Women's Health Flashcards
Kleinhauer-Betke Test
Shows how many fetal RBC are in mom’s circulation
Most common type of Endometrial neoplams
*Adenocarcinoma in endometrial lining
Sarcoma are in the muscle layer
Where is the most common site for edometriosis tissue to implant
Peritoneal
Leiomyomata locations - where is each
- Subserosal
- Submucosal
- Intramural
AKA fibroids
- under outer lining of uterus by bladder, colon, GI
- under inner lining- can cause prolapse
- between the two layers
Name the 3 types of Cyst
and their normal sizes
- Follicular <2.5
- Corpus Luteum <3
- Thecal - bilateral
What size cyst is going to torsion
> 5cm
What are the most common cancers associated with Epithelial Neoplasm
- BRCA mutation
- Lynch Syndrome
- Hereditary Nonpolposis colorectal cancer
Germ cell neoplasms will have what tumor markers increased ?
Any of theses will be in the test question an elevation in: Alpha-fetoprotein Beta-HCG LDH Alkaline Phosphatase
At what age is the HPV vaccine given
Girls 9-26
Boys 9-18
Treatment for Neisseria gonorrhea
Ceftriaxone IM
Treatment for Chlamydia trachomatis
Doxycycline + Azithromycin
Treatment for HSV
Acyclovir or Valacyclovir
Treatment for HPV
Depends on the stage
LEEP
Treatment for Trichomonas
Metronidazole
Treatment for Candida
Fluconazole
What is primary Amenorrhea
No period by Age 14 with boobs
No period by Age 13 without boobs
What is secondary Amenorrhea
Started period normally then stopped periods for 6 months -ovarian failure -pregnancy -Fragile x -PCOS -Asherman syndrome- after a DC
What is the average age for menopause
51
How long can perimenopause last
3-5 years of irregular menopause
What is premature menopause
No menses before age 40
What is the main hormones in menopause
*Estrone
Testosterone
Androstenedione
What is the definitive diagnosis of menopause
FSH >30mIU/ML
Most common organism in mastitis
Staph Aureus
symptoms of Fibroadenoma
round, firm, smooth, mobile, non-tender
Key terms for this diagnosis- Nipple lesions that is sclaey, red
Paget disease - ductal carcinoma of the nipple
where is the most common location for breast cancer
Ductal 80%
Lobular 20%
Treatment for ER postitive breast cancer
Tamoxifen
What medication could cause Glactorrhea
Spironolactone
what is the goal of OCP
inhibit ovulation
What is the windown of Emergency Contraception
3-5 days
What is the first line treatment for Infertility
Clomiphene citrate - clomid
What is Naegele rule
Estimated date of confinement aka due date
Take the first day of the last menstral period
subtract 3 months
add 7 days
What is the first trimester genetic screen option
Pregnancy associated plasma protein A - PAPPA
Low PAPPA and high HCG = Trisomy 18 or 21
at how many weeks can a nuchal translucency screen be done?
12 weeks
low estriol
low AFP
High inhibin
what would these lab values mean in pregnancy?
increase risk for genetic disorders
What is the next step if the nuchal translucency screen
is postitive
chorionic villi sampling - CVA or amniocentesis
Fetal heart rate - what is normal
2 accelerations in 20 mins
up to 15bpm from baseline
NO decelerations
How far does dilation go to
10cm
what is effacement
thining of cervix
what is station
where baby is to the ischeal spine
0- at the spine
if its below its +1 , +2
What is the first stage of labor
bloddy show , mucous plug contractions that are regular 10 cm cervix usually 6-20 hours first 2-14 second kid
What is the second stage of labor
10 cm dilated –> baby is delivered
last 30min-3 hours
What is the Third stage of labor
Delivering placenta
lasts 0-30mins
What is the fourth stage of labor
the hour after delivery
treating lacerations, tears, hemorrhages
what is the external fetal monitoring called
Tocodynamometer
What is the worst thing to see on fetal monitoring
late decelerations are bad
uteroplacental insufficiency with lack of blood flow to infant
what do you do if you are concerned about Fetal heart tones
lay mom on her left side
oxygen
stop oxytocin !!!
