GU-3

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Author:
atmu
ID:
174018
Filename:
GU-3
Updated:
2012-09-28 21:56:28
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Test
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Description:
Test 2 - GU3
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  1. Abortion definition
    termination of pregnancy less than 20 weeks from last menses or fetus less than 500g
  2. Categories of Spontaneous Abortion
    • 1. Threatened - cervix is closed but bleeding
    • 2. Inevitable - cervix open and bleeding
    • 3. Incomplete - same as inevitable except fetus is half out of uterus
    • 4. Complete - whole dead product of conception comes out
    • 5. Missed - baby dies and mom doesn't expel it
    • 6. Habitual - 3 or more spontaneous abortions
    • 7. Infectious - any of previous 6 but w/ fever and sepsis
  3. Indications for initiating pelvic exam in precoital adolescent
    • 1. delayed menarche
    • 2. secondary amenorrhea
    • 3. unusual vaginal discharge
    • 4. abnormal bleeding
    • 5. dysmennorhea unresponsive to first-line therapy
  4. ASCUS (Atypical Cells of Undertermined Significance) pap procedure
    • 1. Repeat pap at 6 & 12 months
    •       -if ASC increases --> colposcopy
    • 2. HPV DNA testing and triage
    •       -if high risk HPV --> colposcopy
    • 3. Adolescents 20yr or younger, repeat @ 12/24 months
  5. LGSIL (Low Grade Squamous Intraepithelial Lesion)
    • -60% will resolve spontaneously
    • 1. HPV DNA testing and repeat pap every 4-6 mo for 3 intervals
    • 2. immediate colpo
  6. HGSIL (High Grade Squamous Intraepithelial Lesion)
    • -Up to 95% have true high grade lesion
    • -Colpo immediately
  7. Cervical PAP surgery modalities
    • 1. Punch biopsy
    • 2. Cryocautery
    • 3. Laser vaporization
    • 4. Loop electrode excision procedure (LEEP)
    • 5. Hysterectomy
  8. Most common PID organisms
    • 1. Chlamydia trachomatis
    • 2. Neisseria gonorrhoeae
    • 3. Bacteroides
    • 4. Aerobic streptococci
    • 5. Anaerobic cocci
  9. Criteria for Dx PID
    • Need these 3:
    • 1. abdominal tenderness + rebound
    • 2. adnexal tenderness
    • 3. cervical motion tenderness
    • Plus 1 or more of following
    • 1. gram stain of endocervic + for gram- diplococci
    • 2. temp > 101F
    • 3. WBC > 10k
    • 4. elevated ESR or CRP
    • 5. documented cervical infection of gonorrhea or chlamydia
    • 6. pus on culdocenteses or laporoscopy
    • 7. pelvic abcess on U/S or bimanual exam
  10. Regimen A
    • Cephalosporins for gonorrhea
    • Cefoxitin
    • Cefotetan
    • For Chlamydia
    • Doxycycline
  11. Regimen B
    • Clindamycin
    • Gentamicin
    • Doxycycline
  12. Tubo-Ovarian Abcess
    • -Complicatino of PID and occurs in 10% of those infected
    • -Sx: tender, inflammatory adnexal mass
    • Image w/ U/S, CT, or MRI
    • -Tx: drainage by laparascopy or laparotomy; broad spectrum IV antibiotics (Clindamycin or Metronidazole, then Doxycycline)
  13. Complications of PID
    • 1. Infertility (adhesions)
    • 2. Ectopic pregnancy
    • 3. Endometritis
    • 4. Chronic pelvic pain
  14. FHR early pregnancy and near term?
    160's early pregnancy

    120's-140's near term
  15. Pregnant weight gain amount?
    25-35lbs

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