PANCE OB, Repro 8/11 Flashcards
abnormal frequency and intensity of uterine bleeding
dysfunctional uterine bleeding
what is metrorrhagia
abnormal bleeding between periods
what is oligomenorrhagia
infrequent menstruation
what often causes dysfunational uterine bleeding
- unopposed estrogen
acute severe vaginal bleeding bleeding TX 2
- high dose IV estrogen
- high dose OCP
how to tx anovulatory cycles
OCP
painful mestration
dysmenorrhea
what is the tx for dysmenorrhea 2
- NSAIDs
- OCP
what is the tx for PMS
- SSRI
- OCP
what phase is PMS in
luteal phase
dysmenorrhea is due to what
increased protagladins
what is secondary amenorrhea
absense of menses for > 3 months
what is primary amenorrhea
- no peroid by 15 with boobs
- no peroid by 13 w/o boobs
scaring of the uterus is called what
ashermans syndrome
if there is no withdraw bleed post progesterone what does that mean
ovarian dysfunction
what is the MCC of amenorrhea
pregnancy
no menses for 1 year
menopause
what is the FSH with menopause
increased
how do you tx vaso motor symptoms of menopause
estrogen + progesterone
how do you tx osteoprosis symptoms of menopause
bisphosphenates
SERM (tamoxafin)
manuapuse if they have a uterus Tx
estrogen + progesterone
manuapuse if they have have no uterus Tx
estrogen
does HRT estrogen only have an increased risk for breast cancer
no
does HRT estrogen+ progesterone have an increased risk for breast cancer
slightly
estrogen+ progesterone protective against what
endometrial cancer
what is the biggest risk with HRT
VTE
benign smooth uterine tumor
leiomyoma
what causes leiomyoma
estrogen
RF leiomyoma 2
- African american
2. >35
leiomyoma MC symptom
bleeding
hard shaped mass on urine exam what pathology is first line dx
- leiomyoma
leiomyoma Dx
ultrasound
what are the 4 tx for leiomyoma
- observation
- Leuprolide
- Hysterectomy
- myomectomy
islands of endometrial tissue in the myometrium pathology
adenomyosis
tender boggy uerus pathology
adenomyosis
adenomyosis tx
hysterectomy
how do you tx endometritis
clinda + gent
what is the biggest risk for endometriosis
nullparity
endometriosis triad
- pelvic pain
- dysmnorrhea
- dysprenua
endometriosis dx
laproscopy
endometriosis tx
OCP + NSAID
what is the MC gyncological cancer
endometrial cancer
what is protective against endometrial cancer
combination OCP
what is the MC type of endometrial cancer
adenomyosis
what does endometrial stripe on US mean
endometrial cancer
endometrial stripe > ? is a sign of endometrial cancer
4mm
endometrial cancer tx
hysterectomy
what is postmenapausal bleeding concerning for
endometrial cancer
prolapse in the anterior portion of vagina
- cystocele
prolapse in the posterior portion of vagina
- rectocele
what are the three types of functional ovarian cysts
- follicular
- corpus luteal
- theca lutein
where is the pain with a functional oviarian cyst
unilateral
oviarian cyst dx
ultrasound
oviarian cyst what size is observation
< 8 cm
what two types of cancer is OCP protective against
ovarian
endometrial
_ ascites
_ sisters merry joshphs node
ovarian cancer
What is the triad for PCOS
- amenorrhea
- obesity
- Hirsutism
Ca-125 associated with what type of cancer
ovarian
what lab is increased with PCOS
LH
what is the vaginal US with PCOS
string of perls
what are the 4 meds for PCOS
- OCP
- Spironolactone
- clomiphene
- metformin
what HPV is associated with cervical cancer
16 + 18
what are the two types of cervical cancer
- squamous cell carcinoma
2. adenocarcinoma
what is the MC symptom of cervical cancer
post coital bleeding
at what age can they not give the gardisil vaccine
26
what ages gets a pap
21-65
Q: 3
Q: 5 if co test
how do you tx cervical imcompetance
cerclage
vulvar cancer primary symptom
pruritius
what does ospemifine tx
vulvovaginal atrophy tx
what is the cause of mastitis
s. aureus
how do you tx mastitis
