Cancer Screening Cervical: Age 21-65 Cytology q3yrs, co-test q5 if normal. ASCCP guidelines (there is an app! Or PDF: http://www.asccp.org/Assets/51b17a58-7af9-4667-879a-3ff48472d6dc/635912165077730000/asccp-management-guidelines-august-2014-pdf ) Breast: ACOG: 40-75 annual mammogram Colon: Colonoscopy, FOBT, FIT. Begin at age 50. If first degree relative with colon cancer begin screening at age 40 or 10yrs prior to youngest diagnosis, whichever is younger. […]
Aug 9, 2018
12 min
Swab/Urine Chlamydia: usually asymptomatic. Screen routinely. Can cause infertility/PID and Fitz-hugh-curtis. Treat with Azithro x1 Gonorrhea: often asymptomatic. Screen routinely. Can cause infertility/PID. Treat with Ceftriaxone and Azithromycin Trich: frothy/watery discharge. “Strawberry cervix” Can see trich moving on wet mount. Treat Flagyl 2g PO once. HPV: Cervical dysplasia/cancer and Genital warts. Topical treatments as needed. […]
Aug 9, 2018
13 min
Why: ASCCP guidelines (there is an app! Or PDF) Cervical dysplasia — caused by HPV CIN I–CIN3 is a progression Risk factors: Smoking, other STIs including HIV, immunodeficiency   Histology: Increased Nuclear: cytoplasmic ratio when abnormal Acetic Acid: exact mechanism unknown, the higher N:C ratio cells (aka abnormal cells) reflect more light and appear white. […]
Feb 7, 2018
14 min
Every visit: Doptones, fundal height, vitals Four question: Vaginal bleeding, contractions, leaking fluid, fetal movement By Weeks: 20wks – get and review anatomy US 24wks – order glucola, cbc (check for anemia), discuss normal growing pains 28wks – Tdap and Rhogam if needed, discuss kick counts 32wks – Discuss BCM, sign tubal papers if needed, […]
Jan 31, 2018
12 min
Planned/Desired Options counseling if needed Exam/pelvic/pap Ultrasound for dating Screening options: QUAD, Sequential, NIPS, invasive testing Pregnancy guidelines Weight: BMI under 18.5 should gain 28–40 pounds. Normal-weight women (BMI, 18.5–24.9) should aim for 25–35 Overweight women (BMI, 25–29.9) should aim for 15–25 Obese women (BMI, 30 or more) should gain only 11–20 Food: Avoid unpasteurized […]
Jan 31, 2018
17 min
Hysteroscopy = looking inside the uterus with a scope Steps: Dilate the cervix Distend the uterus with fluid Look around, identify pathology, identify tubal ostia, remove pathology if using an operative scope or Myosure or another resectoscope. Feared complication: Hyponatremia from excessive hypotonic fluid absorption.
Jan 7, 2018
10 min
Intrapartum Differential diagnosis for Temp >38.0C Epidural fever (transient), DVT/PE (if prolonged IOL or limited mobility), UTI, Intraamniotic infection (with or without ROM), etc   Chorioamnionitis aka IAI aka Triple-I (intrapartum intraamniotic Infection) One temp >39.0C One temp 38.0C-39.0C AND one or more risk factors Two temps >38.0C 30+ mins apart Tx: the standard is […]
Jan 4, 2018
21 min
ACOG Practice bulletin: # 171 PTL or TPTL: Preterm <37wks, cervical change Evaluation: SSE first: Collect GC/CT cultures, FFN (no gel, blood or semen), GBS, eval for rupture if needed SVE: Cervical change–can dilation or effacement changes FFN: Fetal fibronectin If tPTL: Magnesium for neuroprotection if <32wks, decrease CP rates Betamethasone for fetal lung development […]
Dec 11, 2017
20 min
Nonreassuring fetal heart tracing Category 2-remote from delivery Minimal/absent variability is most significant predictor of fetal acidemia Category 3 any time is emergent deliver Failed IOL Many different definitions: Most commonly 12-24hrs ruptured membranes on pitocin without active labor Arrest of dilation Can only meet criteria once in active labor 6cm or greater Do you […]
Dec 2, 2017
16 min
Review anatomy– you’ll be able to see well! Pimped- Youtube Channel videos for laparoscopic anatomy What case are you doing and why? Review common indications, steps to procedure and potential risks/complications Saying hi to the patient first Being helpful setting up — yellowfins or stirrups for lithotomy Scrubbing in — ask to grab your gown/gloves […]
Nov 18, 2017
29 min
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