Check Yourself: PKM Lectures Flashcards
1
Q
According to ACOG, a baby delivered between 39 and 40 weeks 6 days is considered ____ term
A
Full
2
Q
According to ACOG, a baby delivered between 37 and 38 weeks 6 days is considered ____ term
A
Early
3
Q
According to ACOG, a baby delivered less than or equal to 36 weeks 6 days is considered ____ term
A
Pre
4
Q
According to ACOG, a baby delivered in the 41st week is considered ____ term
A
Later
5
Q
According to ACOG, a baby delivered after 42 weeks is considered ____ term
A
Post
6
Q
The number of times a woman has been pregnant
A
Gravida
7
Q
The number of times a woman has birthed a fetus of 20 weeks gestation regardless of outcome or presence of multiples
A
Parity
8
Q
A woman who has never been pregnant NOR carried a pregnancy past 20 weeks is considered a ____
A
Nulliparous woman (nullip)
9
Q
A woman who has had more than one pregnancy is considered ____ gravida
A
Multi
10
Q
A woman who has never been pregnant is considered ____ gravida
A
Nulli
11
Q
A woman who is in her first pregnancy is considered ____ gravida
A
Primi
12
Q
A woman who has had 4 or more pregnancies is considered ____
A
Grand Multipara
13
Q
A woman who has had 7 or more pregnancies is considered ____
A
Great Grand Multip
14
Q
T/F Parity is determined by the number of pregnancies resulting in fetuses delivered.
A
FALSE. It is determined by the number of pregnancies reaching 20 weeks REGARDLESS of fetuses delivered
15
Q
Term (T) = number of infants born at or after ____ weeks gestation
A
37
16
Q
Preterm (P) = number of infants born before ____ weeks but after ____ weeks
A
37, 24 (viability)
17
Q
Abortions (A) = number of spontaneous or induced abortions from ____ to ____ weeks
A
Impregnation, 24
18
Q
Living (L) = number of children ____
A
Alive
19
Q
A woman who has been pregnant twice who lost one fetus at 11 weeks and carried twins to 34 weeks gestation with both babies surviving delivery and living today…
A
G2T0P2A1L2
20
Q
A woman who has been pregnant three times who lost two twin fetuses at 22 weeks, lost another at 10 weeks, and carried one to to 38 weeks 5 days gestation with one child surviving delivery and living today…
A
G3T1P0A3L1
21
Q
A woman who displays linea nigra, chloasma, and amenorrhea is showing ____ signs and symptoms of pregnancy
A
Presumptive
22
Q
A woman who’s breasts and montgomery tubercles are getting larger, is experiencing some mastodynia, and who’s nipples are getting darker is showing ____ signs and symptoms of pregnancy
A
Presumptive
23
Q
A woman who is displaying chadwick sign, uterine soufflé, and hegar sign is showing ____ signs and symptoms of pregnancy
A
Probable
24
Q
A bluish discoloration of the cervix, vagina, and labia as a result of increased blood flow
A
Chadwick sign
25
A blowing sound coordinated with cardiac systole heard on auscultation of the pregnant uterus
Uterine souffle
26
The softening and compressibility of the lower segment of the uterus
Hegar sign
27
The presence of fetal skeleton on radiograph, detection of fetal heart tones, and observable fetal heart activity are all ____ signs and symptoms of pregnancy
Positive
28
When is a immunological pregnancy test usually positive?
4-7 days after missed period of pregnant woman
29
T/F HCG can be detected earlier by urine test than by blood test.
FALSE. Presence of HCG in the blood can be detected about 11 days after conception while HCG levels in the urine cannot be detected until about 12-14 days after conception
30
In general, HCG levels double every ____ hours reaching a peak at ____ to ____ weeks of pregnancy before it declines and levels off.
72, 8, 11
31
A fetal heart beat should be detectable by ultrasound by about ____ weeks
6
32
In general, pregnancy lasts ____ days or ____ weeks or ____ months +/- ____ weeks from the ____ day of the LNMP
280, 40, 9, 2, first
33
In Oregon, pregnancy is ____ days or ____ weeks +/- ____ weeks from the ____ ovulation in a normal ____ day cycle
266, 38, 2, last, 28
34
Use Naegele's rule to calculate the due date of the following woman:
Last LNMP: July 24th, 2013
July 24th, 2013 - 3 months = April 24th, 2013
April 24th, 2013 + 7 days = May 1st, 2013
May 1st, 2013 + 1 year = May 1st 2014 due date
35
T/F Pregnancy is a normal physiological event that is complicated only about 20-25% of the time.
