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175 Cards in this Set
- Front
- Back
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Any intrauterine bleeding before 20 weeks gestation without dilation or expulsion of products of conception. What type of abortion?
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Threatened abortion
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The symptoms cannot be stopped, and a miscarriage will happen. Products of conception do not exit the body, but dilation of cervix and bleeding are evidence that a viable pregnancy is not possible. What type of abortion?
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Inevitable abortion
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The pregnancy is lost and the products of conception do not exit the body. What type of abortion?
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Missed abortion
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Only some of the products of conception exit the body. What type of abortion?
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Incomplete abortion
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All of the products of conception exit the body. Cervix is dilated. What type of abortion?
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Complete abortion
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The lining of the womb, or uterus, and any remaining products of conception become infected. What type of abortion?
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Septic abortion
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What is the definition for a pregnancy that ends before week 20 of gestation.
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Spontaneous abortion
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T or F All Rh-neg pts should receive RhoGAM with any vaginal bleeding?
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True
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Primary causes of 3rd trimester bleeding?
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Placental abruption
Placenta previa Placenta Accretia Vasa Previa |
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Normal or abnormal? The uterus is palpated above the pubic symphysis at 12 weeks?
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Normal
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Normal or abnormal? During pregnancy, cardiac output increases by 30-50% and heart rate is increased 10-15 bpm?
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Normal
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Normal or abnormal? A new systolic murmur is heard in a pregnant patient?
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Normal
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Normal or abnormal? A new diastolic murmur is heard in a pregnant patient?
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abnormal
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Normal or abnormal? CXR reveals cardiomegaly in a pregnant patient?
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Normal. Not actually cardiomegaly, the heart is displaced by the uterus upward and to the left
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Normal or abnormal? WBC count increases during childbirth to more than 20 million/mL?
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Normal
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What is the term for a patient that has prolonged and heavy mentrual bleeding that occurs at regular intervals?
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MenoMetrorrhagia
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What is the term for excessive and prolonged menses?
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Menorrhagia
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What is the term for intermenstrual bleeding that occurs at any time b/w menstrual periods?
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Metrorrhagia
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What is the term for increase in frequency of menstruation
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Polymenorrhea
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What is the term for scanty menstruation?
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Oligomennorrhea
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a female comes in with acute onset of upper right-quadrant abdominal pain and tenderness aggravated by breathing, coughing or movement. PAin is referred to the right shoulder following an episode of PID. Laparoscopy reveals "Violin String adhesions. Name the syndrome?
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Fitz-Hugh Curtis syndrome
(Acute gonococcal perihepatitis) |
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What drug can be used for premature labor to cause uterine relaxation?
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Terbutaline (B2 agonist)
Magnesium sulfate |
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What should be administered to a patient that has preeclamsia prior to 32 weeks to prevent RDS, Intraventricular hemorrhage, Necrotizing enterocolitis?
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Glucocorticoids
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What are the indications for a women to receive antibiotics during labor? (5 points)
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1. History of group B strep
2. Urine Culture GBS 3. Preteen labor prior to 37 weeks 4. Membrane rupture for more than 18 hours 5. Temperature greater than 100.4 in labor |
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a patient who has had multiple myoectomy is at increased risk for?
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Uterine rupture
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Name an absolute contraindication for IUD use?
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STD
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If a fetus is breech when should a external cephalic version be performed?
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37 weeks
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What drug are given to a pregnant women with a diastolic pressure above 110?
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Hydralazine
Labetalol |
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T or F all postmenopausal women with vaginal itching should undergo biopsy?
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True
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What illegal drug can lead to placenta abruptio?
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Cocaine
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How does aspirin affect:
1. Ductus ateriosus? 2. Labor onset? 3. Labor duration? |
How does aspirin affect:
1. Ductus ateriosus? Constriction 2. Labor onset? Delayed 3. Labor duration? Prolonged |
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What drug causes chondrodysplasia punctata in utero? (Hypoplasia bone, eyeball abnormality, mental retardation)
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Coumadin
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Treatment of choice of chlamydia in a pregnancy?
