OB-GYN at your Cervix :(
A 40-year-old woman who is at 22 weeks gestation returns to the office for a routine obstetric appointment. She has a history of benign essential hypertension that is normally controlled with diet and exercise. She has a blood pressure of 154/89 mm Hg with mild proteinuria on dipstick. She has an unremarkable complete blood count. She does not complain of any symptoms, and a physical exam and fetal ultrasound are unremarkable. Which of the following is the most likely diagnosis?
Preeclampsia
McRoberts maneuver
Pull knees to head to open up pelvis.
Preeclampsia
a disorder in pregnant women characterized by elevated blood pressure and proteinuria that occurs after 20 weeks gestation. Requirements for diagnosis include a systolic blood pressure greater than or equal to 140 mm Hg or a diastolic blood pressure greater than or equal to 90 mm Hg on two occasions at least 4 hours apart in a patient who usually has normal blood pressure or a systolic blood pressure greater than or equal to 160 mm Hg or a diastolic blood pressure greater than equal to 110 mm Hg or higher at any given time.
Premature ovarian failure
a loss of ovarian function prior to age 40, which is most commonly idiopathic but may also be related to autoimmune causes. Symptoms are generally amenorrhea and infertility, along with those secondary to low estrogen levels. Diagnosis is made by measuring a serum follicle-stimulating hormone level, which is over 40 mIU/mL and is in the postmenopausal range. Treatment is with hormone replacement therapy and fertility treatments in those wishing to bear children.
Adenomyosis
a painful condition in women that occurs when endometrial tissue, including endometrial glands and stroma, can be found in the myometrium of the uterus. It can be confused with endometriosis, in which endometrial tissue is found outside the uterus, commonly in the pelvis. The pathogenesis of these disorders is not well understood. The classic presentation of uterine adenomyosis is a triad of abnormal uterine bleeding, painful menses, and uterine enlargement. The enlargement of the uterus is often described as "globular," boggy, and symmetric.
Azithromycin
an acceptable alternative to doxycycline in pregnancy and is also given as a single dose to target Chlamydia trachomatis
Early menarche is considered a risk factor for
breast cancer
Risk factors include increasing age, Caucasian race, delayed childbearing, early menarche and late menopause,nulliparity, positive family history or genetic mutations such as BRCA1 and BRCA2, and history of proliferative forms of fibrocystic breast disease. Additional risk factors include alcohol consumption, high dietary fat intake,and lack of exercise.
breast cancer
Starting at age 30 years, women should be screened by
co-testing with the PAP test plus human papillomavirus testing
Initial treatment for adenomyosis
conservative and symptomatic, including nonsteroidal anti-inflammatory drugs and oral contraceptive pills For cases where conservative treatment fails, more invasive options, such as endometrial ablation or resection, can be employed Ultimately, the only definitive treatment is hysterectomy, which also enables a definitive diagnosis through pathology evaluation
Round, firm, mobile,nontender mass
fibroadenoma
Bilateral, tender, round masses and multiple tender, round masses that fluctuate in size
fibrocystic condition of the breasts
ucleic acid amplification testing is used to confirm the diagnosis of
gonorrhea and chlamydia
Risk factors for premature rupture
include cigarette smoking, prior preterm rupture or delivery, infection of the genital tract or sexually transmitted infection, and multiple gestation.
Ovarian cancer
is the leading cause of death from reproductive tract cancer but is not described in this vignette. Most cases of ovarian cancer are asymptomatic or nonspecific early in the disease course and unfortunately lead to a delay in diagnosis and treatment. Symptoms can include vague abdominal discomfort, gastrointestinal symptoms, or pelvic pain. Physical exam may reveal palpable abdominal mass and ascites in later stages. Diagnosis is made with both pelvic examination and transvaginal ultrasound. Lab work shows CA 125 levels elevated in up to 80% of affected women. Treatment is surgical and involves hysterectomy and bilateral salpingo-oophorectomy with omentectomy and selective lymphadenectomy. Chemotherapy may also be employed following surgical intervention. Unfortunately, the prognosis is poor, as 75% of women are diagnosed with advanced disease
Nitrazine test
is used to confirm the diagnosis of premature rupture of membranes (PROM).
A 26-year-old woman is diagnosed with pelvic inflammatory disease and admitted to the hospital due to severe pain and intractable vomiting. Which of the following is the best antibiotic regimen?
