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First Aid for the USMLE Step 2 CK (10th Ed.) | Medicine (MD/DO) School Study Aid

Ectopic Pregnancy

Lower Abdominal Pain

Delayed Menses

Abnormal Vaginal Bleeding

Shock

Referred Shoulder Pain

Cullen Sign

Methotrexate

Surgery

RhoGAM

2 mins

Placental Implantation Abnormalities

Placenta Adheres Directly to Myometrium

Placenta Accreta

Placenta Increta

Placenta Percreta

Caused by Scar Tissue

Hemorrhage

Ultrasound is First-line, then MRI

C-section Delivery

Artery Ligation or Embolization

2 mins

Abruptio Placentae

Premature Separation of Placenta

Tearing Pain

Bleeding (Often Concealed)

Rigid Uterus

Contractions

Corticosteroids as Needed

Emergent Delivery

Increased Risks for Neonate

Rh (Rhesus) Incompatibilities

Increased Risk for Shock

Monitor Fetal Heart Rate

3 mins

Placenta Previa

Placenta Covers Cervical Os

Painless

Bright Red Vaginal Bleeding

Stable Fetus

Bed Rest

Observation

Unstable Fetus

C-section Delivery

Risk for Shock

Magnesium Sulfate

Tocolysis

3 mins

Vasa Previa

Fetal Vessels Over Internal Cervical Os

Velamentous Umbilical Cord Insertion

Placental Abnormalities

Multiparity

Rupture of Membranes

Painless Vaginal Bleeding

Fetal Distress

Doppler Ultrasound

Emergency Cesarean Delivery

2 mins

Intrauterine Growth Restriction (IUGR)

Slowed Fetal Growth

Symmetric Type

Factors Early in Pregnancy

Genetic (Chromosomal) Abnormalities

Congenital Infections

Asymmetric Type

Preserved Head Circumference

Factors Late in Pregnancy (2nd / 3rd trimester)

Placental Insufficiency

Ultrasound

< 10th Percentile (for SGA)

Decreased Fundal Height

Increased Perinatal (Fetal) Morbidity and Mortality

2 mins

Fetal Macrosomia

Increased Birth Weight

> 4500 g

Maternal Obesity

Gestational Diabetes

Weigh Newborn at Birth

Ultrasound

Hadlock's Formula

Birth Canal Trauma

Neonatal Hypoglycemia

Shoulder Dystocia

Planned Cesarean Section

2 mins

Polyhydramnios

Increased Amniotic Fluid

Duodenal Atresia (or Gastrointestinal Atresias)

Maternal Diabetes

Multiple Gestations

Anencephaly

Hydrops Fetalis

Ultrasound

Amniotic Fluid Index (AFI) > 25 cm

Weekly Nonstress Test (NST) and Biophysical Profile (BPP)

Amnioreduction

Indomethacin

3 mins

Oligohydramnios

Decreased Amniotic Fluid

Renal Agenesis (Fetal Urinary Tract Abnormalities)

Uteroplacental Insufficiency

Premature Rupture of Membranes (PROM)

Ultrasound

Amniotic Fluid Index (AFI) < 5 cm

Spontaneous Abortion

Pulmonary Hypoplasia

Musculoskeletal Abnormalities

Intrauterine Growth Restriction (IUGR)

Treat Underlying Cause

Delivery (When Viable)

2 mins

Potter Sequence

Oligohydramnios

Limb Deformities

Facial Anomalies

Pulmonary Hypoplasia (Most Common Cause of Death)

Autosomal Recessive Polycystic Kidney Disease (ARPKD)

Posterior Urethral Valves

Chronic Placental Insufficiency

Bilateral Renal Agenesis

3 mins

Rh Hemolytic Disease of the Fetus and Newborn

Rh (Rhesus) Incompatibilities

Rh(D)^- Mother and Rh(D)⁺ Fetus

Anti-Rh(D) Antibodies

Hemolytic Anemia

Hydrops Fetalis

Neonatal Jaundice

Kernicterus

Positive Coombs Test

Ultrasound

RhoGAM [Anti-Rh(D) Immunoglobulin]

Intrauterine Blood Transfusion

Phototherapy

IVIG (Intravenous Immunoglobulin)

4 mins

ABO Hemolytic Disease of the Fetus and Newborn

ABO Incompatibilities

Type O Mother and Type A/B Fetus

Anti-A or Anti-B Antibodies

Hemolytic Anemia

Often Asymptomatic

Neonatal Jaundice

Negative Coombs Test

Phototherapy

2 mins

Hydatidiform Mole (Molar Pregnancy)

Abnormal Fertilization

Symptoms of Pregnancy

Elevated hCG

Vaginal Bleeding

Inappropriate Uterine Growth

No Fetal Heart Rate (FHR)

Dilation and Curettage (D&C)

Emotional Support

No Pregnancy 1 Year

Hysterectomy

3 mins

Complete Hydatidiform Mole

Gestational Trophoblastic Disease

Fertilization of Enucleated Egg

Diploid Fetal Karyotypes

Hydropic Chorionic Villi

Vaginal Bleeding

Preeclampsia

Increased Beta hCG

"Snowstorm" / "Bunch of Grapes" Appearance

Theca Lutein Cysts

Dilation and Curettage (D&C)

Methotrexate

Increased Risk of Choriocarcinoma

3 mins

Choriocarcinoma

Germ-cell tumor

Trophoblastic tissue

Hematogenous spread to lungs

Malignant

Theca-lutein cysts

Hydatidiform Mole

hCG

59 secs

Partial Hydatidiform Mole

Gestational Trophoblastic Disease

Dual Fertilization of Haploid Egg

Triploid Fetal Karyotypes

Hydropic Chorionic Villi

Vaginal Bleeding

Increased Beta hCG

Fetal Structures

Dilation and Curettage (D&C)

Methotrexate

2 mins

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