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OBGYN:
OBGYN
93
Accounting
Graduate
07/24/2012

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Cards

Term
Initial OB labs:
Definition
- Blood type, Rh
- CBC (hemoglobin)
- Rubella Ab
- Pap test
- STDs (G&C, RPR, HIV, Hep B &C)
- PPD in high risk patients
Term
Chorionic villus sampling (CVS) is offered at ___ weeks and can diagnose __, __, and ___ __, but cannot diagnose ___ __ ___ or ___ __.
Definition
- 10-12 weeks
- Tay-Sach's Disease
- Hemophilia
- Down's Syndrome
- Cannot dx neural tube defects or lung maturity
Term
Amniocentesis is offered at ___ weeks. This can detect __ __, __ __ __, __ __, and ___. It cannot detect ___ __.
Definition
- 15-20 weeks
- chromosomal abnormalities
- neural tube defects
- lung maturity (3rd trimester)
- infection
- cannot detect birth defects like cleft palate or club feet
Term
At ___ to glucose tolerance test is given. Describe this process and the results:
Definition
- 24-28 weeks
- 50 grams glucose given po, 1 hour later glucose tested, <130= normal
- >130-> 3 hour glucose tolerance test is given in which 100 grams of glucose is given and blood sugar is measured at fasting, 1 hr, 2 hr, and 3 hrs, two high readings with this test is dx of GDM
Term
diet controlled GDM:
Definition
A1DM
Term
insulin controlled GDM:
Definition
A2DM
Term
At ___, GBS (group B strep) aka __ __ is tested for from the cervix, vagina, rectum, or vaginal introitus.
Definition
- 34-36 weeks
- Streptococcus agalactiae
Term
Risks of GBS during pregnancy:
Definition
Neonatal sepsis, pneumonia, meningitis
Maternal Metritis
Risks
premature delivery
prolonged rupture of membranes
fever while in labor
positive cultures for GBS during pregnancy
Who to treat
Presentation during preterm labor
History of positive culture for GBS during pregnancy
Spontaneous, premature membrane rupture
Membrane rupture for longer than 18 hours
Presentation with fever
History of previous delivery of a newborn with GBS disease
Term
Treatment of GBS during pregnancy:
Definition
IV Penicillin or Ampicillin and 48 hour observation of baby
Term
At __ weeks, you start doing pelvic exam.
Definition
38
Term
When should you start doing pelvic exam again after labor?
Definition
6 weeks PP

- if episiotomy or lacerations can do pelivic exam only, but no speculum exam
Term
primary amenorrhea:
Definition
- no period by age 16
- no period by age 13 and no secondary sex characteristics
Term
secondary amenorrhea:
Definition
no period for 6 months
Term
PMS occurs in the __ phase ___ weeks before menses.
Definition
- luteal phase
- 1-2 weeks
Term
The triple/quad/penta screens include:
Definition
1. hCG
2. alpha-fetoprotein
3. unconjugated estriol

4. dimeric inhibin A

5. invasive trophoblastic antigen
Term
What could elevated alpha fetoprotein mean on a quad screen?
Definition
- farther along than originally thought
- twins
- neural tube defect
Term
What could low alpha fetoprotein indicate on a quad screen?
Definition
Down's Syndrome
Term
What could low unconjugated estriol mean on a quad screen?
Definition
Down's Syndrome
Term
Top two ddx for bloody nipple discharge:
Definition
- intraductal papilloma
- invasive papillary CA
Term
DDx for galactorrhea:
Definition
- Pregnancy
- Pituitary adenoma
- Acromegaly
- Hypothyroidism
- OCPs
- Anti-HTN medications
- Stress
Term
green sticky nipple discharge:
Definition
duct ectasia
Term
Tmt for Toxic Shock Syndrome:
Definition
IV Vancomycin or Clindamycin x 10-14 days
Term
Tmt of Bartholin's Gland cyst:
Definition
- drainage via word catheter
- marsupialization
Term
Bacterial Vaginosis treatment:
Definition
Metronidazole 500 mg bid x 7 days
Term
Bacterial vaginosis is aka ___ __ __ .
Definition
Haemophilus vaginalis vaginitis
Term
Dx criteria for BV:
Definition
3 of the following:
- Clue cells
- Thin homogenous d/c
- Vaginal pH >4.5
- Fish odor on addition of KOH
Term
Yeast Infection treatment:
Definition
Diflucan 150 mg po once
Term
Gonorrhea treatment:
Definition
Ceftriaxone 250 mg IM once
Term
Chlamydia treatment:
Definition
- Doxycycline 100 mg bid x 7 days

