent upon US:
    - Placental abruption/placenta previa: emergent c-section
    - OB consultation
    - Maternal and fetal monitoring
    - Tocolysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

rupture of membranes before the onset of labor

A

Premature Rupture of Membranes

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

classic presentation of premature rupture of membranes?

A
  • rush of fluid or continuous leakage of fluid from vagina
  • Exam: sterile speculum with STI testing
  • Dx: pool of fluid in posterior fornix
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

mgmt for premature rupture of membranes

A

multifactorial, may need antibiotics/steroids, OB consultation/admission

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

what is a threatened abortion?

A

vaginal bleeding in < 20 wks of pregnancy with a closed cervical os, benign exam, and no passage of tissue

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

vaginal bleeding with open cervical os

what type of sponaneous abortion?

A

inevitable

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

partial passage of the conceptus, more likely between 6 and 14 weeks

what type of spontaneous abortion?

A

incomplete

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

what is a complete abortion?

A

passage of all fetal tissue < 20 wks gestation

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

what is a missed abortion?

A

fetal death < 20 wks w/o passage of any fetal tissue for 4 wks after fetal death

27
Q

w/u for spontaneous abortion

A
  1. CBC, type & cross, quantitative HCG, UA
    - if concern for septic abortion: blood/urine cx, BMP/LFTs, PT/PTT
  2. US
28
Q

mgmt for Threatened/Inevitable/Complete Abortion

A

DC, OB f/u

29
Q

mgmt for Incomplete/Missed abortion

A

OB consultation, D&C

30
Q

mgmt for Septic Abortion

A
  1. OB consultation
  2. admit (consider ICU)
  3. unaysn/clinda + gentamicin
31
Q

pregnancy complications of chronic HTN

A

abruption, preeclampsia, low birth weight, cesarean delivery, premature birth, and fetal demise

32
Q

what is Gestational HTN?
Criteria?

A

> 140/90 after 20 wks or in immediate postpartum period w/o proteinuria

Criteria: SBP >= 140 or DBP >= 90 on two occasions at least 4 hrs apart

33
Q

RF for gestational HTN

A

first-time mothers, FHx PIH, women carrying multiples, < 20 or >40 y/o, HTN or kidney disease prior to pregnancy

34
Q

mgmt for gestational HTN

A
  1. rest/lying on left side
  2. more prenatal checkups
  3. less salt
  4. drink 8 glasses of water a day
  5. meds
35
Q

what is preeclampsia?

A

> 140/90 on two occasions at least 4 hrs apart + proteinuria >= 300 in 24 hrs at 20 wks’ gestation

36
Q

alt criteria for preeclampsia?

A

(HTN w/o proteinuria):

  1. thrombocytopenia
  2. elevation LFTs
  3. new renal insufficiency
  4. pulmonary edema
  5. new-onset mental status/visual disturbance
37
Q

s/s of preeclampsia

A
  • HA, visual disturbances, edema or abd pain
  • Severe Preeclampsia: end-organ involvement; >160/110
38
Q

difference between preeclampsia vs eclampsia

A

Eclampsia is preeclampsia with seizures

39
Q

what is HELLP Syndrome?

A
  • Clinical variant of preeclampsia
  • Criteria: Hemolysis, Elevated Liver enzymes, Low Platelets

Caveat: May only complain of abd pain and NOT have elevated BP

40
Q

w/u for preeclampsia

A
  1. CBC, CMP, LDH, peripheral smear, UA, PT/PTT
  2. Imaging: focused US or a CT abdomen
41
Q

mgmt for preeclampsia

A
  1. Severe preeclampsia or eclampsia - Mg Sulfate
  2. Severe HTN - labetalol, hydralazine; dec BP slowly
  3. Emergent OB consult, admit
  4. definitive tx: deliver baby
42
Q

pelvic pain MC from gynecologic pathology therefore you should always r/o ?

A

pregnancy!

43
Q

what is primary dysmenorrhea?

A

cramping pelvic pain that comes before or during a period

44
Q

what is Mittelschmerz

A

benign pelvic pain that occurs midcycle (during or after ovulation)

45
Q

pelvic pain that may be one-sided, self-limiting (minutes to hours), range from mild to severe pain, MC 2 weeks before period

dx?

A

Mittelschmerz

46
Q

crampy, lower abdominal/pelvic pain; may be associated with nausea/vomiting, back pain, headache and irritability

dx?

A

Primary Dysmenorrhea

47
Q

sacs, usually filled with fluid, in/on an ovary

A

Ovarian Cysts

48
Q

presentation of ovarian cyst

A

sudden-onset unilateral pain
pain caused by stretching of the capsule

49
Q

concerning features of an ovarian cyst

A
  • > 8cm
  • multiloculated
  • solid
50
Q

complication of ovarian cyst

A

bleeding from cyst wall or cyst rupture

hemorrhagic may be more concernign

51
Q

sudden onset of unilateral, severe adnexal pain; may have N/V and low-grade fever
may have h/o ovarian cyst, pregnancy, or chemical induction of ovulation

A

ovarian torsion

52
Q

Endometriosis s/s

A

recurrent pelvic pain associated with menstrual cycles, dyspareunia, and infertility

53
Q

benign smooth muscle tumors, usually in the uterus or GI tract

A

Leiomyomas (uterine fibroids)

54
Q

s/s of Leiomyomas (uterine fibroids)

A

abnormal vaginal bleeding, dysmenorrhea, bloating, backache, urinary sx, enlarged uterus, and dyspareunia

55
Q

RF for PID

A
  1. < 25y
  2. multiple sexual partners
  3. a new sexual partner (last 30 days)
  4. presence of other STI
  5. recent intrauterine device insertion or procedure (< 3 wks)
56
Q

s/s of PID

A

lower abd pain, vaginal discharge, vaginal bleeding, urinary discomfort, fever, N/V

57
Q

dx criteria for PID

A
  • Group 1 (min criteria): uterine or adnexal tenderness and cervical motion tenderness
  • Group 2 (improves specificity): F, vaginal/cervical secretions, inc ESR/CRP, (+) pelvic cx
  • Group 3 (procedure-based): laparoscopy, pelvic US (or MRI), endometrial bx
58
Q

w/u for pelvic pain

A
  • HCG, CBC, UA, ESR/CRP, cervical swabs for GC/Chlamydia
  • transvaginal US (or MRI)
59
Q

general mgmt for nonemergent pelvic pain

A
  1. reassurance
  2. NSAIDs
  3. abx/preventative counseling (if indicated)
  4. gynecology referral
60
Q

indications to admit pelvic pain

A
  • Failed outpatient treatment
  • Tubo-ovarian abscess
  • Toxic appearance
  • Inability to tolerate oral medication
61
Q

parental tx options for admitted PID

A
  1. Cefotetan/cefoxitin + Doxy
  2. Clinda + gentamicin
  3. unaysn + doxy
62
Q

outpatient tx for PID

A
  • Rocephin/cefotxitin + probenecid
  • other 3rd gen cephalo + doxy +/- flagyl
63
Q

alt outpatient tx for PID

A

*if parenteral cephalo not feasible and community prevalence for FQ resistance is low:

Levofloxacin/ofloxacin +/- flagyl

Emergency Medicine (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions