Dr. Chapa’s Clinical Pearls. - podcast cover

Dr. Chapa’s Clinical Pearls.

Dr. Chapa’s Clinical Pearlspodcasters.spotify.com
Relevant, evidence based, and practical information for medical students, residents, and practicing healthcare providers regarding all things women’s healthcare! This podcast is intended to be clinically relevant, engaging, and FUN, because medical education should NOT be boring! Welcome...to Clinical Pearls.
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Episodes

Marijuana use in pregnancy and while breast-feeding

In this podcast, we will review the new clinical expert series from the ACOG on marijuana use in pregnancy and while breast-feeding. This clinical expert series will be slated to be published in the November 2018 edition of Obstetrics & Gynecology (Metz et al).

Oct 23, 201810 min

How a famed surgeon changed the field of obstetrics: William Hallstead, postpartum hemorrhage, and brave genius.

This is a quick historical perspective of an ingenious approach to a deadly obstetrical problem in history. Dr. William Halstead, the father of modern surgery, is credited with performing the first blood transfusion following postpartum hemorrhage in the United States. However, it was British obstetrician James Blundell that first described blood transfusion to prevent death from postpartum bleeding. Let’s take a look at this amazing historical story.

Oct 20, 20184 min

Thrombocytopenia in pregnancy

Thrombocytopenia in pregnancy is defined as a maternal platelet count less than 150,000. In this podcast, we will review the ACOG practice bulletin number 166 reviewing gestational thrombocytopenia, as well as the two most common immune mediated thrombocytopenic conditions: ITP, and fetal-neonatal alloimmune thrombocytopenia.

Oct 18, 201816 min

Intrapartum Care of the HIV Positive Patient

There have been significant changes – and advancement – in the interparty management of the HIV infected patient. In this session, we will quickly review the intrapartum management of the HIV infected patient based on the IDSA guidelines.

Oct 08, 201813 min

Acute Fatty Liver of Pregnancy

Acute fatty liver of pregnancy is a rare but potentially life-threatening condition which usually presents in the 36th week of pregnancy. In this podcast we will cover the ACG (Am. Coll Gastro) clinical guidelines regarding acute fatty liver disease in pregnancy.

Sep 26, 20189 min

GBS in Pregnancy

In this session, we will review the ACOG committee opinion on prevention of early onset GBS neonatal infection. This comes from the committee opinion 485.

Sep 20, 201811 min

Does BMI affect emergency birth-control effectiveness?

Levonorgestrel and ulipristal are 2 oral emergency contraceptive options. Since 2010, pharmacokinetic studies have suggested a lower effectiveness of levonorgestrel in overweight and obese women. In this podcast, we will review the pharmacokinetic data as well as professional society opinions on this topic.

Sep 15, 20188 min

PMS and PMDD: Clinical Review

In this session, we will review the diagnostic criteria for premenstrual syndrome and premenstrual dysphoric disorder. Options for therapy will also be discussed. Data taken from the ACOG and the APA.

Sep 06, 201816 min

Umbilical Cord Prolapse

In this session, we will review and obstetrical emergency that has the potential to result in severe Ville and morbidity or even mortality… Umbilical cord prolapse.

Aug 30, 201813 min

Prophylactic Antibiotics in Labor & Delivery

In this session, we will review the ACOG practice bulletin (199) from September 2018 on the use of prophylactic antibiotics in labor and delivery. This podcast will cover the optimal dose of intravenous antibiotics before C-section, the use of vaginal cleansing, and the adjuvant use of Zithromax before cesarean birth. Care of the MRSA colonized patient, as well as infective endocarditis prophylaxis will be covered.

Aug 28, 201821 min

Ovarian Vein Thrombosis

Ovarian vein thrombosis was recently the subject of a clinical review by the American College of OBGYN in November 2017. Ovarian vein thrombosis occurs in 1 and 600 to 1 in 2000 pregnancies and may have severe sequelae including pulmonary embolism. In this podcast, we will review the latest information from the ACOG and the ACCP on the pathophysiology, diagnosis, and treatment of ovarian vein thrombosis.

Aug 20, 201812 min

Clarification- Klumpke's palsy: "Neuropathy at gyn surg".

Alright, as occasionally happens… There was an error in the editing of our prior podcast regarding nerve injury at gynecological surgery. This very brief section will clarify the occurrence of klumpke's palsy during steep trendelenburg positioning.

Aug 18, 20182 min

Nerve Injury at Gyn Surgery

Gyn surgery can be associated with iatrogenic nerve injury. Neuropathy can be classified into three types: neuropraxia, axonotmesis, and neurotmesis. The most severe form of injury is nerve transaction or complete nerve ligation (neurotmesis). In this session, we will review the mechanism of nerve injury during Gyn surgery, their presentations, and prevention tips. Material is taken from the AAGL and the Society of Gyn Surgeons.

