General Practice Info Flashcards
Four cardinal questions to ask every pregnant woman
- Do you feel fetal movement (expected after 20 weeks)
- Are you having vaginal bleeding?
- Do you have any leaking fluid?
- Are you having contractions?
Questions to ask any pregnant woman with hypertension
- Do you have persistent headache?
- Do you have any visual changes?
- Do you have RUQ pain?
TPAL system
In cases of suspected intimate partner violence, ____ is the appropriate measure
In cases of suspected intimate partner violence, social work referral is the appropriate measure
Elective caesarean sections
Can be performed upon request so long as the patient is made fully aware of the risks and benefits of caesarean section when not necessary.
Should be performed at 39 weeks gestation.
The fewest complications of induced abortion occur when the woman is in the ____
The fewest complications of induced abortion occur when the woman is in the first trimester
The largest barrier that undocumented immigrants face in obtaining healthcare
Obtaining some form of health insurance
About half of women with chronic pelvic pain have a history of. . .
. . . sexual abuse
Sexual abuse represents a strong risk factor for chronic pelvic pain
Best way to assess possibility of opioid abuse
State-regulated pharmacy databases
They are designed specifically for this purpose
Doxylamine-pyridoxine
A histamine antagonist and B6 given together.
Treatment for N/V in pregnancy, however patients cannot breastfeed while taking this.
Telling apart DIC and HELLP
In DIC fibrinogen will be LOW,
in HELLP fibrinogen will be NORMAL TO HIGH
If a provider feels uncomfortable performing a cesarean delivery on request without indication. . .
. . . the correct thing to do is refer to another provider
The woman is entitled to a cesarean delivery on request, but the physician is also entitled to not do something they are ethically opposed to.
Therefore, referal is the correct choice.
Reversing magnesium toxicity
Stop magnesium, give calcium gluconate
For postpartum women, ___ is often the most effective form of contraception
For postpartum women, progestin-only pill or progestin implant is often the most effective form of contraception
The level of progestin present in these does not interfere with breastfeeding.
Patients with short interpregnancy period are at risk for. . .
- PPROM
- Maternal anemia
- Preterm delivery
- Low birth weight
Contraindications for PPH therapies
- Prostaglandins: Asthma
- Tranexamic acid: Hypercoagulability
- Ergots: Hypertension
“Missed” abortion is by definition. . .
. . . an abortion PRIOR TO expulsion of products of contraception, along with a lack of symptoms
ie, no bleeding (threatened abortion) or cervical dilation (inevitable abortion)
Vasa previa vs cord prolapse
Vasa previa is a product of placentation, it does not develop over time
Cord prolapse may occur at the time of SROM if the fetus is not engaged
Treatment of intravaginal foreign body in children
- Local anesthesia and warm water irrigation is usually the best approach
- General anesthesia and vaginoscopy is the last resort
Eyes and Thighs
Eyes: Intraocular erythromycin
Thigh 1: Intramuscular vitamin K
Thigh 2: Hepatitis B vaccine
Most common neonatal endocrine cause of death
Salt wasting due to CAH (21-hydroxylase deficiency)
EBL and hematocrit
100 mL EBL = expected drop in hematocrit by 0.1 the following day (when fluids replaced)
What is going on in this picture of a colposcopic exam?
Acetone has been added and revealed a “punctuated cervix”
The dots we are seeing are the ends of blood vessels. This abnormal blood vessel morphology is indicative of angiogenesis, which was likely driven by neoplasia.
What is going on in this picture of a colposcopic exam?
Strawberry cervix
This is a sign of trichomonas vaginalis infection. Confirm by assessing for clue cells. Frothy discharge will often be present as well. Treat w/ metronidazole.
What is the mechanism by which placental abruption or dead fetus retention lead to DIC?
Placental thromboplastin is introduced into maternal circulation
Thromboplastin then activates the coagulation cascade systemically, causing DIC.
All pregnant women should receive a Tdap booster between ____ of pregnancy
All pregnant women should receive a Tdap booster between week 27 and 36 of pregnancy
Tdap vaccine protects the mother from puerperal tetanus and the neonate from pertussis, diphtheria, and neonatal tetanus.
Rosette test
Screening test for FMH that detects fetal D+ red cells in maternal Rh negative blood.
If the rosette test is positive, follow-up testing is done to quantitate the FMH, eg, a Kleihauer-Betke acid elution test or flow cytometry.
History of multiparity and gallstones
History of multiparity is a risk factor for gallstones due to sludge buildup!
It can last even after the pregnancy is gone, especially if asymptomatic stones form in the bladder.
Postpartum urinary retention
Common, due to a combination of bladder overdistension and use of spinal anesthesia.
