Iran Specialty Board - Obstetrics & Gynecology flashcards

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

Naegele rule

Estimated due date equals the first day of the last menstrual period plus 280 days, or subtract 3 months, add 7 days, and add 1 year.

Physiologic anemia of pregnancy

Plasma volume rises more than red cell mass, diluting hemoglobin to a nadir near 11 g/dL by the third trimester; this is normal, not pathologic.

Folic acid neural tube prevention

Four hundred micrograms daily before conception prevents neural tube defects; high-risk women need 4-5 mg daily starting at least one month before conception.

Preeclampsia definition

New hypertension after 20 weeks with proteinuria or end-organ dysfunction such as thrombocytopenia, renal insufficiency, liver involvement, or pulmonary edema.

Magnesium sulfate toxicity antidote

Calcium gluconate 1 g IV reverses magnesium toxicity; monitor deep tendon reflexes, respiratory rate, and urine output during infusion for seizure prophylaxis.

Gestational diabetes diagnosis

A 100-g three-hour oral glucose tolerance test with two or more values at or above 95, 180, 155, and 140 mg/dL confirms gestational diabetes.

Active phase labor arrest

No cervical dilation change at 6 cm or more despite ruptured membranes and four hours of adequate contractions, or six hours with inadequate contractions.

Postpartum hemorrhage sequence

Give oxytocin first, then tranexamic acid 1 g, then additional uterotonics; address uterine tone, trauma, retained tissue, and coagulopathy.

Category III fetal heart tracing

Absent variability with recurrent decelerations, bradycardia, or a sinusoidal pattern; this predicts acidemia and warrants immediate evaluation and expedited delivery.

Antenatal corticosteroids

Betamethasone 12 mg intramuscularly twice or dexamethasone 6 mg four times between 24 and 34 weeks reduces respiratory distress syndrome, intraventricular hemorrhage, and neonatal death.

Twin-twin transfusion syndrome

Monochorionic twins with oligohydramnios in one sac and polyhydramnios in the other; fetoscopic laser ablation is the preferred treatment before 26 weeks.

Group B streptococcus prophylaxis

Screen at 36-37 weeks; give intrapartum penicillin for positive culture, unknown status with risk factors, or a prior infant with GBS disease.

Cervical cancer screening intervals

Cytology every three years from age 21, co-testing every five years from age 30, or HPV primary testing every five years; stop at 65 if adequately screened.

Endometrial cancer presentation

Postmenopausal bleeding is the classic symptom; endometrial sampling is required, and type I disease is estrogen-driven, endometrioid, and PTEN-mutated.

Gestational trophoblastic disease follow-up

Serial beta-hCG after uterine evacuation; plateauing or rising titers indicate persistent disease treated with methotrexate or actinomycin-D.

PCOS Rotterdam criteria

Two of three: oligo-ovulation or anovulation, clinical or biochemical hyperandrogenism, and polycystic ovarian morphology on ultrasound.

Infertility evaluation timing

No conception after 12 months of unprotected intercourse, or six months if the woman is 35 or older; include semen analysis and tubal assessment.

Premature ovarian insufficiency

Ovarian failure before age 40 with FSH above 25 IU/L on two occasions; hormone therapy is continued until at least age 51 for bone and cardiovascular protection.

Stress urinary incontinence first line

Pelvic floor muscle training is initial treatment for leakage with effort or sneezing; midurethral sling is reserved for selected refractory cases.

POP-Q stage II

The leading edge lies between 1 cm above and 1 cm below the hymen; stage IV is complete eversion of the vagina.

Anterior compartment prolapse

Cystocele is the most common pelvic organ prolapse; evaluation must also assess apical and posterior defects before planning surgery.

Surgical antibiotic prophylaxis

Cefazolin 2 g intravenously within 60 minutes of incision; 3 g if weight exceeds 120 kg; add metronidazole for vaginal or colorectal surgery.

Ureteral injury sites

Most common at the pelvic brim where the ureter crosses the infundibulopelvic ligament and at the ureterovesical junction during hysterectomy.

Ovarian torsion management

Detorsion with ovarian preservation is preferred in reproductive-age women, even when the ovary appears necrotic; oophorectomy is avoided unless clearly nonviable.

Bacterial vaginosis diagnosis

Clue cells, vaginal pH above 4.5, fishy odor after potassium hydroxide, and thin discharge; treat with metronidazole or intravaginal clindamycin.

Pelvic inflammatory disease regimen

Ceftriaxone plus doxycycline plus metronidazole for empiric outpatient treatment; remove an intrauterine device only if symptoms do not improve.

HPV vaccination schedule

Routine at 11-12 years, catch-up through 26 years, and shared decision-making through 45 years; prevents cervical and other HPV-related cancers.

Informed consent elements

Capacity, disclosure of risks, benefits, and alternatives, comprehension, and voluntariness; the discussion must be documented in the record.

Emergency treatment exception

Treatment without consent is permitted when imminent harm exists and the patient lacks capacity; use the least restrictive effective intervention and document.

Reportable confidentiality breaches

Confidentiality may be breached when required by law, such as reportable infectious diseases or child and elder abuse, or to prevent serious harm.

Medical error disclosure

Disclose harmful errors promptly, apologize, explain what happened, and document; follow institutional reporting and risk-management requirements.

Mature minor exception

Some jurisdictions allow minors to consent to certain reproductive care without parental involvement; emancipation and emergency care are other exceptions.