Aug 17, 201819 min

Management of Intra-Amniotic Infection

In this podcast, we will review the ACOG updated guidelines regarding intra-amniotic infections. Three classifications have been given by the ACOG: 1. Isolated maternal fever in labor, 2. Suspected intra-amniotic infection, and 3. Confirmed intra-amniotic infection. We will review these three categories, their diagnosis, and treatment recommendations. Data taken from the ACOG committee opinion 712.

Aug 12, 201812 min

Delayed umbilical cord clamping after birth (ACOG CO 684)

The ACOG, as well as the AAP, recommends delayed umbilical cord clamping in stable term as well as preterm neonates. While once considered necessary to keep the Neonate at or below the level of the placenta, new data shows that placental to child transfusion still occurs if the child is placed on the maternal chest for skin to skin contact. Additionally, the presence of meconium stained fluid – in vigorous neonates – is not a contraindication to delayed umbilical cord clamping. In this podcast, ...

Aug 06, 201810 min

Epithelial Ovarian Cancer

Ovarian cancer is the most deadly of all gynecological malignancies. Most cases present an advanced stage. Epithelial ovarian cancer is the most common histological class at diagnosis. In this session, we will cover the SGO data on presentation, staging, and treatment of epithelial ovarian malignancies. Avastin and PARP therapy will also be reviewed.

Aug 02, 201813 min

Follow us on Facebook

Howdy! Thanks for following our podcast. Be sure to find us, and follow us, on our Facebook page by the same name. Typically, additional information and data is posted on the Facebook feed which serves as a supplement to the podcast. Thanks for listening…

Aug 01, 201849 sec

Cervical Cancer

Persistence of high-grade oncogenic HPV is the key risk factor for the development of cervical carcinoma. In this session, we will review the pathophysiology, clinical staging, and treatment regimens for cervical carcinoma. Additionally, we will review the 2014 approved medication (Avastin) for the treatment of advanced, metastatic, recurrent cervical cancer. (Data taken from the Society of Gynecologic Oncology and the American Cancer Society.

Jul 31, 201812 min

Endometrial Cancer

Endometrial carcinoma is the most commonly diagnosed gynecologic malignancy. The SGO and the ACOG released a practice bulletin in 2015 which is the most recent bulletin on the subject (149). In this podcast we will review the classification, symptoms, work up, and surgical management of endometrial adenocarcinoma.

Jul 28, 201817 min

Endometrial Intraepithelial Neoplasia

EIN Represents a true antecedent lesion in the endometrial cavity with the potential to develop into endometrial adenocarcinoma. This podcast will review the joint committee opinion released by the SGO and the ACOG (#631) covering pre-malignant endometrial pathology.

Jul 28, 201817 min

Emergency Contraception

In this session, we will cover emergency contraception: levonorgestrel, Ullipristal, and the copper IUD. Data for this podcast comes from the ACOG practice bulletin 152.

Jul 24, 201811 min

MRI use in Pregnancy: Is Gadolinium a Concern?

MRI offers some advantages over ultrasound as a diagnostic tool in pregnancy. In this session, we were review the ACOG committee opinion on MRI use in pregnancy with a focus on gadolinium contrast agent.

Jul 23, 20188 min

Ultrasound in Pregnancy PART2

In Part 1, we covered the basics of OB ultrasound. In this session, a short additional piece, we answer a few additional questions regarding ultrasound use in pregnancy. Data taken from the ACOG/AIUM practice bulletin 175

Jul 22, 20183 min

Ultrasound in Pregnancy

Ultrasound is the most common procedure performed during pregnancy. The ACOG recognizes three types of ultrasound: standard, limited, and specialized. In this session, we will review methods to date a pregnancy, determine fetal weight, discuss ultrasound use for genetic screening, and end with a quick recap of ultrasound use in multifetal gestations.

Jul 22, 201814 min

Pelvic Inflammatory Disease (PID)

Unrecognized or misdiagnosed PID may result in infertility, tubal pregnancy, and chronic pelvic pain. In this session, we will review the CDC guidelines for diagnosis and treatment of PID (2015 updated guidelines).

Jul 20, 201814 min

Thromboembolism in Pregnancy

In this session, we will review thromboembolism in pregnancy based on the July 2018 ACOG Practice Bulletin. We will cover DVT and PE presentation, work up, and management. Delivery considerations will also be reviewed.

Jul 17, 201820 min

Chancroid

In this session, we will review chancroid, a genital STI caused by H. Ducreyi. This bacterium causes ulcers presenting as painful sores (soft chancre) on the genitalia. We will cover presentation, diagnosis, and treatment. We will also review the differences between the genital ulcers of syphilis, LGV, and granuloma inguinale.

Jul 16, 201811 min

Syphilis

In this session, we will discuss the clinical stages of syphilis, diagnosis, treatments, and pregnancy considerations.

Jul 14, 201816 min

Gonococcal Infection

In this session, we will cover the microbiology and the pathophysiological processes of gonococcal infections. Screening, treatment, and prevention of neonatal infection will also be reviewed. Data is taken from the ACOG bulletin as well as the practice guidelines from the CDC.

Jul 13, 201810 min
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