Ob/gyn - Shelf, Pt. 2

Front 1

4 signs of placental separation

Back 1

1. gush of blood - coincides with placenta separating from uterus
2. cord lengthening - placenta has dropped to lower portion of the uterus
3. globular uterus
4. uterus ascends to anterior abdominal wall

Front 2

what can cause uterine inversion
complication from inversion

Back 2

if cord doesn't separate from uterus and excessive force is used to cause the separation --> uterine inversion
massive hemorrhage

Front 3

appearance of uterine inversion

Back 3

shaggy mass, red and bulging

Front 4

definition of abnormally retained placenta
tx

Back 4

labor of placenta exceeds 30 mins
try manual extraction

Front 5

risk factors for uterine inversion

Back 5

grand-multip
placental implantation in fundus

Front 6

tx of uterine inversion

Back 6

halothane, terbutiline, and mgso4 to cause uterine relaxation
emergent surgery

Front 7

what is protective of uterine inversion

Back 7

attenuated umbilical cord: it will separate easily and cause cord severing

Front 8

definition of premature ovarian failure

Back 8

cessation of ovulation younger than 40 yo

Front 9

what causes ovarian failure in turner's syndrome

Back 9

ovarian failure

Front 10

relationship between tsh and prl and menstrual cycle

Back 10

low tsh and high prl both inhibit gnrh pulsations --> fsh/lh inhibition

Front 11

sx of tss

Back 11

myalgias
n/v
hypotension
confusion
sunburnlike rash --> maculopapular rash --> desquamation with palm/sole involvment (by 10th day) --> increased serum bili

Front 12

what MAP is required to perfuse vital organs

Back 12

65 mmhg

Front 13

what is the organism in tss
best way to culture it

Back 13

staph
exotoxin-1 enters body
vaginal cx

Front 14

tx of tss

Back 14

iv nafcillin or methicillin + amnioglycosides

Front 15

definition of latent labor

Back 15

cervix mainly effaces and cervical dilation

Front 16

time limit of latent labor

Back 16

<18-20 hrs in prime
<14 hrs in multip

Front 17

arrest of active labor

Back 17

no cervical change during 2h of active labor

Front 18

protracted active labor

Back 18

decreased cervical change over 2 hrs

Front 19

causes of prolonged latent phase

Back 19

decreased power, pelvis, or passenger

Front 20

definition of clinically adequate ctx

Back 20

q2-3 mins
firm abdomen 40-60 s
OR >200 montevideo units over 10 mins

Front 21

bloody show

Back 21

loss of cervical mucous plug
sign of impending labor

Front 22

1st thing to consider in a woman with lower abdominal pain and vaginal spotting

Back 22

ectopic pregnancy, until proven otherwise

Front 23

progesterone levels for nml uterine pregnancy
progesterone levels for nonviable pregnancy

Back 23

>25
<5

Front 24

if non-viable pregnancy is dx, what is next step to determine etiology

Back 24

d&c to assess miscarriage (will see chorionic villi) or ectopic pregnancy (will see no villi)

Front 25

when should mtx be given to tx miscarriage

Back 25

if pts are asx and fetus is <3.5 cm

Front 26

what is cutoff in wks for a pregnancy loss to be considered a spontaneous abortion

Back 26

20w wks

Front 27

definition of pprom

Back 27

rom prior to onset of labor <37 wks
50% will labor w/i 48 hrs and 90% w/i 1 week

Front 28

sx of chorioamnionitis

Back 28

maternal fever, tachy, uterine tenderness, and malodorous d/c
fetal tachy >160 is also an early sign

Front 29

tx of pprom

Back 29

if <32 wks, steroids and broad-spectrum abx

Front 30

dx of chorioamnionitis

Back 30

see gm stained bacteria on amniocentesis

Front 31

time-frame of pre-term labor

Back 31

20-37 wks

Front 32

complication of vbac

Back 32

uterine rupture

Front 33

how to manage arrest of active phase of labor

Back 33

if ctx are not strong enough, give pit, then place iucp if there is still no dilation

Front 34

what things are included in the bishop score

Back 34

dilation
effacement
station
consistency
cervical position

Front 35

what bishop score is favorable for induction

Back 35

>8

Front 36

what are the cardinal movements of labor

Back 36

engagement (oociput transverse)
internal rotation (to occiput anterior)
complete rotation
extension of neck
external rotation
anterior shoulder
posterior shoulder

Front 37

what is the most common type of breech presentation

Back 37

frank breech

Front 38

what are the 3 types of breech and how do they differ

Back 38

frank: flexed hips with knees extended, feet are under fetal head
footling: one or both hips not flexed and foot or knee is in birth canal
complete: flexed hips and knees, with 1 foot near the breech

