ObGyn3 Flashcards
MOA of HoTN post epidural:
Sympathetic block»_space; vasodilation of LE vessels»_space; blood redistribution and venous pooling in lower extremities
Pt with bipolar disorder managed on valproate. How do you manage this in pregnancy?
Switch to lamotrigine if they have severe bipolar disorder. Valproate is assoc with congenital malformations (esp NTD)
What to do in the case of PPH due to uterine atony:
Bimanual uterine massage, IVF, O2. Oxytocin is first line uterotonic med. If oxytocin fails, give methylergonovine (causes SM constriction, uterine contraction, and vasoconstriction). Carboprost can also be used (synthetic prostaglandin that stimulates uterine contraction) but this causes bronchoconstriction so avoid in asthma patients.
New onset hyperandrogenism in pregnancy and bilateral ovarian masses on U/S:
Luteoma (benign ovarian tumor). Could also be theca lutein cysts but this has lower likelihood of female virilization.
How does management of preterm labor differ if mom is < 32 weeks gestation vs <34 weeks?
Rx for preterm labor at < 34 weeks includes tocolytics (indomethacin, nifedipine) to postpone delivery and corticosteroids (betamethasone) to decrease risk of Neonatal RSD. Should also give Mg Sulfate at <32 wks for neuroprotection.
** Don’t give nifedipine and Mg Sulfate together because this will cause respiratory depression.
HRT, age at first live birth, nulliparity, and alcohol consumption should all be considered modifiable risk factors for:
breast cancer.
- Alcohol = dose dependent risk
How would GnRH, FSH, and estrogen levels correlate with primary ovarian insufficiency?
Estrogen is decreased while FSH and GnRH are both increased.
How would GnRH, FSH, and estrogen levels correlate with PCOS?
Estrogen is increased, GnRH is ^, FSH is normal.
Woman presents with high fever, HoTN, diffuse red macular rash involving soles and palms, and has been experiencing HA/vomiting/and profuse diarrhea for the past couple of days. Cause?
TSS from S aureus (preformed toxin)