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Final (Women's Health) Flashcards

1
Q

No menses by 16 yrs old

A

Referral

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2
Q

Normal menstrual cycle

A

28 days +/- 7 days

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3
Q

What phase if the cycle is consistent?

A

Luteal Phase

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4
Q

Optimization of Healthcare PRIOR to Conception

A

Ensure immunizations are current: titers (chicken pox, rubella, Hep)
Folic Acid
Normal weight
Nutrition/Physical Activity
Consider any co-morbid conditions/medications
CDC 10 recommendations for Preconception Counseling

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5
Q

How much folic acid should be given prior to conception?

A

400 mcg Folic Acid (6 months prior is ideal)

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6
Q

Basal Body Temperature

A

monitor temperature every morning before getting out of bed and doing anything. 0.5 degree increase suggests ovulation. Recommend patient have sex

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7
Q

Ovulation predictor Kits

A

Detects LH surge

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8
Q

Mittelschmerz

A

-“ Egg-White” cervical mucus
Occurs just before ovulation
Look for the lowering of the temp, then the spike

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9
Q

Human chorionic gonadotropin (hCG)

A

detected in blood at implantation, doubles q 48-72 hrs, and peaks at 60-90 d post fertilization

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10
Q

Qualitative hCG

A

(urine dip): Yes or No

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11
Q

Quantitative hCG

A

(serum/blood): Level above 50 is considered “positive” sign of pregnancy, repeat in 48-72 hr increments for viability of pregnancy

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12
Q

When can you assess for Fetal Heart Tones?

A

10-12 weeks

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13
Q

Abortion

A

pregnancy termination prior to 24 weeks

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14
Q

Mifepristone (RU486)

A

“antiprogestin” blocks endometrial growth, detaches placenta

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15
Q

Methotrexate

A

prevents placental villi proliferation

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16
Q

Misoprostol(cytotec)

A

causes uterine contractions (used for ripening in labor)

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17
Q

Plan B

A
  • 85% effective in preventing implantation of an embryo

- Does not cause abortions

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18
Q

Hegar’s Sign

A

compressibility and softening of the cervical isthmus

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19
Q

Goodell’s Sign

A

significant softening of the vaginal portion of the cervix from increased vascularization.

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20
Q

Chadwick’s Sign

A

bluish discoloration of the cervix, vagina, and labia resulting from increased blood flow. It can be observed as early as 6 to 8 weeks after conception

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21
Q

Nigel’s Rule

A

estimates the expected date of delivery (EDD) by adding one year, subtracting three months, and adding seven days to the first day of a woman’s last menstrual period (LMP).

