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