treatment for postpartum hemorrhageuterine massage, ¥oxytocin. If refractory, surgical ligation of uterine or internal iliac artery (will preserve fertility since ovarian arteries provide collateral circulation). reproductiveOBGYAmboss level4 Jul 9, 2020, 5:44 AM HirotoShishido
symptoms of abruptio placentae強い下腹部痛，少量の外出血と強度の貧血，板状硬の子宮壁と著明な圧痛，胎児心拍数陣痛図（CTG）で剝離面に比例する基線細変動の減少あるいは消失，胎盤後血腫の超音波所 114回 必修OBGY Aug 1, 2020, 9:25 AM HirotoShishido
gestational age for Nuchal translucency U/S11-14w OBGY卒試 Oct 18, 2020, 7:10 AM HirotoShishido
etiology of septic abortion
pregnancy testabortion resulting in infected retained products of conception in the uterine cavity
☆staphylococcus aureus is a very common pathogen in septic abortion; other causative organisms include gram- negative bacilli and group B Streptococcus.
(★)A positive pregnancy test is common in patients with a septic abortion (even after dilation and curettage) due to retained products of conception OBGYinfectious diseaseUWorld step2CK May 17, 2020, 9:58 PM HirotoShishido
treatment of pregnant woman with symptomatic bacterial vaginosisTreatment of symptomatic BV is metronidazole(500mg twice daily for 7 days)or clindamycin, regardless of pregnancy status. There were concerns about using metronidazole during the first trimester due to possible teratogenicity, but studies have shown no increased risk of congenital anomalies. OBGYinfectious diseaseUWorld step2CK Sep 20, 2020, 3:08 AM HirotoShishido
complications of shoulder dystociaFractured clavicle
Fractured humerus
Erb-Duchenne palsy (5th and 6th cervical nerves)
Klumpke palsy(★ 8th cervical and 1st thoracic nerve, ★can complicated with Horner syndrome)
Perinatal asphyxia OBGYmusculoskeletalUWorld step2CK Sep 20, 2020, 5:43 AM HirotoShishido
diagnosis for chorioamnionitis(CAM) intraamniotic infection
白イチゴ100杯CAME ON
母体発熱38度以上のとき
①母体白血球15000以上
②母体頻脈 HR100/分以上
(Fetal tachycardia>160)
③子宮圧痛 (diffuse pain rather than focal RUQ→ gallstone, ★appendicitis )
④悪臭のある羊水・悪露
の1つ以上みたすときCAMと診断される
発熱がないときは①-④全て満たさなければならない OBGYUWorld step2CK必修 Jul 24, 2020, 3:10 AM HirotoShishido
painful STIgenital herpes
chancroid
☆lymphogranuloma venereum(LGV)→ painful lymphadenopathy, painless genital ulcers(cased by C trachomatis L1-3)→treat with ceftriaxone
tend to be (★)very small (<6 mm) and disappear within a few days ⇔ syphilis
indications of endometrial biopsy for abnormal uterine bleedingPatient is > ★45 years of age
OR
Patient is at high risk for endometrial cancer (risk factors include: age > 35 years, obesity, polycystic ovary syndrome, diabetes mellitus, tamoxifen therapy) or has ★failed medical management
OR
Endometrial thickness is ≥ 4 mm in a postmenopausal patient OBGYUWorld step2CK Nov 27, 2020, 2:11 AM HirotoShishido
Listeria monocytogenes
transmission, infectioningestion of unpapteurized(pˈæstʃərὰɪz) dairy products and cold deli meats, transplacental, vaginal transmission
→ nausea, ★watery diarrhea, and muscle aches in pregnant woman → intrauterine fetal demise
amnionitis, ☆spontaneous abortion, granulomatosis infantiseptia(敗血性乳児肉芽腫症), neonatal+ ☆immunocompromised patient meningitis microbiologyOBGYUWorld step2CK Jun 8, 2019, 3:39 AM HirotoShishido
ABG change in pregnancy↑progesterone
→ stimulate the hypothalamus to increase respiration drive primarily via ↑tidal volume (hormone induced laxity of the intercostal muscles allows for enlargement of the throracic cavity) + a slight ↑RR
→ ☆chronic hyperventilation
