OB/GYN Medical Conditions and Treatments

OB/GYN

• Uterine atony: treated with uterine massage or oxytocin. Retained placenta treated with dilation and curettage.
• Tachysystole: >5 contractions every 10 minutes, potentially causing fetal bradycardia. Treatment: Tocolytics (e.g., terbutaline).
• Beta-thalassemia: Increased HbA2.
• Good accelerations: Increase in fetal heart rate (FHR) by 15 bpm for 15 seconds.
• Endometritis: Symptoms include fever, tender uterus, foul-smelling lochia. Treatment: Ampicillin and gentamicin.
• Chorioamnionitis: Treated with ampicillin and gentamicin.
• Chancroid: Treated with ceftriaxone or azithromycin.
• Chancre: Painless, associated with syphilis
• Placenta issues: Types include accreta (attaches), increta (infiltrates), and percreta (penetrates).
• Intrahepatic cholestasis of pregnancy: Treated with ursodiol.
• Acute fatty liver of pregnancy: Associated with hypoglycemia.
• Pre-eclampsia (PE): Diagnosed using a V/Q scan. Treated with heparin or rivaroxaban.
• Amniotic fluid embolism: Treatment is supportive. May exhibit confusion, chest rash, or petechiae.
• Magnesium toxicity: First sign is hyporeflexia.

Infectious Causes in Infants <3 Months

• Infectious causes: Group B strep, E. coli, Listeria.
• Tubovarian abscess: Treated with clindamycin and metronidazole.
• Recurrent variable decelerations: Treatment involves maternal repositioning or amnioinfusion.
• Sinusoidal heart rate pattern: Seen in fetal anemia.
• Normal amniotic fluid volume: 5-25ml.
• Urinary tract infection (UTI) in pregnancy: Treated with amoxicillin, cephalosporins, or nitrofurantoin.

Prenatal Care and Screening

• GBS prophylaxis: In some cases (prior GBS infection, GBS in urine, prolonged rupture of membranes >18 hours, preterm delivery), Group B streptococcus prophylaxis is appropriate. In all other cases, no prophylaxis is required.
• Vitamin D supplement: Recommended during pregnancy.
• Screenings: Complete Blood Count (CBC), RhoGAM, gestational diabetes testing at week 28.
• Breast cancer screening: Starting at age 40, screened annually.
• HPV vaccine: Recommended for ages 9-26.
• Herpes Zoster vaccine: Recommended at age 60.
• Pneumococcal vaccine: Recommended for patients 65+ years
• HIV-positive patients: Pap smear annually.
• Normal Population Screening: Pap smear at age 21 followed by every 3 years.
• Endometriosis: associated with dysmenorrhea, dyspareunia, dyschezia.

Other Topics

• Lymphogranuloma venereum (LGV) vs Lymphogranuloma inguinale: LGV buboes are painful without ulceration; LGV inguinale buboes do ulcerate. Both treated with doxycycline and ceftriaxone.
• Complete vs Partial Mole: Complete mole: (2 sperm + empty egg) = 46 XX or 46 XY. Partial mole (2 sperms + 1 egg) = 69 XXY
• Septic abortion: Treated with gentamicin and clindamycin.
• Chorioamnionitis: Antibiotics given during delivery.
• Breast nodules: Biopsy is recommended regardless of imaging findings
• Ectopic pregnancy: Management depends on patient stability. A serum B-hCG level and transvaginal ultrasound (TVUS) are used to diagnose.
• Precocious puberty (PCOS): 1st line tx is weight loss, followed by oral contraceptives (OCPs) .
• Sertoli-Leydig cell syndrome: Characterized by sudden onset of virilization.
• Polycystic ovary syndrome (PCOS): Gradual virilization, hirsutism. 1st line treatment is weight loss, follow by OCPs

Additional Topics

• Kallmann Syndrome: Lack of GnRH neurons, leading to infertility. Treatment includes hormone therapy.
• Endometrial cancer: First-line treatment is hysterectomy. The uterus contains glandular tissue.
• Vaginal and cervical cells: Squamous cells.
• Chorionic villus sampling (CVS): Performed at weeks 10-12.
• Amniocentesis: Performed at week 15.

This quiz covers key medical conditions encountered in obstetrics and gynecology, including uterine atony, tachysystole, and pre-eclampsia. It also addresses their respective treatments and associated complications. Test your knowledge on these important topics in women’s health.