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Ob/Gyn > Uworld Ob/Gyn > Flashcards

Uworld Ob/Gyn Flashcards

1
Q

primary syphilis sx, dx

A
  • 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)
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2
Q
  • puerperal

- lochia

A
  • postpartum

- vaginal discharge after giving birth; lasts 4-6 weeks

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3
Q

endometritis px, tx

A
  • fever + uterine tenderness + foul-smelling lochia + leukocytosis
  • broad spectrum abx for gram +/-, anaerobes, and aerobes (polymicrobial infection)
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4
Q

In eclampsia, what do you use if 2 doses of magnesium sulfate have not worked to control the seizures?

A

diazepam or phenytoin

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5
Q

drug of choice for preeclamptic hypertensive emergency?

A
  • labetalol or hydralazine
  • methyldopa used for general HTN; slower onset
  • ultimately tx with delivery
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6
Q

reasons to do a C-section

A
  • breech presentation
  • fetal distress
  • maternal hemodynamic instability
  • history of c-sections
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7
Q

before performing a pelvic what must you rule out in a pregnant female presenting with vaginal bleeding?

A

placenta previa

-pelvic exam increases risk of separating the placenta from the uterus

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8
Q

placenta previa tx

  • stable mom and baby at term
  • stable mom and baby preterm
A
  • scheduled c-section

- expectant management + close monitoring

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9
Q

pathologic vs physiologic vaginal discharge

A
  • pruritus, burning, malodorous, green/ curd-like vaginal discharge, erythema, edema, friable
  • copious white/yellow, non-malodorous = physiologic leukorrhea
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10
Q

Amsel Criteria

A

-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

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11
Q

preeclampsia-eclampsia syndrome pathophysiology

A

abnormal placental vasculature development –> endothelial cell dysfunction or vasospasm

-delivery is the only definitive tx

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12
Q

metronidazole + alcohol intake –>

A

disulfiram-like reaction

-acetaldehyde accumulates in the blood stream –> flushing, n/v, hypotension

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13
Q

HELLP syndrome pathophysiology

A

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

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14
Q

when do you screen for GBS?

A

35-37 weeks

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15
Q

indications to tx for GBS with penicillin?

A
  • GBS(+) swab
  • hx of GBS bacteruria/ UTI
  • prior birth to GBS(+) infant
  • unknown GBS + maternal fever/ prolonged rupture of membranes/ <37 weeks
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16
Q

ovarian vs adnexal torsion

  • which side is more common?
  • causes?
A

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)
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17
Q

what is midcycle pain called? what causes it?

A
  • mittleschmerz

- caused by ovulation

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18
Q

ovarian hyperstimulation syndrome

A

iatrogenic complication of ovulation-inducing drugs –> pain due to ovarian enlargement

+/- ascites, dyspnea, other systemic findings

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19
Q

cause of urge incontinence?

cause of stress incontinence?

A
  • detrusor hyperactivity

- pelvic floor muscle weakness –> ineffective urethral sphincter control

20
Q

ABO vs Rh incompatibility

  • when it occurs
  • what causes it
  • what blood type moms it occurs in
  • level of hemolytic disease of the newborn
A
  • 1st vs 2nd pregnancy
  • A&B antigens in food/environment vs Rh antigen from 1st pregnancy
  • Group O vs Rh(-) moms
  • low vs high
21
Q

risk factors for placental abruption

A
  • maternal HTN
  • smoking
  • cocaine use
22
Q

marker for ovulatory reserve?

A

inhibin A

-decreases in older women

23
Q

periods of amenorrhea indicate unopposed _______

A

estrogen

24
Q

endometrial biopsy indications

A

abnormal bleeding +

  • postmenopausal women/ 45+
  • <45 with persistent sx
  • unopposed estrogen exposure (obesity, PCOS)
  • prolonged amenorrhea with anovulation
25
Q

types of antiphospholipid antibodies?

effects in pregnancy? pathophys?

A

-lupus anticoagulant and anticardiolipin antibodies (in SLE)

  • abortion
  • thrombus development within the placenta
26
Q

adenomyosis vs leiomyomas (uterine fibroids) on exam

A

-symmetrically enlarged, globular, and boggy; constipation, urinary frequency

27
Q

routine vaccines during pregnancy

-special circumstances

A
  • Tdap
  • influenza vaccine (inactivated)

-HBV, HAV, pneumococcus, h flu, meningococcus, Rhogam

28
Q

vaccines to avoid in pregnancy

A
  • HPV
  • MMR
  • varicella
  • smallpox
  • live attenuated flu vaccine

*all are live vaccines

29
Q

when is Rhogam administered?

A
  • 28-32 weeks

- again postpartum if baby is Rh(+) within 72 hours

30
Q

what causes fetal virilization?

A
  • leutoma (high risk; yellow-brown ovarian masses)
  • theca luteum cyst (low risk; bilateral ovarian cysts)
  • Krukenberg tumor (solid ovarian metastases from primary GI tract cancer; high risk)
31
Q

Fetal fibronectin

A
  • measure of preterm labor if found in vagina
  • protein released by fetal cells
  • found in interface b/t chorion and decidua
32
Q

FSH level in Turner syndrome? Why?

A

high because estrogen is not produced by the “streak ovaries” so there is no negative feedback to the pituitary

33
Q

MCC of antepartum hemorrhage?

A
  • placenta previa

- placental abruption

34
Q

can a copper IUD be used as “emergency” postcoital contraception?

A

yes - as long as it is placed within 5 days

35
Q

what is the association between hypothyroidism and hyperprolactinemia?

A
  • low TH –> inc TRH and TSH

- TRH stimulates prolactin production

36
Q

magnesium sulfate toxicity tx?

A

discontinue + calcium gluconate

37
Q

when taking what drug would you monitor cyanide levels?

A

nitroprusside

38
Q

next step after an abnormal NST?

A
  • BPP
  • contraction stress test (CST) –as long as there is no contraindication to labor (previa)

-abnormal NST has a high false-positive rate, thus further testing is needed

39
Q

tx options for intrauterine fetal demise?

after 20 weeks gestation

A
  • watchful waiting for natural delivery

- induction of labor (especially if signs of DIC or chorioamnionitis)

40
Q

gonadectomy after puberty in what disorder?

A

androgen insensitivity syndrome: cryptorchid gonads have a risk of developing dysgerminoma or gonadoblastoma

41
Q

uterine fibroid (leiomyoma) sx

A

local compressive sx:

  • urinary frequency/ retntion
  • constipation
  • pelvic/back pain
42
Q

effects of high exercise regimen

A

-suppression of HPO (hypothalamic-pituitary-ovarian) axis:
low GnRH –> low FSH, LH –> low estrogen, amenorrhea, osteoporosis risk

-will fail progestin challenge test (no withdrawal bleeding)

43
Q

role of HCG in pregnancy?

A

to main the corpus luteum –so that it can continue to produce progesterone before placenta becomes the sole source of progesterone

44
Q

condyloma accuminata definition, cause, px, tx

A

= genital warts

  • cause: HPV
  • px: smooth tear drop appearance; pink or skin color
  • tx: trichloroacetic acid, podophylin, excision, fulguration
45
Q

granulosa cell tumor px

(pre vs postmenopausal), why?

A
  • pre: precocious puberty
  • post: postmenopausal bleeding

-tumor produces excessive amount of estrogen

46
Q

acceptable postpartum contraception? (4)

A
  • tubal ligation
  • IUD
  • progestin-only OCPs
  • condoms

Ob/Gyn (3 decks)

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