Cefotetan and doxycycline
A 30-year-old woman at 33-weeks gestation presents to the obstetrics ward for admission with contractions every five minutes. Her cervix is 3 cm dilated. The pregnancy has otherwise been normal, and evaluation of the fetal heart rate indicates no fetal distress. Which of the following treatments has the best potential to reduce morbidity and mortality associated with preterm delivery?
Betamethasone The most common direct cause of death in preterm infants is respiratory distress syndrome, usually due to lung immaturity. The use of steroid treatment antenatally and surfactant treatment postnatally have significantly decreased mortality rates in preterm infants. Betamethasone is currently the steroidal drug of choice.
What is the pH of amniotic fluid?
7.0-7.3.
Which of the following is a risk factor for cervical cancer?
Exposure to diethylstilbestrol
most accurately describes the anatomical findings seen in endometriosis?
Aberrant growth of endometrium outside of the uterus
A 24-year-old woman is seen by her gynecologist for pelvic pain and painful, heavy menstrual cycles for the last three months. She denies pain with sexual intercourse. A pregnancy test is negative. On physical exam, a uniformly enlarged and boggy uterus is palpated. Which of the following is the most likely diagnosis?
Adenomyosis
Which of the following is the treatment of choice for uncomplicated genital chlamydia infection in pregnancy?
Azithromycin
Which of the following is a contraindication to mifepristone use in a patient needing first-trimester medication abortion?
Chronic adrenal failure Chronic adrenal failure and long-term corticosteroid use are contraindications to mifepristone use as the drug is a glucocorticoid receptor antagonis
What ages can receive the human papillomavirus 9-valent vaccine?
CDC currently recommends the HPV 9-valent vaccine for all patients between 11 and 26 years old, however, the vaccine has been approved for administration as young as 9 years and up to 46 years.
Which of the following is the best antibiotic regimen to treat gonococcal cervicitis in pregnancy?
Ceftriaxone and azithromycin
A previously healthy 23-year-old woman presents to your clinic with complaints of pelvic pain and vaginal discharge. She tells you that she had three male sexual partners in the past year and generally does not use condoms. Cervical motion tenderness is found on physical exam, and an empiric diagnosis of pelvic inflammatory disease is made. Which of the following is the most appropriate treatment?
Ceftriaxone plus doxycycline
A 30-year-old woman and her husband present to their reproductive endocrinologist for evaluation of infertility. They have been trying regularly for the last 18 months to get pregnant. They have undergone initial evaluations, including history, physical exam, semen analysis, and laboratory testing, which have led to a diagnosis of anovulation due to polycystic ovarian syndrome. They have returned to discuss treatment approaches to achieve their goal of pregnancy. Which of the following is the best initial treatment for this patient?
Clomiphene
A 27-year-old woman presents to her primary care provider for her annual physical. Routine Pap smear is positive for atypical squamous cells of undetermined significance. What is the next step in management?
Complete human papillomavirus testing
A 24-year-old woman presents to the clinic complaining of bilateral breast pain that consistently occurs the week prior to the onset of her menstrual cycle. She has not noticed any breast masses or overlying skin changes. She does not notice any other symptoms during this time including irritability or abdominal bloating. Which of the following is the most likely diagnosis?
Cyclic breast pain
A 45-year-old woman presents to her gynecologist for a progressive feeling of heaviness and bulging in her vagina. She also experiences urinary incontinence throughout the day, which has been embarrassing. She has to wear pads daily. The incontinence seems worse at night and is definitely worse with physical activity. She denies abdominal pain, dysuria, and abnormal menses. Other than four previous vaginal births, she does not have any notable medical history. On pelvic exam, a bulge is noted on her anterior vaginal wall when she performs the Valsalva maneuver. Which of the following is the most likely diagnosis?
Cystocele
A G4P4 68-year-old woman presents to her primary care clinic worried that she has a tumor in her vagina. She states that she can feel a bulge "down there" and is worried it is something serious. Further history reveals that she has been having frequent nocturia and stress incontinence. On exam, the anterior wall of the vagina collapses into the vaginal canal. What is the most likely diagnosis?
Cystocele
A 31-year-old G3P2 at 39 weeks gestational age is on a fetal heart monitor in labor and delivery after presenting with ruptured membranes. Fetal heart monitor abruptly changes revealing severe prolonged bradycardia with variable decelerations. In the event of a prolapsed umbilical cord, which of the following can be done to reduce pressure on the cord while preparing for emergency delivery?
