OB/GYN (Shelf)

Syphillis tx in pregnancy

Penicillin, even if allergic

Thyroid studies in pregnancy

hCG increases TBG and stimulates TSH
Overall, this causes an increase in TOTAL T4, and FREE T4 stays the same as well TSH

Renal changes in pregnancy, effect on BUN and creatinine

Increased RPF and GFR lead to decreases in BUN, creatinine

Guideline for chronic vs obstetric HTN

Whether it's before or after 20 wks

HTN puts you at risk for what OB complication?

abruptio placenta

Causes of vomiting in pregnancy

Hyperemesis gravidarum
Hydatidiform mole

Hyperemesis gravidarum (sx, labs)

Severe N/V, ketonuria, elevated LFTs, amylase, lipase (from salivary glands)

External cephalic version

For breeches at 37 weeks+
Make sure you do it in a safe, prepared environment

Cardinal Movements

Engagement
Flexion
Internal rotation
Extension
External rotation
Lateral rotation

Most common twin types

Monochorion, diamnion
Dizygotic

Metastasis location for trophoblastic gestational disease and endometrial CA

Lungs

SE of tocolysis

Pulmonary edema

DM risk to fetus

Cardiac

Recommended weight gain for obese pregnant pt

11-20lbs

Fourth stage of labor

After placental delivery

When to go to the hospital during labor

ctx/5 min
ROM
Vaginal bleeding

How to treat infant from HIV+ mom

24 hrs zidovudine (AZT)

APGAR categories

Color
Activity
Breathing
Reflex
HR

GDM vs lifelong DM effect on fetus

Macro vs microsomia

Danger of one twin getting too much blood

Polycythemia

Mg + preeclampsia worry for fetus

RDS

How to suppress lactation

Breast binding, ice packs
NO MEDS

Most common cause of postpartum hemorrhage

Uterine atony

Uterine atony (RF, tx)

Chorio, multiple gestations, macrosomia, multiparous
Pitocin IV --> PGs --> D&C --> uterine balloon --> hysterectomy/surgery

Placenta accreta tx

Exploratory lap

PPH sources

Uterine atony (MC)
Cervical or vaginal lacerations
Placenta accreta
Retained POCs
Uterine rupture

Methylergonovine (Use, CI)

Used for uterus contraction if boggy after birth
CI in HTN pts

Chorio tx

Amoxicillin
Gentamicin

Septic pelvic thrombophlebitis (defn, sx, tx)

Thrombosis of pelvic veins
Fever, rule out other causes of postpartum infection
Anticoagulation, abx

Paroxetine in pregnancy can cause

Heart defects
PHTN

Placental sulfatase deficiency

Causes postterm gestations

Amnioinfusion indication

Repetitive variable decels

Assymetric growth restriction vs symmetric

Weight is decreased while height is fine
vs
Weight and height are proportionally decreased
Later vs earlier in pregnancy

pruritus gravidarum (tx, similar to)

Ursodeoxycholic acid
similar to intrahepatic cholestasis, where bile builds up in skin and itches

What is NST?

Non-stress test
Seeing if FHR responds to FM

Difference between mild and severe preeclampsia

3+ vs 5+ proteinuria

Sx of Mg toxicity

diminished reflexes, resp depression, and cardiac arrhythmias at worst

SSRI CI in pregancy?

paroxetine

Discriminatory zone

2000hCG (when pregnancy detectable on US)

Definition of recurrent abortions

3

Tests for recurrent abortions (3)

lupus, thyroid, DM

in early pregnancy what can cause abortion

Smoking, alcohol

What vaccine do you always give pregnant women

Flu

Osteoporosis in women is exacerbated by what substance?

