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PANRE > Repro > Flashcards

Repro Flashcards

1
Q

which hormone rises day 0 to day 14 in the menstrual cycle

A

estrogen

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2
Q

which hormone rises day 14 to day 28 in the menstrual cycle

A

progesterone

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3
Q

what hormone spikes on day 14 in the menstrual cycle to trigger ovulation

A

LH

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4
Q

how do you treat cystitis in pregnancy

A

amoxicillin or macrobid x 7-14 days

sulfisoxazole unless the last week of pg

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5
Q

describe the pap screening guidelines

A

start at 21
q3y age 21-29
q5y age 30-65 with hpv
discontinue at 65+

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6
Q

what are 4 reasons you wouldn’t discontinue paps at age 65+

A

hx CIN2
hx CIN3
hx adenocarcinoma in situ
recent + screening

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7
Q

patient is age 21-24
pap comes back + for ASCUS or LSIL
what is the management

A

repeat pap in 12 mos

if negative, repeat pap in another 12 pos
if negative then - routine screening
if positive then - colposcopy

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8
Q

patient is age 21-24
pap comes back + for HSIL, ASC-H, AGC
what is the management

A

colposcopy

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9
Q

patient is age >/ 25
pap is negative
hpv is positive
what is the mgmt

A

repeat pap in 12 mos

if both negative - routine screening
if either are positive - colposcopy

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10
Q

patient is age >/ 25
pap shows ASCUS
hpv is negative
what is the mgmt

A

repeat hpv cotest every 3 years

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11
Q

patient is age >/ 25
pap shows ASCUS
hpv is positive
what is the mgmt

A

colposcopy

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12
Q

patient is age >/ 25
pap shows LSIL
hpv is negative
what is the mgmt

A

repeat hpv cotest every 1 year

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13
Q

patient is age >/25
pap shows LSIL, HSIL, AGC, or ASC-H
hpv is positive
what is the management

A

colposcopy

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14
Q

in ectopic pg what happens to hcg

A

it fails to double every 24-48 hours

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15
Q

at what point in pregnancy does a molar pg occur

A

from 6 weeks to 4-5 months

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16
Q

what are the symptoms are molar pregnancy

A

painless bleeding
uterus size discrepancy
hyperemeis

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17
Q

what does US show with molar pregnancy

A

cluster of grapes
or
snowstorm appearance

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18
Q

how to treat molar pregnancy

A

curettage

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19
Q

what can molar pregnancy lead to?

A

choriocarcinoma

20
Q 
1st trimester bleeding
no POC expelled
os is closed
bloody vaginal discharge
\+/- ctx

what is it, and whats the tx

A

threatened abortion

tx = rest and follow hcg

21
Q

pregnancy bleeding
bleeding is > 7 days with cramping
cervix dilated >3cm, +/- membrane rupture
no POC expelled

what is it and what’s the tx

A

inevitable abortion

tx = D+E

22
Q 
pregnancy bleeding
bleeding is heavy, cramping, with retained tissue
boggy uterus
cervix is dilated
some POC expelled

what is it and what’s the tx

A

incomplete abortion

tx = D+C, pitocin

23
Q

pregnancy bleeding
pain, cramping, bleeding that stops
os is closed
uterus is pre-preg size

what is it and what’s the tx

A

complete abortion

tx = none

24
Q

pregnancy bleeding
brown discharge, no pregnancy sx
os closed, no POC expelled
embryo not viable but is retained

what is it and whats the tx

A

missed abortion

tx = D+C/E

25
Q

as a general rule when do you do D+C versus D+E

A

D+C is 1st trimester

D+E is 2nd trimester

26
Q

3 causes of 3rd trimester bleeding

A

placenta previa
abruptio placenta
vasa previa

27
Q 
3rd trim:
sudden painless bright red bleeding
and soft, nt
fetal HR normal
pelvis US shows placenta implanted near to os, partially or completely covering fetus' head

dx and tx?

A

placenta previa

hospitalize for bedrest
stabilize w tocolytics (mag sulfate) to stop ctx
perform amniocentesis to check lung maturity

then deliver baby

28
Q

when can you give steroids for lung maturity

A

24-34 weeks

29
Q 
3rd trim:
continuous, painful, dark red bleeding
severe abd pain, rigid uterus
\+/- sx of shock
fetal distress w/ bradycardia
pelvis US shows placenta prematurely separated from the uterus

dx and tx?

A

abruptio placenta

hospitalize to stabilize
immediate delivery

30
Q

what MC causes abruptio placenta?

what can abruptio placenta lead to?

A

MC cause HTN

can lead to DIC

31
Q

3rd trim:
painless vaginal bleeding with rupture of membranes
fetal distress with bradycardia
US shows fetal vessels crossing over the os

dx and tx?

A

vasa previa

immediate C section

32
Q

when is the prenatal screen for gestational DM

A

24-28 weeks

33
Q

two diagnostic tests for gestational DM and results?

A
  1. Screening
    50g oral glucose test
    Fail test if 140+ after 1 hour
2. Gold standard
3 hour oral glucose tolerance test
Fail test if
180+ after 1 hour
155+ after 2 hours
140+ after 3 hours
34
Q

management / birth plan of gestational DM

A

insulin

deliver at 38 weeks

35
Q

when does mom need rhogam

A

if she is rh negative

36
Q

what are signs of a rh incompatible baby

A

hemolytic anemia, jaundice, kernicterus, hsm, fetal hydrops

37
Q

where does fluid build up in fetal hydrops

A

heart - CHF
pericardium - pericardial effusion
lungs - pleural effusion
liver - ascites

38
Q

when do you give RhoGam

A

at 28 weeks gestation

and within 72 hours p birth of Rh + fetus

39
Q

tests for PROM? (3)

A

NITRAZINE test to check ph
FERN test to check amniotic fluid pattern
speculum test

40
Q

management for PROM?

A

wait for labor and monitor for infx

41
Q

what is premature labor defined as

A

before 37 weeks

42
Q

patient is before 37 weeks gestation with sx of labor

explain the 3 categories of cervical dilation/effacement and how likely labor is

A
  1. dilated < 2cm, effaced < 80%, labor unlikely
  2. dilated 2-3cm, effaced <80%, labor likely
  3. dilated > 3cm, effaced >80%, labor definite
43
Q

management of premature labor (3)

A
  1. tocolytics to suppress ctx x 48h
  2. steroids for lungs
  3. abx maybe - GBS
44
Q

when can you dx gestational HTN

A

after 20 weeks

45
Q

what is HELLP syndrome

A

pre-eclampsia can cause HELLP syndrome

Hemolytic Anemia, Elevated Lft’s, Low Platelets

46
Q

management of pre-eclampsia

A

plan for delivery at 34-36 weeks

+/- BP meds

47
Q

management of eclampsia

A

mag sulfate for seizures
deliver as soon as pt is stable
definite BP meds

PANRE (13 decks)

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