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Clin Med- Repro > Green PANCE book- OB > Flashcards

Green PANCE book- OB Flashcards

1
Q

start at the first day of last menstrual period, go back 3 months and add 7 days

A

how to determine due date

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2
Q

The initial prenatal visit should occur how many weeks after LMP (last menstrual period)

A

6-8 weeks

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3
Q

pregnant women should be examined every ___ weeks until the 32nd week

A

4 weeks

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4
Q

pregnant women should be examined every ___ weeks up to 36 weeks of gestation

A

2 weeks

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5
Q

A woman should be examined every ___ week from 36 weeks till the end of gestation

A

1! every week!

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6
Q

fetal heart tones should be examined at…

A

10 weeks (9-12 weeks)

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7
Q

check fundal height starting at….

A

20 weeks

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8
Q

normal fetal HR

A

120-160 bpm

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9
Q

Quickening or the first awareness of fetal movement usually occurs at…

A

18-20 weeks (first pregnancy)

14-18 weeks (multiple pregnancies)

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10
Q 
Backache
Increasing varicosities
Heartburn
Hemorrhoids
Bleeding gums
Profuse salivation
Fatigue
A

associated with healthy pregnancy

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11
Q

abnormally low PAPP-A and abnormally high B-hCG indicated increased risk of…

A

Trisomy 21 and other genetic disorders

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12
Q

Ultrasound can detect fetal HR as early as _____ weeks after LMP

A

5-6 weeks

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13
Q

Bluish discoloration of vagina and cervix seen in pregnancy

A

Chadwick’s sign

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14
Q

Softening between funds and cervix in pregnancy

A

Hegar sign

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15
Q 
Amenorrhea
N/V
Breast tenderness
Quickening (fetal movement)
-nullipara: 18-20 weeks
-multipara: 14-16 weeks
Easy fatigue
Urinary frequency
A

Symptoms of pregnancy

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16
Q 
Chadwick sign
Increased basal body temp
Skin changes (melanoma, linea nigra)
Hegar sign
Uterine growth
A

Signs of pregnancy

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17
Q

At 12 weeks pregnant, uterus is palpable above…

A

pubic symphysis

and fetal heart sounds heard

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18
Q

At 14-16 weeks pregnant, uterus is midway between…

A

pubic symphysis and umbilicus

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19
Q

At 20 weeks, uterus is at level of…

A

umbilicus

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20
Q

20-38 weeks, height of uterine funds corresponds roughly (+/-2 cm) to weeks of…

A

gestational age

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21
Q

38-40 weeks, gravid uterus is about 2-3 cm below the

A

xiphoid process

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22
Q

A catheter or needle is used to biopsy placental cells

*avail 10-14 weeks gestation

A

Chorionic villus sampling (CVS)

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23
Q

Withdrawal of amniotic fluid via needle under ultrasound guidance

*avail 15-18 weeks gestation

A

Amniocentesis

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24
Q

External doppler monitor, along with an external stress gauge for uterine contractions (together called the non stress test) is used….

A

near term to monitor fetal well being!

*third trimester screening

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25
Q

Implantation of a pregnancy anywhere but the endometrium

*more than 95% occur in fallopian tube

A

Ectopic pregnancy

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26
Q

Most common cause of ectopic pregnancy is occlusion of the tube secondary to….

A

adhesions

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27
Q 
Hx of previous ectopic implantation
Previous salpingitis (caused by PID)
Previous abdominal or tubal surgery 
Use of IUD
Assisted repro
A

risk for ectopic pregnancy

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28
Q

Unilateral adnexal pain
Amenorrhea or spotting
Tenderness or mass on pelvic exam

also….dizziness or syncope as well as GI distress

A

Ectopic pregnancy

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29
Q

Severe abdominal or shoulder pain associated with peritonitis, tachycardia, syncope or orthostatic hypotension

A

Rupture ectopic pregnancy

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30
Q

if serial increases of hCG are less than expected, what should be suspected?

A

Ectopic pregnancy

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31
Q

_______ _______ is diagnostic in 90% of ectopic gestation

A

transvaginal ultrasonography

32
Q

methotrexate can be used in the tx of

A

ectopic pregnancies

33
Q

the termination of pregnancy, by any means, before 20 weeks gestation

A

abortion

34
Q

Spontaneous, premature expulsion of the products of conception

A

Spontaneous abortion

35
Q

80% of spontaneous abortions occur during the…

A

first trimester

50% of these associated with genetic abnormalities

36
Q

Smoking, infection, maternal systemic dz, immunologic parameters, drug use

A

Risk factors for spontaneous abortion

37
Q

Spectrum of diseases arising from the placenta and include complete and partial hydatidiform moles, placental site invasive moles, trophoblastic tumors and choriocarcinomas

*divided into benign and malignant forms

A

Gestational trophoblastic disease (GTD)

complete molar pregnancies are most common form of GTD

38
Q

A hydatidiform mole (also called a molar pregnancy)

benign or malignant?

A

Benign

complete molar pregnancies are the most common form of GTD

39
Q

Characterized by an empty egg and the appearance of “grape like vesicles” or a “snow storm pattern” on ultrasound

A

Complete hydatidiform moles

40
Q

What is present in partial hydatidiform moles?

