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268 Cards in this Set

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What is the recommended method of emergency contraception w/in 48h?
Which medication is proven to be effective in reducing perinatal morbidity and mortality associated with preterm labor?
Should lesbian women receive the Hep B vaccine?
Concern with women with seizures and OCPs?
Doctors can provide care to adolescents w/o parental consent for what?
60 y/o F p/w mass protruding through vagina upon bearing down. C/o vaginal bleeding, pressure in pelvic area relieved by lying down. What is this?
Most common complication with norplant?
Why are the following medications CI in pregnant pts?
Tetracycline
Cipro
Bactrim
What do you do for pregnant pts w/ si/sx suggestive of UTI?
Tx of acute pyelonephritis in pregnant women?
How do you differentiate b/t the different causes of ascites?
Most common cause of ascites is?
Clinical conditions associated with a high SAAG?
Clinical conditions associated with low SAAG?
What is Budd Chiari syndrome?
What is HELLP syndrome?
What do you do for HGSIL on Pap smear?
Most common cause of postmenopausal bleeding?
Tx of PID?
1st thing to do with pts with severe preeclampsia?
14 y/o starts having sex. When do you do the PAP smear on her?
The most common cause of an arrest disorder in nulliparous women in the active phase of labor is? What do you do?
Absolute CI to OCPS:
Relative CI to OCPs
How much Vit D and calcium should be recommended to all postmenopausal women?
Which cysts in a pregnant woman need to be removed?
Woman has HGSIL. Colposcopy confirms CIN II. What do you do?
What do you do for an asymptomatic pregnant female with bacteriuria?
How do you manage mother and baby if mother has HBsAg?
Exercise induced amenorrhea is due to what?
Describe the sx of androgen insensitivity syndrome:
What do you do if woman has no endocervical cells on pap smear?
Subchorionic hematoma. What do you do?
What is the treatment for a young pt with significant hypoestrogenic symptoms and low bone density?
How does Rh incompatibility work?
What is the recommended method of emergency contraception w/in 48h?
Levonorgestrol w/in 48 hours but can even work up until 120 hours.
IUD is for pts who present > 120 hours.
Which medication is proven to be effective in reducing perinatal morbidity and mortality associated with preterm labor?
Antenatal corticosteroids
Should give to any pregnant pt 24-24 weeks of gestation w/ intact membranes at high risk for preterm delivery
Betamethasone or Dexamethasone
--↓risk of infant respiratory distress syndrome by stimulating surfactant
-- ↓risk of intraventricular hemorrhage
Should lesbian women receive the Hep B vaccine?
Yes.
Although they are at much lower risk of acquiring Hep B infection than gay men, they can still acquire the infection via vaginal and cervical secretionsà especially if they have multiple or new partners.
Concern with women with seizures and OCPs?
↓OCP efficacy due to induction of cytochrome P450 by the anti-seizure meds.
Neurontin and Valproate don’t, but the others do.
Doctors can provide care to adolescents w/o parental consent for what?
Pregnancy
Contraception
STD
Substance use
Emotional illness
60 y/o F p/w mass protruding through vagina upon bearing down. C/o vaginal bleeding, pressure in pelvic area relieved by lying down. What is this?
Uterine prolapse.
Treat with surgery
Most common complication with norplant?
Menorrhagia (prolonged vaginal bleeding during the period)
Norplant=Levonorgestrol
Why are the following medications CI in pregnant pts?
Tetracycline: dental staining, ↓bone growth
Tetracycline
Cipro
Cipro: tendon rupture in young children
Bactrim
Sulfonamides: near term can cause displacement of bilirubin in fetal circulation (↑risk of hyperbilirubinemia and kernicterus) Bactrim not advised in 1st & 3rd trimester
What do you do for pregnant pts w/ si/sx suggestive of UTI?
Begin empiric ABY tx immediately w/:
Cephalexin or Amoxicillin or Nitrofurantoin for 3-7 days
Tx of acute pyelonephritis in pregnant women?
Hospitalization & IV ABY (Ceftriaxone or Amp/Gent)
x 10-14 days
Remainder of pregnancy: low-dose ABY prophylaxis with Nitrofurantoin or cephalexin and monitoring of urine occasionally for infection.
How do you differentiate b/t the different causes of ascites?
Abdominal paracentesis and ascitic fluid analysis
SAAG: serum to ascitic fluid albumin gradient
SAAG= serum albumin –ascitic fluid albumin.
SAAG >/= 1.1 g/dLà portal HTN
Most common cause of ascites is?
hepatic cirrhosis
Clinical conditions associated with a high SAAG?
SAAG >/= 1.1
Cirrhosis
CHF
Alcoholic Hepatitis
Clinical conditions associated with low SAAG?
SAAG < 1.1
Peritoneal carcinomatosis (i.e. ovarian cancer)
Peritoneal TB
Nephrotic syndrome
Pancreatitis
Serositis
What is Budd Chiari syndrome?
