Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OB/GYN > UWorld 3 > Flashcards

UWorld 3 Flashcards

1
Q

intrauterine fetal demise (IUFD)

A

-fetal death at >20 weeks
-diagnosis: absence of fetal cardiac activity on US (dec or absent fetal movement)
-management:
20-23 weeks: dilation and evacuation or vaginal delivery
>24 weeks: vaginal delivery
complication: coagulopathy after several weeks of fetal retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

evaluation of fetal demise

A

fetal: autopsy, gross and microscopic exam of placenta (eval for signs of abruption or infection), membranes, cord; karyotpye/genetic studies
maternal: Kleihauer-Betke test for fetomaternal hemorrhage; antiphospholipis Ab; coagulation studies (for h/o recurrent pregnancy loss, fhx or personal h/o venous thrombosis, fetal growth restriction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Primary infertility

A
  • inability to conceive after a year of unportected sex in nulliparous pt <35yo
  • hysterosalpingogram is used to diagnose an anatomic cause of infertility such as tubal obstruction from prior pelvic infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

congenital aromatase deficiency

A
  • rare enzyme deficiency that prevents conversion of androgens to estrogens=undetectable estrogen levels
  • causes virilization of female fetuses–>nml internal genitalia with ambiguous external genitalia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

McCune-Albright syndrome

A
  • triad: cafe au lait spots, polyostotic fibrous dysplasia, autonomous endocrine hyperfunction
  • most common ft: gonadotropin-independent precocious puberty=early puberty
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

CAH (21) CP

A
  • at birth: ambiguous external genitalia and nml internal female reproductive organs (uterus, ovaries)
  • electrolyte abnormalities (hyponatremia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Bartholin duct cyst

A
  • common in women <30yo
  • duct obstruction causes fluid accumulation, gland distension=cyst
  • soft, mobile, nontender cystic mass is usually asymptomatic and found at base of labium majus
  • if asymptomatic, observation is recommended
    (symptomatic: treat like an abscess, with incision and drainage, followed by placement of a word catheter)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Mittelschmerz

A
  • physiologic cause of unilat abdo pain in young women
  • pain occurs in the middle of the menstrual cycle (days 10-14) corresponding with time of ovulation
  • reassurance is indicated once acute path is excluded
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Differential diagnosis of dysmenorrhea

A
  • primary dysmenorrhea: crampy lower abdo and back pain during menses
  • endometriosis: pain peaks before menses, dyspareunia, infertility
  • fibroids: heavy menses with clots; constipation, urinary frequency, pelvic pain/heaviness; enlarged uterus on exam
  • adenomyosis: dysmenorrhea, pelvic pain, menorrhagia, bulky globular and tender uterus
  • pelvic congestion: dull and ill defined pelvic ache that worsens with standing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

pubic symphysis diastasis

A

RF:
-fetal macrosomia, multiparity, precipitous (traumatic) labor, operative vag delivery
CP:
-difficulty ambulating/weight-bearing, radiating suprapubic pain, pubic symphysis tenderness, intact neuro exam
Management:
-conservative, NSAIDs, physical therapy, pelvic support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hydatidiform mole

A

CP:

  • abnml vaginal bleeding +/- hyropic tissues
  • uterine enlargement>gestational age
  • abnormally elevated beta-hcg levels
  • theca lutein ovarian cysts
  • hypermesis gravidum
  • preeclampsia with severe features
  • hyperthyroidism

RF:

  • extremes of maternal age
  • h/o hydatidiform mole

Diagnosis:

  • snowstorm on US
  • quantitative beta-hcg
  • histologic eval of uterine contents

Management:

  • dilation and suction curettage
  • serial serum beta-hcg post evacuation
  • contraception for 6 mo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Initial painful lesion

A

chancroid, genital herpes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

chancroid

A
  • haemophilus ducreyi
  • multiple and deep ulcers
  • base may have gray to ylw exudate
  • organism clump: “school of fish”
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

genital herpes

A
  • multiple small grouped ulcers
  • shallow with erythematous base
  • multinucleated giant cells and intranuclear inclusions (Cowdry type A)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

granuloma inguinale (donocanosis)

A
  • klebsiella granulomatis
  • ectensive and progressive ulcerative lesions without LAD
  • base may have granulation-like tissues
  • deeply staining GN intracytoplasmic cysts (donovan bodies)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

syphilis

A
  • single indurated well circumscribed ulcer
  • clean base
  • thin, delicate, corkscrew shaped on dark field microscopy
17
Q

lymphogranuloma venereum

A
  • chlamydia trachomatis
  • small and shallow ulcers
  • large painful coalesced inguinal LN (buboes)
  • intracytoplasmic chlamydial inclusion bodies in epithelial cells and leukocytes
18
Q

syphilis diagnostic serology

A
  • nontreponemal: Ab to cardiolipin-cholesterol-lecithin Ag
  • –decrease in titers confirms treatment
  • treponemal: Ab to treponemal Ag
  • quantitative (reactive/nonreactive); greater sn in early infection, positive even after treatment
19
Q

endometrial biopsy indications

A
  • -Age >45: abnml uterine bleeding, postmenopausal bleeding
  • -Age<45: abnml uterine bleeding PLUS: unopposed estrogen (obesity, anovulation); failed med management; Lynch syndrome (hereditary nonpolyposis CRC)
  • -Age >35: atypical glandular cells on Pap test
20
Q

Antiphospholipid syndrome

A 
Diagnosis:
vascular thrombosis (transient ischemic attack/stroke, DVT) and/or pregnancy complication (Recurrent miscarriage) PLUS >1 of the following Ab:
-anti-cardiolipin Ab
-lupus anticoagulant
-anti-beta2-glycoprotein Ab
21
Q