Front 39

when can external version of breech be performed

Back 39

after 37 weeks b/c of risk of abruption or rom secondary to external maneuvering

Front 40

#1 cause of post-partum hemorrhage

Back 40

uterine atony

Front 41

definition of post-partum hemorrhage

Back 41

>500 cc blood loss after vaginal birth
>1000 cc blood loss after c/s

Front 42

orgs involved in endometritis

Back 42

anaerobes and aerobes

Front 43

why is bromocriptine no longer given to prevent galactorrhea post-partum

Back 43

sz and htn can result (uncommonly)

Front 44

what causes prolonged fetal tachy

Back 44

maternal fever
chorioamnionitis

Front 45

cause of early decels
morphology

Back 45

head compression during ctx
mirror images of ctx tracing

Front 46

cause of late decels

Back 46

placental insufficiency
chronic htn
post-date pregnancy

Front 47

causes of variable decels

Back 47

cord compression
cord around fetal parts
fetal anomolies
oligohydramnios

Front 48

causes of sinusoidal fht

Back 48

severe fetal anemia
maternal drugs

Front 49

causes of prolonged brady in fht

Back 49

uterine hyperstimulation

Front 50

when is an amnioinfusion performed

Back 50

to tx variable decels or meconium stained amniotic fluid

Front 51

which pg is contraindicated in asthma

Back 51

pg f2

Front 52

what is used to decrease uterine bleeding post-partum

Back 52

ergots
oxytocin
pgs

Front 53

which 2 placental problems often go together

Back 53

accreta and previa

Front 54

what effect does pregnancy have on peptid ulcer dz
on ms

Back 54

makes both of them better

Front 55

dx of endometriosis

Back 55

laparoscopy

Front 56

management of placental abruption in setting of painful bleeding in 3rd trimester

Back 56

can progress rapidly so pt should be carefully monitored
ensure rapid vaginal delivery
c/s only if there is rapid deterioration in early stages of labor

Front 57

when is rhogam given

Back 57

at 28 wks

Front 58

after 1h gtt, what is the threshold for gdm

Back 58

>140

Front 59

after the 3hr gtt what is the threshold for gdm

Back 59

at 1h >180
at 2h >155
at 3h >140

Front 60

what can be done to decrease utis in sexually active women

Back 60

void after sex

Front 61

what is the most common genetic mutation associated with ovarian ca

Back 61

p53 (much more common than brca)

Front 62

consistency of granulosa theca cells

Back 62

solid

Front 63

appearance of a serous cystadenoma

Back 63

larger than a functional cyst
pt has increased abdominal girth

Front 64

what determines prognosis in ca

Back 64

tumor stage

Front 65

standard of care for advanced ovarian ca in a pt s/p oopherectomy and surgical staging

Back 65

post-op chemo

Front 66

definition of anemia in pregnancy
most common cause

Back 66

hb <10.5
fe deficiency

Front 67

tx of hellp

Back 67

delivery

Front 68

what happens to haptoglobin lvls in hemolysis

Back 68

they decrease b/c they are bound by hb

Front 69

side effects of mgso4

Back 69

decreased dtr
pulmonary edema
respiratory depression

Front 70

when should antenatal steroids be given in ptl

Back 70

between 24-34 wks, after that not needed

Front 71

should tocolysis be given to pts with suspected abruption

Back 71

no they should be delivered, b/c if tocolysis is used the abruption can continue

Front 72

what effect do b-agonists have on k

Back 72

hypokalemia

Front 73

complication of pyelonephritis in pregnancy

Back 73

2-5% --> ards (usually endotoxin related)

Front 74

what is the most common reason for septic shock in pregnancy

Back 74

pyelo

Front 75

how is incidence of pyelo reduced

Back 75

at 1st pnv urine cx is done to id asx bacteriuria

Front 76

tx of dvt in pregnancy

Back 76

heparin x 5-7 days then subq heparin to keep ptt 1.5-2.5 x nml limit x 3 mo

Front 77

stages of pelvic relaxation

Back 77

first degree:structure has descended into the upper 2/3 of the vagina

2nd degree: structure descends into the introitus

3rd degree: structure protrudes outside the vagina

Front 78

stress incontinence

Back 78

urine loss with exertion ro straining
caused by pelvic relzxation and displacement of urethrovesical junction

Front 79

urge incontinence

Back 79

detrusor instability
urine leakage is 2ndary to involuntary and uninhibited bladder contractions

Front 80

total incontinence

Back 80

continuous urine leakage 2ndary to urinary fistulas (usually 2ndary to pelvic surgery or pelvic radiation)

Front 81

overflow incontinence

Back 81

incomplete voiding
urinary retention
and overdistension of the bladder

Front 82

treatment of bv

Back 82

metronidazole