OR

- Azithromycin 1 gram po once (use this in pregnancy)
Term
Bluish discoloration of the vagina and cervix that occurs during pregnancy:
Definition
Chadwick's sign
Term
Softening of the cervix that occurs during pregnancy:
Definition
Hegar's sign
Term
Softening and cyanosis of the cervix that occurs at the fourth week of prenangy:
Definition
Goodell's sign
Term
Quickening occurs around the ___ week of pregnancy.
Definition
16-18 weeks
Term
Meds CI in pregnancy:
Definition
LTBMR
- Lithium
- Tetracycline
- Bromocriptine
- Methotrexate
- Radioactive substances
Term
__ causes condyloma acuminata.
Definition
HPV- condyloma acuminata
Term
__ causes condyloma lata.
Definition
Syphilis> condyloma lata
Term
A chancroid is caused by __ __.
Definition
Haemophilus ducreyi
Term
Lymphogranuloma Venereum is caused by ___ ____, while Granuloma inguinale is caused by ____ ___.
Definition
- Lymphogranuloma Venereum> Chlamydia trachomata
- Granuloma inguinale> Calymmatobacterium Granulomatis
Term
Calymmatobacterium granulomatis causes ___ ___.
Definition
Granuloma inguinale
Term
raised red lesions with rolled margins, rough elevated base and firm induration:
Definition
Granuloma inguinale caused by Calymmatobacterium granulomata
Term
Granuloma inguinale treatment:
Definition
- Doxycycline
- Cipro
- Bactrim
Term
MC STD:
Definition
Chlamydia
Term
Chlamydia is an obligate __ __.
Definition
intracellular parasite
Term
Management of women with ASC-H (atypical squamous cells cannot r/o HSIL), no matter the age?
Definition
Colposcopy
Term
LSIL (low grade squamous intraepithelial neoplasia) is a good indicator of __ __.
Definition
HPV infection
Term
Pap smear of teenager reveals LSIL, what do you do?
Definition
re-pap one year later

(only do coloposcopy in adolescents after 3 paps reveal LSIL)
Term
20 y/o female with LSIL, next step?
Definition
Colposcopic exam with directed biopsies (in reproductive age women with LSIL do colposcopy right away)

(but if prego, wait until 6 weeks pp before doing colposcopic biopsies)
Term
HPV DNA testing is/is not indicated in adolescents.
Definition
is NOT
Term
Adolescent with ASCUS, at 12 months still ASCUS, at 24 months, still ASCUS, what now?
Definition
colposcopy
Term
Reproductive age group women, first LSIL, what do you?
Definition
colposcopy
Term
LSIL colposcopoic exam does NOT reveal CIN2 or 3, what now?
Definition
- cytology at 6 or 12 months OR HPV DNA testing> if >ASC or HPV+> colposcopy
Term
LSIL colposcopic exam does reveal CIL 2/3, what now?
Definition
Leep conization of cervix
Term
Complete molar pregnancy is formed when an ___ ovum is fertilized by a sperm.
Definition
anucleate (empty egg)
Term
An incomplete molar pregnancy is formed when a ___ egg is fertilized by __ sperm.
Definition
- normal egg
- 2 sperm

This results in a triploid genotype
Term
3 types of malignant trophoblastic disease:
Definition
- Invasive
- Choriocarcinoma
- PSTT (Placental Site Trophoblastic Tumor)
Term
what hormone is used to determine pregnancy viability?
Definition
Serum Progesterone

>25ng/mL= viable
<5 ng/mL= non-viable
Term
Gestational sac can be seen on u/s at __ weeks when bhcg is greater than ___.
Definition
5-6 weeks
5000
Term
From __ weeks until __ weeks, fundal height in ___ equal the number of weeks.
Definition
- 16 weeks to 36 weeks
- cm
Term
Down's syndrome has __ alpha fetoprotein, ___ estriol, and __ b-hcg.
Definition
- decreased alpha fetoprotein
- decreased estriol
- increased b-hcg
Term
Trisomy 18 has __ alpha fetoprotein, __ estriol, and __ b-hcg.
Definition
- decreased alpha feto protein
- decreased estriol
- decreased beta-hcg
Term
Choroid plexus cyst on u/s suggests __ __.
Definition
Trisomy 18
Term
Echogenic intracardiac focus (calcification of papillary muscle) on u/s suggests __ __.
Definition
Down's syndrome
Term
see slide 44 of cervical cancer ppt.
Definition
Term
No matter the pts age, if HSIL is present do ___.
Definition
colposcopy

(even if they're pregnant)
Term
__ ___ is UNacceptable for pregnant women.
Definition
Endocervical curettage
Term
management of HSIL in reproductive age women:
Definition
- LEEP
or
- Colposcopy
Term
management of HSIL in adolescents:
Definition
- colposcopy with biopsies and ECC
Term
Immediate ___ is UNacceptable for adolescent women with HSIL.
Definition
LEEP is unacceptable for adolescents with HSIL
Term
___ is unacceptable as primary therapy for CIN2,3.
Definition
Hysterectomy is unacceptable as primary therapy for CIN2,3.
Term
F/U after treatment of CIN2,3:
Definition
HPV DNA testing and cytology testing q6months, if either positive> colposcope exam
Term
With HIV pts, if any ASC-US or SIL, perform __.
Definition
colposcopy
Term
If there are atypical glandular cells, this could be from the __ or the ___, so you have to take a sample of both and do __, __, and __.
Definition
- endocervix
- endometrium
- colposcopy
- ECC
- EMB
Term
ECC reveals adenocarcinoma in situ. What now?
Definition
cold knife cone of the cervix
Term
After ECC, cold knife cone confirms adenocarcinoma in situ. What do you recommend?
Definition
LAVH
Term
Initial evaluation of Atypical Glandular Cells (AGC)?
Definition
- Colposcopy
- HPV DNA testing
- ECC
- EMB
Term
A Chancroid is caused by _ ___. __ __ __ and __ __ is pathognomic for this STD.
Definition
- H. ducreyi (gm negative rod)
- suppurative inguinal adenopathy
- painful ulcers

The early chancroid lesion is a vesicopustule on the pudendum, vagina, or cervix. Later, it degenerates into a saucer-shaped ragged ulcer circumscribed by an inflammatory wheal. Typically, the lesion is very tender and produces a heavy, foul discharge that is contagious. A cluster of ulcers may develop. Lesions typically occur on the vulva, cervix, and perianal area in women.
Term
Chancoid tmt:
Definition
- 1 gm Azithromycin once po
- 250 gm Ceftriaxone IM once
- 500 mg Erythromycin tid x 7 days
Term
Granuloma inguinale will have ___ __ on the __ stain or ___ stain. This is a __ __ __ __. It is caused by ____ ___. This is almost non-existent in the U.S.
Definition
- Donovan bodies (bacteria encapsulated in mononuclear leukocytes) on the Write stain or Giemsa's stain
- Calammyobacterium granulomatis

Granuloma inguinale is Gone from U.S.
Term
Granuloma Inguinale symptoms:
Definition
A malodorous discharge is characteristic. The disorder often begins as a papule, which then ulcerates, with the development of a beefy-red granular zone with clean, sharp edges. The ulcer shows little tendency to heal, and the patient usually has no local or systemic symptoms.
Term
Granuloma inguinale tmt:
Definition
BEADC
- Bactrim 1 double strength tablet bid x 3weeks
- Doxycycline 100 mg bid for 3 weeks
- Ciprofloxacin 750 mg bid x 3 weeks
- Erythromycin base500 mg 4 times/day x 2-3 weeks
- Azithromycin 1 g po once/week for 3 weeks

(PCN NOT effective)
Term
UTI defintion:
Definition
- > 100,000 CFU or 10,000 if symptoms present
Term
Pyuria definition:
Definition
5 WBC/high power field
Term
Lymphogranuloma Venerum essentials of diagnosis:
Definition
- rectal ulceration, inguinal lymphadenopathy, or rectal stricture
- positive complement fixation test
Term
Positive complement fixation test:
Definition
Lymphogranuloma Venerum
Term
The cause of lymphogranuloma venerum is an __ __ of __ ___
Definition
- L-serotype
- Chlamydia trachomatis
Term
Are men or women more frequently infected by LGV?
Definition
men
Term
Lymphogranuloma inguinale symptoms:
Definition
- early course: vesicopustular eruption
- inguinal/vulvar ulceration
- lymphedema
- inguinal bubo phase
- hard cutaneous (red to purplish blue induration)
- anorectal lypmhedema
- painful blood streaked bowel movements
Term
Dx lymphogranuloma venerum:
Definition
Complement fixation test
Term
Lymphogranuloma Venerum treatment:
Definition
- Doxycycline 100 mg bid x 21 days
- Erythromycin 500 mg 4times/day x 21 days

think LV> DE.
Term
Primary syphilis:
Definition
• Painless genital sore (chancre) on labia, vulva, vagina, cervix, anus, lips, or nipples.
• Painless, rubbery, regional lymphadenopathy followed by generalized lymphadenopathy in the third to sixth weeks.
• Dark-field microscopic findings.
• Positive serologic test in 70% of cases.
Term
Secondary syphilis:
Definition
• Bilaterally symmetric extragenital papulosquamous eruption.
• Condyloma latum, mucous patches.
• Dark-field findings positive in moist lesions.
• Positive serologic test for syphilis.
• Lymphadenopathy
Term
Tertiary syphilis involves __, __, __, and __ lesions and the formation of __.
Definition
- cardiac
- neurologic
- opthalmic
- auditory
- gummas
Term
Latent syphilis:
Definition
• History or serologic evidence of previous infection.
• Absence of lesions.
• Serologic test usually reactive; titer may be low
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