ABPS Obstetrics & Gynecology flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Naegele's rule

Estimated due date calculation: add 280 days (40 weeks) to the first day of the last menstrual period. Accurate only if cycles are regular and conception occurs on day 14.

Active phase arrest

Cervical dilation ≥6 cm with ruptured membranes and no cervical change for ≥4 hours of adequate contractions or ≥6 hours with inadequate contractions. Diagnosis requires documented uterine activity.

Postpartum hemorrhage definition

Cumulative blood loss ≥1000 mL or blood loss accompanied by signs or symptoms of hypovolemia within 24 hours after birth. Uterine atony is the most common cause.

Magnesium sulfate toxicity

Signs include loss of deep tendon reflexes, respiratory depression, and oliguria. Monitor reflexes, respiratory rate, and urine output. Antidote is calcium gluconate 1 g IV.

Shoulder dystocia first-line maneuvers

McRoberts maneuver (hyperflexion of maternal hips) and suprapubic pressure. Avoid fundal pressure and excessive traction. These relieve impaction of the anterior shoulder.

Preeclampsia severe features

Blood pressure ≥160/110 mmHg, platelets <100,000, elevated liver enzymes, pulmonary edema, or new cerebral/visual symptoms. Delivery is recommended at ≥34 weeks.

Gestational diabetes screening

50-g glucose challenge test at 24–28 weeks; if abnormal, perform 100-g 3-hour OGTT. Diagnosis requires two or more elevated values using Carpenter-Coustan or NDDG criteria.

Category III fetal heart tracing

Absent baseline variability with recurrent late decelerations, recurrent variable decelerations, bradycardia, or a sinusoidal pattern. Requires immediate evaluation and possible delivery.

RhD immune globulin

Given at 28 weeks and within 72 hours postpartum if infant is RhD positive. Also for antepartum bleeding, amniocentesis, or external cephalic version. Dose 300 mcg.

Twin-twin transfusion syndrome

Oligohydramnios (deepest vertical pocket ≤2 cm) in donor and polyhydramnios (DVP ≥8 cm) in recipient. Treatment is fetoscopic laser photocoagulation.

Cervical cancer screening intervals

Start at age 21 with cytology every 3 years. Ages 30–65: cytology every 3 years, HPV testing every 5 years, or co-testing every 5 years. Stop after age 65 if adequate prior screening.

Bacterial vaginosis diagnosis

Amsel criteria: at least three of homogeneous discharge, clue cells, pH >4.5, positive whiff test. Treatment is metronidazole or clindamycin. Not a sexually transmitted infection.

PCOS Rotterdam criteria

Diagnosis requires at least two of: oligo/anovulation, clinical or biochemical hyperandrogenism, polycystic ovaries on ultrasound. Exclusion of other causes is necessary.

Endometriosis diagnosis

Dysmenorrhea, dyspareunia, chronic pelvic pain. Definitive diagnosis by laparoscopy. First-line treatment includes NSAIDs and combined hormonal contraceptives.

Endometrial cancer risk factors

Obesity, unopposed estrogen, tamoxifen, Lynch syndrome, and nulliparity. Postmenopausal bleeding is the classic presentation. Most common gynecologic malignancy.

Ovarian cancer screening

No effective screening for average-risk women. CA-125 and transvaginal ultrasound are not recommended for screening. Risk-reducing salpingo-oophorectomy for BRCA carriers.

Gestational trophoblastic neoplasia

Persistent elevated β-hCG after molar pregnancy. Treatment is chemotherapy: methotrexate for low-risk, EMA-CO for high-risk. Monitor hCG until undetectable.

Vulvar cancer

Most common type is squamous cell carcinoma. Risk factors include HPV and smoking. Treatment is wide local excision with inguinal lymph node evaluation.

Infertility definition

Failure to achieve pregnancy after 12 months of regular unprotected intercourse. For women aged ≥35, evaluate after 6 months. Earlier evaluation for known risk factors.

Letrozole ovulation induction

First-line for anovulatory infertility (e.g., PCOS). Aromatase inhibitor that reduces estrogen feedback, increasing gonadotropin release. Preferred over clomiphene citrate.

Ovarian hyperstimulation syndrome

Enlarged ovaries, hemoconcentration, ascites, electrolyte imbalance. Prevention: low-dose gonadotropins, GnRH antagonist protocol, GnRH agonist trigger in high-risk patients.

Primary ovarian insufficiency

Amenorrhea ≥4 months with FSH >25 IU/L on two occasions ≥4 weeks apart in women <40 years. Causes include genetic, autoimmune, and iatrogenic factors.

Stress urinary incontinence

Leakage with increased intra-abdominal pressure (cough, sneeze). First-line treatment is pelvic floor muscle training. Surgical options include midurethral sling and Burch colposuspension.

Overactive bladder

Urgency, frequency, nocturia with or without urge incontinence. First-line: behavioral therapy and bladder training. Second-line: antimuscarinics or beta-3 agonist.

POP-Q staging

Pelvic organ prolapse quantification using points Aa, Ba, C, D, Ap, Bp, gh, pb, tvl. Stage 0 = no prolapse; stage IV = complete eversion.

Pessary for prolapse

Ring or Gellhorn pessary used for pelvic organ prolapse. Follow-up every 3–6 months for vaginal erosion. Local estrogen for atrophy.

Antibiotic prophylaxis for hysterectomy

First-generation cephalosporin (cefazolin) within 60 minutes before incision. Add metronidazole for vaginal hysterectomy. Reduces surgical site infection.

VTE prophylaxis in gynecologic surgery

Use Caprini score. Mechanical prophylaxis for moderate risk; pharmacologic (e.g., heparin) for high risk. Early ambulation. Consider extended prophylaxis for malignancy.

ERAS principles

Enhanced recovery after surgery: preoperative counseling, carbohydrate loading, opioid-sparing multimodal analgesia, early feeding, and early mobilization. Reduces length of stay.

Postoperative fever workup

Common causes: atelectasis (early), urinary tract infection, wound infection, deep vein thrombosis, abscess. Evaluate with history, exam, urinalysis, and imaging.

USPSTF breast cancer screening

Biennial mammography for women 50–74 years. Individualized decision for 40–49 years. Screening reduces breast cancer mortality.

Informed consent elements

Must include diagnosis, nature of procedure, risks, benefits, alternatives, and consequences of refusal. Patient must have decision-making capacity. Document the discussion.