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OBGYN > UW OB1 > Flashcards

UW OB1 Flashcards

1
Q

Prego women w/HSIL(High grade squamous intraepithelial lesion) how do you F/U?

A

since shes pregnant you must do a colposcopy first & if invasive do cervical excision

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2
Q

@ what weeks is tocolytics C/I?

A

34 wks or more

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3
Q

before — wks you can give corticosteroids

A

37 wks

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4
Q

C/I to breastfeeding

A

Galactosemia, Untreated TB, HIV infection, Herpetic breast lesions, Active Varicella Infection, Chemo or Radiation, Active Substance Abuse

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5
Q

describe the normal changes in thyroid function during pregnancy

A

decreased TSH, Increased total T4 and mild increase in free T4

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6
Q

Pt has Hydatidiform mole removed. What will you see in b-hCG? How do you follow up?

A

b-hCG will slowly fall and be gone in 6 months. During this time she MUST BE ON CONTRACEPTION FOR 6 MONTHS

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7
Q

what type of cancer is mammary pagents dz?

A

adenocarcinoma

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8
Q

prego women w/hyperemesis gravidarum; confusion, fallen 2x while standing, nystagmus. dx?

A

wernicke encephalopathy(encephalopathy, oculomotor dysfunction/nystagmus, ataxia)

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9
Q

Risk factors for cervical cancer

A

tobacco use, low SES, Immunosup, oral contraceptive use, high risk sex partners, STI, HPV

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10
Q

inpatient PID tx

A

IV cefoxitin or cefotetan + doxycyclin

If PCN allergy: clindamycin + gentamycin

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11
Q

outpatient PID tx

A

IM ceftriazone + oral doxy

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12
Q

Lichen Plantus v Lichen Simplex Chronicus v Lichen Sclerosus

A
  • Lichen Sclerosus = thin, white, wrinkled skin over the labia majora/minora + atrophic changes.
  • Lichen Simplex Chronicus = hyperplastic response to repetitive scratching and irritation = thick leathery textured skin.
  • Lichen Planus = glassy bright red erosiuns and ulcerations of vulvovaginal area(purp papules assoc w/HEP C), wickham striae
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13
Q

Pathogenesis of ovarian torsion

A

ovary mass causes twisting of ovary = ischemia & necrosis

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14
Q

Why do you do a Biophysical Profile on a baby?

A

to asses fetal oxygenation through ultrasound observation and the nonstress test.

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15
Q

pt w/endometriosis are at greatest risk for….

A

infertility

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16
Q

what is Pseudocyesis?

A

woman who wants to be prego but cant basically believes shes prego = somatization stress!

= somatization stress fx hypo-pit-ovar axis causing weight gain, amenorrhea and causes her to imagine a + prego test when its actually neg.

dx: neg U/S, neg Prego tests + clinical

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17
Q

Tx of HELLP & Eclampsia?

A

delivery!

18
Q

women in 3rd trimester comes in complaining of bleeding, PE shows bright red blood from cervix. dx?

A

placenta previa

*shoudl always do U/S before PE

19
Q

Tx of Hyperemesis Gravidarum

A

dietary modification > Diphenhydramine(anti-his) > Metoclopramide(D-antag) > Ondansetron(5HT antag)

20
Q

What will you see with intra-amniotic Infection/Chorioamnionitis? tx?

A

PROM >18h, Uterine tenderness, maternal fever, fetal tach >160bpm maternal leukocytosis
tx: abx(ampicillin +gentamycin for vag +clindamycin if C) + delivery

21
Q

Which Ig crosses the placenta?

A

IgG

22
Q

Why is Rh incompatibility so much worse than ABO incompatibility?

A

Rh exposure takes time to develop so by end of 1st prego mom has recently started making IgG to baby = will make immediate attack on 2nd Rh + baby.
*ABO incompatibility causes an acute response and will lyse RBCs. type O moms have large Anti A&B IgG = big hemolysis vs Type A&B moms have small O IgG & mostly IgM which doesnt really cross the membrane.