Elevating the fetal head Elevating the fetal head is the most common step in the initial management of umbilical cord prolapse as a clinician can easily perform this while preparing for emergency delivery
A 25-year-old woman presents to the emergency department with pelvic pain and vaginal bleeding. An adnexal mass is palpated on examination. Her serum human chorionic gonadotropin level is 4000 international units per liter. Transvaginal ultrasound does not reveal an intrauterine gestational sac and shows a suspicious adnexal mass. Which of the following is the most likely diagnosis?
Ectopic pregnancy
At one minute of life after an uncomplicated vaginal delivery, a neonate is noted to have some cyanosis in the extremities, his pulse is 115 bpm, he actively flexes his arms and legs equally, he grimaces weakly, and he has a strong cry. What is this neonate's APGAR score?
Eight
A 65-year-old postmenopausal woman with obesity presents with abnormal bleeding for the past several months. She reports no pelvic pain. She has a history of breast cancer that was treated with tamoxifen 5 years ago and has been in remission. Physical examination reveals normal appearing cervix and normal size uterus. Which of the following is the most likely explanation for her symptoms?
Endometrial cancer
Risk factors include exogenous unopposed estrogen use, obesity, polycystic ovarian syndrome (PCOS), tamoxifen therapy, early menarche, late menopause, or nulliparity
Endometrial cancer
The most common presenting sign seen in up to 90% of women is abnormal postmenopausal bleeding
Endometrial cancer
A G2P1 woman who is 31 weeks pregnant with twins presents to the emergency department concerned that she is in labor. She reports a large gush of fluid from her vagina one hour ago. She does not report any contractions. Sterile speculum exam reveals fluid pooling in the vaginal vault, and when the fluid is examined under a microscope, a distinct fern pattern is observed. An ultrasound and fetal heart monitoring are performed and reveal no fetal distress. What is the best management at this time?
Expectant management
Which of the following is the treatment of choice for threatened abortion?
Expectant management
A 23-year-old woman presents with complaints of intermittent lower abdominal pain, painful periods, and occasional pain with defecation. She is not currently sexually active. Physical exam is unremarkable. Which of the following is the most likely diagnosis?
Endometriosis
Which of the following is considered first-line treatment for the management of dysfunctional uterine bleeding (DUB)?
Estrogen-progestin contraceptives
most common anatomical site of an ectopic pregnancy?
Fallopian tube
Which of the following are measured during a fetal nonstress test?
Fetal heart rate and uterine contractions
A 46-year-old woman presents with years of abnormal uterine bleeding. She has a history of ductal carcinoma in situ, hypertension, and iron-deficiency anemia. She is a current everyday smoker, and her anemia is treated with iron supplementation. An endometrial biopsy reveals normal endometrial tissue, and her transvaginal ultrasound reveals a normal, 6 cm uterus without leiomyomata or endometrial polyps. Which of the following medical management approaches is appropriate to treat her bleeding?
High-dose oral progestin
A 26-year-old woman presents to her primary care physician for routine annual cervical screening. She has been sexually active since she was 18 years old. She has no presenting complaints. Her Pap smear comes back with a finding of atypical squamous cells of undetermined significance. Which of the following is the most important next recommendation for this patient?
Human papillomavirus testing
A 28-year-old woman presents to her gynecologist for her annual visit including a routine Pap smear. The cytology report notes findings of atypical squamous cells of undetermined significance (ASC-US). Which of the following is the best follow-up test for this finding?
Human papillomavirus testing
What antihypertensive drugs are used to treat severe hypertension in pregnancy?
Hydralazine, nifedipine, labetalol, and sodium nitroprusside
A 31-year-old woman who is at 39 weeks gestation with a breech fetus is requesting vaginal delivery. Which of the following is a contraindication for this patient to undergo an attempt of external cephalic version?
Hyperextended fetal head
A nulliparous, 41-year-old pregnant woman at 36 weeks gestation presents to the emergency department with concerns about her blood pressure and complaint of severe headache and blurry vision. She says that her home blood pressure readings have been elevated, and her blood pressure taken four hours ago was 175/115 mm Hg. Vital signs in the emergency department include a blood pressure of 180/120 mm Hg. Urine dipstick shows a protein level of 2+. She is diagnosed with preeclampsia. Which of the following is the most appropriate next step in management?
Induce delivery Those between 34 and 37 weeks of gestation should be induced in the case of severe disease Women diagnosed with preeclampsia prior to 34 weeks of gestation and without severe symptoms are managed conservatively with corticosteroids administered to promote fetal lung maturity.
