Study 5 Gynecologic Emergencies with 12 free online flashcards. Review key terms, definitions, and concepts with this interactive flashcard deck.
What is the first priority in a suspected gynecologic emergency?
Assess airway, breathing, circulation, vital signs, and signs of shock or severe illness; resuscitate and seek urgent specialist help when indicated. Do not delay treatment for imaging in an unstable patient.
When should pregnancy be assessed in acute pelvic pain?
Obtain a urine or serum pregnancy test early in anyone who could be pregnant, even if contraception is used or pregnancy seems unlikely.
Which symptoms with possible pregnancy raise concern for ruptured ectopic pregnancy?
Possible pregnancy with severe pain, fainting, weakness, shoulder pain, or signs of shock raises concern for ruptured ectopic pregnancy and requires emergency evaluation and treatment.
What is usually the first imaging study for suspected gynecologic pelvic pain?
Pelvic ultrasonography, often transvaginal, is usually the first imaging study for suspected gynecologic causes of pelvic pain.
How may an uncertain early pregnancy location be followed in a stable patient?
If the patient is stable but pregnancy location remains uncertain, serial human chorionic gonadotropin measurements and repeat ultrasound may be needed.
What presentation suggests adnexal torsion?
Sudden, often one-sided pelvic pain with nausea or vomiting suggests adnexal torsion; the pain may come and go. Torsion is a time-sensitive surgical emergency.
What must be excluded before classifying reproductive-age bleeding as nonpregnancy-related?
Exclude pregnancy before labeling bleeding in a reproductive-aged patient as nonpregnancy-related abnormal uterine bleeding.
When should empiric PID treatment be considered?
Consider empiric PID treatment when a patient at STI risk has pelvic pain with no better explanation and at least one of cervical-motion, uterine, or adnexal tenderness.
What principles guide examination after sexual assault?
Explain options, ask permission before each step, and let the patient decide whether to have an examination or forensic evidence collected. Medical care is available whether or not the patient reports to law enforcement.
Does normal Doppler blood flow rule out adnexal torsion?
Normal Doppler blood flow does not reliably exclude torsion. With significant clinical suspicion, seek urgent gynecologic consultation rather than waiting for imaging to prove it.
What initial evaluation is recommended for most patients with postmenopausal bleeding?
Most patients with postmenopausal bleeding should have both transvaginal ultrasound and endometrial tissue sampling as part of the initial evaluation.
When should a patient treated for PID as an outpatient be reassessed if not improving?
Reassess outpatients treated for PID if they do not improve within 72 hours.