FALSE. Though it is a very normal physiological event, it is only complicated 5-20% of the time.
36
'POPRAS' stands for...
Problem Oriented Prenatal Risk Assessment
37
A pelvic type that resembles an oval running anterior to posterior is considered ____
Anthropoid
38
A pelvic type that resembles a circle is considered ____
Gynecoid
39
A pelvic type that resembles an oval running laterally is considered ____
Platypelloid
40
A pelvic type that resembles a heart with the 'point' of the heart at the pubic symphysis is considered ____
Android
41
The classic prenatal screening test is the ____ screen
Triple
42
The quadruple screen includes the ____, ____, and ____ of the triple screen and adds ____
Alpha-fetoprotein (AFP), beta - HCG, and estriol (uE3), hormone inhibin-A
43
Universal screening for gestational diabetes should be performed between ____ and ____ weeks and is done by giving a ____ gram glucose challenge
26, 28, 50
44
When should you perform a RhoGAM?
28 weeks
45
When should you perform a group B beta-hemolytic strep culture?
36 weeks
46
T/F Prenatal visits are usually schedule every 4 weeks from 0-32 weeks gestation, every 2 weeks from 32-36 weeks gestation, then every week from 36 weeks to delivery.
TRUE DAT!
47
The components of the A-F screening include...
```
A) Amniotic fluid - Leak or Gush?
B) Bleeding?
C) Contractions 5-10 min apart or closer?
D) Dysuria?
E) Eclampsia/Preeclampsia?
F) Fetal Movements?
```
48
S/S of Eclampsia or Preeclampsia include...
Headache, vision changes, abdominal/epigastric changes, marked edema
49
Which of the following are NOT a common complaint of pregnancy? Increased urination, dependent edema, joint/back/pelvic pain/pressure, leg cramps, craziness, breast soreness, fatigue, varicose veins, dizziness, gingival hypertrophy, stretch marks, weight loss, hemorrhoids, morning sickness, heavy bleeding.
Craziness, dizziness, weight loss, heavy bleeding
50
ACOG and March of Dimes recommend ____ to ____ pounds of weight gain in a "normally" weighted pregnant woman.
25-35
51
T/F A pregnant woman should increase her caloric intake by about 100-300kcal per day.
TRUE
52
Recommended weight gain for a woman pregnant with twins is ____ to ____ pounds.
35, 45
53
T/F The greater a pregnant woman's BMI, the more weight she should plan to gain during pregnancy
FALSE. The opposite is true
54
Average first labor lasts ____ hours with subsequent labors lasting an average of ____ hours
24, 12
55
Frequency of contractions is measure from the ____ of one contraction to the ____ of the next contraction
Start, start
56
Contactions accomplish 4 things, they are….