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22
Q

Uterine Size at 10 weeks

A

baseball

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23
Q

Location of uterus at 12 weeks and size

A

symphysis pubis ; softball

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24
Q

Location of uterus at 12 weeks and size

A

symphysis pubis ; softball

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25
Location of uterus at 16 weeks
Halfway to navel
26
when does quickening (moment in pregnancy when the pregnant woman starts to feel or perceive fetal movements ) occur?
16 weeks
27
location of uterus at 20 weeks?
umbilicus
28
How does uterus size increase after 20 weeks?
- 1 cm/week gestastion | - Concordant with Gest. Age + or minus 1 (no more than 3cm)
29
People needing early referral
``` Advanced age (30+) Hx of miscarriage Hx of medical conditions or Fhx Obese/overweight “The NEEDY” ```
30
Best predictor of gestational age
crown rump length
31
When does 1st visit prenatal occur?
ideally preconception | - 6-8 weeks, after 1st missed period
32
Tx for N/V
Ginger 500mg
33
Should patients continue steroid use in pregnancy
MOMMA DON’T BREATHE THEN BABY DON’T BREATHE. Okay to take Advair. Need to monitor peak flow every day. If done 1st thing in morning then you can usually predict when you will need to step up asthma treatment plan.
34
Tx for runny nose?
salt water. NO SUDAFED/AFRIN. Can take Claritin low dose, conservatively-Contraindication in woman with low amniofluid.
35
T/F: Pregnant women can only take tylenol
TRUE
36
Subsequent Prenatal Visits
- Q4 weeks until 28 weeks - Q2 weeks 28-36 weeks - Q1 week til delivery
37
Weeks 4-12
Baselines
38
Weeks 12-16
Genetic Screening/Testing
39
Weeks 16-20
20 week ultrasound, sex of baby; anatomy
40
Weeks 20-24
Age of vitality, begin Leopolds
41
Weeks 24-28
Prepare for OGTT and RhoGAM if indicated
42
Weeks 28-32
repeat HgB, STI testing
43
Weeks 32-36
Kickcounts, group beta-strep, manage “TOBP” (tired of being pregnant)
44
1st Trimester: Genetic Screening
cfDNA: Noninvasive screen at 10-12 weeks DNA from mom & baby taken from maternal blood sample Screens for specific chromosomal abnormalities Indicated for women at risk, triggers more testing
45
2nd trimester: Genetic Screening
Triple Screen: hCG, estriol, alpha-fetoprotien | Quad Screen: hCG, estriol, alpha-fetoprotien, inhibin-A
46
Risk Assessment
Preterm labor: cervical effacement/dil between 20-37 wks #1 RF is hx of PTL, premature birth, or repeated pregnancy loss Tx: cerclage, tocolytic agents= breathine, MgSO4, Indomethacin Bedrest, close follow up, watch for Cx > q6-8 hr Cervical length >30 mm reassuring that effacement is neg
47
Effacement
thinning of cervix
48
Pregnancy Induced Hypertension
- elevated blood pressure without proteinuria: >30 mmHg S or >15 mmHg D to values before 20 weeks (140/90 if no other reading available) - BP returns to normal usually 12 weeks post-partum - Hgb/Hct = elevated, Platelets = decreased - LFT = elevated
49
HELLP syndrome (PIH)
``` H emolysis E levated L iver enzymes L ow P latelet ```
50
Preeclamsia
``` Sudden wt gain > 2lb/wk Digital/facial edema 1+ HA/visual disturbance HTN, trace protein on UA Reflexes WNL progress to 3-4+ Tx: bedrest, surveillence, steroids to mature fetal lungs, hospitalization ```
51
Eclampsia
``` PIH + preeclampsia + SEIZURE” Prodromal ss Bp over 160/100 consistant Tonic/clonic seizures Oliguria Fetal distress in utero ```
52
Placenta Abruption
- separation of placenta from uterine wall - bright red, frank - bleeding may be concealed - “rigid abdomen”
53
Placenta Previa
- do not do cervical exam | - placenta covers cervix
54
Kick Counts
- Can start 28-32 weeks - Decreased activity = Increased risk for fetal death - 1 hr/day count movement - 10 movements / hr = Normal - 10 movements not preceived, repeat in 1 hr - If still 10 movements not precieved, call OB
55
Biophysical Profile
5 variables: 1) Fetal breathing 2) Gross body movements 3) Fetal tone 4) Amniotic fluid volume 5) NST Total of 10 points possible: < 4 = delivery; 6-8 rep in 24 hr; 8-10 normal
56
MCV (Mean Cell Volume)
- SIZE - Microcytic: < 80 - Normocytic: 80-100 - Macrocytic > 100
57
MCHC (Mean Corpuscular Hemoglobin Concentration)
- COLOR - Hypochromic: < 32% - Normochromic: 32-36% - Hyperchromic: > 36%
58
Hypothryoidism
- Increase thyroid medication for patient that is hypothyroid - Pre-conception: Test those at high risk - Pregnancy: Test q 4-6 weeks until 20 weeks or med stable - Postpartum: Test 3 mo, 6 mo, diff dx until 1 year.
59
Mastitis
- Causative Organism? Staph | - How should the breast milk be handled? Pump and Dump after the dose of medication then continue feeding
60
Presumptive Pregnancy Sign
- Amenorrhea - Breast tenderness and enlargement - Chadwick's sign - Fatigue - Hyperpigmentation - Chloasma - Linea nigra - Fetal movements (quickening) - Urinary frequency - Nausea/vomiting
61
Positive Pregnancy Sign
- Auscultation of fetal heart sounds - Palpation of fetal movements - Radiological and/or ultrasonic verification of gestation
62
Probably Pregnancy Sign
- Abdominal enlargement - Ballottement - Braxton-Hicks contractions - Goodell's sign - Hegar's Sign - Palpation of fetal contours - Positive pregnancy test - Uterine enlargement
63
GnRH
stimulates pituitary gland to produce FSH
64
LH
ovulation
65
Progesterone
Maintained during pregnancy

Women's Health (2 decks)

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