U-Wise 2 Flashcards by Robby Skinner

IUPC measures?

If contractions are adequate

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What makes a good acceleration

More than 15 bpm lasting more than 15 seconds

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Prolonged fetal tachycardia seen with

Maternal fever or chorioamnionitis

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Variable deceleration shape

Rapid fall and variable upslope

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Initial measurement to treat fetal hypoperfusion

Move patient to left lateral decubitus position, discontinue tocolytics, fluids

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Why no methylgonovine in pt’s with pre-eclampsia or HTN

Vasodilator, can cause bleeding

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Who can’t get Prostaglandin F2

Asthmatics, has a bronchoconstrictive effect

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Low lying placenta w/ hx of c-section worry

Placenta accreta

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Risks for retained placenta

Prior C section
Uterine leiomyomas
Prior uterine curettage
Succenturiate lobe of placenta

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How is oxytocin administered to prevent uterine atony

Rapid infusion of a dilute solution (20-80 units)

Not an IV push

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Suture to prevent uterine atony in surgery

B-lynch suture (uterine compression suture)

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Complications of epidural

Spinal headache, localized back pain, and meningitis

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Gentamicin gets what kind of bugs

Gram negs

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Erythromycin good for

URIs

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What increases risk of UTI post delivery

Indwelling catheter

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What causes breast engorgement

Exaggerated response to lymphatic and venous congestion associated with lactation

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Post partum fever spikes and normal exam, suspect?

Septic pelvic thromboembolus

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First step in fever day 1 post c section

Chest xray (atelectasis)

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What does preg class C mean

Animal studies have shown hard but no human studies have been done

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Hx of psychiatric illness risk factor for

Post-partum depression (up to 1/3 of patients report a problem)

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Most common SSRI adverse effect

Insomnia

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SSRIs in breastfeeding

OK, is in breast milk but no detectable levels in infant

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AE of SSRIs in 3rd trimester use

Agitation and poor feeding of newborn

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When are symptoms of PMDD found

In luteal phase, absent in beginning of follicular phase

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Post-partum pyschosis feature

Visual or auditory hallucinations

Tests to do in post term patients

NST and assessment of amniotic fluid volume

Post term pregnancies associated with

Placental sulfatase def, fetal adrenal HYPOplasia, anencephaly

Dx of post-term pregnancy based on

Establishment of an accurate gestational age

Amnioinfusion for

Repetitive variable decelerations

What do fetal dysmaturity babies look like

Withered, meconium stained, long nailed and fragile | Associated small placenta

Cardiac defects most common in what trisomy

21 (up to 50%)

Most commonly used cervical ripening agents

Prostaglandins

Maternal vascular diseases lead to

Uteroplacental insufficiency (asymmetric IUGR)

What do you do after IUGR is diagnosed

Antenatal testing of fetal well being

US of fetal well being not useful when

If used more than once every 2 weeks

NST based on the principle that

When fetus moves, its HR accelerates

1st trimester crown-rump length dates how accurate

+/- 4-5 days

Macrosomia definition

> 4000 grams in a diabetic and >4500 in a non diabetic

Lacerations more common in forceps or vacuum?

Forceps

Most likely complication with tubal ligation

Unplanned pregnancy

When should irregular bleeding end after depo shot

2-3 months

OCPs decrease risk of

Ovarian and endometrial cancer

Tubal ligation reduces the risk of what cancer

Ovarian

Strongest predictor of regret for permanent sterilization

Age (under 25 biggest risk)

Fever and bleeding with a dilated cervix is? Tx?

Septic abortion | Surgical abortion and antibiotics

Two lupus anticoagulant Ab? Prevention?

Anticardiolipin and beta-2 glycoprotein antibody | Help prevent with heparin

Why mifepristone and then misoprostol in medical abortion

Misoprostol -- antiprogestin | Misoprosol -- prostaglandin that induces uterine contractions

Gestational age limit for vacuum abortion

First step in heavy bleeding after termination of pregnancy

Dilation and curettage

Most common cause of vaginitis

Chronic pruritus with vagina not involved is

Lichen sclerosis

Sever pain of vestibular touch or attempted vaginal entry

Vulvar vestibulitis

What causes lichen simplex chronicus

Chronic scratching and rubbing | Tx: steroids and antihistamines

GC mixed tx

Ceftriaxone and azithromycin

Least invasive tx for pelvic organ prolapse

Pessary fitting

Exposure to hep B regimen

HBIG and start hep B vaccination series

Mucopurulent cervicitis + bi adnexal and uterine tenderness? tx?

Salpingitis | IV cefotetan and doxy + gent

What causes overflow incontinence

Underactive detrusor muscle or obstruction (prolapse)

What type of urinary incontinence is due to detrusor instability? Tx?

Urge (uninhibited contraction of the bladder with filling) | Tx: Oxybutynin

What type of incontenence is caused by urethral hypermobility

Stress incontinence

Stress incontinence best surgery

Retropubic urethropexy

Tx for urethral intrinsic sphincteric def

Urethral bulking procedure

What is colpoclesis

Vagina is surgically obliterated --> good for severe prolapse in elderly

First step when US shows complex cyst in an older woman

Surgical exploration

First and 2nd line endometriosis drugs

1. COC | 2. Danazol (synthetic estrogen but lots of AE)

Definitive dx for endometriosis

Diagnostic laparoscopy (surgery and biopsy)

First step for hemhorragic cyst

repeat US in 2 months as should resolve

Sudden onset of pain and nausea and cyst on US likely?

Ovarian torsion

Good workup for unknown chronic pelvic pain

Laparoscopy (endometriosis present even in the youngens)

What is interstitial cystitis

Chronic inflammation of the bladder --> recurrent voiding symptoms and frequency in absence of evidence of any other disease

How do GnRH agonists work

Down-Regular hypothalamic pituitary gland production

New onset of pelvic pain often associated with

Abuse (up to 40% of pelvic pain)

Pelvic adhesions think

Chronic PID

Pelvic congestion features

worse during periods and pregnancy, aggravated by standing, fatigue, and coitus

Iilohypogastric nerve senstation

sensation to skin and groin overlying pubis

What nerve damage would keep patient from being able to adduct thigh

Obturator

Best time to get a prolactin level

Not during physical exam, which may stimulate prolactin

Tx for cervical dysplasia

LEEP

Complications from LEEP

Cervical stenosis, preterm delivery

LSIL in youngen

Repeat pap in 1 yer

Vulvar lesion unresponsive to medical therapy needs

Biopsy

Best way to begin workup for an incidental mass

Pelvic US