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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
Simple Mastectomy
removal of breast tissue, nipple-areolar complex, and skin
26
Modified radical mastectomy
Removal of breast tissue, n-a complex, skin, pectoralis fascial and axil LNs
27
Radical mastectomy
Removal of everything else plus pectoralis major and minor muscles
28
Breast swelling, pain and tenderness in a 3-40 year old
Think fibrocystic disease
29
Mastitis?
Tx with Dicloxacillian | -Cont to breast feed or pump, prevent accum of infected material
30
PID?
A serious complication of STD - N gonorrhea or C trachomatis - abdominal or pelvic pain, increased vag discharge, burning, cramping, stabbing pain
31
PE of PID?
lower abdominal tenderness, cervical motion tenderness | Chandelier's sign
32
Def dx of PID
Laparascopy
33
TX of PID
Cehpalosporins or give linda Clinda or Gentamycin
34
Effectivness of condom method?
10-15% failure rate | Only method that protects against HIV
35
Failure rate of the Diaphragm?
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
36
Cervical cap fail rate?
5-20%
37
Nonoxynol-9?
Spermadice used in Contra sponge
38
IUDs?
Very low fail rate 1-3%
39
Absolute contraind to IUD
- Current preg - Abn vaginal bleeding - Acute cervical or uterine infxn ``` Relative -Nullparity -Prev ectopic preg -Mod to severe Dysmen - ```
40
OCP/Patch?
Messes up FSH/LH and suppresses ovulation. Changes the endometrium makes it hard to implant
41
OCP Contraindicated in?
Over 35 and who smoke
42
Norplant?
Low fail rate 0.09-0,2% | Makes endometrium unstable for implantation. Released slowly over 5 years
43
Depo-Provera?
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
44
Infertility
Innablility to conceive after one year of unprotected sex, many causes Get sperm count first check a bunch of other stuff if needed
45
Female infertility?
Try induce ovulation with Clomiphene which stim release of Gonadotropin releasing hormone which stim FSH and LH release
46
Nagele rule?
EDC date of last menstrual period minus 3 months plus 7 days
47
Fetal quickening?
16-20 weeks
48
Fetal heart tones
10 weeks by Doppler | 20 weeks by non-electrical fetoscope
49
SS of Pregnancy
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
First trimester?
Until 14 weeks
51
Second trimester?
14-28 weeks
52
Third trimester?
28 weeks until delivery
53
12 weeks?
12 weeks: above pubic symphysis 20-22 weeks: Umbilicus 38-40 weeks: Below the Xiphoid process
54
Screening US?
Offered between weeks 18-20
55
OGTT?
during second trimester if screening tests positive for DM
56
Determine phase of labor and labor progression on cervical exam?
1) Dilation 2) Effacement 3) Station 4) Cervical positon 5) Cervical consistency
57
Contraindications to Inducuction?
``` Prostaglandin use Maternal asthma Glaucoma more than one prior C section unstable fetus status ```
58
Induction?
Ammniotomy or Pitocin via cont IV infusion
59
Amniotomy ?
Rupture of Amniotic sac with a hook thing
60
Baseline fetal heart rate?
110-160 BPM worrysome if greater than 160 Decelrations
61
Fetal scalp electrode
Used to sense depolarizaoins of the fetal heart rate Don't use with fetal thrombocytopenia, maternal Hep or HIV
62
Abruptio Placentae?
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
Ectopic preg?
Unilateral pelvic pain and vag bleeding Beta HCG levels low for gest age Methrotrexate can be used for stable ectopic preg
64
OK to use Oral Hypoglycemics in preg?
No, agents cross over to the placenta casuing taratogenic effects
65
Most common cause of postpartum bleeding?
Uterine Atony
66
Preg induced HTN?
BP greater than 140/90 in obstetric pt
67
Pre-eclampsia?
- 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
Elcampsia?
Siezures in a pre-eclamptic pt Tx with Mg sulfate for seizures and Hydralazine for BP
69
HEELP syndrome?
Subcategory of sever eclampsis Hemolytic anemia Elevated liver fxn Low platelets Delivery is def tx
70
PROM?
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
RhoGAM is given at 28 weeks gestation and then again postpartum if neonate is Rh positive.
Whatever
72
What organism is the most common sex transmitted dz?