What is the APGAR score
Appearance Pulse Grimace Activity Respiration score 0, 1, 2
What does the placenta cord contain
3 vessels
2 artries
1 vein
what does oxytocin or potocin do?
Increases contraction strenghts
what is the definition of post-partum hemorrhage
10% drop in Hematocrit %
>500ml blood loss from vaginal birth
1000ml blood loss from c-section
What are reasons for Early postpartum hemorrhage
<24 hours after delivery
laceration
retained products of conception
abnormal involution- didn’t go back to normal position
What are reasons for Late postpartum hemorrhage
Retained POC
endometritis
How long can Lochia last ?
normal vaginal bleeding after baby
up to 6 weeks
what are clues tot ectopic pregnancy
HCG lower than normal
What is the Discrimiatory Zone
Used for ectopic pregnancies
If the BHCG is >1500 you should see a little baby on US
Treatment for Ectopic pregnancy
Early- Methotrexate
Folic acid antagonist - kills the embryo
Later- surgery
What are 3 types of Gestational Trophblastic Diseases
Hydatidiform mole
Trophoblastic tumor
Choriocarcinoma
Key terms for this diagnosis- Grape like or snowstrom on ultrasound abnormal bleeding uterine size is bigger than dates Hyperemesis Gravidarum HCG levels higher than normal 20% go onto malignancy
Hydatidiform mole
What is the most common type of Gestational Trophblastic Disease
Hydatidiform mole
What is the most common type of Multiple Gestation
Fraternal - Dizygotic
two eggs fertilized by two sperm
Diagnosis for <20 weeks with HTN
Chronic hypertension
she probably had HTN before getting pregnant
Treatment for Hypertension in <20 weeks Pregnancy
negtaive for protein
Methyldopa
Labatol
Key terms for this diagnosis
Edema +/-, protein in urine, blood pressuer >140/90
but less than 160/110
mild Preeclampsia
Severe 160-180
What is HELLP syndrome
Severe Precclampisa- BP 160-180
Protein in urine
Edema +/-
Hemolysis
Elevated Liver enzymes
Low Platelets
Treatment for PreEclampisa
Hydralazine OR Labetalol
Magnesium sulfate IV to prevent seizure
ultimate treatment is delivery !!!!
Can happen up to 6 weeks after delivery !!!!
What is Eclampsia
Preeclampsia + seizure
when is Rhogam given
28-29 weeks
At any time there could be bleed or trauma
+ another dose if baby is RH +
what is the most common cause of painful bleeding in the 3rd trimester
Abruptio Placentae
Treatment for Abruptio Placentae
large = C-section small = follow
what is the most common cause of painless bleeding in the 3rd trimester
Placental Previa
what is the most important thing to remember for Placental Previa
No pelvic exam
Treatment for Placental Previa
C - section if complete
Vaginal bleeding and the Os is closed
Threatened Abortion
Vaginal bleeding and the OS is open
Inevitable Abortion
Vaginal bleeding and the Os is open the US shows incomplete expulsion of POC
Incomplete
Treatment for Incomplete or Missed abortion
D & C
What weeks is the quad screen done?
15-22 weeks
at how many weeks can an amniocentesis be done?
15-18 weeks
Treatment for Pregnant patient with UTI
Nirtrofuratoin
what happens in the luteal phase?
decrease in estrdiol and increase in progestrone
what are days 1-23 & 13-17 of the menstration cycle
Days 1-13 follicular phase
Days 13-17 Ovulatory phase
How many mL are lost during menstration
80mL
what is the best treatment for DVT in pregnancy
Levonox
what genetic disorder is Hunington disease
Autosomal Dominant
In the first trimester what is the most accurate way to measure baby EGA
Crown - to -rump
In the second-Third trimester what is the most accurate way to measure baby EGA
Use a combo
Femur lenght *
abdominal
Head circumference
what hormone level causes the basal tempature to rise during mentration
progesterone
