hydronephrosis Compression by uterus and R ovarian vein Braxton hicks Short duration less intense pain 39 weeks early labor no ROM, next step? Physical can No milk let down, slow mentation, wt gain, Sheehans syndrome fatigue, cant stay warm, hypotension, amenorrhea MC karyotype for spontaneous abortion Trisomy Asthma worsens with pregnancy, tx? Corticosteroids Graded compression ultrasonography Dx of appendicitis in pregnant women What lab indicates severity of RH disease of Bilirubin newborn? High AFP Check twins Stages of greif Denial anger bargaining depression acceptance Complication of VBAC UTERINE RUPTURE Premature constriction of ducturss arteriousus Indomethiasis after 32 weeks ROM + tender fundus Chorioamnionitis Cause of fever you wouldnt think of Breast engorgement on day 2 or three Indication for progesterone only DVT hx Fever bleeding dilated cervix 8 weeks Septic abortion Pubocervical facia repair Cystocele Simple cyst, hx of endometriosis Hemmoragic cyst, repeat ultrasound in 2 months Postmenopausal bleeding w/ hx of ovaran cancer Transvaginal ultrasound (more sensitive than CT) TYPE OF leyoma causes of miscarrages Submucosal Endometrial cancer Mc SYMPTOM ABNORMAL VAGINAL BLEEDING, POST MENOPA Boggy uterus Adenomyosis (D and C, hysterectomy) Ca125 Epithelial cancer ovarian Mammography on pt <30? No, breast too dense do us Molar pregnancy, next step CXR (mets of trophoblastic dz) Palapte umbilical cord in vagina C section (vasa previa) Breast feeding decreases risk of Ovarian cancer Ambivalence towards baby Post partum depression (not blues) Obese pt, common complication Hypertension 30CC FETAL BLOOD NEUTRALIZED BY 300MICROGRAMS OF rhoGAM Twin infant death rate 5x higher than singletons Cytotec PGE analog (misoprostol) induces labor for unfavorable cervix at 40 weeks Dilate cervix Prostaglandins Smoking Cervical cancer Most common cause of preterm labor Idiopathic
Tocolytics at 36 weeks Contraindicated
Steroids controversial after 32 weeks Risk of placenta accrete C sections Headache photophbia nausea Meningitis d/t epidural, do lumbar puncture Hysterectomy, dont do this test Papsmear APGO uwise
Colon cancer screen no fam hx; with fam hx; 50; 40
Folate antagonist Methotrexate; tx of ectopic Amen, bleeding, ab pain, tachycardic Ruptured ectopic First depo provera Bleeding at the beginning, norma Missed abortion tx Misoprostol prost E1 (expulsion of products) Recurrent preg lause, hx of thrombosis Dx: antiphosphlipid, tx: asprin + heparin Tx of vulvular pain (pain with sex, tampons etc) TCA White plaques and red errosions on vulvula, wrist Leichen planus and mouth (skin, scalp, nails, mouth) Leichen sclerosis White patch only on vagina Burning irritation followed by geneital lesions Herpes simplex Hx of ehlers danlos Pelvic organ prolapse (FAM HX) Uterosacral nodularity Endometriosis (lazer ablation if young) Urgency frequency pelvic pain, nocturia Interstitial cystitis 54 104 lbs amenorrea Hypothalamic pituitary problem (aneoxrexia nervos) Hx of diabetes, and acanthosis ni, next step? Fasting insulin (PCOS) ANOVULATION, HYPERANDROGEN, POLYCISTIC Pcos OVARIES STRETCH MARKS ON ABDOMEN Cushings Fibroids, next step? Endo bx to r/o endometrial carcinoma Contraindication to hormone replacement Vaginal bleeding (endo cancer) Principle symptom of endo cancer Vaginal bleeding Pt w/ previous fracture Immediate bisphosphonates Why does exercise help PMS ENDORPHINS Elevated firm irregular vulvular lesion BOPSY Pap normal but white plaque on PE Colposcopy biopsy (paps can have false positives) Tx of fibroid gnRH agonist SE of tamoxifen Endometril cancer; biopsy only if vaginal bleeding Best test to evaluate pelvic mass CT scan Known ovarian cancer, test for reoccurance Pet scan Suspected ovarian cancer test Ct scan Risk of endometritis Prolonged labor Endometritis Most common cause of postpartum fever Thin endometrial stripe Rules out intrauterine pregnancy must be ectopic High bhcg but nothing on ultrasound Ectopic pregnancy Bhcg leve at which you can see baby on 2000 ultrasound Pain w/ percussion of back Pyelonephritis (septic shock) Most common cause of sepsis in pregnancy Pyelonephritis Fam hx of diabetes, fat, Screen NOW w/ 50g oral glucose Pregnant, depressed, drug contraindicated Paroxetine (fetal cardiac malformations pul htn) Dead baby at 34 weeks, no preterm care Diabetes caused it probably Arrest of dilation Amniotomy - oxytocin APGO uwise
How to give fibrinogen Fresh frozen plazma
4 c sections, risk of? Accrete Cause of cord compression (and decels) PPROM CORD COMP DECEL TENDER FUNDUS Chorio deliver b-lynch suture Unresponsive uterine atony Placental sulfatase def Post term pregnancy Fatty tissue during D and C after missed abortion Stop, do laparotomy (omental tissue from bowel) What is preformed earler cvs or amniocentesis CVS What contraception decreases risk of Combined OCP endometrial cancer Oichen simplex chronicus Itchy at night, skin markins only from itching Infection of fallopian tubes Salpingitis PID aka Salpingitis Closure of the vagina to tx vaginal prolapse Colpocleisis Ovarian torsion, next step Surgical exploration Complications of hysterectomy Adhesive disease, chronic pain Complications of mullarian agenesis Renal anomalies, do renal US BLIND POUCH VAGINA MULLERIAN AGENESIS Tx of hirsutisim Spirolactone Tx of endometriosis Anazol (wrsens hirsutism and acne) Second line tx of hirsutism Provera nd Lupron Confirm endometriosis w/ Laproscopy Menstrual pain refractive to depo provera Probably endometriosis, do laproscopy Tx of painful menstrual cramps Ibuprofen and OCP Mass in Bartholin gland Biopsy Tx of fibroid Myomectomy Fam hx of endometrial ca, but no symptoms Annual exams, no good test. Test for brca in AFFECTED individuals (pt mom if she has breast cancer)