COMAT obgyn shelf 7 2015

ruhland1's version from 2015-07-20 13:06

Section 1

Question Answer
anatomic screen u/s wk18-20 (2nd tri)
anatomic screen dxNTD, anencephaly, encephalocele, myelomeningocele
myelomeningocele =spina bifda
cystic fibrosis screen indicfam hx
GBS culture wk32-36
one hour glc challenge wk24-28
2nd line GBS tx when ALL to penicillincefalozolin
when is cefalazolin contrahx of anaphylaxis, urticaria, angioedema, or resp distress
3rd line GBS txclindamycin/vancomycin
treat of choice chylmidiaAZT
ABX that do not cross placentaerythromycin and AZT
penicillin ALL-high + resist clindamycin then usevanco
GBS + and hx of anaphylaxiscefalozolin is contra!

Section 2

Question Answer
physiological nipple dischargelabs can be normal (idiopathic)
unilateral bloody nipple dischductal carcinoma in situ
unilateral straw-colored nipple dischintraductal papilloma
inhibit DA *up galactorrhea
metocolpramideantiemitic, up gallactorrhea
antiemetic, up gallactorrheaprochlorperazine
verapmilantihtn up gallactorrhea
anti htn up gallactorrheamethyldopa
pear shapedtrichomonas bug ID
smelly yellow green dischtricomonas presentation
trichomonasstrawberry cervix
+ whifftricho and bact vag
how to ddx tricho and bact vaginosisbact vag is more "fishy" smell
clue cellsgardenella in bact vaginosis
gardenlla motilitycorkscrew
chandelier signextreme cervical tenderness upon palp in PID
PID can causeFitz-Hugh-Curtis syndrome
Fitz-H-C syndromeinfection of liver capsule (PID can cause)
vulvoaginitisumbrella term for STI causing inflamm of vag wall
pH tricho>5.4
pH candiasis<4.5

Section 3

Question Answer
EXIT=ex utero intrapartum tx
role of EXITallows lifesaving interventions to fetus during c-sec
need to ? for EXIT proceduresmust relax it in order to maintain uteroplacental circ and fetal gas exchange
uterine relaxation adverseup hypotn up atony * up risk PPHemm
defective LH/FSH receptorsOvarnian resist synd (dn estrogen and progesterone)
ovarian resist labsup LH/FSH/GnRH dn estro/progest
hypothyroid pit labsdn GnRH, LH/FSH, Estro/progest
PCOSup estrogen and androgen
Ovarian Resistance synd= savage syndrome hypergonadotrophic hypogonadism and primary amenorrhea
emergent C-section and GBS + maternal complicpostpartum endometrititis
postpartym endometritisthink malodorus lochia within 36 hours postpartum
postpartum endometritis txclinda/gentamycin
up FHR, maternal F, purlent amniotic fluid thinkchorioamnionitis
abd/back pain, "picket fence" oscilating feverseptic pelvic thrombophlebitis

Section 4

Question Answer
use oxytocin for long time causesantidiuresis and natriuresis * up hyponatremia
oxytocin similar to ____ in structurevasopressin
maximum oxytocin dose (mU/min)40
oxytocin receptor requires ____ to workmagnesium
adverse of oxytocin IV oloushypotn, N/V
hi dose vasopressin admin can causeuterine contractions
pain assoc w mensesdysmenorrhea
primary vs 2ndary dysmenorrhea first begins sx with menstration and no pelvic pathos, 2nd begins in 20s/30s after previous normal menstration mid-cycle
primary dysmenn txNSAID/ OC
dx endometlaparoscopy
endomet causes2ndary dysmenn
PID buggon/chyl
"honeymoon cystitis"S. saprophyticus

Section 5

Question Answer
low MSAFP found and no other hx do whatfetal U/S to r/o inaccurate gest age/multiple gestations
triple screenestriol, B-hCG, MSAFP
triple screen wk16-18
triple screen usedetect chr abnormalities
aminocentesis wk15-17
aminocent indicold gest age and abnormal quad/triple screen
quad screentriple screen + inhibin A
why look for inhibin Abetter sensitivity than MSAFP alone
ABE Imnemonic for for quad
stage 220-70 min
stage 1 activepainful contract, dilating >1cm/hr
stage 1 latent`dil <1 cm/hr
stage 41st couple hours after placental delivery to restablish uterine tone
stage 4 hasten of completion viaoxytocin up by up breast feed

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