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OBGYN > Blueprints 1, 3, 12, 22, 28 > Flashcards

Blueprints 1, 3, 12, 22, 28 Flashcards

1
Q

when will a urine preg test be positive

A

at the time of a missed period

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2
Q

from what organ do they hormones of pregnancy that affect every organ come from

A

the placenta

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3
Q

what CV changes occur in pregnancy?

A 
increase CO, 
decrease SVR (progesterone-> SM relaxation), 
decrease BP ( but return to normal by 24 weeks)
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4
Q

3 common screening tests for fetal abnormalities

A

MS-AFP (maternal serum AFP) : 15-18 weeks
and triple screen( AFP, hCG, and estriol)
quad: add on inhibin

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5
Q

3 diagnostic tests for screening abnormalities

A

amniocentesis, CVS, ultrasound

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6
Q

tests for fetal status antepartum

A

BPP= U/S and NST (fetal nonstress test- activity over 30 minutes- good if 2 accelerations 15 beats above for 15 sec). BPP>10 is reassuring.
OCT (oxytocin challenge test- goal is 3 contractions every 10 minutes)

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7
Q

how early can you see gestational sac on transvag US

A

5 weeks, fetal heart at 6 weeks

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8
Q

chadwick sign

A

blueish color or vagina and cervix during prgenancy

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9
Q

NAAGELS rule for EDD. US estimation?

A

subtract 3 months from LMP and add 7 days. U/S should be within 1 weeks first TM, 2 weeks second TM, 3 weeks third trimester

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10
Q

lung changes in pregnancy

A

TLC decreased 5% but tidal volume increases 30-40% which causes decrease in expiratory respiratory reserve 20%

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11
Q

paco2 in pregnancy

A

decreases to 30 mmHg from 40 mmHg likely caused by progesterone. gradient increases oxygen delivery and CO2 removal from fetus

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12
Q

kidney in pregnancy

A

GFR increases 50%, BUN and creatinine decrease by 25%. even though increased aldo and increased NA reabsorption, plasma levels of sodium stay the same

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13
Q

heme in preg

A

dilutional anemia, incresed WBC, hypercoagulable

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14
Q

hPL

A

produced in placenta for ensuring constant nutrient supply to fetus-> lipolysis with increase in circulating FA. HPL is insulin antagonist=diabetogenic.

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15
Q

preg and thyroid

A

increased TBG so slight increase in total T3 and T4 but same level of free T3/4 and stimulates TSH a little. overall euthyroid.

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16
Q

third trimester screening tests

A

hematocrit (iron supplement), RPR/VDRL, glucose loading test

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17
Q

when do most fetal congenital abnormalities occur

A

embryogenesis

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18
Q

what chromosomes are most common inherited aneuoploidies

A

of sex chromosomes- usually less severe

19
Q

what types of cells do you need for karyotype and DNA tests

A

fetal or trophoblastic cells

20
Q

what can you use to screen for downs

A

quad screen- AFP, bHCG, estriol, inhibit- sn=80% in second trimester

21
Q

when do neural tube defects occur

A

defective closure of neural tube at week 4 of development (6 weeks by gestational aging)

22
Q

nuchal transluscency

A

a way to test for downs and chromosomal abnormalities in the first trimester

23
Q

dangerous HPV strains for cancer

A

16, 18, 31, 45

24
Q

what PAP results should get a colposcopy?

A

ASC-H (atypical squamous cells), LSIL, and HSIL

25
Q

someone gets a pap of CINI…next steps?

A

repeat pap smears every 6 months x2 OR HPV testing in 12 months

26
Q

what to do with adult women result of CINII or III

A

treatment with surgical excision, typically with loop/LEEP/Lletz

27
Q

tx of stage 0, 1a-1, 1a-2

A

0 and 1a-1: cone biopsy, ia-2: radical hysterectomy

28
Q

5 year survival for cervical cancer for stage I, stage IV

A

stage 1: 85-90%, stage 2: 15-20%

29
Q

how to make the diagnosis of PMS and PMDD

A

sxs must be in the second half of the menstrual cycle with at least a 7 day sx free interval in the first half of the menstrual cycle. sxs must occur in at least two cycles

30
Q

menorrhagia, metrorrhagia, menometrorrhagia

A

menorhhagia: regular bleeding that is heavy or prolonged.
metrorrhagia: bleeding between periods.
menometrorrhagia: heavy or prolonged irregular bleeding.

31
Q

causes of menometrorrhagia

A

polyps, fibroids, adenymyosis, cancer, pregnancy complications

32
Q

most common causes of oligomenorrhea (35 days apart)

A

PCOS, chronic ovulation, pregnancy

33
Q

acute hemorrhage- drugs

A

IV estrogen and high dose oral estrogen. not responsive to medicine-> D&C, endometrial ablation, hysterectomy

34
Q

most common cause of postmenopausal bleeding

A

atrophy. other causes= cancer, endometrial polyps, exogenous hormonal stimulation. rule out cancer with CDC, TSH, PRL, FSH, endometrial biopsy, pelvic U/S

35
Q

two central issues in immediate postpartum period

A

pain management and wound care

36
Q

which birth control can you use postpartum

A

depo-provera, norplant, poregesterone only minipill- dont decrease milk production

37
Q

endomyometritis

A

dx is clinical: fever, elevated WBC, uterine tenderness. tx: broad sprectum antibx and D&C for retained POCs

38
Q

peak of bHCG and when

A

10 weeks= 100,000

39
Q

how early can you see pregnancy on US. bhcg?

A

5 weeks on TVUS. should have bchg of 1500-2000.heart motion at 6 weeks.

40
Q

embryo vs fetus

A

embryo= 8 weeks. fetus>8 weeks

41
Q

at what age can you auscultate fetal heart

A

20 weeks by nonelectric fetoscope and 10 weeks by doppler US

42
Q

cardiac output in pregnancy

A

increases by 30-50%. mostly in first TM max in 20-24 weeks gestation

43
Q

what causes fall in SVR in preg

A

most likely increase in progesterone

44
Q

hyperemesis gravidarum definition

A

morning sickness with wt loss >5% of pre pregnancy wt AND ketosis

OBGYN (2 decks)

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