Wernicke encephalopathy

A

associated conditions: chronic alcoholism (m/c), malnutrition (anorexia nervosa), hyperemesis gravidarum

path: thiamine deficiency

CF: encephalopathy, oculumotor dysfunction (horizontal nystagmus, bilat abducens palsy), postural and gait ataxia

tx: iv thiamine followed by glucose infusion

22
Q

RF for vulvovaginal candidiasis

A
  • DM
  • immunosuppression
  • pregnancy
  • OCPs
  • antibiotic use
23
Q

theca lutein cysts

A

CP: multilocular, bilateral, 10-15cm ovaries
Path: ovarian hyperstim d/t: gestational trophoblastic dz, multifetal gestation, infertility tx
clinical course: resolve with decreasing beta-hcg levels

24
Q

management of preterm prelabor ROM

A

<34 weeks:

  • sign of infection or fetal compromise?
    yes: Abx, corticosteroids, mag if <32wks, delivery
    no: Abx, corticosteroids, fetal surveillance

34 to <37 weeks
-Abx, +/- corticosteroids, delivery

25
Q

PCOS

A

CF:

  • androgen excess
  • menstrual irregularities
  • polycystic ovaries

Pathophys:
-INC T, INC estrogen, LH/FSH imbalance

Comorbidities:
-metabolic syndrome, OSA, NASH, endometrial hyperplasia/ca

Tx options:
-weight loss, OCP for menstrual regulation, clomiphene for ovulation induction

26
Q

Late and post term pregnancy

A

-late term: >41 wk, post term: >42 wk
RF:
prior post term pregnancy, nulliparity, obesity, age >35, fetal anomolies

Complications: fetal/neonatal (macrosomia, dysmaturity syndrome, oligo, demise); maternal (severe obstetric laceration, cesarean, PPH)

Management:frequent fetal monitoring (nonstress test), delivery prior to 43 weeks gestation

27
Q

types of miscarriages

A

Missed:
-no vaginal bleeding, closed cervical os, no fetal cardiac activity or empty sac

threatened:
-vaginal bleeding, closed cerv os, fetal cardiac activity

Inevitable:
-vag bleeding, dilated cerv os, products of conception may be seen or felt at or above the cerv os

Incomplete:
-vag bleeding, dilated cerv os, some products of conception expelled and some remain

complete:
-vag bleeding, closed cerv os, products of conception completely expelled

28
Q

granulosa cell tumor

A

path: sex cord-stromal tumor, inc estradiol and inc inhibin
CF: complex ovarian mass, juvenile subtype-precocious puberty; adult subtype: breast tenderness, abnml uterine bleeding, postmenopausal bleeding

histo: call-exner bodies (Cells in rosette pattern)
management: endometrial bx (endometrial ca), surgery (tumor staging)

29
Q

external cephalic version

A

procedure: manual rotation of fetus, dec cesarean delivery rate
indications: breech/transverse presentation, >37 weeks gestation

absolute contraindications ( to vaginal delivery): prior classical cesarean delivery, prior extensive uterine myomectomy, placenta previa

complications: abruptio placentae, intrauterine fetal demise

30
Q

Sheehan syndrome

A

CF:

  • lactation failure (dec prolactin)
  • amenorrhea, hot flashes, vaginal atrophy (dec FSH, LH)
  • fatigue, brady (dec TSH)
  • anorexia, weight loss, hypoTN (Dec ACTH)
  • dec lean body mass (dec growth hormone)
31
Q

early decels
late decels
variable decel

VEAL CHOP

A

early: fetal head compression, can be nml, nadir of FHR coincides with peak of mom
late: uteroplacental insufficiency; nadir after peak of mom

variable: umbilical cord compression, oligo, cord prolapse
- intermittent are tolerated by fetus
- persistent may be alleviated by maternal repositioning; second line: amnionfusion

32
Q

ocp and htn

A

ocp can cause htn, d/c ocp=relieve htn in most pts

33
Q

maternal cardiopulm adaptation to pregnancy

A

maternal adaptations

  • cardiac: inc CO, inc plasma volume, dec systemic vascular resistance
  • resp: INC TV, dec FRC (elevation of diaphragm)

clinical manifestations:

  • peripheral edema
  • dec BP, inc HR
  • systolic ejection murmur
  • dyspnea
34
Q

placental abruption=premature detachment of the placenta

A

RF: maternal HTN or preeclampsia/eclampsia

  • abdo trauma
  • prior placental abruption
  • cocaine and tobacco use

CP: sudden-onset vaginal bleeding (80%)

  • abdo or back pain
  • high-freq low intensity contractions
  • hypertonic tender uterus

diagnosis: primarily by CP
US to r/o placenta previa, may show retroplacental hematoma

35
Q

placenta previa

A

RF: prior placenta previa, prior cesarean delivery, multiple gestation

CF: painless vaginal bleeding >20 wks gestation

diagnosis: transabdo followed by transvaginal sonogram
management: no intercourse, no digital cervical examination, inpt admission for bleeding episodes

36
Q

Sjogren syndrome

A

exocrine features: keratoconjunctivitis sicca, dry mouth, salivary hypertrophy, xerosis of skin

extraglandular features: raynaud phenom, cutaneous vasculitis, arthralgia/arthritis, interstitial lung dz

diagnostic: objective signs of dec lacrimation, positive anti-Ro and/or anti-La
- salivary gland biopsy with focal lymphocytic sialoadenitis
- classification: primary if no associated CTD, secondary if comorbid CTD (eg SLE, RA, scleroderma)

37
Q

indications for hospitalization for PID

A
  • pregnancy
  • failed outpt tx
  • inability to tolerate po meds
  • noncompliant
  • severe CP (high fever, vomiting)
  • complications (tubo-ovarian abscess, perihepatitis)

OB/GYN (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions