PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+, Exercises of Nursing

Download PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ and more Exercises Nursing in PDF only on Docsity! PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ Follicular Phase vs. Luteal phase - correct answers ✅1. Estrogen dominant (Day 1-14) 2. Progesterone dominant (Day 14-28) FSH vs. LH - correct answers ✅1. Causes follicle & egg maturation 2. Stimulate maturing follicle to produce estrogen Estrogen vs. Progesterone - correct answers ✅1. Thickens endometrium 2. Enhances lining of uterus to prepare for implantation In the follicular phase (days 1-14) of the menstrual cycle, FSH is increasing which causes a _______ to develop which produces ________ to help proliferate the lining of the endometrium; at the end of this phase _______ surges causing ovulation - correct answers ✅1. Primary ovarian follicle 2. Estrogen 3. LH PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ In the luteal phase (days 14-28), after ovulation, the leftover follicle becomes the _________ which produces _________ which maintains the endometrial lining for fertilization - correct answers ✅1. Corpus luteum 2. Progesterone In the luteal phase, the endometrial lining is prepared for fertilization from progesterone from the corpus luteum; the ________ degrades causing a drop in progesterone/estrogen and _________ begins - correct answers ✅1. Corpus luteum 2. Menstruation In the luteal phase, the endometrium is prepared for fertilization by progesterone from the corpus luteum; if fertilization does occur __________ gets released by the developing trophoblast/placenta which maintains the __________ to continue making progesterone/estrogen - correct answers ✅1. hCG PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ In a pt with primary amenorrhea, who's uterus & breasts are present, what may be the cause? - correct answers ✅Outflow obstruction (transverse vaginal septum, imperforated hymen) In a pt with primary amenorrhea, who's uterus is present but breasts are not, what may be the cause? (2) - correct answers ✅1. If elevated FSH and LH = *Ovarian causes* (Premature ovarian failure, gonadal dysgenesis) 2. If normal/low FSH and LH = *Hypothalamus-Pituitary failure* In a pt with primary amenorrhea who's uterus is absent but breasts are present, what may be the cause? (2) - correct answers ✅1. Mullerian agenesis (46XX) 2. Androgen Insensitivity (46XY) In a pt with primary amenorrhea who's uterus and breasts are absent, what may be the cause? - correct answers ✅*RARE* PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ Defect in testosterone synthesis; presents like a phenotypic immature girl but will often have *intraabdominal testes* Secondary Amenorrhea Definition (2) - correct answers ✅1. No menstruation for *> 3 months* in a pt with previously normal menstruation 2. No menstruation for *> 6 months* in a oligomenorrheic pt Amenorrhea caused by Ovarian Disorders Sx + Dx - correct answers ✅Elevated FSH/LH, Decreased estradiol *Dx: Progesterone challange test* (10 mg for 10 days; if has withdrawal bleeding = ovarian; if no withdrawal bleeding = hypoestrogenic or uterine disorder Amenorrhea caused by Hypothalamus Dysfunction Sx (3) + Tx (2) - correct answers ✅1. Normal or decreased FSH/LH 2. *Normal prolactin* PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ 3. Low estradiol *Tx: Stimulate GnRH (Clomiphene, Menotropin)* Amenorrhea caused by Pituitary Dysfunction Sx (2) + Tx (2) - correct answers ✅1. Decreased FSH/LH 2. *Elevated prolactin* (Prolactin inhibits GnRH) *Tx: Tumor removal; Bromocriptine* Amenorrhea caused by Uterine Disorder Sx + Tx - correct answers ✅Asherman's Syndrome (scarring of the uterine cavity) *Tx: Estrogen* Primary vs. Secondary Dysmenorrhea - correct answers ✅1. *NOT* due to pelvic pathology → due to *↑ prostaglandin* PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ stops estrogen from being unopposed and limits endometrial growth; repeat EMBx in 3-6 mos 2. WITH atypia: hysterectomy (TAH +/- BSO) progestin tx if pt not surgical candidate or if wishes to preserve fertility Pelvic Inflammatory Disease (PID) Sx (4) - correct answers ✅*Ascending infection of upper reproductive tract* 1. Lower abdominal tenderness 2. Purulent cervical discharge 3. *Chandelier sign* 4. Infection present Chandelier Sign - correct answers ✅Extreme *CMT* that they seem to rise off the bed Pelvic Inflammatory Disease (PID) Tx (2) - correct answers ✅1. Outpatient → *Doxycycline + Ceftriaxone* +/- Metronidazole PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ 2. Inpatient → *IV Doxycycline + 2nd Gen Cephalosporin* Pelvic Inflammatory Disease (PID) Complications (3) - correct answers ✅1. *Fitz-Hugh Curtis Syndrome* 2. Infertility 3. Ectopic pregnancy Fitz-Hugh Curtis Syndrome Sx (2) - correct answers ✅*Hepatic fibrosis and peritoneal involvement* 1. *Violin string* adhesion on anterior liver surface 2. RUQ pain, may radiate to right shoulder Bacterial Vaginosis Sx (3) + Tx (2) - correct answers ✅1. MCC of vaginitis 2. *(+) Whiff test* → fishy odor 3. *Clue cells* → epithelial cells covered with bacteria *Tx: Metronidazole, Clindamycin* PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ Trichomoniasis Sx (5) + Tx (2) - correct answers ✅1. *Sexually transmitted* 2. Pruritus 3. Dysuria 4. *Frothy yellow-green discharge* 5. *Strawberry cervix* *Tx: Metronidazole, Tinidazole* (MUST TREAT PARTNER) Candidiasis Sx (4) + Tx - correct answers ✅1. Swelling 2. Burning 3. Pruritus 4. *Thick cottage cheese discharge* *Tx: Fluconazole (1st line)* PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ What bug causes syphilis? - correct answers ✅Spirochete Treponema pallidum Primary Syphilis Sx (2) - correct answers ✅*(3 - 4 wks)* 1. *Chancre* (Painless ulcer) 2. *Nontender LAD* Secondary Syphilis Sx (3) - correct answers ✅*(3 wks - 6 mos after)* 1. Maculopapular rash *(palms/soles common)* 2. Condyloma lata (wart-like lesions on mucous membranes) 3. Systemic symptoms (fever, LAD, arthritis, meningitis, HA, hepatitis, increased alk phos) Tertiary Syphilis Sx (4) - correct answers ✅*1-20 yrs after infection* 1. Gumma (noncancerous granulomas) 2. Neurosyphilis (HA, meningitis, dementia, vision/hearing loss, incontinence, tabes dorsalis) PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ 3. Argyll-Robertson pupil (accommodation only) 4. Cardiovascular (aortitis, AR, aortic aneurysms) Syphilis Tx (4) - correct answers ✅1. *PCN G* 2. Doxycycline, Macrolide, Ceftriaxone if PCN allergy BRCA 1 & 2 genetic mutations are associated with what cancers? - correct answers ✅Breast and Ovarian cancers Breast Cancer (2) - correct answers ✅1. MC non-skin malignancy in women 2. 2nd MCC of cancer death Breast Cancer Main Types (2) - correct answers ✅1. Ductal Carcinoma (associated with lymphatic METS, especially axillary) *MC* 2. Lobular Carcinoma (↑ risk of invasive breast CA in either breasts) PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ Breast Cancer Sx (5) - correct answers ✅1. Painless, hard, fixed mass 2. *MC Upper outer quadrant* 3. Unilateral nipple discharge (purulent/green, +/- blood) 4. Paget's Disease of the nipple (eczematous itchy scalinng rash on nipple and areola) 5. Red, swollen, warm, itchy breast *(inflammatory breast CA)* Breast Cancer on Mammogram - correct answers ✅Microcalcifications and spiculated mass What neoadjuvant medication could be given to a 55yo w/ ER (+) breast cancer? (2) - correct answers ✅1. *Tamoxifen* (anti-estrogen) binds ER and blocks them 2. Aromatase inhibitors (*Letrozole, Anastrozole*) that reduce production of estrogen (best used in PMP women) What neoadjuvant hormone therapy could you give to a pt with HER2 (human epidermal growth factor receptor) (+) breast cancer? - correct PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ Ovarian Cancer (2) - correct answers ✅1. 2nd MC GYN cancer (after endometrial) 2. Highest mortality of all gyn cancers Ovarian Cancers Sx (4) - correct answers ✅1. *Rarely symptomatic until late in disease course* (extensive METS) 2. Palpable abdominal/ovarian mass +/- ascites 3. *Sister Mary Joseph's node* (METS to umbilical lymph nodes) 4. 90% epithelial cells on biopsy especially postmenopausal (germ cells seen in <30 y/o) CA 125 - correct answers ✅Ovarian cancer tumor marker What age range receives pap smear w/o HPV screening q 3 yrs? What age do you start doing pap + HPV co-testing? - correct answers ✅Pap only: start at age 21 to 29 PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ Pap + HPV: 30+ 27 yo pt with ASCUS (atypical squamous cells of undetermined significance) on pap; next step? If she was 23? - correct answers ✅21-24 w/ ASCUS → *repeat pap in 1 yr* or can do HPV testing but not recommended ≥25 w/ ASCUS → *HPV testing* If (-) repeat co-testing in *3 yrs* If (+) *colposcopy + Bx* 22 yo w/ ASC-H (atypical squamous cells can't exclude HSIL) on pap; next step? - correct answers ✅Any age w/ ASC-H = *colposcopy + Bx* 27 yo pt with LSIL (low grade squamous intraepithelial lesion) on pap; next step? If she was 23? PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ If she was 33? - correct answers ✅21-24 w/ LSIL → *repeat pap in 1 yr* 25-29 w/ LSIL → *colposcopy + Bx* ≥30 w/ LSIL → *HPV testing* If (-) repeat pap in *1 yr* If (+) *colposcopy + Bx* *LSIL includes CIN1* 27 yo pt with HSIL (high grade squamous intraepithelial lesion) on pap; next step? - correct answers ✅Any age w/ HSIL = *colposcopy + Bx* *HSIL includes CIN2, CIN3, and carcinoma in situ* What region of the cervix has the highest risk for malignancy? - correct answers ✅*Transformation zone (squamocolumnar junction)* - junction PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ 2. Adenocarcinoma (10%) Cervical cancer Sx (3) + Dx - correct answers ✅*3rd MC GYN cancer* 1. *Post coital bleeding/spotting* (MC) 2. Metrorrhagia 3. Pelvic pain *Dx: Colposcopy + Bx* What strains does Gardasil protect against? - correct answers ✅Gardasil: 6, 11, 16, 18 Gardasil 9: 6, 11, 16, 18, 31, 33, 45, 52, 58 Gardasil Vaccine Schedule. What are the contraindications? - correct answers ✅<15 y/o = 2 doses; 6 months apart >15 y/o = 3 doses; at 0, 2, 6 months PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ *Contraindication: immunosuppressed, pregnant, or lactating* Vaginal Cancer Sx (4) + Tx - correct answers ✅1. *Squamous cell* (95%) 2. *Clear cell* if DES exposure in utero 3. *Asymptomatic* 4. Changes in menstrual period *Tx: Radiation* Vulvar Cancer Sx (6) + Tx (3) - correct answers ✅1. *Squamous* (90%) 2. Linked to DES exposure 3. Risk includes HPV 16, 18, 31 4. *Pruritus* (MC presentation* 5. Post coital bleeding 6. *Red/white ulcerative, crusted lesions* PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ *Tx: Excision, radiation, chemotheraoy* 50 yo women comes in with c/o vaginal/vulvar itching, post-coital bleeding and on exam has red/white ulcerative, crusted lesions... Bx will most likely show? - correct answers ✅Vulvar carcinoma (most likely squamous cell carcinoma) Congestive vs. Infective Mastitis - correct answers ✅1. Congestive: *bilateral* breast enlargement 2-3 days postpartum 2. Infective: usually *unilateral* in lactating women w/ *tenderness, swelling, warmth, & nipple discharge* Infective Mastitis vs. Breast Abscess - correct answers ✅1. Mastitis: usually redness, swelling, warmth, and tenderness in one quadrant of the breast 2. Breast abscess: more *localized induration* w/ fluctuance and is rare PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ Enterocele - correct answers ✅Prolapse of pouch of Douglas *(small bowel)* into *upper vagina* Rectocele - correct answers ✅Prolapse of distal sigmoid colon into *posterior distal vagina* Uterine Prolapse Sx (4) - correct answers ✅1. Pelvic/vaginal fullness, heaviness, *"falling out"* sensation 2. Lower back pain 3. Vaginal bleeding/purulent discharge 4. *Urinary frequency/urgency/stress incontinence* Ovarian Torsion Sx (2) - correct answers ✅1. Acute unilateral pelvic pain 2. Adnexal mass Ovarian Torsion Tx (2) - correct answers ✅1. Detorsion and ovarian conservation PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ 2. Salpingo-oopherectomy ONLY if PMP or necrotic ovary Uterine Prolapse Grades - correct answers ✅I: Descent into upper 2/3 of vagina II: Cervix approaches introitus III: Outside introitus IV: Entire uterus outside of vagina (complete prolapse) Endometriosis Sx (5) - correct answers ✅1. Endometrial tissue are outside the uterus Triad: *2. Pelvic pain* *3. Dysmenorrhea* *4. Dyspareunia* (painful intercouse) 5. Infertility PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ Endometriosis Dx (2) - correct answers ✅1. Laparoscopy biopsy *(definitive)* → "powder burn" 2. *Chocolate cyst* → endometrioma (endometriosis large enough to be considered a tumor) Endometriosis Tx (7) - correct answers ✅*1. Combined OCP* *2. NSAIDs* 3. Progesterone (suppress GnRH and ovulation) 4. Leuprolide (suppress FSH/LH from pituitary) 5. Danazol (testosterone suppress FSH/LH) 6. Conservative laparoscopy with ablation (preserves uterus and ovaries for future fertility) 7. Total abdominal hysterectomy with salpingo-oophorectomy (Remove uterus, fallopian, ovaries) What is the MC site affected by endometriosis? - correct answers ✅Ovaries PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ Ovarian Cysts Dx - correct answers ✅*Pelvic US* Follicular → smooth, thin-walled Corpus luteal → complex, thicker-walled *MUST CHECK HCG* Ovarian Cysts Tx (4) - correct answers ✅1. *Spontaneously resolves if <8 cm* 2. Repeat US in 6 weeks 3. OCP 4. Laparoscopy or laparotomy *if >8 cm or persistent or in postmenopause* What is natural family planning? - correct answers ✅Abstain from sex during fertile period PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ What is coitus interruptus? - correct answers ✅Withdraws penis from vagina before ejaculation (20% failure because sperm in pre-ejaculatory fluid can lead to pregnancy) What is spermicide? (2) - correct answers ✅*1. Nonoxynol-9* *2. Slight ↑ risk of HIV* What barrier methods of contraception can ↑ risk for TSS? (3) - correct answers ✅1. Diaphragm 2. Fem cap 3. Contraceptive sponge What is a diaphragm? (5) - correct answers ✅1. Rubber cuplike device that holds spermicide against cervix 2. Protects against pelvic infection and cervical dysplasia *3. Must remain in place 6-24 hours after intercourse* 4. Require pelvic exam and fitting PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ *5. ↑ risk of TSS and cystitis* What is a fem cap? (4) - correct answers ✅1. Silicone rubber cap with strap that covers the cervix 2. No fitting required 3. No additional spermicide needed between intercourse *4. ↑ risk of TSS if left too long* What is a contraceptive sponge? (4) - correct answers ✅1. Polyurethane sponge with spermicide *2. Need to insert few hours prior* *3. Must be left in place for 6-24 hours* *4. ↑ risk of TSS if left too long* What is combination OCP? (3) - correct answers ✅1. Estrogen + Progesterone 2. Prevents ovulation by *inhibiting mid cycle LH surge* PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ 2. Best if taken *within 72 hours* of unprotected sex *3. Seek medical attention if no menses 21 days after tx* What is Mirena? (4) - correct answers ✅*1. Levonorgestrel - long acting progestin IUD* (5 years) 2. Same effects of progestin *3. ↑ Risk of PID* *4. Spotting* *Most effective form of contraception (besides sterility and abstinence)* What is Paragard? (3) - correct answers ✅1. Copper IUD *2. 10 years of action* *3. ↑ Risk of PID* PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ What is Implanon? (3) - correct answers ✅*1. Etonagestrel - long acting progestin implant (3 years)* 2. Same effects as progestin pills (menstrual irregularity) *3. Higher risk of osteoporosis* What is Depo Provera? (2) - correct answers ✅*1. Medroxyprogesterone - long acting injectable progestin (3 months)* 2. Same effects as progestin pills (menstrual irregularity) What is Ortho Evra? (3) - correct answers ✅*1. Norelgestromin/ethinyl estradiol - combo transdermal patch* 2. Apply weekly x 3 weeks → 1 week off with withdrawal bleeding (period) 3. Less effective if underweight What is Nuvaring? (3) - correct answers ✅*1. Etonogestrel/estradiol - combo flexible plastic vaginal ring* PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ 2. Applied 3 week → 1 week off with withdrawal bleeding (period) 3. *MUST* be removed during intercourse but *replaced* within 3 hours What is sterilization? (2) - correct answers ✅1. Tubal ligation (permanent, *↑ risk of ectopic*) 2. Essure (chemicals or coils to scar portion of fallopian tubes) *(difficult to reverse, ↑ risk of ectopic*) Infertility Definition - correct answers ✅Inability to conceive after 1 year Infertility Etiologies (3) - correct answers ✅1. Male abnormal spermatogenesis (40%) 2. Female anovulatory cycles or ovarian dysfunction (30%) 3. Congenital or acquired disorder (30%) PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ *5. Estrogen* Urge Incontinence Sx (5) - correct answers ✅1. Urine leakage accompanied by or preceded by urge 2. Caused by *detrusor muscle overactivity* by muscarinic acetylcholine receptors *(overactive bladder)* 3. Urinary frequency 4. Small volume voids 5. Nocturia Urge Incontinence Tx (6) - correct answers ✅*1. Bladder training* (timed frequent voids and decrease fluid intake) *2. Anti-cholinergics* (*oxybutinin* or tolterodine) → blocks ACh receptors in bladder but s/e are can't see, can't spit, *can't pee*, can't shit *3. TCAs* (imipramine) central/peripheral anticholinergic effect and alpha adrenergic agonist *4. Mirabegron* (B3-agonist = bladder relaxant) PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ *5. Surgical* (injection of botox or bladder augmentation) *6. Diet* (avoidance of spicy food, citrus fruits, chocolate and caffeine) Overflow Incontinence Sx (5) + Dx - correct answers ✅1. Urinary retention (incomplete voiding) due to *decreased detrusor activity (atony or underactive bladder)* 2. Can be caused by DM, MS, autonomic dysfunction (spinal injury) or BPH outlet obstruction *Dx: Post void residual volume >200 mL* Overflow Incontinence Tx (2) - correct answers ✅1. Intermittent or indwelling *catheter* is *1st line* 2. Cholinergics *Bethanacol* → increase detrusor activity Gravida Para - correct answers ✅G_P_ _ _ _ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ G (# pregnancies) T (# term deliveries at 37+ weeks) P (# preterm deliveries at 20-37 weeks) A (abortions or miscarriages <20 weeks) L (# living children) Ladin's Sign - correct answers ✅*Uterus softening* after 6 weeks Hegar's Sign - correct answers ✅*Uterine isthmus softening* after 6-8 weeks Piskacek's Sign - correct answers ✅*Palpable lateral bulge* or softening of uterine cornus after 7-8 weeks Goodell's Sign - correct answers ✅*Cervical softening* due to increased vascularization after 4-5 weeks PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ *If does not know LMP, can use US to estimate weeks* How often are OB visits scheduled? - correct answers ✅q4 weeks first 2 trimesters (1-28 weeks) q2 weeks at 28-36 weeks q week at 36 weeks-birth First Trimester Screening (4) - correct answers ✅1. Down Syndrome screening 2. Uterine size and gestation (if abnormal, chorionic villus sampling or amniocentesis can be done around *10-13 weeks*) 3. US (Fetal heart tone) 4. Chorionic villus sampling (for abnormal screening