Uworld Ob/Gyn Flashcards
primary syphilis sx, dx
- painless ulcer (usually on genitalia) = chancre
- painless inguinal lymphadenopathy
- dx non-serologic: dark field microscopy (preferred in primary)
- dx serologic: FTS-ABS (treponemal; confirmation); RPR & VDRL (nontreponemal; screening)
- puerperal
- lochia
- postpartum
- vaginal discharge after giving birth; lasts 4-6 weeks
endometritis px, tx
- fever + uterine tenderness + foul-smelling lochia + leukocytosis
- broad spectrum abx for gram +/-, anaerobes, and aerobes (polymicrobial infection)
In eclampsia, what do you use if 2 doses of magnesium sulfate have not worked to control the seizures?
diazepam or phenytoin
drug of choice for preeclamptic hypertensive emergency?
- labetalol or hydralazine
- methyldopa used for general HTN; slower onset
- ultimately tx with delivery
reasons to do a C-section
- breech presentation
- fetal distress
- maternal hemodynamic instability
- history of c-sections
before performing a pelvic what must you rule out in a pregnant female presenting with vaginal bleeding?
placenta previa
-pelvic exam increases risk of separating the placenta from the uterus
placenta previa tx
- stable mom and baby at term
- stable mom and baby preterm
- scheduled c-section
- expectant management + close monitoring
pathologic vs physiologic vaginal discharge
- pruritus, burning, malodorous, green/ curd-like vaginal discharge, erythema, edema, friable
- copious white/yellow, non-malodorous = physiologic leukorrhea
Amsel Criteria
-need 3 of 4 to diagnose bacterial vaginosis
1) thin, gray-white vaginal discharge
2) pH>4.5
3) positive whiff test upon adding KOH to the vaginal discharge
4) clue cells = vaginal epithelial cells with adherent coccobacilli on wet mount
-tx: metronidazole
preeclampsia-eclampsia syndrome pathophysiology
abnormal placental vasculature development –> endothelial cell dysfunction or vasospasm
-delivery is the only definitive tx
metronidazole + alcohol intake –>
disulfiram-like reaction
-acetaldehyde accumulates in the blood stream –> flushing, n/v, hypotension
HELLP syndrome pathophysiology
abnormal placentation –>
systemic inflammation & activation of coagulation system –>
circulating plts are consumed & microangiopathic hemolytic anemia –>
hepatocellular necrosis –>
elevated liver enzymes, liver swelling, dissension of hepatic/Glisson’s capsule –> RUQ pain
when do you screen for GBS?
35-37 weeks
indications to tx for GBS with penicillin?
- GBS(+) swab
- hx of GBS bacteruria/ UTI
- prior birth to GBS(+) infant
- unknown GBS + maternal fever/ prolonged rupture of membranes/ <37 weeks
ovarian vs adnexal torsion
- which side is more common?
- causes?
twisting of the ovary vs ovary+Fallopian tube over the suspensory ligament of the ovary & utero-ovarian ligament
- more common on the right side
- ovarian enlargement (mass, tumor, pregnancy, infertility tx)
what is midcycle pain called? what causes it?
- mittleschmerz
- caused by ovulation
ovarian hyperstimulation syndrome
iatrogenic complication of ovulation-inducing drugs –> pain due to ovarian enlargement
+/- ascites, dyspnea, other systemic findings
cause of urge incontinence?
cause of stress incontinence?
- detrusor hyperactivity
- pelvic floor muscle weakness –> ineffective urethral sphincter control
ABO vs Rh incompatibility
- when it occurs
- what causes it
- what blood type moms it occurs in
- level of hemolytic disease of the newborn
- 1st vs 2nd pregnancy
- A&B antigens in food/environment vs Rh antigen from 1st pregnancy
- Group O vs Rh(-) moms
- low vs high
risk factors for placental abruption
- maternal HTN
- smoking
- cocaine use
marker for ovulatory reserve?
inhibin A
-decreases in older women
periods of amenorrhea indicate unopposed _______
estrogen
endometrial biopsy indications
abnormal bleeding +
- postmenopausal women/ 45+
- <45 with persistent sx
- unopposed estrogen exposure (obesity, PCOS)
- prolonged amenorrhea with anovulation
