World OB Flashcards
Granulosa cell tumor s/s
estrogen producing
- breast tenderness, post- menopausal bleeding, precoucious puberty
- ↑ estrogen –> endometrium hyperplasia–> carcinoma
what is a risk of LEEP
cervical stenosis–> ↓ fertility and pre-term labor
When is symmetric fetal growth restriction seen
early prego problems: infection, chromosomes, genetics, etc
When is asymmetric fetal growth restriction seen
maternal vascular disease
What must you avoid while taking metronidazole
Alcohol+ metro= di-sulfrum reaction
OCPs protect for
benign breast disease
ovarian and endometrial cancer
What is step 1 when you suspect lichen sclerosis
punch biopsy, need to rule out squamous cell cancer
What are the symptoms of uterine rupture
recession of baby during labor (going from + 1–> -3)
severe sudden ab pain
fetal heart rate abnormal
pregos with herpes should do what
prophylactic anti-viral at 36 weeks
Neonatal thyrotoxicosis
maternal graves anti-TSH AB crosses the placenta
*levothyroxine does not cross the placenta
Neonatal thyrotoxicosis Rx
Methimazole and B blocker
usually will self resolve
Most common side effect of tamoxifen
Hot flash
Tamoxifen dangers
endometrial cancer
venous thromboembolism
Endometriosis Rx
NSAIDs
OCPs
Progesterone IUD
Asymptomatic= no treatment
When would a baby need to NOT breastfeed
galactosemia
What does lithium do to babies and when
Ebstein congenital heart abnormality (big LA w/ VSD)
Can a woman use asthma meds in prego
YES! albuterol and steroid inhalers are fine
Is mom/baby ABO incompatibility a problem
sorta, but not really. Might get jaundice.
Rh is a big deal.
Accurate prolactin levels are best obtained
in the fasting state. If still elevated, then a TSH level and brain MRI would be indicated to rule out a pituitary tumor.
Post partum women may continue to produce milk for up to ?
two years after cessation of breastfeeding.
A ___________ is usually indicated in patients who have bloody discharge from a single breast duct.
ductogram
HPV vaccine is recommended for
all girls 9-26
regardless of HPV status and sexual activity
Prognosis of ERB Duchenne palsy
C5, C6 (~C7) damage
80% resolve in 3 months
surgery if no improvement by 6 months.
What contraception cant be used in breast cancer
All hormonal methods
Copper IUD would be a GOOD choice
One reason you would not do a contraction stress test
Reasons labor itself would be bad
IE Previa
What is a good fetal nonstress test
> 2 accelerations
Fetal HR monitor for 20-40 minutes
What is a biophysical profile
Amniotic fluid index
Fetal breathing, movement, and tone
8-10 points is normal
What next after non reactive fetal non-stress test
BPP or CST
What do you do for a very abnormal fetal BPP
ex: 0/10– 4/10
Immediate delivery- fetal hypoxia due to placenta dysfx
What is the presenting s/s of intraductal papilloma
unilateral bloody nipple discharge
benign condition
When would you do a LEEP on a prego lady
colopscopy indicates invasive cancer
Risk factors for uterine atony include
most common cause of postpartum hemorrhage
precipitous labor multiparity general anesthesia oxytocin use in labor prolonged labor, macrosomia hydramnios twins chorioamnionitis.
Can you use sulfonylurea in prego?
no, crosses placenta
How can you determine the anti-D dose in high risk exposure moms
Kleihauer betke test
Looks at blood on slide, gets ratio of mom to baby blood–> determines dose
Trastuzumab treats?
HER2 breast cancer
Trastuzumab s/e
cardiotoxic. Get an ECHO first
Can you give Hep A and B vaccine to pregos
yes- and you should if they didn’t before
How do you treat syphilis in prego
penicillin
IT DOES NOT MATTER IF YOU ARE ALLERGIC
Get ova that sh!t
What should make you think a baby is dystocia
turtle sign- head retracts to perineum
Fetal growth restriction is a risk factor for
polycythemia
lymph obstruction of fetal neck
cystic hygroma
Diagnostic criteria for premature ovarian failure
3 months with menopausal FSH and no periods
What hormone stimulates resp alk in prego
progesterone acts on resp drive
↑ TV, minute ventilation, PaO2–> compensated chronic resp alk
