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34 Cards in this Set
- Front
- Back
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how to manage postpartum hemorrhage
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fundal or bimanual massage, IV access, infusion to keep SBP above 90, notify blood bank for pRBCs, give oxytocin
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when to do uterine artery embolization with hemorrhage
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stable vital signs and persistent bleeding if rate of loss is not excessive
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risks for uterine atony
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overdistention, uterine fatigue (prolonged labor)
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hyperemesis gravidarum
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usually 4-10wks, usually managed with supportive care, ketonuria
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gesterational trophoblastic disease
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enlarged uterus, hyperemesis, markedly elevated bHCG
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ddx of hyperemesis gravidarum
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pyleo, gestational trophoblastic disease, gastroenteritis, heptatobiliary disease
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presenation of trichomonas vaginalis
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pruritic, green frothy, foul smelling, pear shaped motile organisms, tx is oral metronidazole
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decels- early, late, variable
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early- fetal head compression, late uteroplacental insufficiency/ acidosis, variable- fetal cord compression
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inhibin b checks for?
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ovulatory reserve, older women have less
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when/what to test for ovulation
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mid luteal serum progesterone level (should be >10ng/mL)
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tx of DUB
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mild: iron, mod: progestin, mod w/ bleeding or severe: estrogen
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PCOS
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androgen and LH excess
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contra to breast feeding
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HIV, tb, HSV on breasts, malaria, sepsis, typhoid, eclampsia, nephritis, substance abuse, breast ca
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tx of preg pt with RMSF
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chloramphenicol, not preg- doxy
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aromatase def
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poor funct or absent conversion of androgens to estrogens, maculinization of mother during pregnancy, nomral internal b/ ambiguous external genetalia, clitoromegaly, delayed puberty, osteoporosis, undetectable estrogen, high LH FSH, PCOS,
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mccune albright
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cafe au lait, polyostotic fibrous dysplasia and autonomous endocrine hyperfunction, precocious puberty
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htn meds during pregnancy
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NO ACE, ARB, give labetalol and methyldopa, only start if BP> 150/95
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epidural effects on bp
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10% hypotension from sympathetic fiber block that results in vasodilation of lower extremities
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pathophys of preeclampsia
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vasospasm
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metformin and PCOS
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helps prevent type 2 DM, helps lose weight, helps with fertility, helps with hirsutism
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clomiphene citrate
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used to induce ovulation in PCOS
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NSAIDs and pregnancy
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can increase risk of miscarriage, promote premature closure of fetal ductus arteriosus
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tx of UTI during pregnancy
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ampicillin, amox, nitrofurantoin, cephalexin
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causes of chorioamnionitis
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PROM, intrauterine instrumentation, STD, prolonged labor
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pt with multiple sex partners, mucopurulent urethral d/x
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chlamydia (gonorrhea is more purulent and will see organisms on gram stain)
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amenorrhea... approach?
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preg test --> TSH--> prolactin
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tx of gonorrhea, chlamydia
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ceftriaxone, azithromycin OR doxycycline, if stain shows gonorhea- tx for both
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pt with placental abruption, but stable pt and baby
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vaginal delivery, only to C/S if condition calls for it
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coag neg staph
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skin
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endometriosis and adenomyosis
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endometrial tissue inside uterus (endometriosis) if OUTSIDE like uterine muslce (adenomyosis)
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ruptured fetal umbilical vessel
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antepartum hemorrhage, fetal heart changes from tacky to brady (late decal) vasa previa
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abruptio placenta
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premature placental separation, dark red antepartum hemorrhage, and pain, uterin tenderness, increased uterine tone
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placenta previa
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abd insertion of placenta on lower segment of uterus over os, painless antepartum hemorrhage
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ideal maternal fasting glucose?
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75-90
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