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OBGYN > UW OB2 > Flashcards

UW OB2 Flashcards

1
Q

28yo Prego. NV, RUQ Pain, BP 160/94, 98.9 F, Hg 8.5, Platelets 96K, +3 protein, AST/ALT elevated. dx? tx?

A

HELLP Syndrome = systemic inflammation + platelet consumption.

tx: DELIVERY, MgSO4, Hydralazine

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2
Q

Whats the major benifit with transdermal estrogen?

A

no increased risk of DVT!

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3
Q

FHR monitoring: Nadir + contraction mirroring each other

What could this mean?

A

normal or fetal head compression

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4
Q

FHR monitoring: Nadir occurs slowly after contraction. as contraction subsides nadir is being reached.(late deceleration)

What could this mean?

A

uteroplacental insufficiency

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5
Q

FHR monitoring: Nadir is sharp and not related to contractions

What could this mean?

A

cord compression, oligohydraminose, cord prolapse

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6
Q

How do you manage cord compression? what would you see on FHR monitoring?

A

move mother onto left side to avoid compressing IVC, Amnioinfusion if ruptured membranes.

On FHR monitoring would see sharp decelerations not related to contractions.

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7
Q

describe the histology seen on bx of fat necrosis of the breast?

A

foamy macrophages w/fat.

*may see in women how had previous breast surgery

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8
Q

HTN meds safe in prego

A

methyldopa, labetalol, hydralazine, nifedipine

2nd line: clonidine, Thz

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9
Q

HELLP or Eclampsia…which do you deliver?

A

both! tx is immediate delivery!

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10
Q

Tx of chorioamnionitis?

A
  1. Abx(amp + genta +/- clinda if c-section)

2. delivery

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11
Q

Placenta previa vs Placeta abrution on presentation?

A 
Previa = PAINLESS
Abrution = PAINFUL
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12
Q

Gestational diabetes goals. Tx hierarchy?

A

Fasting <95, 1hr pp <140, 2h pp <120

tx: diet > insulin > metformin > glyburide

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13
Q

What labs do you need @ initial vists for prego?

A
  1. RhD type + ab
  2. Hg/Hct, MCV(CBC)
  3. HIV, VDRL/RPR, HBsAg
  4. Rubella + varcella immunity
  5. pap test
  6. chlamydia PCR
  7. urine cult + protein
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14
Q

What labs do you need for prego @ 24-28 wks?

A
  1. Hg/Hct, MCV(CBC)
  2. RhD type + ab
  3. 1hr Glucose tests
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15
Q

What labs do you need from prego @35-37 wks?

A

GBS Culture!

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16
Q

Genitourinary Syndrome of Menopause

sx? pe?

A

sx: dryness, itching, dysparuria, urinary incon,recurrent UTI, Pelvic pressure, VAGINAL BLEEDING
pe: narrow introitus, pale mucosa, dec elasticity, dec rugae, PETECHIA, FISSURES, loss of labial volume

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17
Q

Women w/painful ulcers on vaginal who also has feeling of not being able to empty her bladder completely. comes in to ER complaining of Fever + HA + dysuria.
how do you dx?

A

THIS IS HSV! dx w/ viral PCR

*lumbosacral neuropathy of HSV can cause urinary retention

18
Q

24 F prego, LMP 9w ago, recently stopped OCP and now has heavier periods, feels “incomplete bladder emptying” which she has had for awhile. PE shows 15w uterus w/irregular contores. dx?

A

leiomyomata uteri = bitch got fibroids she aight

19
Q

Women with skin colored papules on labias. dx?

A

Condylomata acuminata = HPV 6 & 11!

*smooth, flat, papules, or califlower like

20
Q

Placental abrution risks factors? what are you worried about when thsi happens?

A

RF: HTN, trauma, Cocaine + tobacco

*DIC, hypovolemic shock, fetal hypoxia, preterm deliver

21
Q

Weird shit tahts normally w/in first few hrs of delivery

A

Shivers, temp <100.4 is considered normal, bloody discharge up to 3 weeks afterward(will get lighter and ligher in color)

22
Q

Modifiable Breast cancer risk factors

A

HRT, Null parity, increase in age of 1st brith, alcohol

23
Q

nonmodifiable breast cancer risk factors

A

BRCA +, 1st degree relative, white, increase in age, early menarch/late meno

24
Q

23 yo F w/FNV, LQ tenderness, RUQ pain w/inspiration, intermenstral spotting, pain that is worse w/menses. dx?

A

PID! *intermenstral spotting was prob cervicitis

25
Q

cause of symmetrical IUGR(<10% for gestational age) in 1st trimester.

A

Chromosomal Abnormalities > infection

26
Q

cause of asymmetrical IUGR(<10% for gestational age) in 2/3st trimester.

A

HTN, smoking,maternal malnurition, utero-placental insufficiency

27
Q

T/F raloxifene has no risk of DVTs

A

FALSE! Raloxifene still has risks of DVTs + hot flashes

+bone & -breasts

28
Q

When do u treat osteopenia?

A
  1. When they bc osteoportic
  2. When they have a fragility fracture
  3. When the FRAX score tells u to
29
Q

15 yo girl with heavy heavy menstral bleeding. How do you stop bleeding?

A

IV estrogen + anti emetic bc it’s gonna make her sick

30
Q

How do you explain post partum urinary retention? when shoudl you be able to pee?

A

regional anethesia can cause bladder atony. should be able to void 6h s/p deliver/cath removal

31
Q

Hyperemesis Gravidarm dx vs regular NV in 1st trimester

A

presence of ketones in urine = hyperemesis!

32
Q

RF for Shoulder Dystocia

A

big baby, mom obesity, increase weight gain in prego, gestational diabetes, post term prego

33
Q

Sx in inflammatory breast carcinoma vs IDC or LBC

A

Inflammatory = Peau d’orange, edema + erythema

*erythema not seen in others.

34
Q

What happens if you dont treat primary genital herpes?

A

resolves on its own and will decrease in freq over time. Meds will speed resolution.

35
Q

Mittelschmerz syn?

A

pain on 1 side of lower abdomen around d10-14 of menstral cycle lasting 1 d = ovulation!

36
Q

can you breastfeed w/hep C?

A

yup!

37
Q

mom gets epidural then hypotension why? tx?

A

epidural causes vasodilation + venous pooling

tx: fluids, move onto Lside and give vasopressors

38
Q

cervical insufficiency =

A

<2.5cm

progesterone

39
Q

girl on period presetns with fever (102), diffuse macular rash on palsm + soles, hypotension, NV, diarrhea + AMS…dx? tx?

A

Toxic Shock Syndrome = will see desquamation 1-3 wks later

tx: remove foreign body, Clinda+Vanc

Usually due to GAS or S.Aureus

40
Q

What must you do for a mom with hypothyroid in prego?

A

increase her dose of durgs bc TBG increases in prego and will further take up T4 resulting in low lvls if not.

OBGYN (25 decks)

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