Effacement of cervix, dilation of cervix, movement of the fetus through the stations, neonate respiratory stimulation
57
T/F Effacement is measured in ____ and dilation is measured in ____
%, centimeters
58
T/F A 2cm dilation can accommodate a fingertip
TRUE
59
A woman who is in labor and dilated to a 7 is in the ____ stage of labor
First
60
A woman who has delivered a baby and has not yet delivered the placenta is in the ____ stage of labor
Third
61
A woman is fully dilated and the babies head is protruding from the vagina is in ____ stage of labor
Second
62
The first hour after a woman delivers the baby is often referred to as the ____ stage of labor
Fourth
63
The active labor phase of stage one is when a woman is dilated to ____
4-7cm
64
The early labor phase of stage one is when a woman is dilated to ____
0-4cm
65
The transition phase of labor of stage one is when a woman is dilated to ____
8-10cm
66
____ signals the beginning of stage 2 labor
Pushing
67
____% of fetuses present vertex/cephalic
95%
68
Lie is the relationship between the long axis of the ____ to the long axis of the ____ and is either ____ or ____
Fetus, uterus, transverse, longitudinal
69
T/F Left Occiput Anterior (LOA) is the most common presentation
TRUE
70
While assessing the fontanelles of an unborn child in order to determine where the occiput is, you feel a TRIANGULAR shaped fontanelle…this fontanelle is the ____ fontanelle and is ____ to the occiput
Posterior, closest
71
While assessing the fontanelles of an unborn child in order to determine where the occiput is, you feel a DIAMOND shaped fontanelle…this fontanelle is the ____ fontanelle and is ____ the occiput
Anterior, furthest away from
72
T/F A midline episiotomy will prevent further tearing toward the anus
FALSE. A medio-lateral episiotomy may prevent further tearing by opening the passageway, relieving pressure on the perineum, and potentially preventing tearing toward the anus
73
T/F It is normal for the placenta to deliver an hour or two after delivery of the baby
FALSE. It should deliver within 5-15 minutes
74
____% of breast tissue is made up of epithelial elements (lobules with branching ducts to the nipple)
20%
75
____% of breast tissue is made up of stromal elements (adipose and fibrous connective tissue)
80%
76
"Each breast has ____ to ____sections, called ____, that are arranged like the ____ of a ____."
15, 20, lobes, petals, daisy
77
_____ ligaments - fibrous
bands that connect the superficial and
deep pectoral fascial layers
Cooper
78
A clinical breast exam detects up to ____% of cancers not found on mammogram
5%
79
T/F Only breast abnormalities and masses larger than 2cm should be fully evaluated.
FALSE. Any and all abnormalities or masses should be fully evaluated.
80
T/F Breast cancer is usually associated with pain.
FALSE. Only 1-6% of cases
81
Top 3 treatments for mastalgia are...
NSAIDs, warm compresses/ice packs, proper breast support
82
Mastitis, breast abscesses, and galactoceles are examples of...
Infections/inflammation of the breast
83
Fibroadenomas, ductal hyperplasia, and intraductal papillomas are examples of...
Proliferative breast lesions without atypia
84
Cysts and fibrocysts are examples of...
Nonproliferative breast lesions
85
Atypical ductal hyperplasia, atypical lobular hyperplasia are examples of...
Atypical hyperplasia
86
T/F Benign disorders are far more common than malignancies.
TRUE
87
T/F Breast cancer is the most common malignancy among women.
TRUE
88
Breast cancer comes second behind ____ cancer in female deaths.
Lung
89
1 in ____ women living beyond 90 years of age will develop breast cancer
8
90
A woman presents with fever, chills, malaise, and flu-like symptoms. She has myalgia and a hard, red, tender, warm, and swollen breast. She is currently a breast-feeding mother. What are you thinking? What is the likely etiology? How would you treat it?
Lactational Mastitis. Breast feeding introduced staph A or strep. 10-14 diclox, augmentin, continue breastfeeding
91
If mastitis doesn't improve within a few days of diclixacillin, ____ should be considered and treated with bacterium or doxycycline
MRSA
92
If mastitis doesn't improve regardless of antibiotic therapy, ____ should be considered and a ____ biopsy should be performed.
Inflammatory breast cancer, skin punch
93
A mother has shooting/burning sensations in her breast. She also notices thrush and a sever diaper rash in her infant. What are you thinking? How could you treat it?
Candidal Infection. Topically or with Fluconazole
94
A mother notices a fluctuant tender mass in her right breast that does not resolve with antibiotic therapy. Her PCP suggests she only breast feed from the opposite side and attempt to express milk from the affected side. What might this be? How common is it? How might you have to treat it?
Breast Abscess. 0.1% incidence. May require incision and drainage.
95
A breastfeeding mother suddenly noticed a lump with tenderness in her left breast. A thick, creamy, oily, cheesy material has been coming from her breast. What could this be? How is it treated? When should it go away if at all?
Galactocele. Active management that may require needle aspiration. It should resolve on its own within 72 hours.
96
Paget disease is a (Rare/Common) cancer involving the ____ and ____
Rare (1-4%), nipple, areola
97
A woman presents with an eczematous appearing area over the nipple and areola. There is slight discharge from her nipple, the affected side appears larger, and the nipple is retracted. What might this be? When should you worry?
