Card Set Information
What is the classic triad of symptoms for ectopic pregnancy?
Abdominal pain, light vaginal bleeding, amenorrhea
What are the risk factors for ectopic pregnancy?
PID, Tubal surgeries, IUD, Fertilization
What are the diagnostic tests for ectopic pregnancy?
serum quantitative B-hCG
What are the classifications of spontaneous abortions?
Complete-all products expelled
Incomplete-some products remain
Threatened-Bleeding, cervix closed
Inevitable-bleeding, cervix dilated
Missed-fetal death <20 weeks
What is the most common first trimester complication?
Spontaneous abortion - no tx necessary
will require D and E
must always check mother's blood type
What is placenta previa?
Abnormal location of placenta over or in close proximity to the internal cervical os
PAINLESS until labor
bleeding is usually maternal in origin
What are risk factors of placenta previa?
Previous placenta previa
4+ cesarean sections
What is placental abruptio?
Premature separation of the implanted placenta from the uterine wall
What is placental abruptio associated with?
Hydramnios(excessive amniotic fluid)
After multiple deliveries
What are signs of placental abruptio?
PAINFUL vaginal bleeding
fetal distress, HR<100 bpm
What is Pre-eclampsia?
Elevated blood pressure 140/90 or higher
20mmHg rise in systolic/10mmHg in diastolic
headache, visual disturbance, abdominal pain
What is the work-up of pre-eclampsia?
Renal and liver function tests
What is Eclampsia?
Rise in blood pressure just as Pre-eclampsia but with the presense of SEIZURE
How do you treat eclampsia?
Hydralazine which preserves uterine blood flow
Only cure is delivery of baby
What is PROM?
Premature Rupture of Membrane
Leaking of amniotic fluid prior to 37 weeks gestation
How do you confirm PROM?
Nitrazine paper - detects pH
normal vaginal secretions 4.5-5.5
amniotic fluid is 7.0-7.4
What are risk factors for pre-term labor?
PROM, placental abruptio, multiple gestation, infection, incompetant cervix, drug abuse
What are signs and symptoms of pre-term labor?
Mentrual like cramps
increase in change in vaginal discharge
What are risk factors of PID?
high # of sex partners
inconsistent or no use of condoms
sex at an early age
What are signs of PID?
Bilateral abdominal pain
low back pain
irregular vaginal bleeding
What does PID show on exam?
Lower abdominal is usually non-tender
Mucupurulent vaginal discharge
cervial motion tenderness
What does the PID workup include?
GC and Chlamydia test
Explain the presentation of a ruptured ovarian cyst
dull, aching or severe, sudden, sharp pain
lower abdomen, pelvis, vagina, lower back or things
Constant or intermittent
Fullness, heaviness, pressure, swelling or bloating in the ab
What are signs and symptoms of Ruptured ovarian cyst?
Greatly mimic PID
bilateral abdominal pain
low back pain
irregular vaginal bleeding
What are the token symptom of a tubo-ovarian abscess?
Symptoms will mimic ovarian cyst but FEVER will be present
What is Ovarian torsion?
sx mimic ovarian cyst
tenderness with rebound and guarding
shown on US or doppler
What is dysfunctional uterine bleeding?
Uterine bleeding that occurs outside the normal menstrual cycle
21-45 days cycle
1-7 days of bleeding
determining blood loss can be difficult
need to get H and H
Describe Bacterial vulvovaginitis
+ whiff test
"clue cells" on wet prep
thin gray-white to yellow discharge
-preterm labor, PROM
vaginal erythema, frothy malodorous discharge
wet prep diagnosis
thick "cottage cheese" discharge
causes severe pruritis, dysuria, dyspareunia
What is Dysmenorrhea?
may be primary or secondary
refer to GYN
What is mittelschmerz?
vague aching pain 2 weeks before menses
typically unilateral pain, mild to moderate
occurs days 14-16
no tx other than prego test
What is endometriosis?
Prescense of endometrial tissue outside of the uterine cavity
What are sx of endometriosis?
chronic pelvic pain
abnormal uterine bleeding
Explain post menopausal bleeding and what it could indicate
endometrium should be evaluated via endometrial biopsy or US if unable to obtain biopsy