Obstetrics And Gynecology Flashcards by Charlene Omekwu

Sinusoidal fetal heart rate tracings are typically associated ____________

With severe fetal anemia

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______ present with positional headache within 72 hours after neuraxial anesthesia often have associated nausea, vomiting and neck stiffness

Postural puncture headaches

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First line drugs for blood pressure control include ___________, __________ and ___________

IV Hydralazine, IV labetalol and oral nifedipine

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hCG is a hormone secreted by the synctiotrophoblast and is mainly responsible for ___________

The preservation of the corpus luteum in early pregnancy

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_______________ is commonly administered for eclamptic seizure prevention and fetal neuroprotection.

Magnesium sulfate

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___________ is the first-line treatment for magnesium toxicity.

Calcium gluconate

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The most common cause of oligohydraminos (amniotic fluid index

Spontaneous rupture of membranes

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management of pregnant women with genital HSV or history of genital HSV

antiviral prophylaxis at 36 weeks gestation until delivery

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a rare and life-threatening effect of ______ used in labor causes hyponatremia, cerebral edema and seizures.

excessive or prolonged oxytocin

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When does the second stage arrest of labor occur

When there is insufficient fetal descent after pushing for >/= 3 hrs for nulliparous or >/= 2hrs for multiparous patients

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Then most common cause of arrest of second stage arrest of labor is

Cephalopelvic disproportion

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MSAFP, estriol, beta-hCG decreased and normal inhibin A

Trisomy 18

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In stress urinary incontinence in a post Partum (<6 weeks) is managed how

With observation and reassurance

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What effect does elevated progesterone in pregnancy have on the respiratory centers on the brain

Increased tidal volume, increased minute ventilation, increased PaO2, and a physiological chronic compensated respiratory alkalosis

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Contraindications to raloxifene

History of venous thromboembolism

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Function of raloxifene

Selective estrogen receptor modulator with estrogen antagonist activity in the breast and uterus and agonist activity on the bone

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Management of uncomplicated preterm prelabor rupture of membranes at < 34 weeks gestation

Antibiotics and corticosteroids

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postpartum fever (≥38 C more than 24 hours after delivery) as well as incisional induration and erythema after cesarean delivery is suspicious of

Superficial surgical site infection (ie cellulitis)

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Prepregnancy BMI (Kg/m2) of <18.5; ideal weight gain

28- 40lb (12.7-18kg)

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Prepregnancy BMI (Kg/m2) of 18.5-24.9; ideal weight gain

25-35lb (11.4-15.9 kg)

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Prepregnancy BMI (Kg/m2) of 25-29.9; ideal weight gain

15-25 lb (6.8-11.4kg)

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Prepregnancy BMI (Kg/m2) of >/=30; ideal weight gain

11-20lb (5-9 kg)

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Complications of inadequate weight gain in pregnancy

low birth weight

- preterm delivery

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Complications of excessive weight gain in pregnancy

gestational diabetes mellitus
fetal macrosomia
cesarean delivery

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The most common risk factor for pelvic organ prolapse is

Multiparity

Diagnosis of menopause in women without previous normal menses is confirmed by

An elevated serum FSH level

Abdominal pain; ascites; bilateral enlarged, cystic ovaries; and third spacing 1/2 weeks after ovulation induction for infertility treatment is most suspicious for

Ovarian hyperstimulation syndrome

Obese woman of child bearing age presents with positional headaches, pulsatilla tinnitus and papilledema Most likely diagnosis?

Idiopathic Intracranial hypertension

Diagnosis of Idiopathic intracranial hypertension is with

MRI of the brain followed by lumbar pressure

How does ovarian cyst rupture typically present on pelvic ultrasound

Thin-walled cyst with pelvic free fluid

The first line treatment of gestational DM is

Dietary modification and exercise

Management of shoulder dystocia | BECALM

Breathe; don’t push Elevate legs and flex hip, thigh against abdomen Call for help Apply suprapubic pressure L- enlarge vaginal opening with epiostomy Maneuvers: deliver posterior arm; rotate posterior shoulder; adduct fetal shoulder; mother on hands and knees; replace fetal head into pelvis for cesarean delivery

Irregular bleeding, vaginal discharge, and a visible raised cervical lesion in a pt with history of long term tobacco use require ______

Immediate cervical biopsy (cervical cancer)

