Step 3- OBGYN

zms2187's version from 2015-11-24 19:23


Question Answer
GBS screening when? 35-37 weeks with a swab (also get cervical GC/chlamydia culture/RPR/HIV in at risk pops)
when to screen for down syndrome? 15-19 wks triple marker screen/quadruple test (triple + inhibin A), can also offer amnio for >35yo
When to give rhogam in pregnancygive to Rh- pts at 28 weeks
CVS vs amniocentesis?CVS can be done earlier at 10-12 weeks (rather than 15-20 wks) to screen for genetic dz (risk fetal loss 1-5%)
early vs late decelerations? early decel begins/ends at same time as contractions= fetal head compression (no distress), late is when decels begin after onset of contractions and persist until after contractions are finished (>30s) and indicates fetal hypoxia
variable decel signifies?umbilical cord compression
managing sugars during labor for diabeticsif pre-gestational DM then use D5+/- insulin drip w/checks q1-2 hours
Key features hyperemesis gravidarummetabolic alkalosis, hyponatremia, ketonuria.
tx of eclampsia seizuresIV mag
features of gestational trophoblastic dz (moles)1st tri uterine bleeding, grape-like molar clusters into vagina, "snowstorm" on u/s w/no sac or fetus or heart tones, very high beta-hcg >100,000

Section 2

Question Answer
M.c presenting symptom of sheehansfailure to lactate 2/2 decrease prolactin levels. Also amenorrhea, loss of sexual hair, lethargy.
Tx sheehanslifelong HRT (steroids, levothyroxine, E and P)
M.c causes of post-partum hemorrhageuterine atony (boggy soft uterus, tx w/vigorous bimanual massage/oxytocin/methylergonovine if no HTN), genital tract trauma, retained placenta
Risks for endometritisc-section, prolonged ROM
when is chorioamnionitis diagnosed?during labor
Tx mastitisdicloxacillin or erythromycin. continue nursing. I&D if abscess
C.I to breast feedingHIV, active hepatitis, warfarin, chloramphenicol, tetracycline
side effect of SSRI in newborn?persistent pulm htn
when to give rhogamRh- mom w/hx of devliery of Rh+ baby, if dad is Rh+ or uncertain Rh status, if baby is Rh+ at delivery
risks for placental abruptionhtn, cocaine use, smoking, pelvic trauma
Placenta previa risksprior c-section, multiple gestations, prior hx previa
risks for uterine ruptureprior uterine scar, trauma, grand multiparity

Section 3

Question Answer
causes of oligohydramniosfetal UT abnormalities (renal agenesis, polycystic kidneys, GU obstruction), chronic uteroplacental insufficiency
causes of polyhydramniosfetal duodenal atresia or TE fistula, uncontrolled maternal DM, multiple gestations
how to diagnose placental abruption, previa, and uterine ruptureclinical diagnosis for abruption and rupture, do u/s for previa to determine placenta position (NO CERVICAL EXAMS)