usmlethree wrote:
1. Treatment of ovarian carcinoma is Carboplatin and Taxol.
2. Forceps cannot be used with a high placed fetal head or in the presence of a cervix that is not fully dilated.
3. Ureteral injury: Any injury above the pelvic brim --- end-to-end anastomosis; any injury below the pelvic brim --- reimplant the ureter into the bladder.
4. Insulin requirements are high during pregnancy; reduce during delivery and post-partum.
5. HELLP syndrome: Deliver.
6. Pre-term labor + HELLP syndrome: Deliver; no time for steroids / tocolysis.

Infections:
7. HSV during pregnancy: Primary infections are of greater risk; negative anti-HSV IgG titer implies primary infection.
8. Endomyometritis is the most common cause of puerperal fever.
9. LGV caused by Chlamydia trachomatis: 'painless' lesion; Chlamydia trachomatis is difficult to culture; detected by DNA tests; treatment is with doxycycline for 3 weeks.
10. Chancroid is caused by Haemphilus ducreyi: 'painful' ulcer with inguinal lymphadenopathy; Haemophilus ducreyi is difficult to culture.
11. Tubo-ovarian abscess: use antibiotics directed against GC and chlamydia.
12. Mastitis: treat with first-generation cephalosporins or dicloxacillin or erythromycin.
13. Gonococcal infections are transmitted at the time of delivery.
14. Toxoplasma; HIV, VZV, Parvovirus B19 are transmitted across the placenta.
15. HIV: treat irrespective of the viral load; give zidovudine for women with low viral loads; give zidovudine + PI for women with high viral loads; once viral loads are undetectable, cesarean section is not compulsory; HAART may be held upto 12 weeks only because of possible teratogenesis; breast feeding is contraindicated.
16. PROM + chorioamnionitis: Induce labor regardless of the gestational age.
17. Obturator nerve injury: during retroperitoneal dissection; sensory loss over medial thigh and motor weakness of hip adductors.
18. Femoral nerve injury: sensory loss over anterior thigh and medial aspect of thigh and calf; motor weakness at hip and knee.
19. Genitofemoral nerve injury: sensory loss over ipsilateral mons pubis, labia majora, skin over the femoral triangle.
20. Pudendal nerve injury: sensory loss over perineum.
21. Rx options for endometriosis: combined OCP's; Progesterone; Danazol; GnRH analogs.
22. Rx of bleeding associated with cervical carcinoma: pack vagina; external radiation therapy; arterial embolisation of uterine or hypogastric arteries; radical hysterectomy.
23. ACOG guidelines for screening women on Tamoxifen for endometrial carcinoma: routine yearly gynec exams in asymptomatic women.
24. Hereditary non-polyposis colon cancer: risk of endometrial cancer.
25. Estrogen replacement therapy is used in patients treated with surgery for endometrial cancer.
26. GnRH agonists are used in the pre-operative treatment of uterine fibroids. They reduce uterine volume, and induce amenorrhoea--- improve hematocrit.
27. Oxybutynin = leads to urinary retention.
28. Osteoporosis: T-score < -2.5
29. Osteopenia: T-score b/w -1 and -2.5
30. MgSO4 is used to prevent eclamptic seizures; Phenytoin is used when MgSO4 is contraindicated as in myasthenia gravis.
31. Influenza vaccine (killed virus vaccine) = during 2nd or 3rd trimester in flu season.
32. Patients with BRCA1 chromosomal defects have a 30-50% risk for ovarian cancer; 60-80% risk for breast cancer.
33. r/o following when PCOD is suspected: PRL levels to r/o hyperprolactinemia; TSH to r/o hypothyroidism; 17-OH progesterone levels to r/o 21-hydroxylase deficiency (congenital adrenal hyperplasia); diabetes; 24-hour urinary free cortisol or overnight dexamethsone suppression test to r/o Cushing's syndrome.
34. Positive pregnancy test following tubal ligation = Ectopic pregnancy until ruled out.

Tumor markers:
35. Embryonal carcinomas: beta-HCG, AFP, CA-125
36. Choricarcinoma: beta-HCG
37. Dysgerminoma: LDH
38. Endodermal sinus tumors: AFP
39. Immature teratomas / dermoids: CA-125