12 - 16 yo F with vaginal bleeding and UCG Flashcards
the USPSTF recommends screening for chlamydia in which groups?
- all sexually active women age 24 and younger
- sexually active women age 25 and older who are at increased risk
what are the risk factors for chlamydial infection?
- hx of chlamydial or other STI
- new or multiple partners
- inconsistent condom use
- exchanging sex for money or drugs
NO RECOMMENDATION FOR SCREENING MEN
what is Goodell’s sign?
softening of the cervix
what is Hegar’s sign?
softening of the uterus
what is Chadwick’s sign? what is the cause?
- bluish-purple hue in the cervix and vaginal walls
- caused by hyperemia
enlargement of the uterus can be felt at week ___ on bimanual exam
8
at what week can the uterine fundus be palpated about the pubic symphysis?
week 12
during what weeks will the uterine enlargement, measured in centimeters, approximate gestational age?
weeks 20-36
fetal heart tones can be elicited via handheld doppler bewteen weeks _____
10-12
fetal movement is detected by the mother around weeks _______
18-20
softening of the cervix = __________ sign
Goodell’s sign
softening of the uterus = __________ sign
what is Hegar’s sign?
- bluish-purple hue in the cervix and vaginal walls
- caused by hyperemia
what is the name of this sign?
Chadwick’s sign
what is implantation bleed?
bleeding that occurs in early pregnancy around the time of missed menses as a result of an invasion of the trophoblast into the decidua
what is Naegele’s rule?
- add 1 year
- subtract 3 months
- add 1 week
- definition: ectropion
- what is its significance?
- when the central part of the cervix appears red from mucous-producing endocervical epithelium protruding through the os, onto the face of the cervix
- no clinical significance and is common in women who are taking OCPs
what % of women who have miscarriages have subsequent normal pregnancies and births?
87%
what are the 3 most common causes of first trimester bleeding?
- spontaneous abortion
- ectopic pregnancy
- idiopathic bleeding in a viable pregnancy
BHCG should approximately double every ____ hours during weeks _______ in a normal pregnancy
- 48
- 6-7 weeks
intrauterine contents (gestational sac, fetal pole, etc) are not expected to be seen until the quantitative BHCCG reaches over _________ IU/L
1500 IU/L
to detect an intrauterine pregnancy by transabdominal US, the BHCG will typically be over ______ IU/L
5000 IU/L
what is Kleihauer-Betke testing?
- helps to estimate the quantitative amount of fetal Hb in the maternal circulation and with dosing RhoGam
- helps determine if a type and screen should be done
definition: spontaneous abortion
loss of a pregnancy without outside intervention before 20 weeks gestation
definition: threatened abortion
bleeding before 20 weeks gestation
definition: inevitable abortion
dilated cervical os
definition: incomplete abortion
some but not all of the intrauterine contents have been expelled
definition: missed abortion
fetal demise without cervical dilation and/or uterine activity
definition: septic abortion
with intrauterine infection (abdominal pain and fever)
definition: complete abortion
products of conception have been completely expelled from uterus
loss of a pregnancy without outside intervention before 20 weeks gestation
spontaneous abortion
bleeding before 20 weeks gestation
threatened abortion
dilated cervical os
inevitable abortion
some but not all of the intrauterine contents have been expelled
incomplete abortion
fetal demise without cervical dilation and/or uterine activity
missed abortion
with intrauterine infection (abdominal pain and fever)
septic abortion
products of conception have been completely expelled from uterus
complete abortion
what are the main indications for suction D&C?
- heavy bleeding
- patient preference
what are the main contraindications for suction D&C?
- active pelvic infection
- patient refusal
what is the most common protocol for medical abortion?
800 mcg misoprostol (cytotec), possibly repeated day 3
