REI
Definition of Infertility
<35 yo: Inability to concieve after 12mo unprotected interoucrse
>=35 yo: Inability to concieve after 6mo
When to administer antenatal steroids; rescue dose?
Risk of preterm delivery within 7 days give a single dose bewteen 24.-33.6 (May ne considered btwn 22-23.6 if planning on neonatal resuscitation)
34.0-36.6: If no prior administration, then give a dose
Rescue dose can be given as early at 1 week after if risk of delivery within 7 days and under 34 wks
Vaccination schedule for HPV
9-14yo: 2 dose regimen 0m and 6-12mo
15-26yo: 3 dose reigmen 0mo, 1-2mo, 6mo
Level 1 support of pelvis
Apical Support: Cardinal and Uterosacral Ligament Complex
BRCA1 associated with what chromosome?
BRCA2 associated with what chromosome?
BRCA1: 17
BRAC2: 13
Ovarian cells that secrete AMH
First line vasopressor in pregnancy and postpartum in septic shock
Norepinephrine
Amsels Criteria
3/4:
Vaginal pH >4.5
Thin milky noninflammatory discharge
>20% clue cells
Fish odor after 10% KOH / +Whiff test
What stage prolapse am i
Aa -3, Ba -3, C -7
gh 3, pb 3, VL 9
Ap -3, Bp -3, D -9
* What point is missing post hysterectomy?
Syndrome and gene mutation involved in: breast, endometrial, thryoid cancer; mulitple benign hamartomas, mucocutaneous lesions, macrocephaly, autism spectrum
Cowden Syndrome, AD, PTEN (phosphatase and tenisin homolog gene)
Steps of Female Development
*When to start workup for delayed puberty?
Thelarche: Breast growth, 9-10yo
Pubarche: Pubic hair, about 6 months after thelarche
Menarche: Menses, about 1-3 years after thelarche
*No thelarche @13, No menarche @15
Rocker bottom feet, clenched hands with overlapping fingers, micrognathia, severe mental retardation
Trisomy 18 or Edwards Syndrome
Age to start DEXA scan
65yo
Innervation of the detrusor muscles for micturition
Muscarinic M2,M3 receptors under parasympathetic stimulation: M3 in Bladder=contraction, M2 in urethra=Relaxation
Syndrome and mutation involved in: breast cancer, bone cancer (osteosarcoma), adrenocortical cancers, brain cancer, leukemia
Li Fraumeni, AD, TP53
Mechanism of Action of Letrozole
Aromatase Inhibitor: Stops conversion of androgen to estrogen
>=15 weeks
Most effective methods of Contraception
Implant (0.05%)
IUD (0.2% lng, 0.8% copper)
Vasectomy (0.15%)
Tubal Ligation (0.5%)
% of women experiencing unintended pregnancy in 1st year of use
Mechanism of Action of Mirabegron, whats the most common contraindication, and what is it used for
beta AGONIST targets the beta receptors in the bladder wall causing it to relax
-Contraindicated in uncontrolled HTN
-Overactive bladder
Syndrome and mutations involved in: colon cancer, endometrial cancer, ovarian and gastric cancer; requires endometrial biopsy every 1-2 years starting at 30-35yo and colon cancer screening @20-25yo every 102 yrs, hysterectomy with BSO by mid 40s
Lynch Syndrome / Hereditary Nonpolyposis Colorectal Cancer, AD, Defect in MMR: MLH1, MSH2, MSH6, PMS2, EPCAM
Diagnosis for PCOS
2/3 Rotterdam Criteria:
-Oligo/anovulation
-Clinical/ biochemical signs of hyperandrogenism
-12+ cysts on sonogram or ovarian volume 10cc
When to deliver?
30w0d to 32w0d
What are new patient codes
99202 - 99205; upcode depending on complexity
Establish patient: 99212-99215
How to repair a distal ureteral injury
Ureteroneocystotomy when the injury invoves the distal 4-5cm: then reimplant ureter with psoas hitch or boari flap
Syndrome and Gene Mutation for: Hamartomatous polyps in GI tract, mucocutaneous pigmentation; increased risk of breast, ovarian, colorectal, stomach and pancreatic cancer
Peutz Jegher, AD syndrome, mutation in STK11 gene