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Erythromycin
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What is the leading nonobstetric cause of postpartum death?
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Pulmonary embolism
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What is the most common congenital infection?
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CMV
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What stage of labor? The cervix is dilated 6 cm.
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1st, active
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What stage of labor? The cervix is dilated 1 cm
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First, latent
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What are the stages of labor?
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1. First
Latent: Onset of labor to 4 cm dilation Active: 4 cm to complete cervical dilation (10 cm) 2. Second: Complete cervical dilation to delivery of infant 3. Third: Delivery of infant to delivery of placenta |
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Is early deceleration normal? What causes it to happen?
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Early deceleration is normal.
It is caused by uterine contraction |
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What causes Late decelerations?
What position should the mother be placed in to treat decelerations? |
Uteroplacental insufficiency and fetal hypoxia
Placenta Abruptio Preeclampsia HTN Diabetes Left lateral decubitus (Displaces uterus off of inf vena cava increasing venous return therefore increases CO |
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What causes Variable decelerations?
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Umbilical cord compressions
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If morning sickness persists after the first trimester what should one consider for the diagnosis?
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Hyperemesis gravidarum
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If your considering Hyperemesis gravidarum what type of pregnancy do you need to rule out first?
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Molar Pregnancy
R/O with Ultrasound and B-hCG |
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If a patient has hyperglycemia in the first trimester of pregnancy, what type of diabetic should this patient be managed as?
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Pregestational Diabetes
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If a UA demonstrates glycosuria before 20 weeks what would be the diagnosis?
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Pregestational diabetes
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Idiopathic HTN without significant proteinuria develops >20 weeks. What type of HTN is this?
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Gestational HTN
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Why are ACEI and or diuretics contraindicated in pregnancy?
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ACEI & Diuretics: Uterine Ischemia
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Patients close to term or preeclamsia worsens, how do you manage?
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Induce delivery with IV oxytocin, prostaglandin or amniotomy
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Patient with severe preeclampsia, describe the three steps of management?
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1. Control BP
2. Prevent Seizures 3. Deliver by induction or c-section |
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Patient with severe preeclampsia what is the treatment of choice for the HTN?
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Hydralazine and/or labetalol
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What is the target BP for a patient with severe preeclamsia?
What does the diastolic BP need to be maintained at? |
<160/110
DBP maintain 90-100 to maintain fetal blood flow |
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What is the drug of choice to prevent seizures in preeclampsia?
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Magnesium Sulfate
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What toxicity causes Loss of DTRs, Respiratory paralysis, coma?
How do you treat it? |
Magnesium Sulfate
Calcium Gluconate |
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How long should Magnesium Sulfate be continued as a seizure prophylaxis (Magnesium Sulfate) in a patient with severe preeclampsia?
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continue Magnesium Sulfate seizure prophlaxis for 24 hours postpartum
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What is the treatment of choice for severe preeclampsia?
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Delivery or c-section once patient is stable
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Spread of gonococci into the upper abdomen may cause perihepatitis with an audible hepatic rub, Name the syndrome?
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Fitz-Hugh-Curtis syndrome (perihepatitis)
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1. What is the infecting organism of Chancroid?
2. Is a Chancroid painful or painless? |
1. Hemophilus ducreyi
(Chancroid) 2. Painfull |
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Pregnant female with HTN, proteinuria (>300mg/24 h) and edema of face and hands, Name the diagnosis?
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Preeclampsia
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The following risk factors are for the following disease?
African American Nulliparity Multiple gestations Exteme ages (<15 or >35) Chronic HTN Positive famaily History |
Preeclampsia
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Patient with preeclamsia and seizures, what is the diagnosis?
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Eclampsia
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Hemolysis, Elevated Liver enzymes,
Low enzymes, Low Platelets, name the syndrome? |
HELLP Syndrome
Hemolysis, Elevated Liver enzymes, Low enzymes, Low Platelets, name the syndrome? |
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What is HELLP syndrome?
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Hemolysis, Elevated Liver enzymes,
Low enzymes, Low Platelets, name the syndrome? |
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The following are risk factors for what type of pregnancy?
Previous history of PID IUD, DES exposer, Prior pelvic history, and a positive histroy of the disease? |
Ectopic Pregnancy
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Describe the risk factors for Ectopic Pregnancy?
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1. Previous history of PID
2. IUD, 3. DES exposer, 4. Prior pelvic history 5. a positive history of ectopic pregnancy |
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Patient presents with abdominal pain that radiates to the shoulder, vaginal bleeding, cervical motion tenderness, pelvic mass 1-8 weeks after missed period, What is the diagnosis?
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Ectopic pregnancy
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Presence of fixed abdominal tenderness on turning the patient and may be seen in ectopic pregnancy, Name the sign?
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Adler's sign
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Name all the abortions that present with vaginal bleeding and occur less than 20 weeks?
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1. Threatened abortion
2. Incomplete abortion, 3. Complete abortion 4. Inevitable abortion |
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Patient complains of abdominal pain and vaginal bleeding. The membranes remain intact and no products of conception are expelled. Internal cervical os is closed and the fetus is viable, Name the abortion?
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Threatened Abortion
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Which abortion is there abdominal pain and bleeding with the internal cervical os is open and some products of conception are expelled?
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Incomplete Abortion
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Vaginal Bleeding, all products of conception are expelled and the cervical os is closed?
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Complete Abortion
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Membranes are ruptures, the internal cervical os is open and no products of conception are expelled, patient complain of abdominal cramps, what type of abortion?
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Inevitable Abortion
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Retained fetal tissue, , no vaginal bleeding, no products of conception are expelled and the internal cervical os is closed, What type of abortion?
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Missed Abortion
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Patient b/w 30-55 premenstrually has bilateral lumpy and tender breats. Mammography shows dense breat\st tissue, Diag?
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Fibrocystic breast disease
(Benign cyst formation) |
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What is the most common infecting organism in Mastitis?
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Staph Aureus
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a women who is breastfeeding presents with a warm, tender, swollen and erythematous breast,
Diag? |
Mastitis (Staph Aureus)
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Nonmalignant condition that affects menopausal women. The subareolar ducts become blocked with debris, causing pain, inflammatory nipple discharge, and retraction of the nipple. Name the diag?
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Mammary duct ectasia
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Benighn neoplasm found in young women, they are usually round, rubbery, movable, and nontender, name diag?
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Fibroadenoma
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What are the two most common causes of third trimester bleeding?
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1. Placenta previa
(Painless Bleeding) 2. Placenta abruptio (Painful Bleeding) |
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Abnormal implantation of the placenta near or at the cervical os?
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Placenta Previa
(Painless Bleeding) |
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What are the risk factors for Placenta previa?
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1. Advanced maternal age
2. Multiparity 3. Smoking history 4. Prior C-section |
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Patient presents at >20 weeks gestation with PAINLESS vaginal bleeding? Fetus not in distress?
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Placenta previa
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T or F, Vaginal examination is contraindicated in a patient with Placenta Previa? (Painless bleeding)
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True
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What is the diagnostic test of choice to diagnos Placenta Previa? (Painless bleeding)
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Sonogram
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Premature seperation of a normally implanted placenta?
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Abruptio Placentae (Painful Bleeding)
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Pregnant women >20 weeks gestation with unremitting abdominal and back pain) Painful vaginal bleeding. There is fetal distress? whats the diagnosis?
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Abruptio Placentae
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Fetal Distress and Painfull Bleeding >20 weeks getation?
Placenta Previa or Abruptio Placenta |
Abruptio Placenta
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No fetal distress and painless bleeding, >20 weeks getation?
Placenta Previa or Abruptio Placenta |
Placenta Previa
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A placenta that adheres to the myometrium, associated with postpartum hemorrhage
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Placenta accreta
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Fetal Vessels associated with the cord tranverse across the lower uterine segment and present in advance of the fetal presenting part, Causes rapid bleeding when disrupted during labor.
