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113 Cards in this Set

  • Front
  • Back
Primary causes of 3rd trimester bleeding
Placental abruption and placenta previa
Normal or abnormal? The uterus is palpated above the pubic symphysis at 12 weeks.
Normal
Normal or abnormal? During pregnancy, cardiac output increases by 30-50% and heart rate is increased 10-15 bpm.
Normal
Normal or abnormal? A new systolic murmur is heard in a pregnant patient.
Normal
Normal or abnormal? A new diastolic murmur is heard in a pregnant patient
Abnormal
Normal or abnormal? CXR reveals cardiomegaly in a pregnant patient.
Normal. Not actually cardiomegaly, the heart is displaced by the uterus upward and to the left
Normal or abnormal? WBC count increases during childbirth to more than 20 million/mL.
Normal
What is the leading nonobstetric cause of postpartum death?
Pulmonary embolism
What is the most common congenital infection?
CMV
What parasite should pregnant women be aware of who have household cats?
Toxoplasma gondii. Pregnant women should NOT change the litter box.
What stage of labor? The cervix is dilated 6 cm.
1st, active
What stage of labor? The cervix is dilated 1 cm
First, latent
What stage of labor? The infant is delivered, but the placenta remains
Stage 3
What is the significance of late decelerations of the fetal heart rate during labor
Uteroplacental insufficiency and fetal hypoxemia
Persistent vomiting not related to other causes, acute starvation (large ketonuria), and weight loss (5% decrease from pre-pregnancy weight)
Hyperemesis gravidarum
Hyperglycemia in the first trimester suggests...
Pre-existing diabetes
Pregnant woman has signs of edema, polyhydramnios, and a large for gestational age fetus (>90th percentile). Diagnosis?
Gestational diabetes
Work-up for diagnosis of gestational diabetes
UA reveals glycosuria, abnormal glucose challenge test (routinely performed at 24-28 weeks gestation)
What is HELLP syndrome?
A variant of pre-eclampsia with a poor prognosis.
Hemolysis
Elevated LFTs
Low Platelets (thrombocytopenia)
Idiopathic hypertension during pregnancy without significant proteinuria (<300mg/L) that develops at >20wks gestation
Pregnancy-Induced Hypertension. 25% go on to develop pre-eclampsia
New-onset grand mal seizures in patients with pre-eclampsia
Eclampsia
What is the definitive cure for eclampsia/pre-eclampsia?
Delivery of the fetus
Seizure control/prophylaxis in patients with eclampsia?
MgSO4
Premature separation of normally implanted placenta
Placenta abruption
Abnormal placental implantation
Placenta previa
Placenta covers the cervical os
Total placenta previa
Placenta extends to the margin of the os
Marginal placenta previa
Placenta is in close proximity to the os
Low-lying placenta previa
Tubal, abdominal, ovarian, or cervical pregnancy
Ectopic
Medical treatment of ectopic pregnancy
Methotrexate for small unruptured tubal pregnancies, surgical options for salpingectomy
Estimated fetal weight is less than 10th percentile for gestational age
Intrauterine growth restriction (IUGR)
Birth weight >90th percentile
Fetal macrosomia
Gestational trophoblastic disease resulting from sperm fertilization of an empty ovum
Complete mole
Gestational trophoblastic disease in which a normal ovum is fertilized by 2 sperm
Incomplete (partial) mole
Most common 1st trimester presentation of gestational trophoblastic disease (mole)
uterine bleeding
Slow, abnormal progression of labor
Dystocia
Spontaneous rupture of membranes >1hr before onset of labor
Premature rupture of membranes (PROM)
Spontaneous rupture of membranes that occurs at <37 weeks gestation
Preterm premature rupture of membranes (PPROM)
primary cause of neonatal morbidity and mortality
premature labor
Most common fetal malpresentation
Breech
Most common presentation of Sheehan's syndrome
Failure to lactate
Pituitary ischemia and necrosis, the primary cause of anterior pituitary insufficiency in adult females
Sheehan's syndrome
What is the most common cause of postpartum hemorrhage?
