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PoM II - Final Exam > 04. Prenatal Care > Flashcards

04. Prenatal Care Flashcards

1
Q

Preconception general preparation

A

Start PNV & folic acid > 6wks before conception.

Achieve healthy state and comorbidities should be controlled

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2
Q

Time required to detect Beta hCG in blood

A

11 days after conception

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3
Q

Time required to detect Beta hCG in urine

A

12-14 days after conception

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4
Q

What should happen to beta hCG levels during pregnancy?

A

Should double every 48-72 hr & peak between wks 8-11

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5
Q

When does beta HCG have limited clinical significance in a healthy pregnancy?

A

After ~6 weeks when fetal heartbeat can be monitored

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6
Q

Naegle’s Rule

A

Due date estimation. (LMP + 7 days) - 3 months = Estimated due date

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7
Q

When is Naegle’s Rule useless?

A

Unknown LMP; Irregular menses; No menses

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8
Q

How many visits does ACOG recommend for a 40 week pregnancy?

A

14

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9
Q

S/Sx of Presumptive Pregnancy

A

Amenorrhea; Breast tenderness; Fatigue; N/V; Urinary frequency

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10
Q

S/Sx of Probably Pregnancy

A

Uterine enlargement; (+) Preg test; Signs (Hegar’s; Chadwick’s; Goodell’s)

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11
Q

Signs of Confirmatory Pregnancy

A

(+)FHT; Movement by examiner; (+) U/S

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12
Q

1st Pregnancy Visit

A

5-6 weeks to check for FHR; Quantitative beta HCG should be ~ 5000; Obtain PMH; Psychosocial hx; FH; Prev Preg; GYN

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13
Q

Prenatal Labs that should be drawn

A

UA & culture; Type& screen; HIV/HepB/RPR; Rubella titer; CBC; Pap/GC/CHL; Hemoglobin profile;

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14
Q

Common Symptoms in 1st Trimester

A

Vaginal bleeding d/t Intercourse, Implantation bleeding; Cramping (everyone); Back pain d/t stretching broad lig.; Urinatary frequency d/t hormones

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15
Q

What should determine weight gain during pregnancy?

A

BMI

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16
Q

How much weight should a woman with an average BMI gain during pregnancy?

A

25-35 lb

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17
Q

How much weight should an obese woman gain during pregnancy?

A

11-20 lb

18
Q

How much weight should morbidly obese woman gain during pregnancy?

A

0 lb

19
Q

What are pregnancy complications associated with overweight mothers?

A

Higher C-section rates; Macrosomic fetus; Shoulder dystocia

20
Q

What are pregnancy complications associated with underweight mothers?

A

Malnutrition; Malabsorption; Eating disorder?

21
Q

What is the recommended amount of folic acid for most pregnancies?

A

0.4 mg QD = 400 mcg QD

22
Q

What is the recommended amount of folic acid when there is higher risk of neural tube defects?

A

4.0 mg QD = 4000 mcg QD

23
Q

What factors predispose a fetus to higher risk of neural tube defects?

A

Mother with history of a fetus with NTD; Mother with NTD; Mother on Dilantin

24
Q

What foods should be avoided by pregnant women?

A

Raw/undercooked meats; Deli meats/salads

25
Q

At what point in fetal development should the fundus be palpable at the umbilicus?

A

22 weeks gestation

26
Q

What activities are restricted during pregnancy?

A

No heavy lifting (> 30 lb)

27
Q

How long is travel acceptable in pregnancy?

A

Up to 32 weeks gestation; after 32 weeks, travel may be approved to areas with hospitals. If traveling by car, must stop every 2 hours to reduce DVT risk

28
Q

How many caffeinated drinks can be safely enjoyed daily during pregnancy?

A

1

29
Q

Preterm contractions

A

Contractions before 37 wks without cervical dilation

30
Q

Preterm labor

A

Contractions before 37 wks with cervical dilation

31
Q

How are preterm contractions treated?

A

With patient education

32
Q

How is preterm labor treated?

A

With Magnesium Sulfate

33
Q

What is leukorrhea? What is it’s relationship to pregnancy?

A

Increased watery, odorless vaginal d/c; Normal during pregnancy. Advise patients it’s normal before it happens.

34
Q

What are three drug classes notorious for teratogenic effects during the first trimester?

A

ACE inhibitors; Anti-epileptics; Illicit drugs

35
Q

When is Rhogam indicated?

A

Indicated for patients with KNOWN negative Rh factor

36
Q

When should Rhogam be given?

A

After any bleeding episode during gestation for 12 wks;
Regular dosing @ 28 wks
Repeat after delivery if baby is Rh(+)

37
Q

What does Rhogam do?

A

Protects Future pregnancies

38
Q

If antenatal testing shows thickened nuchal translucency and absence of the nasal bone, what genetic disorder should be suspected?

A

Trisomy 21- Down Syndrome

39
Q

What are the components of a Quad Screen?

A

AFP; hCG; Estriol; Inhibin-A

40
Q

Why is a Quad Screen ordered?

A

Screen for genetic disorders; abnormal results warrant more extensive investigation

41
Q

When is a Quad Screen performed?

A

16-18 weeks of gestation

PoM II - Final Exam (12 decks)

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