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Vasa Previa
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Blood-tinged vaginal discharge that occurs when the cervix is dilated and the onset of labor is imminent?
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Bloody Show
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How can Gestational thrombocytopenia and ITP be differentiated?
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ITP
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How do you define Thrombocytopenia:
1. nonpregnant patients? 2. Pregnant patients |
1. Platelet count < 150,000/щL
2. < 100,000 |
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Patient complaines of Petechiae, ecchymoses, and nose and gum bleeding?
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Gestational Thrombocytopenia or ITP
ITP lasts after delivery |
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How can Gestational thrombocytopenia, ITP, HELLP, Pseudothrombocytopenia, TTP and HUS? be differentiated?
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ITP will persist after delivery
HELLP variant of preeclampsia and will have hemolysis and increased liver enzymes ITP: FAT RN: Fever, Autoimmune hemolytic anemia, Thrombocytopenia, Renal disease, Neurologic disease HUS Renal disease |
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Weakness in the fascia of the posterior vaginal wall in which the rectum appears as a bulging mass, Name the condition?
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Rectocele
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Protrusion of the bladder into the anterior vaginal wall. Asking to bear down will enhance the protrusion, Name the condition?
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Cystocele
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What is the most common cause of postmenopausal vaginal bleeding?
Can you name another cause of postmenopausal vaginal bleeding? |
1. Atrophic Vaginitis
2. Endometrial Carcinoma |
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Patient presents with amenorrhea, obesity, hirsutism and infertility, What is the diagnosis?
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POS (Stein-Leventhal syndrome)
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T or F all postmenopausal women with vaginal bleeding require a biopsy to r/o endometrial carcinoma?
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True
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How would you classify a
1. Hydatiform mole 2. Invasive mole 3. Choriocarcinoma |
They are all Malignant gestational trophoblastic neoplasms.
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Patient with a positive prenancy test <20 weeks presentd with vaginal bleeding and signs of preeclampsia.
Incease B-hCG titer out of proportion with gestational age, absent heart sounds and cluster of grapes appearance on gross exam and snowstorm appearance on ultrasound? |
Maligant Gestational Trophoblastic Neoplasm.
1. Hydatiform mole 2. Invasive mole 3. Choriocarcinoma |
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At 20 weeks where is the fundal height of the fetus?
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Umbilicus
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What does GPAL stand for?
(Georgia Power And Lights) |
Gravida, Para, Abortions, Living Children
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What is the most common cause of vaginitis?
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Gardenella Vaginalis
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Thick white cottage cheese appearing discharge, Pseudohyphae, what is the infection?
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Candida
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Strawberry-appearing cervix or vaginal mucosa, vaginal discharge is green and frothy.
What is the infection? |
Trichomoniasis
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A woman under the age of 30 years presenting with a mobile breast mass that has well-defined borders most likely has?
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Fibroadenoma
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A benign tumor, patterns often present with a bloody discharge from the nipple in the absence of a breast mass?
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Intraductal papilloma
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Patient who presents with an erythematous and warm breast may have?
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Inflammatory breast carcinoma
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Eczemoid breast changes in the nipple( itching, oozing and bleeding)?
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Paget's disease of the breast
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How is the Expected date of confinement calculated?
(EDC) |
Nagele's or McDonald's rule
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What is Nagele's or McDonald's rule?
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1. 1st day of LMP
2. Go back 3 months 3. Add 7 days (based on a 28 day menstrual cycle) |
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If a womens LMP is Jan 15 what would be the EDC?
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October 22
Go back 3 motns from LMP Oct 15 and add 7 days Oct 22 |
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What does each of the terms stand for?
1. Gravida? 2. Parity (P)tpal? |
Gravida: # of total pregnancies
Parity: # of deliveries t: term infants (37 to 42 wk) p: Pre term 20 to 36 wks a: abortions <20 weeks l: living children |
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When should the initial visit occur and each susequent visit?