Uterine atony
When is breast-feeding contraindicated?
maternal HIV infection, active hepatitis, and use of certain medications
What is the term for "early breast milk", that contains protein, fat, secretory IgA, and minerals?
Colostrum
Type of spontaneous abortion in which all products of conception are expelled and pain ceases.
Complete
Type of spontaneous abortion in which there is mild cramping and bleeding, some products of conception are expelled. There may be visible tissue in the vagina or endocervical canal.
Incomplete
Type of spontaneous abortion in which no products of conception are expelled, membranes remain intact. There is uterine bleeding and abdominal pain. The fetus is still viable.
Threatened.
Type of abortion in which no products of conception have been expelled, but there is uterine bleeding and cramps. The os is open.
Inevitible
Type of abortion in which pregnancy has ceased to develop, but no products of conception have been expelled. Fetal tissue is retained. There is no uterine bleeding. The os is closed.
Missed
Type of abortion which is associated with infection. Maternal mortality is 10-15%
Septic
True or false: breast-feeding patients with mastitis should stop breast-feeding
False. They should continue breast-feeding to prevent the accumulation of infected material.
Unilateral breast tenderness, erythema, edema, warmth, and purulent nipple drainage.
Mastitis
Most common benign breast condition
Fibrocystic change
33 year old female presents with bilateral painful breasts and multiple masses 1 week before her period.
fibrocystic breasts
Most common breast lesion in women <30 years of age
Fibroadenoma
What diagnostic study can differentiate breast cysts from solid masses?
Breast ultrasound
Where is the most common area for breast cancer to occur?
Upper outer quadrant
What are the risk factors for breast cancer?
Female, older age
Hx of breast cancer
Breast cancer in 1st deg relative
BRCA1 and BRCA2 mutations
High fat, low fiber diet
History of fibrocystic change with atypical cells
Increased exposure to estrogen (nulliparous, early menarche, late menopause)
1st full term pregnancy after 35
What are the tumor markers for recurrent breast cancer?
CEA, CA 15-3, CA 27-29
What chemotherapeutic agent should estrogen-receptor positive breast cancer patients receive?
Tamoxifen
Are estrogen-receptor and progesterone-receptor positive breast cancers associated with a favorable or nonfavorable course?
Favorable
What are the absolute contraindications to OCPs?
Pregnancy
History of stroke, CAD, or DVT
Breast cancer
Undiagnosed abnormal vaginal bleeding
Estrogen-dependent cancer
A benign or malignant tumor of the liver
Cigarette smoking
Age >35
Type of amenorrhea characterized by no menses present by age 16 with secondary sexual development present
Primary amenorrhea
Type of amenorrhea characterized by no sexual characteristics at the age of 14
Primary amenorrhea
Type of amenorrhea characterized by absence of menses for 6 consecutive months in women who have passed menarche
Secondary amenorrhea
Most common anatomic cause of amenorrhea
Asherman's syndrome
What is Asherman's syndrome?
Type of secondary amenorrhea associated with endometritis, scarring after delivery, or D&C
Most common cause of secondary amenorrhea
Pregnancy
Lab tests to obtain in a patient with secondary amenorrhea and a negative pregnancy test
FSH, LH, prolactin, TSH, free T4, potassium, creatinine, liver enzymes, testosterone levels if hirsute or virilized, PAP smear and vaginal smear, 1-mg overnight dexamethasone suppression test (hypercortisolism)
Highly increased prolactin in the setting of secondary amenorrhea indicates...
prolactin-secreting pituitary adenoma
Menstrual pain associated with ovulatory cycles in the absence of pathologic findings
Primary dysmenorrhea
Treatment for primary dysmenorrhea
NSAIDs, topical heat therapy, combined OCPs
Menstrual pain for which there is an organic cause
Secondary dysmenorrhea
Normal menstrual bleeding lasts an average of ___ days, and has a mean blood loss of ___mL
4, 40
Vaginal bleeding that occurs 6 or more months following the cessation of menstrual function
Cancer until proven otherwise
>80ml blood loss per cycle or prolonged bleeding (>8 days)
Menorrhagia. May lead to anemia.