results, maternal age >35 y/o, prior pregnancy abnormalities) → increases risk of spontaneous abortion PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ How to test for Down Syndrome? (3) - correct answers ✅1. *Abnormal high/low* free b-hCG 2. *Low* PAPP-A (Pregnancy associated plasma protein A) 3. *Thick* nuchal translucency (at 10-13 weeks) Second Trimester Screening (5) - correct answers ✅1. Triple Screening (AFP, b-hCG, Estradiol) 2. Inhibin A *(High = abnormal chromosome)* 3. US (amniotic fluid level, fetal viability, and growth for gestational age) 4. Amniocentesis (same indications as CVS) 5. Gestational DM screening *(24-28 weeks)* What is Quad Screening? - correct answers ✅Triple screening + Inhibin A testing *For Trisomy 21, Trisomy 18, and NTD* PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ Triple Screening Results (3) - correct answers ✅1. Low AFP, High b-hCG, Low Estradiol = *Down syndrome (Trisomy 21)* 2. High AFP, N/A b-hCG, N/A Estradiol = *open neural tube defects or multiple gestation* 3. Low AFP, Low b-hCG, low Estradiol = *Trisomy 18* (often stillborn or die within 1 year) Third Trimester Screening (7) - correct answers ✅1. Gestational DM Screening *(24-28 weeks)* 2. Repeat antibody titers 3. *RhoGAM* for Rh- mothers *at 28 weeks* and *within 72 hours after childbirth* 4. Group B Strep Screening *(32-37 weeks)* via vaginal-rectal culture (if +, give *IV PCN* when presenting in labor) 5. H/H *(35 weeks) 6. Biophysical profile (fetal breathing, fetal tones, amniotic fluid levels, Non-stress test, gross fetal movement) 7. Non-Stress Testing PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ 3. ↓ Platelets 4. Hypercoagulable state 5. Fe deficiency anemia What are the effects of pregnancy on the heart and BP? (2) - correct answers ✅1. ↑ CO by 30-50% (first in SV then in HR and a dec in SVR) 2. ↓ BP slightly (so if there is an inc be suspicious of preE/eclampsia) Dyspnea of pregnancy occurs in 60-70% of pts and is due to? (3) - correct answers ✅1. ↓ PaCO2 levels 2. ↑ Tidal volume 3. ↓ TLC What kidney changes occur in pregnancy? (2) - correct answers ✅1. 50% ↑ in GFR 2. Kidneys ↑ in size and the ureters dilate (cause of inc r/o pyelonephritis) PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ What are the effects of pregnancy on the endocrine system? (6) - correct answers ✅1. Hyperestrogenic state (produced by placenta) 2. Placenta also produces hCG (doubles Q48 hrs in early pregnancy peaking at 10-12 wks) which maintains corpus luteum early on 3. Corpus luteum produces progesterone which maintains uterine lining 4. Human placental lactogen is produced by placenta and responsible for nutrient supply to fetus but can cause a diabetogenic state (bc insulin antagonist) 5. Prolactin greatly increases 6. ↑ in T3/4 while fT4 and TSH remain minimally changed What are the effects of pregnany on the msk system? (2) - correct answers ✅1. Change in center of gravity = low back strain 2. Carpal tunnel syndrome is common What are the effects of pregnancy on the dermatologic system? (3) - correct answers ✅1. Spider angiomatas PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ 2. Palmar erythema 3. Hyperpigmentation of nipples, umbilicus, abdominal midline (linea nigra), perineum, face (melasma) What is the cal/day recommendation in normal BMI pregnant women? - correct answers ✅300 cal/day (500 cal/day when breastfeeding) What amount of weight gain is recommended in underweight, normal, and overweight patients? - correct answers ✅1. Underweight: 28-40 lb 2. Normal: 20-30 lb 3. Overweight: 15-25 lb Morning Sickness and Hyperemesis Gravidarum (HEG) Tx (5) - correct answers ✅1. High protein foods 2. Avoid spicy/fatty foods 3. Total parenteral nutrition if severe 4. *Pyridoxine (Vit B6) +/- Doxylamine* (1st line) PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ *Tx: Supportive, observe, Serial b-hCG, RhoGAM if needed* Inevitable Abortion Sx (4) + Tx (2) - correct answers ✅1. No POC expelled 2. Cervical dilation >3 cm 3. +/- ROM 4. Mod-severe uterus cramping *Tx: D&E in 2nd trimester; Suction curettage in 1st trimester* Incomplete Abortion Sx (3) + Tx (4) - correct answers ✅1. Some POC expelled 2. Os dilated 3. *Boggy uterus* PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ *Tx: D&C in 1st trimester, D&E after 1st trimester; May be allowed to finish; Pitocin* Complete Abortion Sx (3) + Tx - correct answers ✅1. All POC expelled 2. Os closed 3. Pain and bleeding subsided *Tx: RhoGAM if needed* Missed Abortion Sx (5) + Tx (3) - correct answers ✅1. Dead fetus in the uterus 2. No POC expelled 3. Os closed *4. Brown discharge* 5. Loss of pregnancy sx *Tx: D&C in 1st trimester, D&E after 1st trimester; Misoprostol* PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ Septic Abortion Sx (7) + Tx (3) - correct answers ✅1. Retained POC becomes infected 2. Some POC retained 3. Os closed *4. CMT* *5. Foul brown discharge* 6. Fever, chills 7. Spotting → heavy bleeding *Tx: D&E to remove POC + Broad spectrum Abx; hysterectomy if refractory* Methods for Elective Abortion (4) - correct answers ✅1. Mifepristone → Misoprostol 1-3 days after (safe up to 9 weeks) 2. Methotrexate → Misoprostol 3-7 days after (safe up to 7 weeks) 3. D&C during 4-12 weeks PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ Preeclampsia Tx (9) - correct answers ✅*Mild*: - Delivery if 37 or more weeks - Conservative if <37 weeks - Steroids to mature lungs if <34 weeks *Severe*: - Delivery *(ONLY CURE)* PLUS - Hospitalization - Magnesium sulfate (prevent eclampsia/seizures) - Hydralazine, Labetalol, Nifedipine Eclampsia Sx (4) + Dx - correct answers ✅1. Seizures/Coma in pts who meet preeclampsia criteria *(LIFE THREATENING FOR MOTHER AND FETUS)* 2. HA PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ 3. Visual changes 4. Cardiorespiratory arrest *Dx: Same as preeclampsia* Eclampsia Tx (5) - correct answers ✅*1. ABCD* of Emed 2. Magnesium sulfate 3. Lorazepam (if no reaction to magnesium sulfate) 4. Delivery of fetus *(once pt is stabilized)* 5. Hydralazine, Labetalol What is the TOC for chronic HTN in pregnancy? - correct answers ✅*Methyldopa* Can give Labetalol, Hydralazine, Nifedipine as second lines What BP medications are CI in pregnancy? - correct answers ✅ACEI and ARBs PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ Gestational DM Dx Steps (5) - correct answers ✅1. *Screening* 50g oral glucose challenge test *at 24-28 weeks* 2. If >/= 140 mg/dL after 1 hour → positive and needs confirmatory test 3. *Confirmatory* 100g oral 3 hour oral glucose tolerance test *(gold standard)* 4. Performed in the morning after overnight fast 5. If fasting > 95 mg/dL; 1 hour > 180 mg/dL; 2 hour > 155 mg/dL; 3 hour >140 mg/dL → fail 2/4 is positive for gestational DM Gestational DM Tx (4) - correct answers ✅1. Insulin *(TOC)* → doesn't cross placenta - 2/3 in AM 1/3 in PM - 0.8 IU/kg in 1st trimester; 1.0 IU/kg in 2nd trimester; 1.2 IU/kg in 3rd trimester - Goal is fasting sugar <95 2. Glyburide (doesn't cross placenta but ↑ risk of eclampsia) PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ 4. Placental site trophoblastic tumor <1% *ALL ARE CAUSED BY ABNORMAL PLACENTAL DEVELOPMENT* Complete Molar Pregnancy (3) - correct answers ✅1. Egg *with no DNA* fertilized by 1 or 2 sperms 2. 46XX with all paternal chromosomes 3. Higher risk of malignant development into *choriocarcinoma* Partial Molar Pregnancy (2) - correct answers ✅1. Egg is fertilized by 2 sperm (or 1 sperm that duplicates its chromosomes) 2. May develop fetus but it is always *malformed* and never viable Gestational Trophoblastic Disease Sx (7) - correct answers ✅1. *Painless* vaginal bleeding 2. +/- *Brownish discharge* 3. *Large* uterine size than expected PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ 4. Hyperemesis gravidarum 5. Choriocarcinoma (METS to lungs MC, lower genital tracts - purple black nodules, pelvic mass) 6. *Very high b-hcg* 7. *Snowstorm* or *cluster of grapes* on US Gestational Trophoblastic Disease Tx (5) - correct answers ✅1. D&C 2. Monitor b-hcg weekly 3. RhoGam to Rh- mothers 4. Hysterectomy 5. Methotrexate *(if METS)* Incompetent Cervix (3) - correct answers ✅1. Painless dilation and effacement of the cervix MC during 2nd trimester 2. Puts fetus at risk of infection 3. Risk of trauma and ROM PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ Incompetent Cervix Risk Factors (4) - correct answers ✅*1. MC is previous surgery or cervical trauma* 2. Previous D&C 3. LEEP (loop electrocautery excisional procedure) 4. Congenital abnormality of cervix How is incompetent cervix differentiated from preterm labor? - correct answers ✅Preterm labor has contractions while cervical insufficiency has only mild cramping caused by cervical dilation Incompetent Cervix Tx (4) - correct answers ✅1. Elective termination in previable pregnancies <24 wks 2. *Betamethasone* to ↑ fetal lung maturity 3. Strict bed rest 4. Cerclage PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ When is APGAR score performed? (3) What is the normal score? - correct answers ✅1. 1 min after birth 2. 5 min after birth 3. 