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1. Initial visit: 6-8 weeks after LMP
2. Every 4 weeks Initial visit- 28 wks 3. 2 to 3 weeks 28-36 4. 36 to delivery weekly |
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When does fundal height measurement start?
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20 weeks (Umbilicus)
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When do you listen for fetal heart tones?
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10 weeks
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When do you do a urinalysis for glycosuria and proteinuria?
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10 weeks
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When do you add a routine vaginal examination?
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37 weeks
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What happens at 10 weeks gestation?
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1. Fetal Heart tones are heard
2. Urinalysis for glycosuria and proteinuria |
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When is the fundus seen at the uterus?
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20 weeks
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What is the normal fetal heart rate?
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120-160 bpm
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What is the term for first awarness of fetal movement?
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Quickening
Primigravida: 18-20 weeks Mulrtigravida: 14-18 weeks |
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When does quikening occur in:
Primigravida? Mulrtigravida? |
Quickening
Primigravida: 18-20 weeks Mulrtigravida: 14-18 weeks |
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Bluish discoloration of vagina and cervix, Name the sign?
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Chadwick's sign
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What is Chadwick's sign?
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Bluish discoloration of vagina and cervix,
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Softening between the fundus and cervix, Name the sign?
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Hagar's sign
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What is Hagar's sign?
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Softening between the fundus and cervix
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At how many weeks of gestation does the uterus reach the:
1. symphysis pubis 2. b/w pubis and umbilicus 3. umbilicus 4. 2-3 cm below xiphoid process |
1. symphysis pubis
12 weeks 2. b/w pubis and umbiliccus 16 weeks 3. umbilicus 20 weeks 4. 38-40 weeks Gravid uterus 2-3 cm below xiphoind process |
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When is Chroionic villous sampling done?
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b/w 10-13 weeks (first trimester)
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What is the advantage of chronic villous sampling?
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The ability to do it in the first trimester (this allows the option of a first trimester termination, also results are available within 48 hours. CVS is a diagnostic not screening test.
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What is the disadvantage of chronic villous sampling?
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Unlike amniocentesis, CVS specimens cannot be used in AFP testing for neural tube defects.
Also risk is slightly higher with CVS than amniocentesis |
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Name some factors that increase AFP?
(five of them) SPAM IS HIGH IN AFP |
1. Spina Bifida
2. Placental anomalies 3. Abdominal Wall defects (Omphalocele, gastroschisis) 4.Multiple gestations |
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What is MUGR in association with Montagia and Galeazi?
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Montagia ulnar
Galeazi is radius |
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Define the normal Menstrual cycle?
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Normal Menstrual Cycle?
28 days |
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How long is the Luteal phase of the cycle?
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Normally 14 days
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Name the hormones, and their source, that are involved in mainitaining a normal menstrual cycle?
1. From the ovary? 2. From the Pituitary? 3. From the hypothalamus? |
1. From the ovary?
Estrogen and Progesterone 2. From the Pituitary? FSH, LH, 3. From the hypothalamus? Prolactin and TSH |
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What do all the following have in common?
1. Spina Bifida 2. Placental anomalies 3. Abdominal Wall defects (Omphalocele, gastroschisis) 4.Multiple gestations |
Increase levels of AFP. SPAM
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What is the life span of a normal corpus luteum in the absence of pregnancy?
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14 days
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What stimulates the maturation of the fillicle and it's production of Estradiol?
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FSH
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What causes follicular rupture, ovulation and establishment of the corpus luteum?
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LH
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Describe the following curves on a basal body temperature chart of a 25 year old women?
1. Monophasic curve 2. Biphasic 3. Elevated temperature following a Biphasic curve? |
1. Monophasic curve
Anovulatary Cycle 2. Biphasic Normal 3. Elevated temperature following a Biphasic curve? Pregnancy |
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What is the most accurate test of ovulation?
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Endometrial Biopsy
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What hormone caused mid-cycle spotting or light bleeding?
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Decline in Estrogen wqhich occurs right after the LH surge
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Decline inwhich hormone causes the onset of menses?
