Obstetrics and Gynecology Flashcards
how is secondary amenorrhea described
Absence of menses for 3 months in a woman with previously normal menstruation or 6 months in a woman with a history of irregular cycles
what is the treatment of secondary amenorrhea
treat the underlying cause
use OCPs
cyclic progesterone 10mg for 10 days
a 27-year-old female who comes to the emergency department with a 2-day history of lower abdominal pain, fever, chills, and malaise. The patient also complains of nausea and multiple episodes of vomiting in the past 24 hours. On physical examination, there is bilateral adnexal tenderness, mucopurulent cervical discharge, and cervical motion tenderness.
What is the diagnosis
pelvic inflammatory disease
what are the causative agent for pelvic inflammatory disease
Gonorrhea and chlamydia
what is chandelier sign
cervical motion tenderness
what are complications of Pelvic inflammatory disease
infertility
ectopic pregnancy
tubo-ovarian abscess
what is the outpatient treatment of pelvic inflammatory disease
Ceftriaxone IM 500mg one + PO Doxycycline 100mg BID for 14 days +/- flagyl 500mg BID for 14 days
how is dysfunctional uterine bleeding defined
excessive uterine bleeding with no demonstrable organic cause
what is Menorrhagia
prolonged/heavy bleeding; regular intervals
what is metorrhagia
variable amounts of bleeding at irregular, frequent intervals
what is menometrorrhagia
more blood loss during menses and frequent and irregular bleeding between menses
what is polymenorrhea
menses that occur more frequently (menses <21 days apart)
what is oligomenorrhea
menses that occur less frequently (>35days)
what is the gold standard diagnostic test for dysfunctional uterine bleeding
uterine dilation and curettage
a 22-year-old female complaining of severe left lower quadrant abdominal pain associated with some spotting. She is sexually active, does not use contraception, and has a history of PID. She denies being pregnant. Her last period was 9 weeks ago. On physical exam, the patient is hypotensive and tachycardic. A vaginal ultrasound is performed, demonstrating free fluid and a mass in the right adnexa.
what is the diagnosis
ectopic pregnancy
what is the most common cause of ectopic pregnancy
occlusion of tube secondary to adhesions
what are risk factors associated with ectopic pregnancy
hx of previous ectopic
previous salpingitis (Caused by PID)
previous abdominal or tubal surgery
use of IUD
assisted reproduction
smoking
how is ectopic pregnancy diagnosed
betaHCG >1,500 but no fetus in utero
US - ring of fire sign
what is the ring of fire sign
aka ring of vascularity signifies a hypervascular lesion with peripheral vascularity on color or pulsed doppler exam of adenexa due to low impedance high diastolic flow
what is the treatment for ectopic pregnancy
methotrexate
surgical laparoscopy salpingostomy
a 29-year-old at 36 weeks gestation who arrives at the emergency department with a sudden onset of back pain with uterine contractions that are very close together, one after another. She describes PAINFUL, bright red vaginal bleeding. There is pelvic tenderness on examination which reveals a closed cervix and no evidence of rupture of the membranes.
What is the diagnosis
placenta abruption
what is the most common cause of third trimester bleeding
placenta abruption
what are risk factors for placenta abruption
trauma
smoking
HTN
preeclampsia
cocaine abuse
what is the treatment of placenta abruption
delivery of the fetus and placenta is the definitive treatment
blood type and cross
coag studies
corticosteroids as indicated to enhance fetal lung maturity
