Reproductive Health Flashcards
when can you see gestational sac on US?
5-6 weeks
Smoking during pregnancy is associated with…
low birth weight, increased risk of miscarriage, prematurity and VTE
When can you give methotrexate for ectopic pregnancy?
small <3 cm, unruptured, w/o fetal cardiac activity.
Normal fetal heart rate
120-160 bpm
Quad screen is offered between weeks…
15-18 weeks
When do you do a GTT?
24-28 weeks
Prego women should avoid airline travel after…
35-36 weeks
IUGR is defined as fetal growth below the —%.
<10%
Late decels indicate…
uteroplacental insufficiency & fetal acidemia
Variable decels indicate…
cord compression, no fetal distress
Early decels indicate…
head compression
Chorioamnionitis antibiotics?
Amp + gent
True/false emergency contraceptive works after implantation
False emergency contraceptive only works before implantation
Up to how many days after unprotected sex can you use emergency contraceptive?
Up to five days for progesterone only and combination emergency contraceptive and up to 5–8 days for copper IUD
Combined hormonal contraceptives are contraindicated in…
DVT, pulmonary embolism, thrombophlebitis, uncontrolled hypertension, CAV, CAD, MI, heavy tobacco use, any estrogen dependent cancer including breast cancer, migraines with aura, hepatic adenoma, hepatic carcinoma, pregnancy
True/false Combined hormonal contraceptives can only be started at the beginning of a menstrual cycle
False they can be started on any day of the menstrual cycle however if started on day one there’s no need for back up method. Starting any other day requires a barrier method or abstinence for 7 to 14 days
What should you instruct the patient to do if she misses a single dose of her OCP
Take her missed doast immediately in the next dose at the usual time
What should you instructed patient to do if she’s missed two doses of her OCP
Take two pills immediately and two pills the next day
What should you instruct the patient whose missed three or more doses of her OCP
Discard the pack of pills, allow withdrawal bleeding and then start a new pack
Is the Depo-Provera estrogen or progesterone or both?
Medroxyprogesterone only
True/false progesterone only methods are safe for breast-feeding mothers and babies
True
Once a patient stops Depo-Provera how long does it usually take for fertility to return
7 to 12 months
What is the only absolute contraindication for progesterone only contraceptives
Breast cancer. Caution is recommended in those with: Respecters for cardiovascular disease, uncontrolled hypertension, current DVT or PE
Long-term use of Depo-Provera can lead to…
Decreased bone mineral density however this appears to return to normal after Depo-Provera is stopped.
What supplements should you recommend for a patient on the Depo-Provera to take
Calcium and vitamin D in addition to weight bearing exercise to prevent bone loss
True/false high-risk sexual activity and young age are contraindication to intrauterine contraceptives
False
IUCs are contraindicated with
Pregnancy, active infection, anatomic abnormalities or fibroids at the store at the uterine cavity enough to make insertion difficult, current gynecological cancer, unexplained vaginal bleeding, allergy or Wilson’s disease and current/history of breast cancer(Mirena only)
Abortion with D&C during the first trimester can be performed up to —-weeks
12 weeks
First trimester abortion with mifepristone and misoprostol can be used for up to —- weeks
FDA approved for up to seven weeks but commonly used up to nine weeks
If cardiac activity is detected — Weeks after medical abortion it is considered a failure and surgical abortion is needed
Two weeks
What lab should you order to further evaluate an ovarian mass
Ultrasound to determine size, beta hCG, alpha-fetoprotein, LDH, serum CA 125
What should you do for further evaluation of a prepubertal patient with ovarian mass
Ultrasound in referral to GYN has these are most likely malignant
What should you do for a pre-menopausal patient with ovarian mass
Ultrasound, basic labs and if less than 10 cm can be followed with ultrasound. If persistence for more than 12 weeks referral to GYN
What should you do for the postmenopausal patient with ovarian mass
Ultrasound, basic labs for 5 to 10 cm with normal CA 125 can be followed with serial ultrasounds due to low risk of malignancy. Larger system should be laparoscopically excised
Antibiotics of choice for epididymitis individuals 14 to 35 years old
Treat for gonorrhea and chlamydia with Rocephin and Doxy or azithromycin
Antibiotics of choice for epidermidis an individuals greater than 35 years
Bactrim or FQ
Drug of choice and treatment duration for prostatitis
Bactrim or FQ. Treat for 4 to 6 weeks
Drug of choice for treatment of trichomonas? Duration in dosage?
One time dose of metronidazole 2g, treat partner.
- is treatment fails go to Flagyl 500 BID times seven days
After an RPR what test do you have to do to confirm diagnosis of syphilis?
FTA-ABS
Irregular bleeding is coming after HRT and improves after…
6-12 months
Nausea and vomiting in pregnancy starts around ——and usually resolves by——.
4 to 8 weeks in resolves by 13 to 14 weeks
Monitoring of MTX for ectopic pregnancy
After diagnosis of ectopic give single dose of methotrexate. Recheck beta hCG on days four and seven if level continues to rise patient will need laparoscopy. If Betah H she do use down trending, turned it out to zero
Preeclampsia during pregnancy raises your lifetime risk of
Ischemic heart disease
Women with preeclampsia should plan to deliver at
37 weeks
MC type of ovarian cancer
epithelial ovarian cancer
whats ospemifene?
SERM that acts as an estrogen agonist in the vagina but has no effects on the endometrium or breast. Daily pill. Side effects include hot flashes and risk of VTE. Also reduces bone turnover =)
