Week 4 Uworld Flashcards
what is coccydynia?
tail bone pain at coccyx that is worse with sitting
when does coccydynia get worse?
with sitting
what is an OB cause of coccydynia?
vaginal assisted delivery
what is rx for coccydynia?
analgesics
what is rash associated with maternal toxoplasmosis?
non pruritic diffuse maculopapular rash
in preterm labor when do you stop giving tocolytics?
34 weeks
what sx of dysmenorrhea are concerning for a secondary cause?
unilateral pain, minimal constitutional symptoms, symptoms start past 25 yo
what are symptoms of acute hemolytic transfusion reaction?
hemoglobinuria, flank pain, fever chiils and hypotension
what is test for acute hemolytic transfusion reaction?
direct coombs test
what are two complications of acute hemolytic transfusion reaction?
DIC and renal failure
what type of pain can occur with imperforate hymen?
low back pain, pelvic pressure and defecatory pain
what is postpartum management of baby from HIV+ mom with viral load less than 1000?
zidovudine
what is postpartum management of baby from HIV+ mom with viral load more than 1000?
combo ART
what are indications for HIGH risk STI qualifications in pregnancy?
age less than 25, prior STI multiple partners, sex worker,
what testing is done at initial prenatal visit in high risk STI patients?
RPR, chlamydia, gonorrhea, Hep B and HIV
what testing is done at 3rd trimester prenatal visit in high risk STI patients?
RPR, chlamydia, gonorrhea, Hep B and HIV
anyone that is high risk for STIs in pregnancy gets testing when?
1st prenatal visit and 3rd trimester
aside from obstetric trauma and pelvic surgery, what are four other risk factors for rectovaginal trauma?
crohns, diverticulitis, colon cancer, pelvic radiation
how does a rectovaginal fistula appear in vagina?
dark red velvety lesion
patient has cyclic breast pain and exam totally normal, what should be done/
NSAIDs and supportive bra
patient has cyclic breast pain and exam finds a mass, what should be done?
imaging
what is a common symptom of type 2 perineal tear?
pain with urination
what bug can be found on pap smear and is not very specific?
actinomyces
why is actinomyces found in women?
often part of the GI/GU flora
what is a risk for actinomyces infection in upper GU area?
IUDs
what can actinomyces cause in GU tracts?
pelvic inflammatory disease
if patient has actinomyces on pap testing and is asymptomatic what do you do?
nothing…unlikely she has PID
if patient has actinomyces on pap testing and is symptomatic what do you do?
remove IUD and treat with penicillin
how does uterus feel on examination of abruptio placentae?
rigid and diffusely tender uterus
3 teratogenic anti epileptics
carbamazapine, phenytoin and valproate
teratogenic anti epileptics can cause what issues in fetuses?
fetal hydantoin syndrome
what is fetal hydantoin syndrome?
after exposure to anti epileptic fetus has cleft lip and palate, wide anterior fontanelle, distal phalange hypoplasia and cardiac anomalies
what are the signs of fetal hydantoin syndrome?
cleft lip and palate
wide anterior fontanelle
distal phalange hypoplasia
cardiac anomalies
an abdominal mass that increases with valsava maneuver is concerning for what?
incisional hernia
when do incisional hernias usually present
/
can be months to years post op
what type of incision increases risk for incisional hernias?
vertical or midline
what are symptoms of incisional hernia?
usually asymptomatic actually `
ABO disease of newborn is what severity level?
usually pretty mild
what is cause of hemolytic disease of newborn?
ABO incompatibility…O mom
what are symptoms of hemolytic disease of newborn
jaundice only minimal though
2 concerning signs for sepsis in a neonate?
respiratory distress and poor peripheral perfusion
what should be screened for at post partum visit that is social issue?
intimate partner violence
what effect does indomethacin have on fetus?
decrease prostaglandin so leads to vasoconstriction
what does indomethacin cause in fetus if vasoconstriction bad?
can lead to oligohydramnios from constriction of renal artery
three drugs that can cause minimal variability on a Fetal heart tracing?
opioids, alcohol, illicit drugs
with persistent pyelonephritis what can happen to the kidney?
