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Family Medicine > ANC > Flashcards

ANC Flashcards

1
Q

Return visits in ANC

A

0-28w: once every month
28-36w: twice every month
>36: once till labor

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2
Q

Decreasing no. Of ANC visits to 4 was associated with:

A
  • Not increase in AE

- decreased satisfaction

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3
Q

pregnancy test results occur after

  • urine
  • blood:
A

Urine: 12-14d
Blood: 11d
From ovulation

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4
Q

What could give false positive urinary pregnancy test results

A
  • Increase protein in the urine like in hematuira, IgM, proteinurea.
  • disease increasing HCG like choriocarcinoma
  • LH increasing disease
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5
Q

Risk of Down syndrome increases in patients aged:

A

35 or older

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6
Q

When to add +9 and when to subtract -3 from month for EDD

A
  • jan
  • feb
  • march
    Add 9 months
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7
Q

What is the naegler’s rule for EDD

A

LMP + 7d

+9m or -3m

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8
Q

Full duration of pregnancy is

A

280days

40weeks

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9
Q

What are the weeks for

  • 1st trimester
  • 2nd
  • 3rd
A
  • 1w to 13w+6d
  • 14w to 28+6d
  • > 29
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10
Q

Urine dipstick is done routinly in ANC to detect

A
  • protein

- glucose

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11
Q

What are the indicators of gestational age:

A

Most accurate is US up to 13+6\7d

  • fetal heart rate (10-12w)
  • fetal movement (20w)
  • Fundal height
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12
Q

If fundal height is at the level of

  • umbilicus:
  • symphysis pubis:
  • xiphoid process:

What is the probable gestation age?

A
  • 20wks
  • 12wks
  • 38 which is higher than 40 due to engagement.
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13
Q

Measurement of fundal height should be done:

A

Each visit

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14
Q

Physiological oversized uterus

A
  • wrong dates

- twins

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15
Q

Pregnancy during period of amenorrhea (lactation\contraception) can cause:
(Small - large uterus)

A

Small

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16
Q

When to give women of Rh incompatibility (Anti-D) injection?

A
  • Week 28

- 24hrs-72 post-delivery.

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17
Q

Anti-D given regardless of weeks is only in cases of:

A
  • abortion
  • miscarriage
  • amniocentesis
  • secretions
  • trauma
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18
Q

What are the test to preform in the first visits:

A
  • Ultrasound
  • UA\UC
  • Blood test: [CBC, blood type, RH, Ab coomb’s, FBG, sickle cell, titers (rubella\hep\syphlis) ]
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19
Q

Detection of asymptomatic bacteriurea should be at weeks …. to ……

A

12-16 weeks.

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20
Q

What are the infections that we screen for in the first visit

A 
1- rubella & vericella 
2- syphlis 
3- HIV 
4- chlymedia\gonorrhea 
5- hepatitis b
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21
Q

What is the recommended dose of folic acid?

A

400 mcg

22
Q

In which trimester should one start iron therapy

A
  • iron deficiency: 1st

- normal: 2nd

23
Q

When is the peak of nausea and vomitting

A

7-8 weeks.

24
Q

Medications used to reduce N&V

(B6 - B12 - B1)?

A

B6

Known as Navidoxine (B6 + antihistamine)

25
Q

In case of patient was at high risk of pre-eclampsia, she should start which medications?

A

Asprin

26
Q

How to reduce the following symptoms in pregnancy

  • heartburn
  • constipation
  • hemorrhoid
  • Varicose
A
  • meal spacing
  • increase water &fiber intake (don’t give normacol)
  • decrease constipation
  • wear compression socks
27
Q

What are the risk factors for pre-eclampsia?

A
  • Old >40
  • Obese
  • prev\family hx of pre-eclampsia
  • nuliparity - multiples - 10yr interval
  • renal disease - HTN
28
Q

How to screen pregnant patients for pre-eclampsia? “Method of screening”

A
  • BP monitoring
  • Urinanlysis for protein

At each routine visit

29
Q

How to treat women with pre-eclampsia

A
  • Anti-hypertension medications
  • Magnesium sulfate
  • fetal monitoring
30
Q

What is the prophylactic measures recommended by USPSF?

A

Low dose asprin 81mg\d given at 12weeks.

31
Q

Duration of prophylaxis therapy for pre-eclampsia?

A

12-28 weeks
Optimally before 16

[continued until delivery]

32
Q

Why prophylaxis therapy for pre-eclampsia (low dose aspirin) is not recommended in the first month of pregnancy?

A

Because of high risk for bleeding and abortion

33
Q

When to call the presence of diabetes during pregnancy
- gestational diabetes
& when to call it
- DM2

A
  • Gestational: after 20 weeks.

- DM2: before 20 weeks

34
Q

Screening for GD should be

A
  • all patients: 24-28wks

- high risk: early in pregnancy

35
Q

Which test is usually used in most patients for GD:

1step or 2step

A

1 step.

36
Q

What are the values of the 1 step OGTT test, that if “one of them” is exceeded the patient is diagnosed w\ gestational diabetes:

A 
1- give 75g of oral glucose 
2- measure the following 
   - FBG: 92 (5.1) 
   - 1hr: 180 (10)
   - 2hr: 153 (8.5)
37
Q

In which group of population is a 2step OGTT used?

A

In high risk (obese, previous GDM, DM)

38
Q

When to preform Group B-strep test during pregnancy?

A

35-37weeks.

39
Q

If B-Strep was positive during week 35-37 and patient is asymptomatic, what’s your next step

A

IV ampicillin during delivery.

40
Q

What type of swab is taken for B-strep diagnosis?

A

Low Vaginal swab

41
Q

What are the 3 tests done to identify Down’s syndrome in first trimester?

A

1- NT by US
( 10+4\7 to 13+6\7) “best at 12-13”
2- PAPPA protein
3- Free B-hcg

Weighed by maternal age

42
Q

What are the 4 tests done to identify Down’s syndrome in 2nd trimester?

A
  • [low] Serum alpha-fetoprotein
  • [low] Estriol
  • [high] B-HCG
  • [high] inhibin A
43
Q

What is NT

A

Fluid collection in the back of the neck

44
Q

NT can identify

A

1- Down syndrome
2- Cardiac defect
3- diaphragm hernia
4- abdominal wall defect

45
Q

Sensivity of First trimester tests in detecting down’s syndrome is:

A

82-87%

46
Q

Sensivity of second trimester triple tests in detecting down’s syndrome is:

A

70%

47
Q

Sensivity of First trimester quadruple tests in detecting down’s syndrome is:

A

81%

48
Q

aminocentensis is preformed at ….. wks.

A

15-20wks

49
Q

Chorionic villus sampling is preformed at ….. wks.

A

10 wks

50
Q

Which test is higher at fetal loss

Amniocentesis or CVS

A

CVS

51
Q

Post-term pregnancy is considered after

A

40 weeks

52
Q

Air travel safety in pregnancy

A

4 weeks before due date.

Family Medicine (15 decks)

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