MS3 > OBGYN 8 > Flashcards

OBGYN 8 Flashcards

(51 cards)

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1
Q

Tx of chorioamnionitis

A

♣ Broad spectrum IV antibiotics (e.g. ampicillin, gentamicin, clindamycin)
♣ Induction of labor

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2
Q

What are contraindications to using Indomethacin to stop preterm labor

A

3rd trimester (closure of ductus arteriosus)

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3
Q

What are contraindications to using Nifedipine to stope preterm labor

A

Hypotension

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4
Q

What are contraindications to using Mag to stop preterm labor

A

Myasthenia gravis

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5
Q

What are contraindications to using terbutaline to stop preterm labor

A

Terb is NOT used to stop preterm labor because it is ineffective and dangerous if used for long periods of time

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6
Q

Contraindications to using beta agonists (Terb and Ritodrine) as tocolytics

A

arrhythmia, HTN, seizure disorder, diabetes

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7
Q

Describe the results of amniocentesis in chorioamniotiis

A
  • Elevated IL-6
  • Low amniotic fluid glucose
  • Presence of leukocytes has low predictive value
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8
Q

When do you give steroids in PPROm

A

< 34 weeks

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9
Q

When do you give mag in PPROM

A

< 32 weeks

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10
Q

When do you augment delivery in PPROM

A

> 34 weeks

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11
Q

Adverse effects of oxytocin

A
  • Hyponatremia (Oxytocin is produced by posterior pituitary and can act similar to antidiuretic hormone)
  • Hypotension
  • Tachysystole
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12
Q

Management of woman with history of genital HSV

A

Prophylactic acyclovir or valacyclovir beginning at 36 weeks to reduce risk of outbreak during delivery

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13
Q

What are the severe features of preeclampsia

A 
♣	Thrombocytopenia (platelets <100,000)
♣	Impaired LFTs (2x normal)
♣	Renal insufficiency (Cr > 1.1)
♣	Pulmonary edema
♣	New onset cerebral disturbance, or visual impairment
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14
Q

Meds to treat severe HTN in pregnancy

A
  • Labetalol IV (do not give if bradycardic)
  • Hydralazine IV
  • Nifedipine PO
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15
Q

Diagnostic test for endometriosis

A

Laparoscopy - allows for direct visualiztaion, biopsy, and removal of endometriotic lesions

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16
Q

Common complication of endometriosis

A

Infertility - Cyclic accumulation of ectopic foci of hemorrhage and adhesions can distort pelvic anatomy and impair fertility by obstructing oocyte release or sperm entry

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17
Q

Management of spontaneous abortion without expulsion of fetal parts

A
  • Expectant or medical induction (misoprostol) if hemodynamically stable
  • Suction curettage is infection or hemodynamically unstable
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18
Q

Tx of lichen sclerosis

A

Topical steroids

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19
Q

What medication induces ovulation

A

Clomiphine

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20
Q

Tx of CAH

A

Replacement of cortisol and aldosterone

Recall that disease is caused due to defective enzyme preventing creation of cortisol/aldosterone, which leads to positive feedback to bump up the adrenal gland and all excess activity gets shunted to androgen production

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21
Q

Tx of hot flashes

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A

SSRI (Venlofaxine)

22
Q

Tx of osteoporosis after menopause

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A

Bisphosphonates

Vitamin D + Calcium supplements as prophylaxis

23
Q

What type of drug is Hemabate (category + MOA)

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A

Prostaglandin F2-alpha

Stimulates myometrial contraction via smooth muscle constriction

24
Q

Contraindication for Hemabate

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A

Asthma - also causes bronchoconstriction

25
What is a B-lynch suture
Compression suture used to manually compress an atonic uterus in the setting of postpartum hemorrhage
26
Empiric tx of postpartum endometritis
Ampicillin + Gentamycin + Clindamycin for anaerobes if delivery was C-section
27
Tx of septic pelvic thrombophlebitis
♣ Anticoagulation | ♣ Broad-spectrum antibiotics
28
How do you differentiate postpartum blues from depression
Blues usually resolve within 10 days Depression lasts at least 2 weeks
29
What complications are associated with postterm pregnancy
- Macrosomia - Oligohydramnios - Meconium aspiration - Uteroplacental insufficiency - Dysmaturity
30
Management of diagnosed IUGR
Once- or twice-weekly NST + BPP
31
On a microscopic level, what is happening that leads to cervical change
Breakage of disulfide bonds
32
What is the most common cause of unilateral bloody nipple discharge with no associated mass
Intraductal papilloma
33
Management of intraductal papilloma
Is a benign lesion Work up = mammography US Biopsy +/- excision
34
Describe presentation of Erb Duchenne palsy
* Extended elbow * Pronated forearm * Flexed wrist and fingers
35
Describe what nerves are damaged and presentation of Klumpke palsy
* “Claw hand” * Extended wrist * Hyperextended MCP joing * Flexed interphalangeal joints * Horner syndrome (ptosis, miosis)
36
Describe Moro reflex in Erb Duchenne vs. Klumpke palsy
``` Erb = decreased Moro Klumpke = intact moro ``` THINK: Erb is more a damage to proximal (shoulder/upper arm) vs Klumpke is distal (hand)
37
Describe grasp reflex in Erb vs. Klumpke palsy
``` Erb = intact grasp Klumpke = absent grasp ``` THINK: Erb is more a damage to proximal vs. Klumpke which is distal
38
What does symmetric vs. asymmetric fetal growth restriction refer to
Symmetric = global; proportionate growth lag between head and abd Asymmetric = usually more restriction to abd than to head ("head-sparing" growth lag)
39
Causes of symmetric IUGR
- Chromosomal abnormalities (more common) | - Congenital infection
40
Causes of asymmetric IUGR
- Uteroplacental insufficiency | - Maternal malnutrition
41
What are the two levels that are both the same (either decreased or increased) in Trisomy 21 and 18
AFP and estriol Are both decreased
42
Are b-hCG and Inhibin A increased or decreased in Downs
Increased (THINK Down is up)
43
Are b-hCG and Inhibin A increased or decreased in Trisomy 18
Decreased b-hCG | Normal Inhibin A
44
MOA of Clomiphene
Selective estrogen modulator
45
Management of pregnant woman with HSIL (high grade squamous intraepithelial lesion) on pap smear
Colposcopy (safe in pregnancy) If positive for invasive cancer, proceed with surgical excision
46
Management of stable vs. unstable ectopic pregancy
``` Stable = methotrexate Unstable = surgery ``` D&C can be used to remove uterine contents for spontaneous or incomplete abortion. Not for ectopic
47
Biggest risk factor for adenocarcinoma of the vagina
DES exposure in utero
48
Diagnose: US showing adnexal mass with lack of doppler flow
Ovarian torsion
49
Tx of ovarian torsion
Surgical
50
How can endometriosis lead to infertility
Pelvic adhesions
51
How does menopause affect urinary function
Can lead to incontinence and UTI because hypoestrogenemia results in atrophy of superficial and intermediate layers of urethral mucosal epithelium
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