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Educational Objectives Antepartum Care Antepartum care promotes patient education and provides on going risk assessment and development of an individualized patient management plan. The student will be able to cite methods to: Diagnose pregnancy Assess gestational age Distinguish an at-risk pregnancy The student will be able to describe Appropriate diagnostic studies Patient education programs Nutritional needs of pregnant women Adverse effects of drugs and the environment The student will be able to Perform a physical examination on obstetric patients Answer commonly asked questions concerning pregnancy and labor and delivery. Intrapartum Care Understanding the process of normal labor and delivery allows optimal care and reassurance for the parturient and timely recognition of abnormal events. The student will be able to describe: Characteristics of true and false labor Initial assessment of the laboring patient Stages and mechanism of normal labor and delivery Techniques to evaluate the progress of labor Pain management during labor Methods of monitoring the mother and fetus Vaginal repair Indications for operative delivery Immediate postpartum care of the mother. Postpartum Care Knowledge of normal postpartum events allows appropriate care, reassurance, and early recognition of abnormal events. The student will be able to describe: Normal maternal physiologic changes of the postpartum period Lactation Knowledge of the physiology and function of the breast during lactation allows appropriate counseling to the pregnant and postpartum woman. The student will be able to: List the normal physiologic and anatomic changes of the breast during pregnancy and the postpartum periods Recognize and treat common postpartum abnormalities of the breast Know the reasons why breast feeding should be encouraged Recognize commonly used medications which are appropriate and inappropriate to use while breastfeeding Counsel the lactating patient about commonly asked questions such as frequency, duration, inadequate production of milk, etc. Abnormal Labor Labor is expected to progress in an orderly and predictable manner. Careful observation of the mother and fetus during labor will allow early detection of abnormalities so that management can be directed to optimize outcome. The student will be able to list: Abnormal labor patterns Methods of evaluating fetopelvic disproportion Fetal and maternal complications resulting from abnormal labor Indications and contraindications for oxytocin administration Strategies for management of abnormal fetal presentations Indications for vaginal birth after cesarean delivery Strategies for emergency management of breech, shoulder dystocia, and cord prolapse Preterm Labor Prematurity is the most common cause fo neonatal mortality and morbidity. The reduction of preterm births remains an important goal in obstetric care. Understanding the causes and recognizing the symptoms of preterm labor provides the basis for management decisions. The student will be able to cite: Factors predisposing to preterm labor Signs and symptoms of premature uterine contractions Causes of preterm labor Management of preterm labor, including tocolytics, steroids, and antibiotics. Premature Rupture of Membranes Rupture of the membranes prior to labor is a problem for both term and preterm pregnancies. Careful evaluation of this condition may improve fetal and maternal outcome. The student will be able to describe the following: History, physical findings, and diagnostic methods to confirm rupture of the membranes Factors predisposing to premature rupture of membranes. Risks and benefits of expectant management versus immediate delivery Methods to monitor maternal and fetal status during expectant management. Preeclampsia-eclampsia Syndrome Preeclampsia-eclampsia syndrome accounts for significant morbidity and mortality in both the mother and newborn. The student will be able to explain: Definition(s) and classification of hypertension in pregnancy Spontaneous Abortion Bleeding is common in early pregnancy. A logical approach to its evaluation may not only affect the outcome of the pregnancy, but also will help to reassure the patient. The student will be able to: Develop a differential diagnosis for first-trimester bleeding Third Trimester Bleeding Bleeding in the third trimester requires immediate patient evaluation. Thoughtful, prompt evaluation and management is necessary to reduce the threat to the lives of the mother and fetus. The student will be able to: Describe the approach to the patient with third-trimester bleeding Describe complications of placenta previa and abruptio placenta Describe immediate management of shock secondary to third-trimester bleeding Describe components of the various blood products and indications for their use. Pap Smear and Cultures The Pap smear is one of many screening methods used in medicine. Proper technique in performing the Pap smear and obtaining specimens for microbiologic culture will improve accuracy. The student will demonstrate the ability to: Perform an adequate Pap smear Obtain specimens to detect sexually transmitted diseases Handle specimens properly to improve diagnostic accuracy Provide an explanation to the patient regarding the purpose of these tests. Contraception An understanding of the medical and personal issues involved in decisions regarding contraceptive methods is necessary to adequately advise patients requesting contraception. The student will be able to explain: Physiologic or pharmacologic basis of action Effectiveness Benefits and risks Financial considerations of the various methods of contraception. Sterilization In the process of deciding whether to have a sterilization procedure, men and women often seek the advice of their physicians. Providing accurate information will allow patients to make an informed decision regarding this elective surgery. The student will be able to list:
Factors needed to help the patient make informed decisions, including potential surgical complications, failure rates and reversibility. Financial considerations Abortion Induced abortion is a reproductive option considered by some patients. Regardless of one's personal views, the practitioner should be aware of the techniques, management, and complications of induced abortions. The student will be able to list: Surgical and non-surgical pregnancy termination methods Potential complications of abortion, such as hemorrhage and infection. Psychosocial considerations of abortion. Sexually Transmitted Infection To prevent sexually transmitted infections and minimize their impact on health, the physician should understand their basic epidemiology, diagnosis and management. The student will be able to list organisms and methods of transmission, symptoms, physical findings and evaluation and management of each of the following:: Gonorrhea Chlamydia Herpes simplex virus Syphilis Human papillomavirus infection Human Immunodeficiency virus (HIV) infection Hepatitis B virus infection. The student will be able to list the public health concerns, including: Screening programs Costs Prevention and immunizations Partner evaluation and treatment Salpingitis The potential impact of acute or chronic salpingitis is significant. Early recognition and optimal management may help prevent the long-term sequelae of tubal disease. The student will be able to describe: Pathogenesis Common organisms Signs and symptoms Methods of diagnosis Treatment Sequelae, including tuboovarian abscess, chronic salpingitis, ectopic pregnancy, and infertility.