A 25-year-old G3P2 woman at eight weeks zero days of gestation presents to the emergency department complaining of pelvic pain and vaginal bleeding. Pelvic examination confirms the uterus as the source of bleeding and reveals a dilated cervix. No products of conception are seen. Pelvic ultrasound shows an embryo with a crown-rump length of 9 millimeters without fetal cardiac activity. Which of the following is the most likely diagnosis?
Inevitable abortion
Which of the following is a risk factor for the development of ovarian cancer?
Infertility
A 25-year-old woman presents complaining of a three-month history of dysmenorrhea, dyspareunia, and low back pain that worsens before her menstrual cycle. Pelvic examination reveals tender nodules in the cul-de-sac and rectovaginal septum. Which of the following diagnostic studies is confirmatory for this condition?
Laparoscopy
Which of the following is the best way to definitively diagnose ovarian torsion
Laparoscopy
Which of the following is a risk factor for the development of breast cancer?
Late menopause
A premenopausal woman was evaluated for abnormal uterine bleeding and diagnosed with endometrial hyperplasia without atypical cells. She desires children in the future. Which of the following is the preferred first-line treatment?
Levonorgestrel-releasing intrauterine device levonorgestrel-releasing intrauterine device is first-line.
In a patient receiving magnesium sulfate for eclampsia, what physical exam finding is characteristically the first manifestation of symptomatic hypermagnesemia?
Loss of deep tendon reflexes
Which of the following clinical findings is most common in pelvic inflammatory disease?
Lower abdominal pain
A 25-year-old woman presents to the office with a history of a painless ulcer on the left labia majora four weeks ago, which has since resolved. Physical exam reveals painful inguinal lymph nodes that have coalesced to form buboes along with rectal pain and bloody purulent discharge. Which of the following is the most likely diagnosis?
Lymphogranuloma venereum
During a vaginal delivery, the shoulders of the fetus become impacted and delay the progression of the birth. Which of the following is the initial treatment of choice?
McRoberts maneuver
A 28-year-old G1P1 at 41 weeks gestation has a normal spontaneous vaginal delivery. Due to shoulder dystocia during delivery, an episiotomy was performed. Where would the expected episiotomy incision be found?
Mediolaterally towards the ischial tuberosity
Which of the following is first-line pharmacologic treatment for bacterial vaginosis?
Metronidazole
A 28-year-old woman presents to the ED three months postpartum for exquisite left breast pain. She is currently breastfeeding, although it has been extremely difficult and painful to nurse in the last 48 hours. She has a temperature of 101°F, and her other vital signs are within normal limits. On exam, her left breast is edematous and red with a 4 cm diameter area of tender, fluctuant induration in the upper outer quadrant of the breast that crosses over the areola. Which of the following is the most appropriate initial treatment approach?
Needle aspiration and empirical oral antibiotics
A 26-year-old G2P1 at 37 weeks of gestation presents to labor and delivery reporting an episode of gushing vaginal fluid while at home. She has not started contractions. After a sterile speculum examination is performed, which of the following should be considered to confirm a diagnosis of premature rupture of the membranes?
Nitrazine test
Which of the following physical examination findings is most concerning for breast cancer?
Nontender, firm, immobile mass
A 21-year-old woman presents with irregular menses, hirsutism, and acne of six months duration. She currently does not wish to become pregnant. Which of the following is the first-line pharmacologic treatment for this condition?
Oral contraceptive pills
A 19-year-old female presents to urgent care requesting emergency contraception after unprotected intercourse the night prior. Which of the following is an effective form of emergency contraception that can be offered to this patient?
Oral levonorgestrel
A 25-year-old woman is diagnosed with a ruptured ovarian cyst. She is hemodynamically stable, and a pelvic ultrasound shows a small amount of peritoneal fluid. Which of the following treatment plans is most appropriate?
Outpatient management with oral analgesia
All women aged 21 years and older should be screened for cervical cancer using the
PAP test regardless of sexual activity
A 35-year-old-woman presents to her primary care physician with skin changes on her left breast. The area is itchy and somewhat painful. There is no discharge, and there has been no fever. She has tried to treat the area with topical hydrocortisone for the past two weeks, but there has been no improvement. On exam, an approximately 2 cm scaly lesion is noted covering the left nipple with some extension to the areola. There is some tenderness to palpation over the left nipple. Her left breast exam is also concerning for a 2 cm palpable mass in the upper outer quadrant. Her right nipple and breast are normal. Which of the following is the most likely diagnosis?