A

a fetus!

..but the fetus is nonviable

41
Q

Abnormal vaginal bleeding
Uterine size greater than dates
Hyperemesis gravidarum (excessive vomiting)
Preeclampsia like symptoms before 20 wks

A

presentation of complete or partial molar pregnancy

42
Q

Tx of benign or low risk tumors vs malignant GTD tumors

A

Benign….chemo

Malignant..chemo with or without radiation or surgery

43
Q

what can happen 1/80 births

A

twins

*prenatal visits should occur more frequently!

44
Q

2/3 of twins are…

A

dizygotic (or fraternal)

..formed by the fertilization of 2 ova

45
Q

Fam hx
Those taking fertility drugs
Mothers above average weight and height
African american women

A

more likely to have dizygotic (fraternal) twins

46
Q

These types of twins occur randomly and are associated with fetal transfusion syndrome and discordant fetal growth

A

Monozygotic twins (fertilization of 1 ovum)

47
Q

Most common complications of multiple gestation…

A

spontaneous abortion or preterm birth

preeclampsia and anemia more likely also

48
Q

Carbohydrate intolerance of variable severity that is only present during pregnancy

A

Gestational diabetes

lifetime risk increased by 50% to developing diabetes later

49
Q

Preeclampsia
Hyper acceleration of general diabetic complications
Traumatic births (including shoulder dystocia)

A

Maternal complications with gestational diabetes

50
Q

Macrosomia
Prematurity
Feal demie
Delayed fetal lung maturity

A

Fetal complications with gestational diabetes

51
Q

Obtain a random glucose on all pregnant women during the….

A

first prenatal visit!!

..repeat at 24-48 weeks

52
Q

Managed with diet and exercise

*must check blood glucose levels daily

A

Management of gestational diabetes

53
Q

Delivery of a viable infant before 37 weeks gestation

*most common cause of neonatal deaths not resulting from congenital abnormalities

A

Preterm labor

54
Q
  1. Developmental delays
  2. Cerebral palsy
  3. Lung disease
A

More likely in low birth weight infants

55
Q

Smoking, cocaine use, uterine malformations, cervical impotence, infections, low pre pregnancy weight

A

Increase risk of pre term labor

56
Q

Defined as regular uterine contractions (greater than 4-6 per hour) between 20-36 weeks gestation and the presence of 1 or more..

  1. dilation greater of 2cm or greater on presentation
  2. dilation of 1cm or greater on serial exams
  3. cervical effacement of greater than 80%
A

Preterm labor

57
Q

A length of 2 cm at 24 weeks gestation increases risk to deliver _________

A

prematurely

58
Q

Rupture of the amniotic membranes before the onset of labor at or beyond 37 weeks of gestation

A

premature rupture of membranes (PROM)

*90% of women will go into spontaneous labor after PROM

59
Q

Chorioamnionitis and endometritis increased risk of….

A

premature rupture of membranes (PROM)

60
Q

Abnormal labor, which occurs when the cervix fails to dilate progressively over time and the fetus fails to descend

A

Dystocia

61
Q

3 P’s that can cause abnormalities in labor/delivery

A
  1. Pelvis..sometimes pelvis not lg enough!
  2. Powers..refers to the strength of contractions that are needed to dilate the cervix
  3. Passenger..refers to the baby. The bigger the baby (esp the head), the more difficult
62
Q

What drug can you give if contractions are inadequate

A

Oxytocin (Pitocin)

63
Q

What is the leading indication for C sections?

A

Dystocia

64
Q

The birth of the fetus through an incision in the abdominal and uterine walls (about 32% of deliveries in US)

A

C section

65
Q
  1. repeat C sections
  2. dystocia
  3. failure to progress
  4. breech presenation
  5. fetal distress
A

most common causes of C sections

66
Q

Greater chance of thromboembolic events, increased bleeding and development of infection

A

Risks of C section

67
Q

A low transverse uterine incision is usually made because of…

A

decreased blood loss associated with it!

68
Q

This is considered when prolongation of pregnancy might expose the mother or fetus to complications and when vaginal delivery is not contraindicated

A

Induction of labor

69
Q

Prostaglandin gel put directly on cervix

..is this used for early or late induction?

A

EARLY

70
Q

Oxytocin (Pitocin) given IV

..is this used for early or late induction?

A

LATE

71
Q

Artificially rupturing the membranes with a small hook to induce labor

A

Amniotomy

72
Q

Blood loss requiring transfusion or a 10% decrease in hematocrit between admission and the postpartum period

A

Postpartum hemorrhage

third leading cause of maternal mortality in advanced gestation

73
Q

Occurs less than 24 hours after delivery and is associated with abnormal involution of placental site, cervical or vagina lacerations and retained portions of placenta

A

Early postpartum hemorrhage

74
Q

Occurs more than 24 hours after delivery to 6 weeks post part and most commonly caused by sub involution of uterus, retained products of conception or endometritis

A

Late postpartum hemorrhage

75
Q
  • Initially, uterine massage and compression
  • Establish IV access and prepare blood components
  • Use IV oxytocin if early

**may require surgical intervention depending on severity

A

Management of postpartum hemorrhage

Clin Med- Repro (11 decks)

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