Rapid Review: Obstetrics and Gynecology Flashcards
Primary causes of third trimester bleeding
Placental abruption and placental previa
Classic ultrasound and gross apperance of complete hydatidiform mole
Snowstorm on ultrasound. “Cluster of grapes” on gross examination
Chromosomal pattern of a complete mole.
46XX
Molar pregnancy containing fetal tissue
Partial mole, 69 XXY
Symptoms of placental abruption
Continuous, painful dark vaginal bleeding
Symptoms of placenta previa
Self-limited, painless vaginal bleeding
When should a vaginal exam be performed with suspected placenta previa?
Never
Antibiotics with teratogenic effects
Tetracycline, fluoroquinoones, aminoglycosides, sulfonamides
Medication given to accelerate fetal lung maturity
Betamethasone or dexamethasone x 48 hours
The most common cause of postpartum hemorrhage
Uterine atony
Treatment for postpartum hemorrhage
Uterine massage; if that fails, give oxytocin
Typical antibiotics for GBS prophylaxis
IV penicillin or ampicillin
A patient fails to lactate after an emergency C section with marked blood loss
Sheehan’s syndrome (postpartum pituitary necrosis)
Uterine bleeding at 18 weeks gestation; no products expelled; cervical os open
Inevitable abortion
Uterine bleeding at 18 weeks gestation; no products expelled; cervical os closed
Threatened abortion
The first test to perform when a woman presents with amenorrhea
B-hCG
Term for heavy bleeding during and between menstrual periods
Menometrorrhagia
Cause of amenorrhea with normal prolactin, no response to estrogen progesterone challenge, and a history of D and C
Asherman’s syndrome (intrauterine adhesions)
Therapy for PCOS
Weight loss and OCPs. Consider metformin. Clomiphene for ovulation
Medication to induce ovulation
Clomiphene citrate
Diagnostic step required in a postmenopausal woman who presents with vaginal bleeding
Endometrial biopsy
Indications for medical treatment of ectopic pregnancy
Patient stable; unruptured ectopic pregnancy of
Medical options for endometriosis
OCPs, danazol, GnRH agonists
Laparoscopic findings in endometriosis
Powder burns, “chocolate cysts”
The most common location for an ectopic pregnancy
Ampulla of the oviduct
How to diagnose and follow a leiomyoma
US
Natural history of a leiomyoma
Regresses after menopause
A patient has increased vaginal discharge and petechial patches in the upper vagina and cervix
Trichomonal vaginitis
Treatment for BV
Oral or topical metronidazole
The most common cause of bloody nipple discharge
Intraductal papilloma
Contraceptive methods that protect against PID
OCPs and barrier contraception
Unopposed estrogen is contraindicated in which cancers
Endometrial or estrogen receptor + breast cancer
A patient presents with recent PID with RUQ pain
Consider Fitz-Hugh-Curtis syndrome
Breast malignancy presenting as itching, burning, and erosion of the nipple
Paget’s disease
Annual screening for women with a strong family history of ovarian cancer
CA-125 and transvaginal US
A 50 year old woman leaks urine when laughing or coughing. Nonsurgical options?
Kegel exercises, estrogen, pessaries for stress incontinence
A 30 year old woman has unpredictable urine loss. Exam is normal. Medical options?
Anticholinergics (oxybutynin) or B adrenergics (metaproterenol) for urge incontinence.
Lab values suggestive of menopause
Increased serum FSH
The most common cause of female infertility
Endometriosis
Two consecutive findings of atypical squamous cells of undetermined signiicancce on Pap smear. Follw up eval?
Colposcopy and endocervical curettage
Breast cancer type that increases the future risk of invasive carcinoma in both breasts
Lobular carcinoma in situ.
