Reproductive Health Flashcards
Tamoxifen, a selective estrogen receptor modulator, increases the risk for _________ in postmenopausal women
endometrial hyperplasia/cancer
and uterine sarcoma
*regular screening has no proven benefit in detecting endometrial cancer or uterine sarcoma. So, Pts only require evaluation only if symptoms develop (eg, abnormal uterine bleeding, postmenopausal bleeding).
What physical activities are not recommended during pregnancy?
Scuba diving,
exercise associated with a high risk of falling,
and contact sports
recommended regimen during pregnancy is 30 minutes of moderately intense aerobic exercise (the patient should be able to converse while exercising) on most or all days of the week
Pregnant women with a pelvic mass require surgical intervention when ___________.
Surgical removal is recommended during the _____ trimester to avoid acute complications (eg, torsion, preterm delivery) and to prevent progression of potentially malignant disease.
the mass is persistent, has complex features, and/or is >10 cm in diameter.
early second trimester
__________ jaundice is a common cause of unconjugated (indirect) hyperbilirubinemia that starts at 3-5 days of life and peaks at age 2 weeks in well-appearing and healthy neonates.
Breast milk jaundice
- persistence of physiologic jaundice beyond the first week of life
- results from a direct effect of breast milk itself as human milk promotes an increase in intestinal absorption of bilirubin
- continue breastfeeding (bilirubin levels normalize by 12 weeks)
__________ jaundice occurs during the first week of life and is caused by lactation failure from inadequate milk supply, poor latch, or infrequent feeding.
-This decrease in oral intake results in decreased bilirubin elimination and increased intestinal absorption of bilirubin, thereby increasing serum bilirubin.
Breastfeeding failure jaundice
- essentially an exaggerated physiologic jaundice d/t insufficient milk intake, which leads to fluid and weight loss and an inadequate # of BMs to remove bilirubin from body
_________ hyperbilirubinemia is always pathologic and requires additional workup.
If the direct bilirubin is elevated (>20% of _____), ultrasound of the hepatobiliary tree should be performed to evaluate for biliary atresia.
Conjugated (direct)
total bilirubin
Cervical Cancer screening
- Age 21-29
- Age 30-65
- Age >65
- Hysterectomy
- Age 21-29: cytology q3y
- Age 30-65: cytology q3y or cytology + HPV testing q5y
- Age >65: No screening if negative prior screens and low risk
- Hysterectomy: No screening if negative prior screens and low risk
A complete blood count with differential and blood culture are indicated if a newborn infant is __________
preterm or was exposed to prolonged rupture of membranes.
When do infants born to GBS positive mothers required to be observed in the nursery for 48 hours?
All infants born to GBS-positive mothers, regardless of prophylaxis should be observed in the nursery for 48 hours to monitor for signs of infection (eg, lethargy, poor feeding, temperature instability).
asymptomatic GBS bacteriuria on routine screening require what?
immediate antibiotic treatment with amoxicillin or cephalexin to prevent progression to an upper urinary tract infection
+
intrapartum prophylaxis !!
- Group B Streptococcus bacteriuria indicates heavy, persistent rectovaginal colonization
Pregnant patients are screened at ____ weeks gestation for GBS colonization via rectovaginal culture.
35-37
Additional patient populations requiring intrapartum antibiotic prophylaxis due to a high incidence of early-onset GBS disease include the following:
Unknown GBS status plus any of the following:
- Preterm delivery (eg, <37 weeks gestation)
- Rupture of membranes for >18 hours at any gestational age
Intrapartum fever (eg, chorioamnionitis)
- GBS bacteriuria in the current pregnancy
- Prior pregnancy complicated by early-onset neonatal GBS disease (eg, meningitis, pneumonia, sepsis)
Membrane rupture does not affect the efficacy of antibiotic prophylaxis for neonatal GBS disease prevention. Antibiotic prophylaxis is beneficial with prolonged rupture of membranes (>___hours) as it decreases the risk of vertical transmission
> 18 h
Penicillin is the antibiotic of choice for intrapartum GBS prophylaxis, which is initiated at least __ hours prior to delivery.
4 h
Genetic testing for inherited breast cancer disorders (and more intensive screening) is recommended for individuals with:
- 2 1st-degree relatives with breast cancer (including 1 before age 50)
- 3 1st- or 2nd-degree relatives with breast cancer
- 1st- or 2nd-degree relative with breast and ovarian cancer
- 1st-degree relative with bilateral breast cancer
- Breast cancer in a male relative
- Ashkenazi Jewish women with any 1st- or 2nd-degree relative with breast or ovarian cancer
