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41 Cards in this Set
- Front
- Back
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How do you measure cervical dilation?
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Measured in centimeters:
0 cm is not open at all (walls are touching) 10 cm is completely thinned out (about 5 finger widths) |
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How do you measure cervical effacement?
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Measured in %
0% is not thinned at all (about 2 cm thick) 100% is completely thinned out If the cervix is half of its original thickness it is 50% effaced If the cervix is ¼ of its original thickness it is 75% effaced |
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What unique quality do uterine muscle cells have?
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Retraction: After a contraction the muscle fibers retain some of the shortening of the contraction instead of becoming completely relaxed
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What two processes help push the baby’s head towards the outlet
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Retraction
Uterine contractions starting in the fundus and spreading throughout the uterus |
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What is the rate of cervical dilation (in the active phase) in primiparous and multiparous women?
Friedman Curve |
primiparous: 1.2 cm/hr
multiparous: 1.5 cm/hr |
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When does the active phase begin?
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when the uterus is regularly contracting and the cervix is 3-4 cm dilated.
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What are the 4 stages of labor?
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1.Onset of labor to complete dilation of the cervix
2.Cervical dilation to birth 3.Birth to delivery of the placenta 4.Placenta delivery to stability of the mother |
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What subtypes of HPV are associated with cervical cancer?
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HPV types 16, 18, and 31
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What is the normal pH of the vagina?
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3.8 to 4.4. (A pH > 4.9 indicates a bacterial or protozoal infection)
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What is the MC symptom for patients with cervical cancer?
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vaginal bleeding 80%
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postmenopausal vaginal bleeding is most likely?
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Atrophic Vaginitis
Endometrial cancer |
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Describe the initial office evaluation of a woman whose history is suspicious for endometrial cancer?
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Pelvic examination
PAP smear biopsy of any abnormal cervical or vaginal lesion endometrial biopsy |
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What is the MC condition assoc with the development of endometrial hyperplasia?
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Polycystic ovary syndrome
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What are the risk factors for carcinoma of the cervix?
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1) Multiple sexual partners
2) Early age at first intercourse 3) Early first pregnancy |
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What is the treatment for stage lA or IB ovarian cancer?
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Surgical excision alone (hysterectomy and bilateral salpingo-oopherectomy).
for all other stages of ovarian cancers, surgical resection followed by adjuvant chemotherapy or radiation. |
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What marker is associated with ovarian cancer?
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CA-125
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What is the leading cause of death from reproductive tract cancer in women?
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ovarian cancer
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What are the risk factors of endometrial CA
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Obese
Nulliparity Early menarchy Anovulation Late menopause DM F/Hist HTN Estrogen w/out progest |
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After pap smear what are the next steps in eval possible endometrial CA?
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Biopsy
Hysteroscopy Exploratory laparoscopy |
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What is the order of staging procedures?
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1. Total hysterectomy
2. Omentectomy 3. Lymph nodes 4. Peritoneal sampling |
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What is the MCC of post-menopausal bleed?
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Atrophic vaginitis
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If pap smear is normal in suspect CA, what do you do?
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Continue with the biopsy
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What are the risk factors for Cervical CA
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MLS HHS
Multiparity Low social status Smoking HPV (16&18) HIV STDs |
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What is the MC tumor in women >30 and childbearing age?
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Dermoid cyst
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What tumor can present with symptoms of hyperthyroidism?
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Dermoid cyst
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In a primip, where should the fetal head should be at term
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engaged
multipara may not engage until active labor |
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How do you know the baby is engaged?
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when the mother says:
she can breathe easier her heartburn is better The baby’s pushing on her bladder and she has to urinate all the time Her feet are swollen if she stands up too long Her fundal height has dropped |
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What are the different presentations?
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Cephalic
Breech Shoulder head (vertex) brow or chin (mentum) butt (sacrum) |
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Which transverse diameter presents when the head is well flexed? (Vertex presents)
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Suboccipito bregmatic (9.5 cm)
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Which transverse diameter presents when head is completely extended (face presents)
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Submento bregmatic (9.5 cm)
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Which transverse diameter presents when the head is halfway extended (brow presents)
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Vertico mental (13.5 cm)
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Which transverse diameter presents when the head is “military” (not flexed or extended)
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Occipito frontal (11 cm)
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What are the different types of breech presentation? (occurs in 3 - 4% of full-term pregnancies, more frequent in preterm)
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frank breech
footling breech complete breech |
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what is the least complicated breech?
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Frank
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How do you determine the obstetrical conjugate?
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obstetrical conjugate = 12.5 cm – 1.5 to 2 cm depending on pelvic type
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When is the baby engaged?
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When the baby’s biparietal diameter passes through the obstetrical conjugate
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Which type of pelvis is not suited for childbirth - (deep transverse arrest )
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Android (20% of women)
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MC presenting complaint of vulvar cancer?
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vulvar pruritus
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How do you treat an adnexal mass in a prepubertal pt
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>2cm = Operate
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How do you treat an adnexal mass in a reproductive age pt
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<5cm = Observe
5-8cm = Do sonogram, if solid components then operate, otherwise observe for 1 month >8cm = operate |
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How do you treat an adnexal mass in a menopausal pt
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>4-5cm = operate
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