Postsinusoidal non-cirrhotic causes of portal HTN
Caused by thrombosis of the hepatic veins and/or suprahepatic IVC.
SAAG >/= 1.1
What is HELLP syndrome?
Hemolytic anemia
Elevated LFTs
Low Platelets
Severe form of preeclampsia, therefore, MgSulfate is the standard of care for patients with this in order to reduce risk of seizure.
What do you do for HGSIL on Pap smear?
Immediate referral for colposcopy and endocervical curettage b/c high grade squamous intraepithelial lesion indicates 1-2% probability of already having invasive cervical cancer and a 20% probability of acquiring invasive cervical cancer if left untreated.
Most common cause of postmenopausal bleeding?
Atrophic vaginitis (50-60%)
However, must r/o the most serious conditions, i.e. endometrial carcinoma (less than 10%)
Tx of PID?
Cefoxitin +Doxycycline
Or
Ceftriaxone + Doxycycline
1st thing to do with pts with severe preeclampsia?
Stabilize them w/ anti-HTN med and seizure prophylaxis.
Hydralazine + Mg Sulfate
14 y/o starts having sex. When do you do the PAP smear on her?
At the age of 17.
Remember: 3 years after initiation of sex or at the age of 18 (recently changed to 21), whichever is earlier.
It takes 3-5 years after HPV exposure to develop high-grade cervical cytologic abnormalities due to HPV.
The most common cause of an arrest disorder in nulliparous women in the active phase of labor is? What do you do?
Hypotonic uterine contractions.
Give oxytocin
Absolute CI to OCPS:
1)       h/o thromboembolic event or stroke
2)       active liver disease
3)       h/o estrogen dependent tumor (not ovarian CA)
4)       pregnancy
5)       abnormal uterine bleeding
6)       heavy smokers > 35 y/o
7)       hypertriglyceridemia
Relative CI to OCPs
1)       migraines
2)       poorly controlled HTN
3)       anticonvulsant therapy
How much Vit D and calcium should be recommended to all postmenopausal women?
Calcium: 1200 mg
Vit D: 400-800 mg
Calcium is a longer word, t/ it needs more.
Each pill of cal/vit D has 600 mg Ca/200 mg Vit D
t/ take a MVI: 400 mg Vit D and 2 Cal/Vit Dà enough
Which cysts in a pregnant woman need to be removed?
If it is > 5 cm and persists beyond the 1st trimester or shows no regression in subsequent visits, surgery during the 2nd trimester is recommended b/c cyst could rupture and causes problems.
Woman has HGSIL. Colposcopy confirms CIN II. What do you do?
High grade squamous intraepithelial lesion
HGSIL: CIN II, III, moderate & severe dysplasia, and carcinoma in situ.
LEEP is treatment of choice.
Can do either ablation or excision but the best is excision and the best excision procedure is LEEP.
What do you do for an asymptomatic pregnant female with bacteriuria?
Treat b/c delay may allow the bacteriuria to progress to cystitis or pyelonephritis—associated w/ preterm labor & premature birth
How do you manage mother and baby if mother has HBsAg?
Give Hep B Vaccine & Hep B immune globulin to infant w/in 12 hours after delivery. The Hep B Vac and HBIG are normally only of benefit when administered w/in 12 hours of exposure to infectious secretions. That’s why you don’t give the mother anything.
Exercise induced amenorrhea is due to what?
↓in the pulsatile secretion in LHà ↓ in estrogen produced
Describe the sx of androgen insensitivity syndrome:
Primary amenorrhea
B/L inguinal masses
Breast development w/ NO pubic or axillary hair (constitutional delay will not have asynchronouse delay—breasts develop but no pubic hair and amenorrhea)
Mutation of the AR (androgen receptor) gene
What do you do if woman has no endocervical cells on pap smear?
Depends, if low risk (previously normal smear) follow up in one year. If high-risk (abn previous pap, immunosuppresed or insufficient previous screening)—repeat in 4-6 months
Subchorionic hematoma. What do you do?
Initially dx’d with u/s and should be re-evaluated w/ repeat u/s one week later. No known therapeutic interventions.
Greatest concern with this is the ↑risk of spontaneous abortions.
What is the treatment for a young pt with significant hypoestrogenic symptoms and low bone density?
Combination of estrogen and progesterone (estrogen alone with a woman who still has a uterus can lead to endometrial cancer).
The results of the women’s health initiative studies do not apply to younger pts with premature menopause.
How does Rh incompatibility work?
Only if
1)       Mother is Rh – (negative thing if mother is negative)
2)       Father and baby are Rh +
R: very unlikely if question states that this the mother’s first pregnancy b/c the mother is not sensitized yet which only happens after she becomes sensitized as a result of fetomaternal hemorrhage at or near the end of pregnancy. Risk of sensitization can be reduced by a RhoGAM injection w/in 72 h after delivery.