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EOR OB/GYN > Other > Flashcards

Other Flashcards

1
Q

importance of contraception postpartum

A

increased risk for maternal and fetal bad outcomes within first 6 months postpartum

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2
Q

COC postpartum

A

contraindicated for the first 6 weeks postpartum due to increased risk of VTE

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3
Q

absolute contraindication to COC

A

current breast cancer
severe decompensated cirrhosis
acute deep vein thrombosis
pulmonary embolism
high risk for recurrence of deep vein thrombosis or pulmonary embolism
major surgery with prolonged immobilization
migraine with aura
systolic blood pressure ≥ 160 mm Hg
diastolic blood pressure ≥ 100 mm Hg
history of ischemic heart disease
known thrombogenic mutations
hepatocellular adenoma
malignant hepatoma
moderately or severely impaired cardiac function
diagnosis of normal or mildly impaired cardiac function within the previous 6 months
patients < 21 days postpartum regardless of breastfeeding status
patients ≥ 35 years of age and smoking ≥ 15 cigarettes/day
history of cerebrovascular accident
complicated valvular heart disease

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4
Q

The most prevalent serious adverse effect of COC

A

VTE

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5
Q

how to use diaphragm

A

should be inserted less than 1 hours prior to intercourse up to 6 hours before intercourse and must be kept in place for at least 6 hours after intercourse. If it is placed more than 1 hour before intercourse, another applicator full of spermicide or vaginal pH regulator gel needs to be inserted into the vagina for maximum effect

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6
Q

how to use cervical cap

A

it can be inserted for up to 6 hours prior to intercourse and does not require reapplication of spermicide if time has elapsed between placement and intercourse

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7
Q

ADE cervical cap and diaphragm

A

urinary tract infections (especially with diaphragm use during multiple acts of intercourse) and a small risk of toxic shock syndrome

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8
Q

Max amount of time that a cervical cap or diaphragm should be inserted

A

12–18 hours

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9
Q

should cervical caps or diaphragms be used during menstruation

A

no

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10
Q

IUD contraindications

A

bicornuate uterus, septate uterus, uterine fibroids, cervical stenosis, active pregnancy and current or frequent pelvic inflammatory disease

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11
Q

can patients with current fibroids or a history of fibroids have an IUD place

A

patients with current fibroids or a history of fibroids that do not have severe distortion of the uterine cavity may be able to have an IUD placed, they should be counseled prior to intrauterine device insertion

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12
Q

risk of what illness is increased w IUD

A

PID

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13
Q

IUD placement

A

Intrauterine placement should occur at the end of menses or within 7 days after the last menstrual period. If this is not achieved, backup contraception should be used 7 days following placement

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14
Q

duration of 13.5 mg levonorgestrel-releasing intrauterine device

A

3 years

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15
Q

duration of 19.5 mg levonorgestrel-releasing IUD

A

5 years

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16
Q

duration of 52 mg levonorgestrel-releasing IUD

A

8 years

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17
Q

duration copper IUD

A

10 years

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18
Q

contraindications combined patch

A

history of thromboembolism, history of an estrogen-dependent tumor, abnormal liver function testing, and individuals with a body mass index ≥ 30 kg/m2

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19
Q

common ADE of combined patch

A

unscheduled bleeding during the first few cycles, breast tenderness, and application site reactions

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20
Q

application of combined patch

A

patch is applied weekly for 3 consecutive weeks prior to a patch-free week. The patch can be applied to the buttock, abdomen, or upper torso, and a different site should be used each time a new patch is applied. The patch can be reapplied if it is accidentally detached for < 24 hours. If it is detached for more than 24 hours, a new patch should be applied

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21
Q

Endometriosis

A

the presence of endometrial tissue outside the uterus

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22
Q

MC location for endometriosis to occur

A

ovaries

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23
Q

tx endometriosis

A

NSAIDs or COC
gonadotropin-releasing hormone analogs, such as leuprolide and nafarelin
Danazol, aromatase inhibitors (Anastrazole)

hysterectomy with oophorectomy

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24
Q

laparoscopy for endometriosis

A

areas of peritoneal endometriosis appear as blue-black powder burn lesions, raised flame-like patches, whitish opacifications, yellow-brown discolorations, translucent blebs, or irregularly shaped islands

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25
Q

Risk factors for endometriosis

A

nulliparity, early menarche, late menopause, shorter menstrual cycles, menorrhagia, obstruction of menstrual outflow, exposure to diethylstilbestrol in utero, height > 68 inches, lower body mass index, exposure to physical or sexual abuse in childhood, and excessive consumption of trans fats

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26
Q

endometrioma on US

A

appears smooth-walled with homogeneous internal echoes that have the appearance of ground-glass

The fluid inside endometriomas is old blood and appears chocolate-colored on biopsy

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27
Q

corpus luteal cyst

A

appears complex and heterogeneous with hypoechoic areas representing fluid and hyperechoic areas representing internal debris, such as hemorrhage

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28
Q

dermoid cyst

A

also known as a mature teratoma and arises from germ cells. Dermoid cysts consist of many materials, such as teeth and hair. For this reason, they appear heterogeneous on ultrasound with dots, fluid, and areas of acoustic shadowing

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29
Q

follicular cyst

A

appears smooth and thin-walled and completely fluid-filled on ultrasound. There will be through transmission and an absence of internal echoes

