COMAT obgyn shelf 8 2015

ruhland1's version from 2015-07-20 14:25

Section 1

Question Answer
fetal tachy > than160
tertbutaline s/efetal tach
fetal tach *automatically FHR strip category II
fetal bradyautomatic FHR cat III
absent variabiltyFHR Cat III
decel in CAT IIIlate (fetal acidosis, utplacental insuff, fetal hypoxia)
variables in Cat IIIrecurrent
honeymoon bugS. Saprophyticus (novobiocin resist)
S. Saprocauses honeymoon cystitis
nitrofurantoin, TMP-SMX, cipro1st line for UTI
Actinyces Israleii in OBGYNpelvic inf 2ndary to long intrauterine device use
A. Israelli txpenecillin G
CDACGChylmidia Doxy/AZT Ceftriaxone Gono
S. SaprophyticusMC bug in sexually active young women
most reported STI in USAN. Gono
novobiocin sensitiveS. Epidermis
3rd trimester F, Tachy, Tachy FHR + PROMchorioaminonitis

Section 2

Question Answer
coke in 3rd trim10% rate abruptio placenta
why use U/S to dx appendicitisFetus avoids ionizing RADs
Placenta Accreta txCesarean hysterectomy b/c up risk PHHemm
up PROM * up risk ofchorioaminoitis
placenta percretaplacenta invades through uterine serosa
placenta incretainvasion of myomet
placenta accretaplacenta adheres to myomet w/o invasion of uterine muscle
placenta accreta mxbakri balloon, embolization of internal iliac,
painful dark red bloodpalcental abruption
ddx placental abrupt from previaabrupt=dark red previa=bright red
dn PLT, microangiopathic hemolytic anemia, renal failure, HA and fever, TTP- HUS
HELLP syndimmediate delivery
TTP txplasmapheresis
important to ddx TTP fromHELLP synd
use dexamethsoneless than 34wk promote fetal lung mature
mother must be STABLEwhen administering dexamethasone
severe hypertnhydralazine

Section 3

Question Answer
unilateral mastitis tx if mom breast feedabx ppx for mom and continue bilateral breast feed
mastitisthink staph aure
long heavy period and abnormal shaped uterusthink leiomyoma
leiomyomadysmenn,menorrhagia,abd fullnes
childbearing age + leiomyomatx is NSAID/OC/uterus-preserving srx
endometrial tissue grows into myometadenomyosis
classic adenomyosismultiparous, 35-45 year
adeonmyosis sxnon-cyclical pelvic pain and menorrhagia
ddx adeno from leioformer has homgenous enlargement of uterus
irregular contour uterus can r/oadenomyosis
multiparous + excess estrogen causespelvic congestion syndrome
estrogencauses vasodil, blood pooling, and varicose vein
tender adenexa, posterior fornix, rectovaginal septumthink endometriosis
> 50 yo abnormal vag bleed, post menoendomet cx (severe cx = pain)
nafarelinGnRH agonist
leiomyoma pre-opmed is GnRH agonist to diminsh bleeding/tmx size
U/Sgold for Leiomyoma
Af Am2x up risk leiomyoma

Section 4

Question Answer
HPV thinkVag Squamous Cell cx
pessary indictx uterus prolapse
long pessary useup risk vag cx
DES thinkclear cell vag cx
young premenop vag cxadenocx, endodermal sinus tmx, rhabdomyosarcoma
PMSMRprogesterone-mediated smooth muscle relax
progesterone on GIdn LES tone * up GERD
PMSMR tx is antacid/sucrasulfate
B-hCGrole maintains preg
remodels collagen fibersrelaxin (pelvic only!)
chronic htn only can be dx'ed <20 wks GA
preclampsia proteinuria>.3 g/ in 24 hour
preeclampsia creatinine> 1/1 mg/dL or doubling of it
preclampsia LFT2x normal

Section 5

Question Answer
placenta normal position, prior c-sec, find vag bleedthink placenta accreta
ddx placenta percreta from accretaformer is more severe and involves growth through the myomet
placenta accretatx may need hysterecomy after c-sec
severe htn, trauma, painful bleedthink placental abrupt
abd irreg contour, severe abd pain, traumauterine rupture
fetal vessels run across osvasa previa
vasa previa txc-sec
vasa previa dxu/s
NTD supplement0.4g folic
when use 4 g folate/dayprevious affected pregnancy
B1 defdue to hyperemesis gravidum
contra in pregVit A
Vit Aexcess * up craniofacial malform, CNS, heart, and thymus abnormal
Vit B6used to tx nausea assoc w/ preg

Section 6

Question Answer
screening breast cx begins40 yo or 10 years before earliest dx'd breast cx in relative
screen breast cxbi-yearly in woman 40/50-74
high risk breast cxif >20% in lifetime
if high risk breast cancereval for BRCA
BRCA+screen starting 25 yo
yearly MRI ifknown relatives w BRCA carrier or >20% lifetime breast cx risk
5% breast cxassoc w/ genes
pregnant *remove IUD!
if cant find IUD stringuse u/s or hysteroscopy to find
B-hCG peak wk8-11
miscarriage if IUD left in50%
missing IUD and cant find in U/Sget anteroposterior and lateral upright plain radiographs
1st year IUD explusion5-10%
hormon IUD moaprogestin thickens cervical mucus, alters endomet and tuball motility
levongesterelsynthetic progestin in IUD, use is 5 yr
progestin endocrineNFB to Hthal * dn FSH/LH
copper IUDmoa is spermicidal, use is 10 year
finds uterine position of hormonal IUDMRI
non-preg plus need to find IUD(hormonal or copper)use plain film
plain film contrawhen PREG

Recent badges