nafcillin
can you breast feed with mastitis
nafcillin
FNA of the breast with straw colored fluid
fibrocycstic changes
what breast pathology increases and decreases with menstruation
fibrocycstic changes
does fibrocyctic adenoma increases and decreases with menstruation
no
breast mass
immovable
painless lump
hard
breast cancer
MC type of breast cancer
infiltrate ductal carcinoma
speculated lesions on mammogram good or not good
not good
best beast cancer screen < 40what modality
US
what is the primary antiestrogen for breast cancer
tamoxafen
when do you examine the breast manually
5-7 days post menstruation
what are the two MCC causes of PID
- Gonorrhea
- Chlamydia
what pathology is chandelier sign associated with
PID
what is the age for breast cancer screening
40-74 every 2 years
PID tx
doxcy + cef
toxic shock syndrome Tx 2
clina + Vanco
- fish odor
- clue cells
- > PH
BV
BV tx
metronidazole
frothy discharge
strawberry cervix
Trichomonas
Trichomonas tx
metronidazole
how do you tx vaginal candidia
fluconazole
how long until b- HCG in blood
5 days
how long until b- BCH urine
14 days
what is the sign for cervical softening at 4-5 weeks
Goodell’s
blue color of the cervix 12 weeks what sign
chadwiks sign
uterius softening at 6 weeks what sign
landins signs
what is gravida
how many times she has been pregnant
what is para
births > 20 weeks
what is the fundal height at 20 weeks
- at the umbilicus
what is the fundal height at 12 weeks
- at the pubic symphasis
what is naegeles rule
EDD: LMP + 7 days - 3 months
when is chorionic villus sampling done
10- 13 weeks
AFP: Low
HC-G: high
downs
AFP: High
HC-G: low
spina biffida
AFP: Low
HC-G: low
trisome 18
when do you test for DM preg
weeks 24-28
when do you test for group B strep in preg
32-27 weeks
what should the fetal HR be in third trimester
120-160
- 2 accelerations in 20 min good
how long do you have to be trying for infertility
1 year
what is the triad for ectopic
- unilateral pelvic pain
- vaginal bleeding
- ammemorrhea
how do you tx ectopic with medication
- methotrexate
what med may you need to give with ectopic (protective of the mother)
- Ro- gam
what is the OS postion with thretened abortion
closed
how long can you give misoprostol for abortion
9 weeks
how long can you give methotrexate abortion
7 weeks
How do you give abotionn > 12 weeks
D and E
what is gestational HTN
HTN > 20 weeks
HTN + proteinuria + edema > 20 weeks
pre- ecampsia
Preecamlplesia + seizure =?
ecampsia
what is the acronem for severe Preecamlplesia
HELLP
- Hemolytic anemia
- Elevated liver
- Low platelets
How do you tx HELLP
- Mag
- anti HTN (lebatalol, hydralazine)
when do you give seroids
if < 34 weeks
what anti HTN can be used in preg 3
- hydralazine
- lebatalol
- methyldopa
what is the tx for abruprio placentae
- immediate delivery
placenta previa pain or no pain
no pain
placenta previa tx
monitor
what is the gestational DM glucose level that would result in a + test
> 140
gestational DM Tx
insulin
snowstrom on ultrasound (pregnancy)
Gestational trophoblasic disease
What is teh bad RH combo
RH - mom
RH + baby
what is the medication given for moning skickness in pregnancy
- pyridoxine B6
what are the beginning and ending of each of the following stages of labor
- stage I
- stage II
- Stage III
- stage I: labor to full dilation of the cervix
- stage II:dilation of the cervix - delivery of fetus
- Stage III: dilation of the fetus - delivery of placenta
what is the apgar range
1-10
when do you do an apgar
1, 5, 10 min if abnormal
what are the components of APGAR
Appearance Pulse Grimmise Activity Respiration
what is the MCC of postpartum hemorrhage
uterine atony
two medications for postpartum hemorrhage
oxytocin
misoprostol
how do you tx premature rupture of membranes
await spontanous labor
“fern test “
premature rupture of membranes
