UWorld Flashcards
Can endometriosis cause infertility?
Yes
What is the treatment for late decelerations due to uterine tachysystole?
Discontinue uterotonic agents
What are 3 causes of variable decelerations?
- Cord compression
- Oligohydramnios
- Cord prolapse
What’s a fix for decelerations caused by cord compression?
Maternal repositioning
What 2 patterns are diagnostic of a category III FHR tracing?
- Absent variability
2. Recurrent late decelerations
What is a patient at risk for when they have a massive postpartum hemorrhage?
Sheehan syndrome
What is Sheehan syndrome?
Ischemic necrosis of the pituitary gland
What condition presents with lactation failure, hypotension, and anorexia?
Sheehan syndrome
How does hypothyroidism cause amenorrhea?
Stimulates TSH and prolactin from anterior pituitary; prolactin suppresses ovulation
What syndrome is marked by the triad of cafe au lait spots, polyostotic fibrous dysplasia, and autonomous endocrine hyperfunction?
McCune-Albright syndrome
What condition causes virilization and enlarged, solid-appearing ovaries?
Ovarian hyperthecosis
What condition is characterized by hypogonadotropic hypogonadism with delayed puberty and anosmia?
Kallman syndrome
What can be a potentially fatal cause of postpartum hemorrhage, with risk factors including nulliparity, fetal macrosomia, placenta accreta, and a rapid labor and delivery?
Uterine inversion (when the uterus inverts from too much fundal pressure and traction on the umbilical cord before placental separation)
What is uterine atony?
Failure of the uterus to contract and compress the placental bed blood vessels after placenta delivery
What kind of adnexal mass would cause rapid-onset virilization and signs of estrogen deficiency?
Sertoli-Leydig tumor (testosterone-secreting sex cord-stromal tumor)
How much should the levothyroxine dose be increased during pregnancy for patients with hypothyroidism to avoid worsening hypothyroid state due to inability to increase thyroxine?
It should be increased by 30%
What’s the definition of pre-eclampsia?
New onset HTN at 20+ weeks gestation plus proteinuria and/or end-organ damage
How high does the BP have to be for the dx of pre-eclampsia?
SBP 160+ or DBP 110+ (2 times, 4+ hours apart)
What condition causes theca lutein cysts, bilateral multiloculated ovarian cysts associated with elevated B-hCG levels?
Hydatidiform mole
How can OCPs cause increased hypertension?
By increasing angiotensinogen synthesis by estrogen during hepatic first-pass metabolism
OCPs ______ the risk of endometrial and ovarian cancer?
Reduce
Increased adipose tissue increases the peripheral conversion of _______ to _______?
Androgen to estrone
Twin pregnancy increases the risk for _______ labor?
Preterm
What is fetal dysmaturity syndrome?
When post-term (42+ week neonates) are SGA, have meconium-stained amniotic fluid, and loose skin due to age-related placental insufficiency
What are the following levels in Trisomy 21? a-fetoprotein: B-hCG: Unconjugated estriol: Inhibin A:
a-fetoprotein: decreased
B-hCG: increased
Unconjugated estriol: decreased
Inhibin A: increased
What are the criteria for diagnosing PCOS (2/3 must be met)?
- Irregular menses
- Clinical or lab evidence of hyperandrogenism
- Polycystic ovaries on US
What condition has premature rupture of the membranes as a risk factor, and presents with at least 1 of the following: fetal tachycardia 160+, maternal leukocytosis, maternal tachycardia, or purulent amniotic fluid?
Chorioamniitis
How do you manage chorioamniitis?
Expedited delivery
A short cervical length is a strong predictor of what?
Preterm labor
What can you use fetal fibronectin levels to indicate?
Increased risk of preterm labor (if they are elevated prior to term)
How can you decrease the rate of preterm labor in women with short cervices at <24 weeks gestation?
Give progesterone
What’s the biggest risk factor for breast cancer?
Age
When should routine mammography screening begin?
At age 50
What are the 2 treatment steps for a septic abortion?
- Broad-spectrum abx
2. Suction curettage
What is methotrexate used for in ob?
Ectopic pregnancy abortion
Why isn’t misoprostol used for uterine contraction-expulsion of a septic abortion?
It acts too slowly
If a patient with a septic abortion doesn’t improve within 48 hours of abx and suction curettage, what should the next step be?
Hysterectomy
What’s a first-line treatment for gestational hypertension?
Labetalol
Can you use loop diuretics in pregnancy?
No
Are ACEi’s and ARBs contraindicated in pregnancy?
Yes
What’s the definition of preeclampsia?
New-onset hypertension (140+/90+) at 20+ weeks gestation plus proteinuria and/or end-organ damage
What level of pre-eclampsia has the following signs?: SBP 160+/110+ thrombocytopenia elev creatinine elev transaminases pulmonary edema visual or cerebral sx
Severe
What’s the management of preeclampsia with severe features?
Delivery at 34+ weeks
What’s the management of preeclampsia without severe features?
Delivery at 37+ weeks
What condition during pregnancy might cause nausea, vomiting, abdominal pain, and jaundice?
Acute fatty liver of pregnancy
What condition during pregnancy might cause elevated bilirubin and transaminases as well as generalized priuritis?
Intrahepatic cholestasis of pregnancy
What are the 3 first-line anti-hypertensives for pregnancy?
- Hydralazine
- Labetalol
- Nifedipine
What is the definition of maternal hypertensive crisis?
160+/110+ for 15+ minutes
What might a pool of fluid in the vaginal canal after pelvic surgery indicate?
Vesicovaginal fistula
