OBGYN shelf stuff 3

ruhland1's version from 2015-07-22 13:54

Section 1

Question Answer
peripartum cardiomyopathy (PP CMP) windowlast mo preg, 6 mo postpartum
PP CMP peak incidence2 mo postpartum
PP CMP sxangina, HF, abd fullness, s3, JVD
PP CMP evalecho
PP CMP txdigi, diuretic, ACEi (-pril)
PP CMP post part txheart tp (esp. if not resolved in 6 mo)
GBS colonized mom30%
GBS colonized infant if mom +50%
GBS screening35-37wk
x<37 wk and GBS + do?all pt ppx
x>37 wk + GBS(+ GBS woman)
PROM and GBSppx if >18hrs
fever during laboralways GBS ppx
GBS bacturiameans you got a fuckload
previous infant with GBS diseasemeans you fuckin ppx
GBS txpenicllin G
GBS if allergicclindamycin
GBS if allergic to Peni and Clinvanco
preterm labor and endometritisgest + chyl
tx of chyl in pregAZT for BOTH patient and partner (doxycyline=contra)

Section 2

Question Answer
does not increase risk of cogen malformHSV
active vaginal HSV50% transmission
HSV on momgenital ulcer
HSV infantvesicles all over body, sz, dn resp, menin, dn neuro develop
HSV lz presents in laborc-sec
marked reduces HSV mortacyclovir
pemphigoid gestationis (PMG GES) windowtri 2 - postpartum
T3trimester 3
PMG GES presentationpruritic bullae/papule/vesicles on abd, LE UE
PMG GESNOT assoc with herpes
PMG GES MOAantibodies against hemidesmosomal proteins
PMG GES txtopical steroid/antihist systemic cortico
PUPPP=papular urticarial papules and plaques of preg
most common pruritic dermatosis of pregPUPPP
PUPPPsx include severe periumbilical itching which spreads to extremities
periumbilical eryth papules and hives thinkPUPPP
PUPPP txoral/topical antihist, topical cortico

Section 3

Question Answer
placenta impaired meansdn o2 and nutrients, up waste in baby
uteroplacental insuff= (UPIS)placenta impaird
UPIS etioplacenta previ/abrupt/edema(from hydrops fetalis)
UPIS fetal compensationshunt blood to brain, heart and adrenal glands
UPIS(uteroplacental insuffienciency) undx'edup metab acid up organ damage to fetus
surgical cerlage indicincompetent cervix tx (suture cervix closed)
cerlage untillabor/ROM
2 most common causes of 3rd tri bleedplacenta abrupto/ placenta previa
placenta previa risks of occuringif had prior c-sec, grand multi parous, old mom
grand multiparity=5 or more previous pregnancies

Section 4

Question Answer
placenta previa onset29-30wk
placena previa on fetusdo nothing
eval pla prevtransabd/transvag u/s
proceed to deliver in pla previapersistent labor, x>500ml blood, dn coag, L:S>2, x>36wk gestation
L:S>2 meansfetal lungs are mature
pla prev and cogen malfup risk 2x
vasa previarupture of fetal vessels that cross mem covering the cervix
risk of abruptio placentaetobacco
PIH (preg induced htn)risk of abruptio placentae

Section 5

Question Answer
PROMrisk of abruptio placentae
risk of abruptio placentaenose cola
fetus and abruptio placentaedistress is present
abru plac evalfetal distress and u/s
abrup plac txcotinuos fetal monitory, if moderate/severe then DELIVER
10% of all abruptions haveDIC
2nd leading cause of maternal mortectopic
ectopic locationampulla of tube
ectopic 10x riskprior ectopic
ectopic 6x riskPID (salpingitis)
ectopic and contraceptionup in IUD

Section 6

Question Answer
ectopic 3x riskold mom
ectopic racemexican/black
see abd pain/irreg bleed/ammen thinkectopic preg
PxEx ectopiccervical motion tender, adnexal mass
hypotn/shockrupt ectopic
ectopic labB-HCG lower than norm, prolonged doubling times
B-hCG doubles every48 hours
elevated B-hCG with + ectopic findingno signs of uterine gest sac by u/s
ectopic txMTX or laparoscopic
ectopic med for momsRhoGAM if mom Rh-
follow this post ect txlowering B-hCG levels
B-hCG is made bytrophoblastic tissue (why moles have some much B-hCG