10 min after birth *if abnormal* Normal = 7 or more Fairly low = 4-6 Critically low = 3 or less APGAR Score - correct answers ✅From 0, 1, 2 1. Appearance (blue-gray and pale all over; Acrocyanosis - body pink but blue extremities; Pink) 2. Pulse (0; <100; 100 or more) 3. Grimace reflex irritability (No response to stimulation; Grimaces feebly; pulls away, sneezes, or coughs) PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ 4. Activity muscle tone (none; some flexion; flexes arm and legs, resists extension) 5. Respiration (absent; weak, irregular; strong, crying) A baby is born crying with a pink body but blue extremities, HR of 157, grimaces feebly on stimulation, flexes arms/legs and resists extension; what is the APGAR score? - correct answers ✅8 What is the difference between contractions of pregnancy and Braxton- Hicks contractions? - correct answers ✅Braxton-Hicks are not associated with cervical dilation What are the cardinal movements of labor? (7) - correct answers ✅1. Engagement (fetal presenting part enters pelvic inlet) 2. Flexion 3. Descent 4. Internal rotation 5. Extension PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ 6. External rotation 7. Expulsion What are the stages of labor and their phases? - correct answers ✅1. *Stage I*: onset of labor (true regular contractions to full cervical dilation - 10 cm) - *Latent phase:* cervix effacement with gradual dilation - *Active phase:* rapid cervical dilation (usually beginning at 3-4 cm) 2. *Stage II*: time from full cervical dilation to delivery of fetus - *Passive phase:* complete dilation to active maternal expulsion efforts - *Active phase:* from active maternal expulsion efforts to delivery of fetus 3. *Stage III*: postpartum until delivery of placenta (avg 5 min but can be between 0-30 min) PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ 2. Woods "corkscrew" maneuver 180 shoulder rotation(manipulative) 3. C-section if cannot fix with maneuvers Induction vs. Augmentation of labor - correct answers ✅1. Induction = attempt to begin labor in a nonlaboring pt 2. Augmentation = intervening to increase the already present contractions How do you induce labor? (3) - correct answers ✅1. *Prostaglandin gel* directly on cervix (early induction in women with unfavorable cervix to promote cervical ripening) 2. *Oxytocin* (later induction when cervix is dilated <1 cm with some effacement → *NEED TO MONITOR UTERINE ACTIVITY AND FHR* 3. *Amniotomy* (artifical ROM with a small hook if cervix is partially dilated and there is effacement) An external tocometer is placed on the pt's abdomen near the fundus and is used to measure... - correct answers ✅*Contractions* by sensing PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ pressure when abdomen gets firmer - best for measuring frequency of contractions and to *monitor fetal heart rate accels/decels* What degree of fetal heart rate variability is reassuring? - correct answers ✅*Moderate* (little variability may mean fetus is asleep or inactive and absent variability may mean fetal death) aka lines will appear squiggly What is considered a reactive fetal heart tracing? - correct answers ✅2 accelerations, at least 15 bpm above baseline, for at least 15 seconds in 20 minutes What kind of fetal heart deceleration is a result of fetal head compression during a contraction? - correct answers ✅*Early deceleration* (begins and ends with contraction) PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ What kind of fetal heart deceleration is a result of umbilical cord compression? - correct answers ✅*Variable deceleration* (can occur at any time and drops more precipitously than early or late decels) What type of fetal heart deceleration is a result of uteroplacental insufficiency and are the most worrisome type? - correct answers ✅*Late deceleration* (begin at peak of contraction and slowly return back to baseline after contraction has finished) they may degrade into bradycardias as labor progresses When is a fetal scalp electrode indicated (FSE) to monitor fetal heart tracings? - correct answers ✅A fetus with *late decelerations* because the FSE is more sensitive by tracking the potential difference created by depolarization of the fetal heart; it also is better because the tracings do not get lost during contractions or fetal position changes like they do with the Doppler PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ What is given during stage 3 of labor to strengthen uterine contractions to decrease placental delivery time and blood loss? - correct answers ✅Oxytocin (pitocin) Retained placenta is defined as placental delivery/stage 3 lasting >___ minutes; it is common in preterm deliveries but can also be a sign of _________; how is it removed? - correct answers ✅>30 minutes -sign of placenta accreta (placenta invaded into or byond endometrial stroma) -manual extraction (hand placed in intrauterine cavity and fingers used to shear placenta off surface of uterus) VBAC (vaginal birth after cesarean)/ TOLAC (trial of labor after cesarean) are common but have a slight risk ~1% of _________ - correct answers ✅Uterine rupture *1% after 1 c/s, 2% after 2 c/s, but after 3 risk goes way up so do a c/s PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ How can you diagnose PROM? (4) Tx? (2) - correct answers ✅1. Pooling test on speculum exam 2. Nitrazine paper (will turn *blue if pH>6.5* aka amniotic fluid) 3. Ferning appearance of amniotic fluid on a microscopic slide 4. US to check the amniotic fluid index (AMI) or fluid levels *Tx: await spontaneous labor and monitor for infection (chorioamnionitis or endometritis)* After water has broken or amniotomy performed it is important not to do what that may cause the umbilical cord to prolapse past the head - correct answers ✅do not elevate fetal head from pelvis to release more amniotic fluid Preterm labor is defined as... - correct answers ✅*Regular uterine contractions* (>4-5/hr) with progressive cervical changes (effacement/dilation) *before 37 wks of gestation* PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ *MCC of perinatal mortality* What degree of dilation & effacement is preterm labor likely? - correct answers ✅2-3cm dilation 80% effacement Besides, nitrazine/pooling/ferning tests what other test can be performed between 20-34 weeks to determine if ROM has occured? - correct answers ✅*Fetal fibronectin* (a protein that keeps amniotic sac "glued" to uterine lining- if found means it *STRONGLY SUGGESTS PRETERM LABOR*) If preterm labor is suspected what tests/tx should be started? (3) - correct answers ✅1. Abx prophylaxis *(Ampicillin → PO Amoxicillin or Azithromycin)* 2. *Betamethasone* (enhance fetal lung maturity if L:S ration <2:1 or <34 wks) PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ What is the workup (2) and tx (4) of postpartum hemorrhage? - correct answers ✅Work up: check H/H, US to detect source Tx: 1. Bimanual uterine massage 2. Uterotonic agents- *oxytocin, methylergonovine*, prostaglandin analogs (*carboprost, tromethamine, misoprostol*) -these enhance uterine contractions so are only used in uterine atony 3. Suction & curettage if there are retained products 4. +/- Abx ________ is diagnosed clinically in postpartum patients with *2 fevers and uterine tenderness* and is mostly seen s/p *c-section* but can also be present s/p vaginal delivery or postabortus - correct answers ✅Postpartum endometritis (polymicrobial infection of the endometrium due to exposure during childbirth) PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ What is the ddx (4)/tx for postpartum endometritis? - correct answers ✅DDx: surgical site infxn, UTI, mastitis, PNA Tx: broad spectrum abx (*clindamycin + gentamicin* OR ampicillin- sulbactam in clinda resistance or if GBS (+)); add ampicillin or vancomycin if fever doesn't resolve in 48-72 hrs -*ampicillin + gentamicin* if after vaginal delivery what are the differences between 1st-4th degree lacerations postpartum? - correct answers ✅-1st deg: skin/mucosa only -2nd deg: extend into perineal body but do not involve anal sphincter -3rd deg: extend into or completely through anal sphincter -4th deg: through anal mucosa (may be a button hole laceration so perform rectal exam) How are 1st-4th degree tears repaired? - correct answers ✅-1st deg: interrupted suture PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ -2nd deg: suture anchored at apex of lac, then through hymenal ring and used to bring together the perineal body; then skin closed with subcuticular sutures -3rd deg: repair anal sphincter w/ severel interrupted sutures, then the rest same as above for 2nd deg -4th deg: repair anal mucosa meticulously to prevent fistula formation, repair rectum, and repair the rest as above w/ 3rd deg *all w/ dissolvable sutures What is the size of the uterus postpartum/puerperium after delivery? After 2 weeks? After 6 weeks? - correct answers ✅-after delivery: @ umbilicus -2 weeks: into pelvic cavity -6 weeks: nml size What is normal discharge/bleeding in the postpartum/puerperium period? - correct answers ✅Especially days 4-10, pinkish brown vaginal PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ -surgical (wedge resection of ovary): to restore fertility when clomiphene fails what are some complications of untreated PCOS? - correct answers ✅- infertility -endometrial hyperplasia/cancer risk d/t unopposed estrogen thickening lining -insulin resistance = DM, HL, HTN, CAD, MI risks what is an adenomyosis? - correct answers ✅an island of endometrial tissue w/i the myometrium *muscular layer of the wall) when comparing leiomyomas (fibroids) and adenomyosis signs of uterine symmetry, hard/softness, and tenderness, what is the difference? - correct answers ✅-leiomyomas: asymmetrical, firm, nontender uterus -adenomyosis: symmetrical, soft, tender uterus PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+ *both present with menorrhagia and dysmenorrhea how is adenomyosis diagnosed? treated? - correct answers ✅*diagnosis of exclusion!* -cannot see on US so must do *MRI* or post-TAH examination of uterus -tx: only effective is TAH but can do OCPs/NSAIDs to preserve fertility what are the risks of untreated adenomyosis? - correct answers ✅induces hypertrophy/hyperplasia of surrounding myometrium where ectopic endometrial tissue is implanted PAEA OBGYN EOR TOPICS STUDY GUIDE (LATEST UPDATE 2024) RATED A+