Obgyn Cram

eesohbel's version from 2015-11-06 00:42

Section 1

Question Answer
prenatal visits weeks 0-28every 4
prenatal visits weeks 29-35every 2
prenatal visits 36-birthevery week
9-14 weekstriple screen and CVS
15-22 weeksoffer MSAFP or quad
18-20 weeksultrasound for full anatomic screen
24-28one hour glucose challenge test
35-40GBS and repeat CBC
34-40cervical chlamydia and gonorrhea, HIV, RPR n high risk patients


Teratogenic Drugs + Environmental factors

Question Answer
ACE inhibitorsrenal malformations
Fluoroquinolonescartilage damage
Tetracyclinesdiscolored teeth
Cyclophosphamideear/facial anomalies, limb hypoplasia, absence of digits
Methotrexateneural tube defects (folate metabolism), abortion
Carbamazepineneural tube defects (folate metabolism)
Valproic acidneural tube defects (folate metabolism)
Phenytoinfetal hydantioin syndrome (cleft lip, facial/limb abnormalitis, dvlpmtl delay)
LithiumEbstein anomaly - tricuspid valve is displaced downward into RV
StatinsCNS and limb abnormalities
Warfarinfacial/limb/CNS anomalies, spontaneous abortion
IsotretinoinSpontaneous abortion, parathyroid/brain/heart defects; disruption of neural crest cell migration; defective homeobox gene expression
Diethylstilbestrol (DES)clear cell vaginal adenocarcinoma later in life
Thalidomide limb deformity, severe hypoplasia of arms/legs
Alcoholcleft lip/palate, intellectual disability, microcephaly, holoprosencephaly, distinct facial features
CocaineNot exactly teratogenic, but interferes w blood flow to the fetus; restrictive of growth - spontaneous abortion, placental abruption, prematurity
Uncontrolled maternal diabetesNot exactly teratogenic, but assctd w rare condition-caudal regression syndrome (agenesis of sacrum + occasionally lumbar spine, flaccid paralysis of legs, urinary incontinence)
TobaccoNot exactly teratogenic, but interferes w blood flow to the fetus; growth retardation, placental abruption
Vit. A overdoseCraniofacial abnormalities, posterior fossa CNS defects, auditory defects, abnormalities of the great vessels (defects similar to those found in DiGeorge syndrome)

Common Congenital infections

Question Answer
hyrdocephalus, intracranial calcificiations, chorioretinitis, ring-enhancing lesions on MRItoxo
treatment for toxopyrimethamine + sulfadizine
blueberry muffin rash, cataracts, mental retardation, hearing loss, PDArubella
petechial rash and periventricular calcificiationsCMV

GYn cram

Question Answer
which phase of the menstraul cycle is always the same amount of timeluteal phase
difference in pain presentation between endometriosis and adenomyosisendo is cyclical pain, not enlarged uterus. adeno is triad of noncyclical pain, menorrhagia and an enlarged uterus
a fluctuant swelling 1-4 cm in diameters as seen in the inferior portion of either labia minusnabothian cyst
ulcer pain none and tender draining lymph nodeschlamydia
ulcer pain none and non-tender lymph nodessyphillis
presentation of TSSTabrupt onset of fever, vomitting, watery diarrhea with a fever of 102 or higher. a diffuse macular erythematous rash is also seen
upper third of cervixendocervix
lower two thirds of cervixectocervix
endocervix (upper)columnar cells
ectocervix (lower)squamous cells

Sex genetic disorders

Question Answer
Karyotype of Klinefelter'sXXY
Cause of Klinefelter'smeiotic nondisjunction
Physical presentation of Klinefelter'stesticular atrophy
Eunuchoid body shape
tall, long extremities
gynecomastia, female hair distribution
Hormone dys'fn of Klinefelter's syndromeDysgenesis of seminiferous tubules → ↓ inhibin → ↑ FSH
Abnormal Leydig cell function → ↓ testosterone → ↑ LH. Increased FSH leads to increased aromatase leading to increased estrogen
Cardiac defects in Turnerspreductal coarctation, and bicuspid aortic vavle
Most common cause of 1° amenorrheaTurner syndrome
↓ estrogen → ↑ LH/FSH
Double Y malesPhenotypically normal
very tall
severe acne
antisocial - some with autism
Normal fertility
Disorder w ↑ testosterone & ↑ LHDefective androgen receptor
Disorder w ↑ Testosterone & ↓ LHTestosterone-secreting tumor, exogenous steroids
Disorder with ↓ Testosterone & ↑ LH1° hypogonadism
Disorder w ↓ testosterone & ↓ LHHypogonadotropic hypogonadism (Kallman's)
Female pseudo-hermaphroditeOvaries are present, but external genitalia are virilized or ambiguous
Male pseudo-hermaphroditeTestes present, but external genitalia are female or ambiguous
MC form is androgen insensitivity syndrome (testicular feminization)
True hermaphroditism46,XX or 47,XXY
both ovary and testicular tissue present
ambiguous genitalia
very rare
Androgen insensitivity syndrome46,XY - defect in androgen receptor resulting in normally appearing female. Patients develop testes usually found in labia majory
5α-reductase deficiencyAutosomal recessive - inability to convert testosterone to DHT
Ambiguous genitalia until puberty until ↑ testosterone causes masculinization and growth
Kallmann syndromeDefective migration of GnRH cells and formation of olfactory bulb
Anosmia w lack of sexual characteristics
↓ synthesis of GnRH in hypothalamus → ↓ FSH/LH/Testosterone/sperm count
Male presents with infertility, lack of 2° sexual characteristics, and the inability to smellKallmann syndrome
Hallmark of diagnosis for 5 alpha reductase deficiencyElevated serum ratio of testosterone to DHT, but testosterone/estrogen levels are normal. LH is normal

Section 2

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