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PANRE > Repro part II > Flashcards

Repro part II Flashcards

1
Q

Common infection s/o C-Section?

A

Matritis

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2
Q

Cottage cheese discharge?

A

Vaginal candidosis

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3
Q

First step of tx for endometrial cancer?

A

Total Hysterectomy and bilateral Salpingo-oophorectomy

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4
Q

HPV vaccine, age?

A

9-26 years

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5
Q

Med used to control bleeding due to uterine Atony?

A

Oxytocin (Pitocin)

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6
Q

Snowstorm appearance on US?

A

Hydatidiform mole

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7
Q

Gestation Diabetes puts baby and mother at risk of?

A
  • Pre-eclampsia
  • Macrosomia
  • slow fetal lung develop
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8
Q

Most common Endometerial cancer?

A

75% are ADENOCARCINOMA

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9
Q

Vaginal Candida Tx?

A

Fluconazole PO 1 dose or azole cream for x1 week

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10
Q

Full term?

A

Delivery at 37-42 weeksw.

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11
Q

Pain and cramping during the menstrual cycle that interferes with normal daily activities?

A

Dysmenorrhea

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12
Q

Dysmenorrhea has 2 classifications?

A 
Primary = no obvious cause
Secondary = due to endometeriosis, fibroids, cervical stenosis, or pelvic adhesions
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13
Q

Tx of Dysmenorrhea?

A 
Primary= NSIADS and OCP
Sedondary=  
Endometeriosis: OCP, danazol, surgery
Cervical stenosis: cervical dilation
Pelvic Adhesions: NSAIDS, OCP, surgery
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14
Q

PMS

A

Occurs during 2 half of menstrual cycle

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15
Q

SS PMS

A

Somatic complaints, Emotional complaints, Behavoiral complaints

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16
Q

TX PMS?

A

NSAID, OCP, Depression med

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17
Q

Menopause?

A

48-52, before 40 = premature

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18
Q

What happens during menopause?

A
  • diminished estrogen
  • increased FSH/LH
  • —> looses benefits of Estrogen on lipid profle and vascular endothelium
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19
Q

TX for PMS?

A

Hormone therapy maybe

Progesterone in combo with estrogen therapy which helps decrease endometrial hyperplasia and cancer

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20
Q

Breast Abcess?

A

Many abcesses are Lactational usu due to Staph Aureus

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21
Q

Tx Breast abcess

A

I &D
abx
Bx check for Ca

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22
Q

Breast cancer screening guidlines

A

Routine screening of average-risk women should begin at age 50, instead of age 40.
Routine screening should end at age 74.
Women should get screening mammograms every two years instead of every year.
Breast self-exams have little value, based on findings from several

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23
Q

Clustered microcalcifications in 50 something year old?

A

DCIS

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24
Q

Not seen on mammo, age 40 somethings?

A

Lobular

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25
Q

Simple Mastectomy

A

removal of breast tissue, nipple-areolar complex, and skin

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26
Q

Modified radical mastectomy

A

Removal of breast tissue, n-a complex, skin, pectoralis fascial and axil LNs

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27
Q

Radical mastectomy

A

Removal of everything else plus pectoralis major and minor muscles

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28
Q

Breast swelling, pain and tenderness in a 3-40 year old

A

Think fibrocystic disease

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29
Q

Mastitis?

A

Tx with Dicloxacillian

-Cont to breast feed or pump, prevent accum of infected material

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30
Q

PID?

A

A serious complication of STD

  • N gonorrhea or C trachomatis
  • abdominal or pelvic pain, increased vag discharge, burning, cramping, stabbing pain
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31
Q

PE of PID?

A

lower abdominal tenderness, cervical motion tenderness

Chandelier’s sign

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32
Q

Def dx of PID

A

Laparascopy

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33
Q

TX of PID

A

Cehpalosporins

or give linda Clinda or Gentamycin

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34
Q

Effectivness of condom method?

A

10-15% failure rate

Only method that protects against HIV

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35
Q

Failure rate of the Diaphragm?

A

5-20%
Can be fitted and replaced every 5 years of if pt gains or loses 10 pounds
Risk of Staph Aureus Toxic Shock Syndrome

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36
Q

Cervical cap fail rate?

A

5-20%

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37
Q

Nonoxynol-9?

A

Spermadice used in Contra sponge

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38
Q

IUDs?