EtOH

3 deceleration types and their etiology

Variable-cord compression
Early-head compression
Late-uteroplacental deficiency

Tx of decels

Change mom's position, give oxygen

First year or two of menarche is often...

anovulatory
irregular

Endometriosis (dx gold standard)

Laparotomy

Condyloma acuminata

HPV warts
6 + 11

Crabs (phthirus pubic) and Scabies tx

Anti-parasitics (ivermectin)

SEs of OCPs

Hypercoagulability
HTN

CI for contraceptive patch

Obesity

Lichen planus vs lichen sclerosis vs lichen simplex chronicus

Painful, extragenital rashes
vs
PRURITIC, old and young, consumes stuff
vs
Itching --> lichen buildup --> more itching, etc

Huge hint for endometritis

Foul smelling lochia

First steps in endometriosis tx, and tx for fertility

1) NSAIDs
2) OCPs
For fertility: Clomiphene

Key finding in ovarian torsion

N/V

Danazol mechanism

Blocks LH FSH midcycle surges
Testosterone-like

Most common pathogen in mastitis

Staph

First steps in breast mass

Mammogram
Fine needle aspiration
Excisional biopsy

Tx for molar pregnancy

D&C (first)
Methotrexate too

HSIL always means

Cone that ish

Epidural + BP

Lowers blood pressure by blocking sympathetic vasoconstrictive abilities

Signs of FAS

IUGR
Low ears
Flat philtrum
Thin lip

What causes AGR from the mom? Why is it assymetric?

Maternal blood restriction/vascular restriction, which can be caused by HTN, preeclampsia, smoking
Asymmetry because the baby reroutes the blood to the most important organs

Tx of endometriosis vs adenomyosis

Danazol, OCPs
vs
Hysterectomy

Estrogen replacement therapy means you need to supplement ? hormone

TH

Big difference between trichomonas and BV sx

Trichomonas presents with itching

Physiologic leukorrhea

Normal white discharge with no other sx

Can macrosomia or fibroids indicate for a CS?

Fibroids more so

Cervical insufficiency dx gold standard

Transvaginal US

When do you need to do steroids in preterm delivery?

<35 weeks. Afterwards you can assume the lungs are mature

Plan B generic name

Levonorgestrel

When do you disregard GBS culture results?

If pt has tested positive before, treat as if they still do no matter what

Fitz-Hugh-Curtis syndrome

PID danger
Perihepatitis from the infection ascending to liver

DUB (what it is, tx)

Vaginal bleeding after everything else is ruled out
Iron if mild, progesterone if medium, estrogen if heavy
Endometrial bx if over 35 yo

BPP Components (5)

Breathing
Heart
Moving
AFI
NST

Weight limit for a vaginal delivery

5000g

When do you give RhoGAM

28 wks
Postpartum

Sequelae of eclampsia in later life

CV dz

Emerging STD similar to G/C

Mycoplasma genitalium

Podofilox (use)

Genital warts (HPV)

Clomiphene citrate (M, T)

M-Antiestrogen, inhibiting E's negative feedback in pituitary
T-Because it blocks estrogen, can cause menopausal sx

When is cervical mucous clear and profuse?

Ovulation

Goal glc level in GDM pts

90

Down syndrome quad screen

Increased bHcg, inhibin
Decreased AFP, esriol

Big benefit of CVS over amniocentesis

Can be done earlier

Fibroid tx (meds vs preserving fertility vs definitive)

Danazol, leuprolide, OCPs
vs
Myomectomy
vs
Hysterectomy

Raloxifene's effect on organ systems

Breast - antag
Bone - agonist
Endometrium - antagonist
Hypercoagulability - agonist

Letrozole (M, similar drugs)

Aromatase inhibitor
Increases FSH, LH
Similar to anastrozole

BPP scores

8+ is great
<4 is delivery

PAPP-A

Low value can indicate Down syndrome

Inhibin (fxn)

Decreases FSH

17alpha hydroxylase def sx

This enzyme needed to divert stuff past aldosterone synthesis
No sex hormones, no cortisol, a lot of aldosterone
Females will have normal internal organs, lacking external secondary features