23
Q

When is Rh screening done?

A

28 weeks

24
Q

What do you do if mom is Rh- and baby is Rh+?

A

give Rogam @28wks and within 72 hr of birth

25
Q

Presentation of Placenta Previa VS Placenta Abruption

A
  • Previa = painless vaginal bleeding in 3rd trimester, blood from cervix
  • Abruption = Painful uterus w/bleeding in thrid trimester!
26
Q

41w gestation. NST w/FHR 140. FHR decreased to 120 after contraction peak. BBP score of 4. no accelerations for >40 min dispite vibroacostic stimulation. dx?

A

Uteroplacental insufficiency

27
Q

Itrauterine Fetal Demise(IUFD)

How do you dx this?

A

fetal death at >20 weeks

**can only dx w/lack of fetal cardiac activity(no heart movement) on transabdominal U/S

*absent fetal movement or absence of fetal heart sounds on doppler could be bc baby is sleeping or not in the right position this is why you must visualize absence of heart movement w/U/S

28
Q

Abortion vs Intrauterine fetal demise

A

Abortion is death before 20 wks

IUFD comes after 20 wks

29
Q

women cant get prego. she have regular menstral cycles and you have already worked up the dude and hes fine. what do you do next?

A
  1. Smush test for inhospitable Mucous

2. check for ovulation(ovulation kit checking LH, Progesterone levels, BBT, Endometrial biopsy)

30
Q

Managment of PPROM <34 wks; PPROM >34 wks

A

Preterm premature rupture of membbranes = <37 wks.

if PPROM > 34 wks = deliery +abx + steroids
If PPROM < 34 wks = managed expectantly if not infection +abx +steroids

*if PPROM < 34 wks w/infection = delivery +abx + sterids

**either way always give ABx + STEROIDS!

31
Q

Presenation and tx of uterine rupture

A

sudden extreme abdominal pain, abnormal bump in abdoment, no contractions, regression of fetus as it is now floating in abdomen.

tx: Laparotomy ASAP to get baby out then repair or hysterectomy

32
Q

Uterine Inversion presentation and tx

A

lower abdominal pain, round mass protruding through the cervix, fundus not palpable, hemorragic shock.

tx: fluid replacement, push uterus back in then remove placenta and give uterotonic drugs(helps uterus contract and stops bleeding)

33
Q

treatment for overflow incont.

A

Anti-Cholinergic(betha) > cath

34
Q

What is Pubic Symphysis Diastasis? cause? rf? tx?

A

progesterone & relaxin cause increased pelvic motility and widening, after tramatic delivery(fetal macrosomia, multiparity, precipitous labor, operative vag delivery) can present w/difficulty ambulating, RADIATING SUPRAPUBIC PAIN w/an intact neuro exam.

tx: NSAIDs, PE, resolves 4-6 wks

35
Q

define an acceleration on a NST (assume >35wks). whats a + NST?

A

acceleration: >15 bpm for >15s returning to normal w/in 2 min.

+NST: >2 accel in 20 min each above 15bpm and >15s.

36
Q

women reports pain with penitration. dx? tx?

A

genito-pelvic disorder = due to trauma, abuse or lack of knowledge.

tx: kegals + desensitization

37
Q

Hydralazin vs labetalol for HTN prego

A

cant give labetalol w/bradycardia

38
Q

women with recurrent canidida inf…what shoudl you check?

A

a1c

39
Q

baby born w/warm, moist skin, tachy, poor feeding, irritabliity, poor weight gain…dx?

A

neonatal thyrotoxicosis! mom prob has anti-TSHr ab! which cross the placenta causeing release of excessive TH in baby.

tx: methimazol + BB = will resolve in 3 months

40
Q

Young women tx for some cancer w/chemo now presents with menopause sx…wtf happened?

A

1 ovarian insufficiency due to chemo attacking ovaries.

OBGYN (25 decks)

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