A

Very low fail rate 1-3%

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39
Q

Absolute contraind to IUD

A
  • Current preg
  • Abn vaginal bleeding
  • Acute cervical or uterine infxn
Relative
-Nullparity
-Prev ectopic preg
-Mod to severe Dysmen
-
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40
Q

OCP/Patch?

A

Messes up FSH/LH and suppresses ovulation. Changes the endometrium makes it hard to implant

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41
Q

OCP Contraindicated in?

A

Over 35 and who smoke

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42
Q

Norplant?

A

Low fail rate 0.09-0,2%

Makes endometrium unstable for implantation. Released slowly over 5 years

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43
Q

Depo-Provera?

A

Progestin IM over 3 months. Very low fail rate 0.3% May take up to 18 months to get back to normal after DC use

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44
Q

Infertility

A

Innablility to conceive after one year of unprotected sex, many causes
Get sperm count first
check a bunch of other stuff if needed

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45
Q

Female infertility?

A

Try induce ovulation with Clomiphene which stim release of Gonadotropin releasing hormone which stim FSH and LH release

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46
Q

Nagele rule?

A

EDC date of last menstrual period minus 3 months plus 7 days

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47
Q

Fetal quickening?

A

16-20 weeks

48
Q

Fetal heart tones

A

10 weeks by Doppler

20 weeks by non-electrical fetoscope

49
Q

SS of Pregnancy

A

Chadwick’s —>bluish discolaratoin of cervix
Goodell’s sign—>softening and cyanosis of cervix after 4 weeks
Breast swelling, tenderness
palmar erythema
bunch of other stuff

50
Q

First trimester?

A

Until 14 weeks

51
Q

Second trimester?

A

14-28 weeks

52
Q

Third trimester?

A

28 weeks until delivery

53
Q

12 weeks?

A

12 weeks: above pubic symphysis
20-22 weeks: Umbilicus
38-40 weeks: Below the Xiphoid process

54
Q

Screening US?

A

Offered between weeks 18-20

55
Q

OGTT?

A

during second trimester if screening tests positive for DM

56
Q

Determine phase of labor and labor progression on cervical exam?

A

1) Dilation
2) Effacement
3) Station
4) Cervical positon
5) Cervical consistency

57
Q

Contraindications to Inducuction?

A 
Prostaglandin use
Maternal asthma
Glaucoma
more than one prior C section
unstable fetus status
58
Q

Induction?

A

Ammniotomy or Pitocin via cont IV infusion

59
Q

Amniotomy ?

A

Rupture of Amniotic sac with a hook thing

60
Q

Baseline fetal heart rate?

A

110-160 BPM
worrysome if greater than 160
Decelrations

61
Q

Fetal scalp electrode

A

Used to sense depolarizaoins of the fetal heart rate

Don’t use with fetal thrombocytopenia, maternal Hep or HIV

62
Q

Abruptio Placentae?

A

Most occur after 30 weeks gestation
Present with THRID trimester vaginal bleedin and SEVERE abd pain.
Prepare for delivery and for shock, DIC etc

63
Q

Ectopic preg?

A

Unilateral pelvic pain and vag bleeding
Beta HCG levels low for gest age
Methrotrexate can be used for stable ectopic preg

64
Q

OK to use Oral Hypoglycemics in preg?

A

No, agents cross over to the placenta casuing taratogenic effects

65
Q

Most common cause of postpartum bleeding?

A

Uterine Atony

66
Q

Preg induced HTN?

A

BP greater than 140/90 in obstetric pt

67
Q

Pre-eclampsia?

A
  • Typically seen in 3 trimester
  • Edema
  • Proteinuria
  • HTN

Delivery is the ultimate tx!! Magnesium Sulfate is started to decrease risk of seizures. May use Hydralazine in severe instances for BP

68
Q

Elcampsia?

A

Siezures in a pre-eclamptic pt

Tx with Mg sulfate for seizures and Hydralazine for BP

69
Q

HEELP syndrome?

A

Subcategory of sever eclampsis
Hemolytic anemia
Elevated liver fxn
Low platelets

Delivery is def tx

70
Q

PROM?

A

Leaking of vaginal amniotic fluid from vagina, usu PH .8 indicates Amniotic fluid. Tx with IV abx for poss infxn of amniotic fluid by Group B strep

71
Q

RhoGAM is given at 28 weeks gestation and then again postpartum if neonate is Rh positive.

72
Q

What organism is the most common sex transmitted dz?

73
Q

Purlulent cervical discharge?

A

N Gonorrhoeae

74
Q

Rope like breast mass?

