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ENRP > Ectopic Pregnancy > Flashcards

Ectopic Pregnancy Flashcards

1
Q

What is the leading cause of maternal death in the 1st trimester?

A

Ectopic Pregnancies

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2
Q

What is an Ectopic Pregnancy?

A

Gestation implants outside the uterus

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3
Q

Where do Ectopic Pregnancies usually present?

A

Fallopian Tubes

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4
Q

What are some risk factors for Ectopic Pregnancies?

A
  • PID from tubal infection with chlamydia/gonorrhea
  • IVF/ART
  • Smoking
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5
Q

What are some risk factors for Ectopic Pregnancies?

A
  • PID from tubal infection with chlamydia/gonorrhea
  • Smoking
  • IVF/ART
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6
Q

Describe the risk factor of IUDs for ectopic pregnancies

A

The risk of IUD users is less than that of non-users but IF they become pregnant with an IUD in, they are more likely to have an ectopic pregnancy

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7
Q

Triad of signs of an Ectopic Pregnancy?

A

Missed period
Vaginal bleeding
Lower abdominal pain

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8
Q

3 types of Ectopic Pregnancies?

A
  • Possible
  • Probable
  • Ruptured
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9
Q

With Possible and Probable Ectopic Pregnancies, the symptoms are similar (pain + bleeding). What will be seen on US with a Possible Ectopic?

A

NOTHING

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10
Q

With Possible and Probable Ectopic Pregnancies, the symptoms will be similar (pain + bleeding). What will be seen on US with a Probable Ectopic?

A

Fluid in cul-de-sac

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11
Q

On physical exam, what differentiates a possible to probable ectopic?

A

Probable = tenderness on physical exam

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12
Q

If a patient presents with severe abdominal pain and dizziness, what type of Ectopic is she having? What caused the dizziness?

A

Ruptured Ectopic

– Dizziness is due to blood loss/hemorrhage

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13
Q

What are some physical exam findings that will be present with a Ruptured Ectopic Pregnancy?

A

Distended, tender abdomen with guarding rigidity
Cervical motion tenderness
Signs of hemodynamic instability

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14
Q

What are some physical exam findings with a Ruptured Ectopic pregnancy?

A
  • Distended, tender abdomen with guarding and rigidity
  • Cervical motion tenderness
  • Signs of hemodynamic instability
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15
Q

What will be seen on Ultrasound with a Ruptured Ectopic Pregnancy?

A

Empty uterus with free fluid

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16
Q

An empty uterus with free fluid on ultrasound is likely what type of Ectopic?

A

Ruptured

17
Q

What is the treatment for a Ruptured Ectopic Pregnancy?

A

Surgical emergency

18
Q

hCG signs that could indicate its an ectopic pregnancy?

A

Abnormally rising < 53% in 2 days

19
Q

What is given for compliant and stable women with an Ectopic Pregnancy?

A

Methotrexate

20
Q

What is given for compliant and stable women with an Ectopic?

A

Methotrexate

21
Q

MOA for Methotrexate?

A

(-) folic acid to stop DNA synthesis

22
Q

After you have given Methotrexate, what should you check and when?

A

hCG at days 4 and 7 to ensure it is DECREASING

23
Q

If the hCG is not decreasing with Methotrexate, what is the next step?

A

Another dose
OR
Surgery

24
Q

If a woman is stable and her symptoms of the ectopic pregnancy are resolving, what is a way to treat her?

A

Expectant management by following hCG levels

25
Q

If you are following the hCG levels with an ectopic, what level will indicate that the ectopic will resolve spontaneously?

A

< 1000

26
Q

Lapartomy is used for?

A

Unstable ruptured ectopic

27
Q

Laparascopy is used for?

A

Stable ruptured ectopic

28
Q

Saplingectomy

A

Removal of entire fallopian tube

29
Q

Incision made in the fallopian tube to extract fetal parts and then left open to heal on its own is a?

A

Salpingostomy

30
Q

Incision made in the fallopian tube, fetal parts extracted and then sutured shut

A

Salpingotomy

31
Q

What should you do after surgery for an Ectopic?

A

hCG levels to ensure all fetal parts were extracted

ENRP (45 decks)

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