Reproductive Flashcards
Definition secondary amenorrhea
Absence menses 6 months
1st 2 labs to order if pt presents with secondary amenorrhea?
TSH
Prolactin
Most common type of endometrial CA
Adenocarcinoma
Lynch syndrome at risk for what?
Uterine CA and colon CA
1st 2nd and 3rd line tx for endometriosis?
1-NSAIDS, OCPs
2- GnRH agonist (leuprolide)
3-surgery
Using GnRH agonists for fibroids?
Can use to shrink the fibroid but as soon as you stop the medication it will regrow. Don’t use for more than 1 year due to risk of bone loss.
Atypical Glandular cells on PAP
if over age 35 needs an endometrial bx to r/o uterine ca
vaginal/vulvar CA usually what type?
Squamous
Primary vs secondary dysmenorrhea
Primary: no pathology, usually occurs 1 yr after menarche
Secondary: due to pathology, occurs several years after menarche
Diagnostic test to confirm menopause
FSH (elevated)
Most common cause of mastitis or breast abscess?
Staph, usually during breastfeeding
Fitz-Hugh-Curtis syndrome
Inflammation of the liver capsule from PID causing RUQ pain
Labs to evaluate fertility/ovulation
Luteal phase progesterone level (7d before menstruation). Less than 3, anovulatory. More than 3, recent ovulation.
If anovulatory, check TSH and FSH.
FSH: done on day 3 of menses. 2-10 is normal. Less than 2 is hypogonadism. More than 30 is premature ovarian failure.
Naegele rule
LMP -3 months + 7 days
Rh negative tx
Give rhogam at 28 weeks
Missed abortion
Os: closed
Products of conception: in the uterus
Inevitable abortion
Os: dilated and active bleeding
Products of conception in the uterus
Incomplete abortion
Os: dilated
Products of conception in the cervical canal
Complete abortion
Os: closed
Products of conception have been expelled
Threatened abortion
Vaginal bleeding and viable pregnancy. Unknown cause.
Tx abortion
Rh negative pts need Rhogam shot
Monitor or D&C or misoprostol if missed, invevitable, incomplete
Placental abruption risk factors
Trauma
Cocaine use
Sx placental abruption
3rd trimester bleeding with painful contractions
Complications shoulder dystocia
brachial plexus injury
clavicle fracture
asphyxia (occurs if provider cannot clear shoulder in 5 minutes
Risk factors ectopic pregnancy
Pregnancy with IUD in place
H/o prior ectopic
PID
When is an IUP visible on US (with what level of HCG?)
2,000
What is a normal rise in HCG?
doubling every 2-3 days
3 complications of gestational DM
shoulder dystocia
preeclampsia
macrosomia
DX gestation DM
Fasting glucose > 95
1 hr post prandial > 140
2 hr >120
US: snowstorm pattern
molar pregnancy
Suspect what in a patient with preeclampsia under 20 weeks?
Molar pregnancy
ecclampsia definition
preeclampsia with seizure
HEELP syndrome
Hemolysis
Elevated liver enzymes
Low platelets
What BP reading do pregnant pts require tx?
160/110: treat with methyldopa or labetolol
Placenta previa definition
Placenta covering the os
Presentation of placenta previa?
Painless 2nd or 3rd trimester bleeding
Tx placenta previa?
Majority resolve by 26 week US
If not, repeat US at 35 weeks. If still not resolved, C section at 38 weeks
Definition post partum hemorrhage
More than 500mL blood loss
Endometrial strip greater than 5mm
Suspicious for Uterine CA, needs endometrial bx
Chlamydia tx during pregnancy
Azithromycin. Do not use Doxy.
When is Quad screening done?
15-20 weeks
When is Rhogam given?
28 weeks