Increased length of time between menses (35-90 days)
Oligomenorrhea
Frequent menstruation (<21 day cycle), anovular
Polymenorrhea
Bleeding between periods
Metrorrhagia
Excessive irregular bleeding
Menometrorrhagia
most common cause of abnormal uterine bleeding
Pregnancy
Aberrant growth of endometrium outside the uterus
Endometriosis
Ovary has a characteristic "chocolate cyst"
Endometrioma
32 year old obese woman presents with hirsutism and inability to conceive a child. Likely diagnosis?
Polycystic ovarian syndrome
Lab findings in polycystic ovarian syndrome
Increase LH/FSH ratio (>2:1), increased testosterone
Pelvic ultrasound in a woman complaining of infertility demonstrates a "black pearl necklace" sign
Polycystic ovarian syndrome
Signs and symptoms of menopause (Mnemonic HAVOC)
Hot flashes
Atrophy of the
Vagina
Osteoporosis
Coronary artery disease
Lab findings in menopause
Increased FSH and LH, increased total cholesterol, decreased HDL
What are Amsel's criteria?
Abnormal whitish-gray discharge, vaginal pH >4.5, positive amine ("whiff") test, clue cells.
3 out of 4 Amsel's criteria are required for the clinical diagnosis of bacterial vaginosis
Lab test used to screen for gestational diabetes
1 hour glucose tolerance test
Lab test used to confirm the diagnosis of gestational diabetes
3 hour glucose tolerance test
What is the most common gynecologic cancer in the United States?
Endometrial cancer
What is the most common type of endometrial cancer?
Adenocarcinoma
What are the risk factors for endometrial cancer?
Nulliparity, late menopause, DM, obesity, unopposed estrogen therapy, and use of tamoxifen
What hormone stimulates the release of the ovum from the follicle on day 14 of the menstrual cycle?
Luteinizing hormone (LH)
Uterine fibroids are also known as...
leiomyomas
In what type of female genital cancer do oral contraceptives have a protective effect?
Ovarian cancer
What tumor markers may be used to monitor ovarian cancer?
CA-125, alphafetoprotein, and hCGs
What types of HPV have a correlation with cervical dysplasia?
HPV types 16, 18 and 31
What is the most common cancer type in cervical cancer?
Squamous cell carcinoma followed by adenocarcinoma
What is the next step after an abnormal Pap smear?
Colposcopy with biopsy
What pathogen will cause the cervix to friable with prominent papillae and punctate hemorrhages (strawberry cervix)?
Trichomonas vaginalis
A 20 year old sexually active female presents with pelvic discomfort and dyspareunia. On exam, a thick creamy discharge is noted coming from the cervix. Culture reveals Gram-negative intracellular diplococci. Diagnosis?
N. gonorrhea
What antibiotic should be used to treat mastitis?
Dicloxacillin
What are the risk factors for pelvic inflammatory disorder?
Nonwhite race, unmarried, cigarette smoking, use of IUD
What is Chandelier's sign?
Cervical motion tenderness, a sign of PID
What are the absolute contraindications to the use of IUDs?
Current pregnancy, abnormal vaginal bleeding, gynecologic cancer, acute cervical or uterine infection, history of PID
What are the absolute contraindications to the use of oral contraceptive pills?
Thromboembolism, pulmonary embolism, myocardial infarction, stroke, breast/endometrial cancer, hepatic tumor or abnormal liver function
In what condition is preeclampsia seen before 20 weeks gestation?
Hydatiform mole
What is the gold standard treatment for unruptured tubal pregnancies less than 2.0 cm?
salpingostomy
What are the risk factors for gestational diabetes?
Age over 25 years, obesity, positive family history, history of macrosomia, and previous miscarriage
What is the average doubling time during the first trimester pregnancy for beta-HCG?
48 hours