Paget disease of the breast. If it lasts longer than 1 month, a mammogram and/or biopsy should be considered
98
T/F Fibrocystic changes are very common.
TRUE
99
A woman presents to clinic concerned about a "lump" she felt in her breast. It is well-defined, mobile, slightly tender, and rubbery. What might this be? When would you offer drainage? What other solution may be an option if this recurs?
Simple breast cyst. Drainage could be offered if it is larger than 2cm. Excision could be an option if it recurs twice after an aspiration.
100
____% of postmenopausal women experience fibrocystic changes.
60%
101
Normal but exaggerated response of breast tissue to female hormones and caffeine, cyclic engorgement with increased density of breast, lumpy and/or painful breasts may be...
Fibrocystic changes
102
T/F Fibrocystic changes commonly occur on the outer quadrants.
TRUE
103
How is ductal hyperplasia diagnosed?
Biopsy prompted by other investigation
104
Increased number of cells within a duct that is more than 2 but no more than 4 cells in depth
Mild ductal hyperplasia
105
A woman presents with multiple lumps and some mild nipple discharge. On ductography, it is determined that cells from the wall of multiple cysts have grown into the associated lumens. This might be? This may/may not increase the woman's risk for cancer. How is it treated?
Intraductal papilloma. It may INCREASE the risk of breast cancer. A central duct excision may be required.
106
What are the two types of atypical hyperplasia of the breast?
Lobular, ductal
107
Which of the atypical types of hyperplasia of the breast is associated with an increased risk of subsequent cancer?
BOTH!!!
108
A woman presents with nipple discharge from both breast, multiple ducts, with breast manipulation. This is generally considered a (Benign/Suspicious) presentation.
Benign
109
A woman presents with blood-tinged nipple discharge from one breast, from a single duct, with and without breast manipulation. The discharge tests positive for blood and is guaiac positive as well. This is generally considered a (Benign/Suspicious) presentation.
Suspicious
110
The most common cause of pathologic
| nipple discharge is a ____
Papilloma (52-57%)
111
Malignancy is found in ____ to ____ percent of
| cases of pathologic nipple discharge
5, 15%
112
Most common breast malignancy is ____
DCIS
113
Women who breastfed were less likely
| to have what?
HTN, DM, Hyperlipidemia, and CVD
114
A hard, gritty, irregular mass with hard edges has the features of a ____ tumor
Malignant
115
A soft, cystic, mobile mass with regular borders has the features of a ____ tumor
Benign
116
The three components of a diagnostic triad for breast cancer include...
Physical exam, mammography, needle examination
117
The standard test for breast cancer screening and detection.
Mammogram
118
____% of cancers detected by mammography are node negative
75%
119
The sensitivity of mammogram is ____
75-90%
120
Of 2cm cancerous masses, ____% have already metastasized
50%
121
At what ages are women routinely screened for breast cancer?
50-69 years
122
If you are a woman and have a first degree relative with breast cancer, you should be screened beginning at age ____
40
123
According to ACOG, biannual breast cancer screening should begin at ____
40
124
T/F Mammograms work best on breasts that consist mostly of fat
TRUE
125
On mammographic features of breast cancer include all of the following except: micro calcifications, spiculated ill-defined mass, multiple dilated ducts, architectural distortion, and focal symmetric density.
Multiple dilated ducts are not usually present, but rather a single dilated duct. Focal symmetric density is not usually present, but rather focal asymmetric density
126
T/F Breast ultrasound is a good way to screen for cancer.
FALSE. It is not a screening method but rather a diagnostic f/u method after a mammogram has identified an abnormality
127
T/F A breast MRI is more sensitive but less specific than a mammogram
TRUE
128
T/F Imaging studies are the best most cost effective way to diagnose cancer
FALSE. Imaging DOES NOT diagnose cancer
129
The ____ type of breast cancer is the most common type is infiltrating ductal carcinoma
Epithelial
130
____ usually presents as a diffuse thickening of the breast rather than a discrete mass
Infiltrating lobular carcinoma
131
The removal of the entire breast AND associated lymph nodes
Modified radical mastectomy