Endometriosis Endometriosis is a common problem of women of reproductive age, which may result in pelvic pain, infertility and menstrual dysfunction. The student will be able to describe: Normal and Abnormal Bleeding The occurrence of bleeding at times other than expected menses is a common event. Accurate diagnosis of abnormal uterine bleeding is necessary for appropriate management. The student will be able to: Describe endocrinology and physiology of the normal menstrual cycle Distinguish abnormal uterine bleeding from dysfunctional uterine bleeding Uterine Leiomyomas Uterine leiomyomas represent the most common gynecologic neoplasm and are often asymptomatic. The student will be able to describe the following: Ectopic Pregnancy Ectopic pregnancy is a leading cause of maternal morbidity and mortality in the Unites States. Early diagnosis and management may not only save lives, but may also preserve future fertility. The student will be able to: Develop a differential diagnosis of first-trimester bleeding List risk factors predisposing patients to ectopic pregnancy Describe symptoms and physical findings suggestive of ectopic pregnancy Understand methods and test used to confirm the diagnosis of ectopic pregnancy Disorders of the Breast Every physician should understand the basic approach to evaluating the common symptoms associated with the breast. The student will be able to describe: The student will be able to describe the history and physical findings that might suggest the following abnormalities: The student will be able to teach a woman how to perform breast self-examination. Cervical Disease and Neoplasia Detection and treatment of preinvasive lesions reduces the medical and social costs of, as well as the mortality associated with, carcinoma of the cervix. The student will be able to describe: Evaluation and management of the patient with an abnormal pap smear. Endometrial Carcinoma Endometrial carcinoma is the most common gynecologic malignancy. The student will be able to describe: Risk factors for endometrial carcinoma Symptoms and physical findings Management of the patient with postmenopausal bleeding Methods to diagnose endometrial carcinoma Impact of staging on management and prognosis Management of the patient with endometrial cancer Ovarian Neoplasms Adnexal masses are a common finding in both symptomatic and asymptomatic patients. Management is based on determining the origin and character of these masses. The student will be able to describe: Sexual Assault Individuals who are the victims of sexual assault often have significant physical and emotional sequelae. The student will be able to explain the medical, forensic, psychological evaluation and treatment and followup of:: Domestic Violence Domestic violence affects a significant proportion of the U.S. population in all economic classes and walks of life. All physicians should screen for the presence of domestic violence. The student will be able to:
Climacteric Women spend as much as one-third of their lives in the postmenopausal years. Understanding the physical and emotional changes caused by estrogen depletion is important for all physicians who provide health care for women. The student will be able to describe: Physiologic changes in the hypothalamic-pituitary-ovarian axis. Symptoms and physical findings associated with hypoestrogenism Management, including hormone therapy, nutrition and exercise, and non-hormonal therapeutic options.
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This information is provided by The Brookside Associates, a private organization, not affiliated with any governmental agency. The opinions presented here are those of the author and do not necessarily represent the opinions of the Brookside Associates. The patients presented and discussed here are fictitious and are merely representative of clinical conditions. Any resemblence to real patients is purely coincidental and not intentional. For any clinical condition, many alternative diagnostic and therapeutic efforts may give satisfactory or superior results. The clinical approaches presented here are not intended to reflect and do not reflect the only way to provide good care for these patients. This information is provided solely for educational purposes. The practice of medicine and surgery is regulated by statute and restricted to licensed professionals and those in training under supervision. Performing medical procedures outside of that setting is a bad idea, is not recommended, and may be illegal. The presence of any advertising on these pages does not constitute an endorsement of that product or service by the Brookside Associates. C. 2010 All Rights Reserved Contact Us · Other Brookside Products
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