30
Q

theca lutein cyst

A

An ovarian cyst that results from overstimulation by beta-human chorionic gonadotropin, such as occurs during molar pregnancy, multiple gestation, or clomiphene therapy

31
Q

Infertility

A

the inability to conceive after 6 months of unprotected intercourse for women ≥ 35 years of age or after 1 year of unprotected intercourse for women < 35 years of age

32
Q

four causes of infertility

A

female factors (37%), both female and male factors (35%), unexplained (20%), and male factors (8%)

33
Q

MC cause of female infertility

A

ovulatory dysfunction, and polycystic ovary disease is the most common reason for ovulatory dysfunction

34
Q

meds that can cause ovulatory dysfunction

A

antidepressants, antipsychotics, corticosteroids, and chemotherapy medications

35
Q

what progesterone level indicates ovulatory dysfunction

A

A midluteal serum progesterone level < 10 ng/mL or the absence of the LH surge indicates ovulatory dysfunction

36
Q

normal results for semen analysis

A

Normal results include volume > 2 mL, sperm concentration > 20 million/mL, motility > 50%, and normal morphology > 30%.

Abstinence for 3 days prior to semen collection is recommended

37
Q

MC pelvic tumor in women

A

Leiomyomas

38
Q

what are Leiomyomas

A

uterine fibroids

39
Q

where is an intramural myoma located

A

within the uterine wall

40
Q

where is a submucosal myoma located

A

below the endometrium and protrudes into the uterine cavity

41
Q

where is a subserosal myoma located

A

originates from the myometrium at the serosal surface of the uterus; pedunculated

42
Q

Factors associated with a decreased risk of leiomyomas

A

having one or more pregnancies extending beyond 20 weeks gestation and vitamin A consumption from animal sources

43
Q

sx leiomyomas

A

heavy or prolonged menstrual bleeding, abdominal pressure or pain, reproductive dysfunction, dysmenorrhea, and dyspareunia

44
Q

PE for leiomyomas

A

abdominal or pelvic mass or an irregular, enlarged, or mobile uterus

45
Q

The most common benign ovarian cysts

A

follicular cysts or corpus luteal cysts

46
Q

sx ovarian cysts

A

usually asx
cysts may rupture and cause a sudden onset of severe unilateral lower abdominal pain

47
Q

when do ovarian cysts commonly rupture

A

during intercourse or strenuous activity

48
Q

what would US show if ovarian cyst ruptured

A

blood in the pelvis; ovarian cyst with surrounding fluid in the pelvis

49
Q

uncomplicated ovarian cyst rupture

A

Patients with low concern for malignancy and hemodynamic stability

managed outpatient w observation; given NSAIDs

50
Q

tx for unstable/uncomplicated ovarian cyst

A

surgery

51
Q

empiric abx after sexual assault

A

ceftriaxone to cover for gonorrhea and doxycycline or azithromycin to cover for chlamydia and metronidazole or tinidazole to cover for trichomoniasis

52
Q

What is the most common cause of post-traumatic stress disorder in women?

A

sexual assault

53
Q

urge incontinence is also called

A

overactive bladder

54
Q

diagnostic test of choice for urge incontinence

A

urodynamic study

55
Q

lifestyle tx options for urge incontinence

A

Scheduled toileting, weight loss, and Kegel exercises

56
Q

pharm tx options for urge incontinence

A

antimuscarinics (e.g., oxybutynin, solifenacin, darifenacin, trospium, and tolterodine) and beta-adrenergics (e.g., mirabegron)

57
Q

dx to confirm stress incontinence

A

bladder stress test

58
Q

what may be used in postmenopausal women with urge or stress incontinence

A

vaginal estrogen

59
Q

off label tx for stress incontinence and depression

A

duloxetine

60
Q

surgical options for stress incontinence

A

midurethral sling or a pessary

61
Q

mixed incontinence

A

both urge and stress

62
Q

Overflow incontinence is caused by

A

urinary retention, resulting in bladder distention and overflow of the urine out of the urethra

63
Q

dx for overflow incontinence

A

postvoid residual

64
Q

The classic features of PCOS

A

irregular menses (amenorrhea or oligomenorrhea) or abnormal uterine bleeding (related to ovulatory dysfunction), infertility, endometrial hyperplasia and increased risk of endometrial cancer, type 2 diabetes mellitus, and metabolic syndrome

65
Q

The diagnosis of PCOS

A

two of the three clinical Rotterdam criteria: oligomenorrhea, hyperandrogenism, and polycystic ovaries seen on ultrasound

66
Q

tx PCOS

A

Weight loss is considered the first-line treatment because it may improve metabolic risk, restore ovulatory cycles, and improve infertility

COC are main pharm tx

Spironolactone is used as an adjunct in women who do not improve after 6 months of using combined oral contraceptives

67
Q

what meds can be used to induce ovulation in PCOS

A

Clomiphene citrate and letrozole

68
Q

the most common endocrine abnormality in women of reproductive age

A

PCOS

69
Q

What is the black box warning for metformin?

A

lactic acidosis

70
Q

pts w PCOS have increased risk of developing what type of CA

A

endometrial CA

71
Q

What are common adverse effects of clomiphene citrate?

A

Hot flashes, abdominal distention and pain, nausea and vomiting, and breast discomfort

72
Q
A

EOR OB/GYN (18 decks)

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