U-Wise Flashcards
Two things for ASCUS
Colposcopy and high risk HPV testing
Pap test after hysterectomy when
For cervical Ca or high risk dysplasia
Can co test HPV and pap how often
5 years for co test
What is cryotherapy for a pap issue?
No tissue biopsy results
Mucopurulent cervicitis with symptoms worsening during and after menstruation classically
Gonnorrhea
High suspicion for syphillis test
Treponemal-specific test
Herpes culture false negative rate
10-20%
What age should you start DEXA scans
65 (unless high risk)
When does ACOG recommend mammograms tart
40 years
When to do a colonoscopy below 50
If patient had before 60 (do 10 years before youngest diagnosis)
2 vaccines contra in preg
MMR and Varicella
1 kiler in women
Heart disease
Anemia in pregnancy due to
Hemodilution (increase in plasma volume greater than increase in RBC mass)
Acid-base status in pregnancy
Increased minute ventilation causes a compensated respiratory alkalosis
PFT increases in pregnancy
Inspiratory capacity increases due to increase in tidal volume and respiratory reserve volume
Why is pulmonary edema a greater risk in pregnancy
Plasma osmolarity is deceased in pregnancy
What murmers are always abnormal in pregnancy
Diastolic
Why does the right ureter dilate more than the left in pregnancy
Protection from sigmoid colon on the right side
Most common site for gestational trophoblastic dz to met to
Lungs
Weight gain in pregnancy
Underweight (18.5) 28-40
Overweight (25-39) 15-25
Obese 11-20 pounds
Who gets beta thalassemia
Mediterranean populations
Valproic acid increased risk of what defect
Neural tube, hydrocephalus, and craniofacial
Congenital defects with DM in organogenesis
CNS (neural tube) and cardiac
Fetal loss associated with Chorionic villus samplic
1%
Most common cause of inherited mental retardaiont
Fragile X
When can quad screen be used
2nd trimester
BS goals in pregnancy
Fasting below 90 and 1-2 post prandial below 120
Daily folic acid for low risk and high risk pts
At least 0.6 low risk
4 for high risk
Most common valproic acid anomaly
Lumbar meningomyelocele
When can pregnant woman stop taking ibuprofen
32 weeks
What are brixton-hick contractions
Shorter than true labor, in the lower abdomen, no cervical changes
What do you do if you see umbilical cord prolapse during delivery
Elevate fetal head with hand and do c section
elevating head avoids compression of umbilical chord
Single greatest risk factor for 3rd and 4th degree laceration
Episiotomy
Down syndrome appearance
flattened nasal bridge, small cup shaped ears, sandal gap toes, hypotonia
What do chorioamnionitis babies look like
Lethargic, pale, high temp
What can you see in infants born to DM mothers
Hypoglycemia, polycythemia, hyperbilirubinemia, hypocalcemia, respiratory distress
Best position for peep in newborn
Sniffing position (head back and titled chin)
MCC of PPH
Uterine atony
Most common cause of fever post partu
Endometritis
Feature of PPD vs Baby blues
Ambivalence toward newborn
What causes lactation after delivery
Rapid dec in progesterone (inhibits lactation)
Candida of nipples feature
Intense pain –> check babies mouth
MCC of 1st trimester SaB
Autosomal trisomy
Chronic dz associated with first trimester loss
Lupus, DM, Chronic renal dz
Tx for incompetent cervix in pregnancy
Cerclage at 14 weeks
MCC of sepsis in pregnancy
Pyelonephritis
Thyroid storm acute tx
Thioamides (PTU), propanolol, sodium iodide, dexamethasone
GDM screening
24-28 weeks, unless high risk then as soon as possible
Why do you treat BV in pregnancy
Reduces risk of preterm delivery
Highest risk of maternal mortality from
Things that cause diminished right ventricular filling
Most common complication for overweight patients in pregnancy
Hypertension
Tx for lupus flare in pregnancy
Steroids
SSRI contra in pregnancy
Paroxetine –> cardiac malformations and persistant pulmonary HTN
Drug for intrahepatic cholestasis of pregnancy
Ursodeoxycholic acid
Test for suspected appendicitis in pregnancy
Graded compression US
Gestation HTN criteria
HTN after 20 weeks in the absence of proteinuria or other pre-eclampsia features
BP for pre-eclampsia to recommend mag
160/110
Mag levels and tox
Loss of DTR at 7-10
Resp depression 10-14
Cardiac arrest at 15
Feature for pre-term delivery in severe pre e
Thrombocytopenia
Tracing for placental abruption
Fetal anemia like (sinusoidal pattern)
Diastolic BP goal when over 100 in pregnant
90-100
Percent chance of isoimunization if no rho-gam
2% antepartum, 7% after full delivery, 7% next pregnancy
Best test for fetal anemia
MCA peak systolic flow velocity
What is fetal hydrops
Collection of fluid in two or more body cavities
What does the Kleihauer-Betke test measure
Incidence and size of fetal transplacental hemorrhage (can measure how much fetal blood mother was exposed to)
What do you measure in amniotic fluid to get severity of hemolytic disease in fetus
Bilirubin
US features of di di twins
Twin peak (lambda sign), two placentas, dividing membrane > 2mm
Infant death rate in twins vs single preg
5x higher
Twin-twin transfusion syndrome most common in what kind of twins
Monochorionic diamniotic
Biggest complication for twins
Preterm birth
Birthplan for twins if Twin A breach
C-section
Risk of developing brain damage at what gestational age
8-15 weeks
Hx of DVT and fetal demise likely
Factor V mutation in mother
What should be checked on all women with vaginal bleeding in pregnancy
Maternal blood type
IUFD in 3rd trimester with no bleeding likely
Unctrolled DM
MTX vs misopristol for abortions
MTX for ectopic and LMP 6 weeks
Causes of breech presentation
Prematurity, twins, previa, fibroids
Active phase of labor at how many Cm
4cm
Largest risk factor for shoulder dystocia
GDM
Oxytocin only when
Contractions aren’t adequate
Most common type of breech
Frank (butt first)
Placenta accreta greatest risk by location
Low lying
What does FFP contain
Fibrinogen, Factor V, Factor VIII
What does cryoprecipitate contain
Fibrinogen, VII, VWF
Smoking complications of pregnancy
Abruption, previa, IUGR, preeclampsai, and infection
If looks like bloody show but cervix closed, think what?
Cervicitis
MCC of preterm labor
Idiopathic
When to not use tocolytics
Chorioamnionitis
Toco’s contra in DM patients
Terbulatine and ritodrine
What toco is contra in MG
Mag sulfate
B agonists do what in the cell
inc cAMP, decreasing free calcium
Terbutaline MOA
B-agonist
Amniotic level ass w/ indomethacin
Oligohydramnios
Best medicine to prolong labor in PPROM
Antibiotics (5-7 days)
Amniotic fluid test for infection
Low amniotic glucose levels
PPROM at 36 weeks, what do you do
Induction of labor
