Usmle Step 2 Ck Review Notes

J 1 J Premenopausal Pelvic masses ?-hCG test + Sono simple cyst + Sono complex/solid + Acute sodding(a) pain Elmar P. Sakala, MD, miles per hour J J (c) Elmar P. Sakala, MD miles per hour (2011) 2 CV disease & Hormone Therapy J Recommendations HT (E+P) 2003 Critique of WHI study Elmar P. Sakala, MD, MPH Elmar P. Sakala, MD, MPH (c) Elmar P. Sakala, MD MPH (2011) 3 Menopause WHI WINDOW of hazard Critical period for maximum response to HT 10 yrs too later(a) Start HT here Elmar P. Sakala, MD, MPH Nonoral Options in Hormone Therapy, OBG Management accompaniment to November 2004 Not Here Natural HistoryTreatment Non-contraceptive Benefits steroid hormone Contraception progestogen Progestin Progestin Hysterectomy v Dysmenorrhea v DUB v PID v Ectopic preg suppress PG release stabilizes endometrium thickens cervical mucus thickens cervical mucus TAH, BSO Elmar P. Sakala, MD, MPH Elmar P. Sakala, MD, MPH (c) Elmar P. Sakala, MD MPH (2011) 4 Metabolic effectuate Steroid contrac eption Healthy lipid write ( HDL, v LDL) unwritten contraceptive devices Risk of CANCER Estrogen mediated THROMBOSIS venous & arterial v Endometrial Cervical = Breast Ovarian Unhealthy lipid profile (v HDL, LDL)Progestin mediated Elmar P. Sakala, MD, MPH Contraception Review Intrauterine Contraception Steroid Contraception Elmar P. Sakala, MD, MPH (August, 2011) Elmar P. Sakala, MD, MPH (c) Elmar P. Sakala, MD MPH (2011) 5 Contraceptive Failure Rates Reversible Methods Basic Principles of Contraception Avoid contraindications Elmar P. Sakala, MD, MPH Elmar P. Sakala, MD, MPH Basic Principles of Contraception Avoid contraindications FEW Complic Completed vaginal birth Sterlization Elmar P. Sakala, MD, MPH (c) Elmar P. Sakala, MD MPH (2011) 6 FEMALE Next yard in precaution? -hCG ? -hCG ? -hCG ? -hCG PREGNANCY Next step in management? OB sono OB Sono OB Sono OB SONO J J (c) Elmar P. Sakala, MD MPH (2011) 7 Pathophysiology J F E T U S Vol of RBC needed varies from 0. 1m L to 450 mL M O M J Mechanism of FHR Decelerations HEAD Compression Compression CORD eutherian Insufficiency Elmar P. Sakala, MD, MPH (c) Elmar P. Sakala, MD MPH (2011) 8 Fetal Fibronectin Trophoblast gingiva Matrix that bonds Trophoblast to Decidua Predictor of Preterm Delivery Elmar P. Sakala, MD, MPH Cervical Length vaginal Sonogram Saggital Image Normal 25 mm 1 3 4 (c) Elmar P. Sakala, MD MPH (2011) 9 Described in notes p. 44 Agent TOCOLYTIC agents Side Effects Contraindications J MgSO4 ? -Adrenergic Agonists Ca++ channel blockers PG synthetase inhibitors tendon weakness Renal insuffic Respiratory depression Myasthenia gravis Pulmonary hydrops v? BP, tachycardia, glucose, v K+, Pulmonary edema Tachycardia, v BP myocardial depression Cardiac disease Diabetes Uncontrolled T4 Cardiac disease Hypotension Oligohydram, gestational age IU closure PDA, Necrotiz enterocolitis 32 weeks J (c) Elmar P. Sakala, MD MPH (2011) 10