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Normal menses occurs because of progesterone withdrawal
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What levels of both FSH and LH would you expect in a 63 year old woman who is not on estrogen replacement thereapy?
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High FSH and LH. The ovarian response to FSH and LH is decreased in menopause. Therefore there is less estrogen and progesterone being produced. There is no negative feedback to inhibit rising FSH and LH.
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What is the main physiological stimulus for prolactin release?
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Suckling of the breast
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What is the most common presenting symptom of a prolactinoma in a women?
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Secondary amenorrhea
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What is no menstruation for 6 months or more in a women who previously had regular menses?
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Seconday Amenorrhea
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What is the most common cause of secondary amenorrhea?
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Pregnancy
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What is the progestrone challenge?
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Test used for secondary amenorrhea, IM injection 100mg of progesterone resposce is a normal period.
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Name some causes of hyperprolactinemia?
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1. Pituatray adenoma
2. Hypothyroidism 3. Reserpine, Methyldopa, Phenothiazine, contraceptives |
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If a patient is not menstruating and they have galactorrhea, what do you think of?
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Hyperprolctinemia
1. Pituatray adenoma 2. Hypothyroidism 3. Reserpine, Methyldopa, Phenothiazine, contraceptives |
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List the differential diagnosis of persistent vaginal bleeding in a preadolescent female?
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1, Neoplasm (Sarcoma Botyroides)
2. Precocious puberty 3. Foreign Body 4. Sexual assualt 5. Infections |
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Breast hyperplasia is a normal from what age?
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Neonate - 6 months
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What percent of women were abused as children?
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15-25%
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What is the most common cause of vaginal bleeding in childhood?
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Foreign body
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What is the median age for menopause?
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51
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What is the most common cause of postmenopausal bleeding?
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Atrophic endometrium and Atrophic vaginitis
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The persistance of corpus luteum, delayed menses, pelvic mass, negative pregnancy test. Clinically confused with ectopic pregnancy, Name the syndrome?
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Halban's syndrome
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What are the common changes associated with estrogen depletion?
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1. Menstrual cycle changes
2. Cardiovascular disease 3. Osteoporosis, 4. Genitourinary atrophy 5. Vasomotor changes 6. Psychological changes |
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What are the expected changes in gonadotropin levels after menopause?
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FSH increases 10-20 fold
LH increases 3 fold |
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Which two hormone declines as a result of menopause?
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Estrogen
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What happens to progesterone production in menopause?
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Progesterone is no longer produced in menopause.
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What is the leading cause of death for women?
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heart disease
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How much does the risk of coronary heart disease increase after menopause?
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Doubles
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After menopause what is the percent of bone loss per year?
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2.5% first four years
then 1.5% annually |
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What risk factor are associated with bone loss and osteoporosis?
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1. White
2. Asian 3. Thin women 4. Sedentary life style 5. Smoking 6. age of menopause |
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What causes approximately 60% of spontaneous abortions ? |
60% of spontaneous abortions are caused by chromosomal abnormalities. |
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Loss of tone in the uterine musculature which may lead to acute hemorrhage. |
Uterine atony. Normally contraction of the uterine muscle compresses the vessels and reduces flow. This increases the likelihood of coagulation and prevents bleeds. |
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Placenta attaches abnormally to the myometrium which is associated with increased risk of heavy bleeding at the time attempted placental delivery. |
Placenta accreta |
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Which of the following medications should be discontinued in pregnancy? Amoxicillin, lisinopril, acetaminophen, insulin, methyldopa? |
Lisinopril is contraindicated pregnancy Methyldopa is the preferred treatment of hypertension in pregnancy |
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What is the most common breast mass in premenopausal women. |
Fibroadenoma |
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T or F progestin-only pills as contraceptives are ideal for breast feeding mothers |
True progestin only pill is ideal for breast feeding mothers because the pill does not interfere with lactation the way combination pills do |
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At what age may cervical cancer screening be discontinued for women who have no high grade lesions or cervical cancer history? |
65 years old cervical cancer screening may be discontinued in women with no past medical history of cervical cancer. |