A

Fibrocystic breast mass

75
Q

First line for Mastitis

A

Docloxacllin

cephalexin or EMYCN 2 line

76
Q

Mucopurlulet discharge andcervical motion tenderness?

A

Chlamydia—Cervicitis

77
Q

66 yo female presents with bouts of nausea, wt loss, and vague abd pain, what is proab. dx?

A

Ovarian Cancer

78
Q

Avg age of menopause?

79
Q

5 components of biophysical profile as part of antepartum testing?

A

1) Non-stress test
2) fetal breathing
3) Two gross body movements
4) Fetal tone
5) Amniotic fluid index

80
Q

Secretory phase of menstrual cycle (day 14-28) what hormone dominates?

A

Progestosterone

81
Q

A surge in what leads to ovulation?

82
Q

A pt with PCOS who would like to get pregnant, what 2 meds should you start her on?

A

Metformin and Clomid

83
Q

HCG doubles? Early in pregnancy

A

every 48-72 hours

84
Q

What endocrine tissue is associated with PCOS?

A

Insulin insensitivity

85
Q

Pap comes back with atypical squamous uncertain significance (ASCUS), what is next step?

A

Repeat PAP in 4-6 months

86
Q

What 4 HPV linked to cervical cancer?

A

HPV 16,18,31,33

87
Q

3 factors of etopic pregnancy?

A

1) Prev ectopic
2) Scarred tubes (hx of PID or salpingitis)
3) IUD

88
Q

Cervical bx comes back as CiN2 or CIN3, what is next step?

A

Excision–> LEEP, Cold Knive, Cryotherapy

89
Q

3 labs to order if you are considering secondary amenorrhea?

A

1) Beta Hcg
2) TSH
3) Prolactin

90
Q

How do you defin. diagnosis ENDOMETRIOSIS?

91
Q

Term when the placenta has implanted directly over the cervical Os?

A

Placenta Previa

92
Q

A unilateral, single, mobile, firm, nontender solid breast mass should make you think of what dx?

A

Fibroadenoma

93
Q

Fetus at level of Umbilicus at?

94
Q

Should a breast feeding mother stop breast feeding if she develops mastitis?

A

No, if she has an abcess yes but just Mastitis, NO!!!

95
Q

3 treatments for Uterine Prolapse?

A

Pessary
Kegels
Surgical repair

96
Q

2 meds used to induce labor

A

1) Cervicil (prostaglandin gel applied to the cervix—>encourages cervical ripening
2) Oxytoxin IV—>encourages contractions

97
Q

Folic acid during prenatal?

A

Prevent neural tube defects

98
Q

Interference with work or school with PMS?

A

Premenstrual dysphoric disorder

99
Q

Primary amenorrhea and low FSH should make you think?

A

Hypothalmic Pituatary insufficiency

100
Q

Procidentia?

A

Uterine prolapse beyond the introitus

101
Q

During what part of the menstrual cycle does PMS occur?

A

second half and menstration should relieve sxms

102
Q

Threatened abortion?

A

Vaginal bleeding, closed cervix, products of conception are still inside

103
Q

Strawberry cervix with copious yellow/green discharge should make you think of?

A

Trichomonas

104
Q

Medical tx for early ectopic pregnancy?

A

Methotrexate

105
Q

Incomplete abortion?

A

Vaginal bleeding, cervix is open, products of conception partially passed

106
Q

Genetic cause is the number one reason for primary amenorrhea, what is one very important test?

107
Q

Premature birth?

A

Delivery of unterine contents between 20-36 wks

108
Q

What medium do you need to grow out Neisseria gonorrhea?

A

Thayer Martin

109
Q

Normal fetal heart rate?

110
Q

The follicular phase of menstration is dominated by what hormone?

111
Q

What are tow tocolytic meds you should be aware of?

A

Mg sulfate

CCBs Tocolytics—> stop labor

112
Q

Woman presents to the ER concerned she is in preterm labor. What tx should you begin even before anything else?

A

Give IV fluids, most are suffering from dehydration

113
Q

At how many weeks of preg. can an amniocentesis be done?

A

15-20 weeks

114
Q

4 risk factors of endometrial cancer?

A

Chronic unopposed estrogen, nullparity, early menarche, late menopause, HTN, Tamoxifen, DM, Obesity, HTN, breast ca, ovarian ca`

115
Q

Tx for Turners syndrome?

A

Cyclical estrogen and progesterone

116
Q

what meds used to tx a postpartum metritis?

A

Clindamycin and Gentamycin together Metritis—>Inflammation of the uterus.

PANRE (14 decks)

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