O&G

  1. Pathognomonic of PID caused by C. Trachomatis
    • Fitz-Hugh-Curtis syndrome ( typical violin string appearance)
    • Adhesion b/w liver & peritoneal surface
  2. Risk factors that should avoid COCP
    • 1. Uncontrolled HPT, DM, obese
    • 2. Migraine w aura
    • 3. Hx of VTE
    • 4. > 35 y/o smokes > 15 cigs/day
    • 5. Major surgery w prolonged immobility
    • 6. Vascular dz / stroke
    • 7. IHD, Cardiomyopathy, Afib
    • 8. Liver cirrhosis & tumors
    • 9. SLE & APL
  3. What is pearl index?
    Number of contraceptive failure per 100 women years of exposure

    - failure rate of contraception / used to summarize contraceptive effectiveness

    - smaller the PI, the safer the method of contraception

    • From safest > not safest
    • - Subdermal implant
    • - Male sterile
    • - Mirena
    • - Female sterile
    • - Copper IUD
    • - POP injx
    • - POP
    • - Male condom
  4. How to manage missed oill for COCP
    • Missed 1 pill
    • - take missed pill as soon as pt remembers followed by her regularly scheduled pill

    • Missed 2 or more consecutive pills
    • - remaining pills taken at usual time & backup contraception (ex: condom)
    • - if missed in 1st week of cycle & unprotected sex - need emergency contraceptive

    • Missed pill in 3rd week of active pills
    • - finish that last week of hormone pills (week 3). Skip placebo pills. Immediately move to new pill pack the next day after finish week 3 hormonal pills
  5. Places to put combined transdermal patch on our body - 4
    • Abdomen
    • Upper outer arm
    • Upper back (blkg bahu, not breast)
    • Buttocks

    • Diff side used each time
    • Patch changed once/week for 3 weeks followed by 1 patch-free week
  6. MOA Mirena/hormone releasing IUD/Levonogestrel
    • Foreign body effect
    • 1. Uterus exposed to foreign body by the IUD frame
    • 2. Sterile inflammation occur
    • 3. This is toxic to sperm & ova
    • 4. Impair implantation

    + local changes caused by released meds
  7. Important duration for contraceptives
    Calender based method - avoid unprotected SI D8-D19

    BBT, ovulation method - wait until 3 days after

    Transdermal combined patch - for 3 weeks (change once/week), 1 week patch free

    Vaginal ring - left 3 weeks

    Progestin injectables - last 12 weeks/3 months

    Subdermal implant - 3 years

    IUD (Mirena) - 5 yrs, copper (10 yrs)

    EC - LNG (w/in 1st 3 days), IUD & UPA (w/in 5 days)
  8. Anti-HPT drugs that can be used in pregnancy
    • Labetalol
    • Nifedipine
    • Methyldopa
  9. What are the components of Rotterdam criteria to diagnose PCOS ?
    • At least 2/3:
    • 1) Polycystic ovaries (12 or more follicles/incteased ovarian volume)
    • 2) Oligomenorrhea/Amenorrhea
    • 3) Clinical/Biochemical signs of hyperandrogenism
    • - clinical: acne, hirsutism
    • - biochemical: raised serum testosterone
  10. Treatment of PCOS
    1. COCP - to regulate menses and prevent endometrial hyperplasia from unopposed estrogen

    • 2. Clomiphene citrate (Clomid)
    • Anti-estrogenic effect (inhibit estrogen -ve feedback) cause increase GnRH and FSH for follicular growth so that ovulation can occur

    3. Metformin - glucose intolerance
  11. Clinical features of PCOS
    • HOSARA
    • 1. Hirsutism
    • 2. Obese
    • 3. Subfertility
    • 4. Acne
    • 5. Recurrent miscarriage
    • 6. Acanthosis nigricans
  12. What is Asherman syndrome?
    • Aka intrauterine adhesion
    • Common complication of dilation & curretage
  13. What is MRKH syndrome?
    • Aka mullerian agenesis
    • Absence of uterus, vagina or both. Ovaries preserve unlike in androgen insensitivity syndrome (AIS) - girl but genetically male who is resistant to male hormone who has no uterus, ovaries but has breast & pubic hair
Author
nhr
ID
354276
Card Set
O&G
Description
o&g
Updated