Paget disease of the breast
A healthy 23-year-old woman presents to your office for her annual exam. She has never undergone screening for cervical cancer and says that she has never been sexually active. Which of the following is the most appropriate next step according to the USPSTF?
Papanicolaou test alone
What patient education should be given to pregnant women with a history of previous lactational mastitis to help to reduce the risk of lactational mastitis with their current pregnancy?
Patients with a history of lactational mastitis should take Lactobacillus probiotic in the third trimester
A 63-year-old woman presents to her primary care physician with concern for gastrointestinal upset. She has been feeling bloated and has stomach pain all the time, especially after eating. She is already taking multiple medications for gastrointestinal reflux, but they do not seem to help anymore, and she had not previously felt bloated as she does now. On physical exam, abdominal distention and ascites are noted and there is concern for a possible left adnexal mass. Which of the following is the most important diagnostic approach at this point?
Pelvic ultrasound
A 21-year-old woman presents with a six-month history of anovulation and signs of hyperandrogenism. Laboratory testing reveals elevated free testosterone and slightly elevated DHEA-S levels. Follicle-stimulating hormone is slightly low and luteinizing hormone is within normal limits for Tanner stage, sex, and age. Levels of 17-alpha-hydroxyprogesterone are within normal limits. Which of the following is the most likely diagnosis?
Polycystic ovarian syndrome
A 24-year-old woman with a body mass index of 37 kg/m2 presents to the office for a routine checkup. She reports having very irregular periods since she was a teenager. On physical exam, she has visible hair growth to the upper lip and chin, as well as some acne on her face. Her laboratory results reveal a slightly elevated fasting blood sugar. Which of the following is the most likely diagnosis of this condition?
Polycystic ovarian syndrome
Which of the following is a risk factor for endometrial carcinoma?
Polycystic ovarian syndrome
Which of the following pregnancies would be at risk for causing Rh incompatibility?
Rh-negative mother and Rh-positive fetus
A 31-year-old G3P2 at 35 weeks estimated gestational age is rushed to labor and delivery from outpatient clinic due to hypertension of 172/100 mm Hg, proteinuria, right upper quadrant pain, and nausea. A complete blood count and peripheral smear are obtained. What other tests should be ordered to confirm the diagnosis of HELLP syndrome?
Serum aspartate aminotransferase and bilirubin
hich of the following pathogens most commonly causes lactational mastitis?
Staphylococcus aureus
Which of the following is most important to rule out when considering a diagnosis of endometritis in a postpartum female who recently underwent cesarean section delivery?
Surgical site infection
Which of the following is true regarding the treatment plan of placental abruption?
The treatment plan depends on fetal status, maternal hemodynamic stability, and gestational age of the fetus
A 25-year-old man presents to the clinic with multiple lesions on his penis. The lesions are skin-colored, cauliflower-shaped, and nonpainful. He has had five new sexual partners in the past five months. What is the best approach to diagnosing this patient's condition?
The diagnosis is typically made clinically
A 27-year-old woman is admitted to the labor and delivery unit with regular contractions every 10 minutes. A cervical exam is completed, in part, to ascertain the position of the fetus head. Detection of the fetal head at which of the following maternal anatomic markers indicates the head is engaged?
The ischial spine
Which of the following describes the third stage of labor?
The stage of labor between delivery of the baby and delivery of the placenta
A 28-year-old woman returns to her obstetrician for a routine visit in the third trimester of her first pregnancy. She has noticed her hair feels thick and heavy, and she has developed hemorrhoids, stretch marks over her trunk, and varicose veins on her legs. She wants to know if these problems will get better after she delivers the baby. Which of the following is most likely to resolve during the postpartum period?
Thickened hair
A 64-year-old G0P0 postmenopausal woman presents to the clinic with new-onset vaginal bleeding for one week. She states she went into menopause at age 53 and has not bled since, until now. What is the initial diagnostic test of choice?
Transvaginal ultrasound Endometrial biopsy is used to definitively diagnose endometrial cancer, however, it is not the initial test completed
A 25-year-old woman presents to the clinic complaining of vaginal discharge. She says the discharge is yellow-green and frothy. She also complains of vaginal irritation and pain with intercourse. A wet mount shows motile flagellated protozoa. Which of the following is the most likely diagnosis?
Trichomoniasis
A 25-year-old woman presents to the clinic with yellow-green vaginal discharge. She states that she recently had a new sexual partner. Physical exam reveals yellow and frothy vaginal discharge with punctate hemorrhages on the cervix. Wet mount microscopy reveals motile organisms. Which of the following is the most likely diagnosis?