renal abscess
what is a risk factor for renal abscesses?
pregnancy
what is rx for renal abscess in pregnancy?
kidney ultrasound then broad spectrum abx
if baby is not latching well and is using improper technique, what symptoms can mom experience?
nipple pain even between feedings and breast engorgement
what can happen to the skin with improper latching technique in breastfeeding?
linear abrasions,,bloody
what does in utero DES exposure increase womens risk for?
clear cell adenocarcinoma of vagina
what two meds should be used in severe preeclampsia acutely?
hydralazine or labetalol
what is a rare complication of ovulation stimulation with hCG?
ovulation hyperstimulation syndrome
what are the symptoms of ovulation hyperstimulation syndrome?
ascites, hemoconcentration, DIC and multiorgan failure
nausea and vomiting
when does ovulation hyperstimulation syndrome onset?
1-2 weeks after stimulation
what tests should be done if you see atypical glandular cells on pap smear?
endo biopsy, colposcopy, and endocervical curettage
define uterine tachysystole
more than 5 contractions in 10 minutes
what type of bladder pain is common in interstitial cystitis?
pain with filling that is relieved with voiding
is dysuria common in interstitial cystitis?
no
what is rx for interstitial cystitis?
amitryptiline
why do girls right after menarche often not have consistent bleeding?
lack of GnRH and minimal progesterone so endometrium doesnt slough off
what can you give to determine if no gnrh is reason for abnormal bleeding in menarchal female?
progesterone `
3 causes of stress urinary incontinence in women
obesity, multiparity and exercise
when does post partum psychosis generally onset?
usually 1-2 weeks post partum
prenatal US signs of placenta accreta?
multiple lacunae and thin myometrium
severe hyperemesis gravidum can lead to what other disorder?
thiamine deficieny
what are the features of thiamine deficiency?
occulomotor changes, gait ataxia, and encephalopathy
what is rx for patient with chorioamnionitis and PPROM?
immediate delivery and abx
aside from hyst what is an rx option for fibroid?
uterine artery embolization
what sx do patients have after uterine artery embolization? why
pelvic pain from fibroid necrosis
what is a physical exam sign of endometriosis?
cervical motion tenderness and lateral cervical displacement
4 infections that are contraindications to breast feeding
TB HIV, varicella and breast herpes
what are symptoms of choriocarcinoma?
vaginal bleeding, enlarged uterus and pelvic pain
when can choriocarcinoma occur?
molar pregnancy, regular pregnancy and abortion
where does choriocarcinoma spread?
lung and vagina
what test can you do to confirm choriocarcinoma?
hcg
what point post delivery does symptoms from chroiocarcinoma ccour?
6 months
if pregnant patient has risk factors for gestational diabetes when do you screen?
at 1st visit
what is rx for MVP in pregnancy?
beta blockers
pregnant patient with myasthenia gravis has preeclampsia with severe features, what can you not give her?
Mg sulfate
pregnant patient with myasthenia gravis has preeclampsia with severe features, what can you not give her? what can you give instead?
mg sulfate…give valproic acid
what two places can lichen planus effect
mouth and vagina
who gets lichen planus?
women age 50-60
what do lichen planus lesions look like?
erosive lesions with white border
how do you diagnose lichen planus?
biopsy
how do you treat lichen planus?
strong topical steroids
four characteristics of hydatiform mole that mom can experience
theca lutein cyst
uterine larger than expected
abnormal bleeding
high HCG
three emergency contraception options
ulipristal
levonogestrel
copper IUD
what is management of vasa previa?
usually admitted in week 34-35 and c sxned
what are signs of vasa previa?
ROM with blood following fluid
what are the symptoms of pubic symphysis diastasis?
suprapubic pain that radiates to the back and legs
what makes pubic symphysis diastasis worse?
walking!
two complications of inadequate maternal weight gain in pregnancy
preterm birth and low birth weight
what hormone causes slowed emptying of gallbladder in pregnancy?
progesterone
what hormone causes increased bile in pregnancy?
increased estrogen
what is the main symptom of cholelithiasis in pregnancy?
intermittent RUQ pain
how do you dx cholelithiasis in pregnancy?
US