Chlamydia
73
Purlulent cervical discharge?
N Gonorrhoeae
74
Rope like breast mass?
Fibrocystic breast mass
75
First line for Mastitis
Docloxacllin cephalexin or EMYCN 2 line
76
Mucopurlulet discharge andcervical motion tenderness?
Chlamydia---Cervicitis
77
66 yo female presents with bouts of nausea, wt loss, and vague abd pain, what is proab. dx?
Ovarian Cancer
78
Avg age of menopause?
51
79
5 components of biophysical profile as part of antepartum testing?
1) Non-stress test 2) fetal breathing 3) Two gross body movements 4) Fetal tone 5) Amniotic fluid index
80
Secretory phase of menstrual cycle (day 14-28) what hormone dominates?
Progestosterone
81
A surge in what leads to ovulation?
LH
82
A pt with PCOS who would like to get pregnant, what 2 meds should you start her on?
Metformin and Clomid
83
HCG doubles? Early in pregnancy
every 48-72 hours
84
What endocrine tissue is associated with PCOS?
Insulin insensitivity
85
Pap comes back with atypical squamous uncertain significance (ASCUS), what is next step?
Repeat PAP in 4-6 months
86
What 4 HPV linked to cervical cancer?
HPV 16,18,31,33
87
3 factors of etopic pregnancy?
1) Prev ectopic 2) Scarred tubes (hx of PID or salpingitis) 3) IUD
88
Cervical bx comes back as CiN2 or CIN3, what is next step?
Excision--> LEEP, Cold Knive, Cryotherapy
89
3 labs to order if you are considering secondary amenorrhea?
1) Beta Hcg 2) TSH 3) Prolactin
90
How do you defin. diagnosis ENDOMETRIOSIS?
Exp LAP
91
Term when the placenta has implanted directly over the cervical Os?
Placenta Previa
92
A unilateral, single, mobile, firm, nontender solid breast mass should make you think of what dx?
Fibroadenoma
93
Fetus at level of Umbilicus at?
20 weeks
94
Should a breast feeding mother stop breast feeding if she develops mastitis?
No, if she has an abcess yes but just Mastitis, NO!!!
95
3 treatments for Uterine Prolapse?
Pessary Kegels Surgical repair
96
2 meds used to induce labor
1) Cervicil (prostaglandin gel applied to the cervix--->encourages cervical ripening 2) Oxytoxin IV--->encourages contractions
97
Folic acid during prenatal?
Prevent neural tube defects
98
Interference with work or school with PMS?
Premenstrual dysphoric disorder
99
Primary amenorrhea and low FSH should make you think?
Hypothalmic Pituatary insufficiency
100
Procidentia?
Uterine prolapse beyond the introitus
101
During what part of the menstrual cycle does PMS occur?
second half and menstration should relieve sxms
102
Threatened abortion?
Vaginal bleeding, closed cervix, products of conception are still inside
103
Strawberry cervix with copious yellow/green discharge should make you think of?
Trichomonas
104
Medical tx for early ectopic pregnancy?
Methotrexate
105
Incomplete abortion?
Vaginal bleeding, cervix is open, products of conception partially passed
106
Genetic cause is the number one reason for primary amenorrhea, what is one very important test?
Karotype
107
Premature birth?
Delivery of unterine contents between 20-36 wks
108
What medium do you need to grow out Neisseria gonorrhea?
Thayer Martin
109
Normal fetal heart rate?
120-160
110
The follicular phase of menstration is dominated by what hormone?
Estrogen
111
What are tow tocolytic meds you should be aware of?
Mg sulfate | CCBs Tocolytics---> stop labor
112
Woman presents to the ER concerned she is in preterm labor. What tx should you begin even before anything else?
Give IV fluids, most are suffering from dehydration
113
At how many weeks of preg. can an amniocentesis be done?
15-20 weeks
114
4 risk factors of endometrial cancer?
Chronic unopposed estrogen, nullparity, early menarche, late menopause, HTN, Tamoxifen, DM, Obesity, HTN, breast ca, ovarian ca`
115
Tx for Turners syndrome?
Cyclical estrogen and progesterone
116
what meds used to tx a postpartum metritis?
Clindamycin and Gentamycin together Metritis--->Inflammation of the uterus.

PANRE (14 decks)

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