Trichomoniasis
A 58-year-old postmenopausal woman presents to the clinic complaining of vaginal dryness and irritation for the past three years. She complains of pain with intercouse. She has never had any gynecologic surgeries. She has been using vaginal moisturizers daily and vaginal lubrication during intercourse without improvement. Which of the following is the recommended pharmacologic treatment?
Vaginal estrogen
A 38-year-old woman presents to her gynecologist six months postpartum after her fourth vaginal delivery. She has been experiencing a bulging sensation in her vaginal area and episodes of urinary incontinence. An initial pelvic examination is consistent with urinary incontinence. Which of the following is the best initial treatment for this patient's symptoms?
Vaginal pessary
HELLP syndrome
a complication of pregnancy associated with evidence of hemolysis on peripheral smear, elevated liver enzymes, and low platelet count (thrombocytopenia). Diagnostic workup should include complete blood count, peripheral smear, and liver function tests(including aspartate aminotransferase and bilirubin). Criteria for diagnosis include evidence of hemolytic anemia (elevated indirect bilirubin, low serum haptoglobin), presence of schistocytes on peripheral smear, thrombocytopenia, elevated total bilirubin, and elevated serum AST.
Cervical cancer
leading cause of cancer death among women in developing countries and is caused by sexually transmitted infection with human papillomavirus (HPV) types 16 and 18. Squamous cell carcinoma accounts for up to 80% of cervical cancer cases. Signs and symptoms include metrorrhagia, postcoital bleeding, and cervical ulceration. In late stages, bladder and rectal dysfunction may be seen. Screening is performed using Papanicolaou smear and is confirmed with cervical biopsy. Treatment depends on cancer stage. Total hysterectomy is the treatment of choice for women in which childbearing is not a consideration. For women with localized carcinoma in situ who are interested in having children, treatment may include cervical conization or ablation. Patients with invasive carcinoma may be treated with both surgical intervention along with chemotherapy and radiation. Prevention is with HPV vaccination, which protects against low risk and precancerous HPV types 16 and 18 and is approved for men and women ages nine through 26.
Ceftriaxone
may be used to treat Neisseria gonorrhoeae
Endometrial cancer
most common female genital cancer, with adenocarcinoma most common in women aged 50 to 70 years. The main risk factor for endometrial cancer is an excess of endogenous or exogenous estrogen without adequate opposition by a progestin. Other risk factors include nulliparity, obesity,diabetes, polycystic ovaries, and extended use of tamoxifen for the treatment of breast cancer. Women with a family history of colon cancer are at a higher risk. The most common presenting sign seen in up to 90% of women is abnormal postmenopausal bleeding. It is important to note that early in the disease process, pelvic examination may be normal with a normal appearing cervix and a normal sized uterus. Initial diagnostic workup may include a transvaginal ultrasound to assess endometrial thickness, however, endometrial biopsy is confirmatory. Treatment is total hysterectomy and bilateral salpingo-oophorectomy. Patients with stage three or four disease are treated with surgery followed by chemotherapy and radiation. Patients with metastatic disease are managed with palliative care. When diagnosed and treated early in the disease course, there is a 5-year survival rate of 80 to 85%. Therefore, it is imperative that every woman presenting with postmenopausal bleeding be thoroughly evaluated for endometrial cancer
Pelvic ultrasound with Doppler is the preferred initial imaging for patients with suspected
ovarian torsion
What sign of polycystic ovarian syndrome can be noted on ultrasound?
pearl necklace"
Spironolactones not a first-line treatment, however, it is frequently prescribed in addition to oral contraceptive pills to control the hyperandrogenic effects, such as acne and hirsutism.
polycystic ovarian syndrome
The mother should be placed in Trendelenburg or knee-chest position
prolapsed umbilical cord
Premature rupture of membranes
results from the rupture of amniotic membranes prior to the development of uterine contractions. If rupture occurs prior to 37 weeks of gestation, it is called preterm premature rupture of membranes (PPROM) The diagnosis is based on history and speculum exam. Speculum exam will reveal pooling at the os or flowing fluid from the cervical os. If the diagnosis is uncertain after speculum exam, nitrazine test is performed to test the pH of the fluid. Ferning tests can also be performed if microscopic slides are available. A positive fern test demonstrates a crystallized arborization pattern or "fern" appearance in the presence of amniotic fluid.
Penicillin
used in the treatment of syphilis