UW OB3

Question 1

Endometrial Bx Criteria

Answer 1

A. >45: AUB or postmeno bleeding
B. <45: AUB w/unopposed estrogen(obesity, anov), failed men management, lynch syndrome.
C. >35: Atypical GLANDULAR cells on pap

Question 2

young girl w/pharyngitis, fever, lower ab pain. dx?

Answer 2

Gonococcal pharyngitis, test for w/NAAT

Question 3

Sx of Oxytocin tox? tx?

Answer 3

3: Hyponatremia, Hypotension & TACHYSYSTOLE
tx: 3% hypertonic saline
* Oxytocin is simular to ADH

Question 4

Sx of Mg tox? tx?

Answer 4

NV, flushing, HA, hyporeflexia, hypocal, respiratory paralysis, cardiac arrest

tx: stop Mg, IV Ca-gluconate bolus
* sx will be worse with RENAL INSUFF!

Question 5

do OCP cause weight gain?

Answer 5

nope

Question 6

in addition to paps what must you do for owmen <25

Answer 6

pap + gon/chal test

Question 7

tx of postpartum endometritis

Answer 7

clindamycin + genta

Question 8

tx of Bactauria in prego

Answer 8

Cephelaxin, amox-clau, nitrofurantoin, fosfomycin

Question 9

how do you measure cervical length?

Answer 9

trans vag U/S

Question 10

baby born w/thin, loose skin + small, thin umbilical cord + wide anterior fontanel. cause?

Answer 10

FGR! = do placental hystopath

Question 11

elevated AFP indicates…

Answer 11

abdominal wall defect

*low is trisomy 18 or 21

Question 12

define inadequate contractions?

Answer 12

<3 in 10 min w/ab soft to palp

Question 13

Protracted labor in the active stage of labor.

Answer 13

<1.2cm/h for nullipar

<1.5cm/h for multipar
*tx w/augmentation of labor

Question 14

Arrested labor in the acitve stage of labor.

Answer 14

no change in 4h w/good contrac

or no change in 6h w/o good contrac
*tx w/augmentation of labor

Question 15

Protracted labor in the second stage of labor.

Answer 15

longer than 2h in nullipar (3w/epi)

longer than 1h in multipar(2 w/epi)

*tx w/operative vag del or c-section

Question 16

Arrested labor in the second stage of labor.

Answer 16

no pro after 3h in nulli par(4 w/epi)

no pro after 2h in nulli par(3 w/epi)

*tx w/operative vag del or c-section

Question 17

What is secondary arrest of labor? how do you tx it?

Answer 17

cessation of labor that was initially doing fine for 2h…tx w/membrane rupture manually or just watch

Question 18

APGAR score…explain..

Answer 18

Activity, Pulse, Grimance(irritability), Appearance, Respiration(cry?)

0-2 normal is 7-10

Question 19

how long do postpartum blues lasts? when is it postpartum depression?

Answer 19

blues = less than 2wks

depression = with in 6months

Question 20

what organism causes mastitis? tx?

Answer 20

streptococcus!

Penicillin or cephalosporin

Question 21

Description of Candidiasis of the nipple. tx?

Answer 21

sore nipple, painful nipple, peeling at periphery.

tx: mom w/topical clotrimazole or miconazole; baby w/oral nystatin

Question 22

Signs babies is getting enough breastmilk

Answer 22

• 3-4 stools in 24hrs
• 6 wet diapers in 24hrs
• Weight gain
• Sounds of swallowing

Question 23

women is breastfeeding but experienceing great pain. her breasts are full and tender. what can you recommend to help?

Answer 23

frequent nuring, warm shower + hot compress, massaging breast + expressing milk to soften, good support bra, analgesic 20 min beofre breastfeeding.

Question 24

• 6 wk prego B-hCG initially 1500, 48hrs later its 3100. She has 3 days of spotting and uterine cramping. What would you see on U/S?

Answer 24

Viable IUP = spotting common in 1st trimester & since BhCG dbled its prob a viable prego

Question 25

RF for spontaneous abortion

Answer 25

DM, chronic RF, SLE, smoking, alcohol, radiation, infections, advaced age, advanced parity *preeclampsia is not a RF! neither is previous abortion!

Question 26

T1 DM risks to baby...

Answer 26

spontaneous abortion, congenital malformations, IUFGR, Fetal Macrosomia, polyhydramnios, preterm birth, HTN Complication

Question 27

Tx of HA in prego

Answer 27

Amitriptyline

Question 28

how do you manage asthma inprego?

Answer 28

Inhaled BB, then inhaled corticosteroids or cromolyn sodium then subQ terbutaline+steroids for acute cases

Question 29

how do you treat MVP in prego?

Answer 29

BB

Question 30

Obesity risks to baby...

Answer 30

chronic HTN, Gestational diabetes, preeclampsia, fetal macrosomia, higher C-section rates, postpartum complications

Question 31

SSRI that is not sage in prego...

Answer 31

paroxetine! other SSRIs are safe

Question 32

target HTN in prego...

Answer 32

diastolic 90-100

Question 33

risk factors for preeclampsia

Answer 33

previous hx, chronic HTN, multifetal prego, molar prego, diabetes, chronic renal dz, APLS, vascular dz, tripolidy, extremes of age

Question 34

moms bleeding, baby shows tachy w/decreased variability and sinusoidal pattern...

Answer 34

placenta abruptio! =sinusoidal pattern shows placental insufficiency

Question 35

U/S finding of RH dz...

Answer 35

1. increase systol flow on MCA doppler. | 2. Fetal Hydrops(ascites, pericardial effusions + other effusions, scalp edema)

Question 36

dafuq are lewis antibodies?

Answer 36

- Lewis Antibodies are IgM and do not cross the placenta = not associated w/isosensitization or hemolytic disease of the fetus = no F/U needed.

Question 37

best indicator of severity of Rh hemolytic dz

Answer 37

bilirubin from amniotic fluid

Question 38

risk w/twins...

Answer 38

5x death rate, cerebral palsy, higher incidence of IUGR, increased prematurity, increased congenital abnormalities

Question 39

Twin-twin transfusion syn risks to the babies...

Answer 39

Donor: anemic, hypovol, growth retardation surviving twin: neurological morbidity risk, cerebral palsy, cardiomegaly, tricuspid regurge, ventricular hypertrophy, hydrops fetalis

Question 40

Stages of Loss:

Answer 40

``` o Denial o Anger o Bargaining o Depression o Acceptance ```

Question 41

Cytotec(Misoprostol)

Answer 41

o Given prior to Pitocin | Given for women with unfavorable cervix/closed  increases cervical ripening!

Question 42

MC breech presentations

Answer 42

- Incomplete Breech = 3-4% *one leg down - Complete Breech = 5-12% *baby curled into ball with legs crossed - Frank Breech = 48-73% *babys legs straight up into the air

Question 43

RF for breech presentation

Answer 43

``` o Prematurity o Multiple gestation o Genetic disorders o Polyhydramnios o Hydrocephaly o Anencephaly o Placenta previa o Uterine anomalies o Uterine fibroids ```

Question 44

Risks for baby/mom associated w/tobacco/smoking

Answer 44

``` o Placental abruption o Placental previa o IUGR o Preeclampsia o Infection ```