Treatment of toxic shock syndrome

Fluid replacement and antibiotics with clindamycin and vancomycin

First line treatment for symptomatic labial adhesions, or fused labia minora

Topical estrogen cream

First line prevention of migraine during pregnancy is

Beta blocker eg, propanolol, metoprolol

Best option for management of intrauterine fetal demise at >/= 24 weeks gestation

Induction of labor

Severe, persistent nausea and vomiting of pregnancy that results in a weight loss of >5% of prepregnancy weight, electrolyte abnormalities and ketonuria

Hyperemesis gravidarum

How can Hyperemesis gravidarum be differentiated from typical nausea and vomiting during pregnancy

Presence of ketones on urinalysis

Treatment for symptomatic submucosal fibroids who desire future fertility

Hysterectomy myomectomy

What do Women age < 45 with abnormal uterine bleeding who have failed medical management (eg, oral contraceptives) require

Endometrial biopsy

Complications of oligohydramnios

Meconium aspiration Preterm delivery Umbilical cord compression

Complications of polyhydramnios

Fetal malposition Umbilical cord prolapse Preterm labor Preterm premature rupture of membranes

Contraindications to Copper IUD and progestin IUD

``` Pregnancy Endometrial or cervical cancer Unexplained vaginal bleeding Gestational trophoblastic disease Distorted endometrial cavity Acute pelvic infection ```

Contraindications to progestin IUD

Active liver disease | Active breast cancer

First line treatment option for migraines during pregnancy

Acetaminophen

2nd and 3rd line options for treatment of migraines during pregnancy

Acetaminophen + (low potency opioids) codeine Antiemetics NSAIDs (2nd trimester only)

Management of second stage arrest of labour

Operative vaginal delivery

Vulvar lichen sclerosus is a risk factor for the development of

Vulvar cancer

What is the most common cause of physiologic galactorrhea

Hyperprolactinemia

How should galactorrhea be evaluated?

Pregnancy test Serum prolactin TSH Possible MRI of the brain

Intervention for umbilical cord compression with Category I FHR tracing

Maternal repositioning and possible amino infusion

Who to put on low dose Aspirin at 12 weeks gestation

``` High risk patient for preeclampsia : Multiple gestation Prior preeclampsia Chronic hypertension Chronic kidney disease Diabetes mellitus Multiple gestation Autoimmune disease ```

Management of intrahepatic cholestasis of pregnancy

Ursodeoxycholic acid and delivery at 37 weeks gestation

How is diagnosis of intrahepatic cholestasis of pregnancy confirmed ?

Elevated total bile acids (>10umol/L)

How does intrahepatic cholestasis of pregnancy present

I’m third trimester with pruritus that is worst on hands and feet with no associated rash.

define short interpregnancy interval

< 6-18 months from delivery to next pregnancy

complications of short interpregnancy interval

maternal anemia preterm delivery PPROM Low birth weight

an intrauterine demise associated with growth restriction, multiple fractures and a hypoplastic thoracic cavity is consistent with

osteogenesis imperfecta

what causes meralgia paresthetica

compression of the lateral femoral cutaneous nerve

how does meralgia paresthetica present

pain and paresthesia over the upper outer thigh

initial management of uterine inversion

manual replacement of the uterus

what is lochia

lochia is physiologic vaginal bleeding after delivery due to endometrial shedding and regenetration

for how long can lochia last

6-8 weeks postpartum

screening for STI in pregnancy for high risk patients

initial prenatal screening | third trimester screening

Risk factors of placenta accreta

Prior cesarean delivery Advanced maternal age History of dilation and curettage

Ultrasound findings consistent with congenital cytomegalovirus infection

Bilateral periventricular intracranial calcifications, intrahepatic calcifications and fetal growth restriction

First line treatment of stress urinary incontinence

Pelvic floor muscle (kegel) exercises

Bilateral breast fullness, tenderness and warmth without fever 3-5 days after delivery when colostrum is replaced by milk

Breast engorgement

Pregnancy complications of amphetamine abuse during pregnancy

``` Preterm delivery Preeclampsia Abruptio placenta Fetal growth restriction Intrauterine fetal demise ```

Next step in management of Postmenopausal women with endometrial cells on pap testing

Endometrial biopsy

The combination of dysuria and sterile pyuria is a common presentation for _______ in sexually active women

Chlamydia trachomatis urethritis

What type of twin pregnancy has “T- sign” at intertwin membrane

Monochorionic , diamniotic

What type of twin pregnancy has “lambda sign” at intertwin membrane

Dichorionic, diamniotic

Next step after elevated MSAFP

Fetal ultrasound