Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

O&G > History and examination > Flashcards

History and examination Flashcards

1
Q

What are the first things to establish in an obs history?

A

Estimated date of delivery (EDD) and current gestational age in weeks/40
Using
• measurements of fetus from dating scan
• last menstrual period, gestational wheel and apps)
Most pregnancies are 37-42. Past due date is 40+

Gravidity:
• Total number of pregnancies including current and any miscarriages/terminations/ectopic pregnancies
• Twin pregnancies are counted as 1 pregnancy
• Only used if pregnant
Parity
• 2 numbers
• 1st number is number of livebirths at any gestation and births after 24 weeks whether live or stillbirth (twins count as 2 births)
• 2nd number includes all other pregnancies as above

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When are fetal movements first felt?

A

16-20 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Qs about contractions

A

Freq/strength/pain inbetween/analgesia required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What symptoms do you ask about in an obs hx

A
  • Contractions (freq/strength/pain inbetween/analgesia required)
  • Vaginal loss (blood/fluid)
  • Urinary symptoms (UTI? Abdo pain? Tightening due to bladder and uterus irritation)
  • Bowel history (Constipation more common due to progesterone and decreased movement in abdomen)
  • Vomiting/heartburn
  • Appetite/weight loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

If pt reports vaginal loss in pregnancy, what do you need to clarify?

A
  • Colour
  • Bleeding (provoked or unprovoked, placental localisation, blood group)
  • Odour
  • Volume (pad needed or not)
  • Timing (esp if rupture of membranes suspected)
  • Associated pain
  • Associated systemic symptoms (fevers/rigors)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What other symptoms should be asked about in an obs hx?

A
  • Headaches/visual distrubances (pre-eclampsia toxaemia PET) due to papilloedema
  • Seizures (PET)
  • Liver pain (PET)
  • Vomiting (hyperemesis gravidum)
  • Oedema
  • Calf swelling (DVT)
  • Chest pain (Pulmonary embolus)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What Qs should be asked about current pregnancy?

A
  • Midwife/obstetric led care
  • Planned? (preconceptual folic acid, spontaneous conception/fertility treatment, contraception?)
  • 1st trimester dating scan
  • 1st trimester screening results (Trisomy 21, FBC, blood group, antibodies, haemoglobinopathies, HIV, Hep B, syphilis, rubella)
  • Diagnostic tests (amniocentesis/chorionic villus sampling)
  • Hospital admissions
  • Hospital follow ups
  • 2nd trimester (results of anomaly scan)
  • 3rd trimester (additional scans)
  • Plans for place and mode of delivery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What Qs should be asked about previous pregnancies?

A
  • Number, outcomes, dates
  • Miscarriages (how many weeks gestation, spontaneous/medical/surgical)
  • Complications
  • Terminations (weeks gestation, fetal abnormality, medical/surgical, any complications)
  • Ectopic pregnancies (conservative/medical or surgical treatment)
  • Still births (weeks gestation, mode of delivery, weight of baby, any investigations)
  • Live births (ante/intra/post partum problems, weeks gestation as delivery, induced/spontaneous labour, mode of delivery, sex and weight of baby)
  • Stay on neonatal unit
  • Post partum depression
  • Method of feeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What should be asked about smears?

A
  • Date of last
  • Previous abnormal results
  • Previous cervical treatments
  • Plans for post natal contraception
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What specific parts of the PMH are you interested in for obs?

A
  • Diabetes
  • Hypertension
  • Cardiac disease
  • Thrombosis/bleeding disorders
  • Epilepsy
  • Psychiatry
  • Previous surgery
  • Obstetric cholestasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What do you ask about in FH for obs hx?

A
  • Inherited conditions (CF, sickle cell, anaemia, bleeding disorders)
  • Fetal anomalies
  • Pre-eclampsia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What Qs form a menstrual hx

A
  • Menorrhagia (heavy menstrual bleeding)
  • Dysmenorrhoea (painful periods)
  • Amenorrhoea (no periods)
  • Length of cycles
  • Period heavy/painful, changes
  • Impact on daily life
  • Intermenstrual/post-coital bleeding
  • Post menopausal bleeding
  • Irregular? (acne, hirsutism, weight change, nipple discharge)
  • Vaginal discharge (any change, colour/odour, relationship to menstrual cycle, amount)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What Qs form fertility & obs hx in a gynae history?

A
  • Previous pregnancies (outcomes, mode of delivery, birth weight, postnatal complications)
  • Fertility treatment required
  • How long it took to conceive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What urogynae Qs should be asked?

A
  • Incontinence
  • Frequency
  • Urgency
  • Nocturia
  • Dysuria
  • Flow
  • Prolapse
  • Impact of activities of daily living
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What Qs should be asked about pelvic pain?

A
  • SOCRATES
  • Relationship to menstrual cycle
  • Pain with intercourse: superficial/deep (dysparenuria)
  • GI symptoms (bloating/constipation)
  • Therapies already tried
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What Qs should be asked in a sexual and reproductive hx?

A
  • If in relationship: gender of partner
  • Sexually active?
  • Impact on sex life?
  • STI history, PID
  • Contraception methods used: bleeding pattern, missed pills, renewal dates
17
Q

What are the 2 types of speculum used in O&G?

A

Cusco

Sim’s

18
Q

What general things should be done before abdo exposure in obs exam?

A

– Blood pressure measurement and urinalysis (PET)
– BMI
– Jaundice, anaemia, oedema
– Auscultation of heart and lungs

19
Q

What should be observed in an obs abdo exam?

A 
–	Asymmetry 
–	Skin changes 
–	Foetal movements
–	Scarring
–	Laparoscopy
–	Appendicectomy
–	Transverse suprapubic from previous Caesarean Section
20
Q

At what gestation can you feel the uterine fundus at the level of the pubic bone

A

12 weeks

21
Q

At what gestation can you feel the uterine fundus at the level of the umbilicus

A

20 weeks

22
Q

At what gestation can you feel the uterine fundus at the level of the sternum

A

36-38 weeks

23
Q

What happens at 40 weeks to the level of the fundus?

A

Drops below 38 weeks level as presenting part drops down into pelvis

24
Q

Define SFH

A 
Symphysiofundal height (SFH)
Measured with measuring tape facing away, from highest point of fundus to pubic symphysis
25
Q

What do you say on palpation of a pregnant abdomen?

A

Symphysiofundal height (SFH)

Determine lie of foetus (keep left hand on fundus, right hand palpates) If>30 weeks
Explain where head is and back is (eg on maternal right). Don’t worry until 36 weeks.

Presentations (cephalic versus breech)

Engagement in pelvis (how many 5ths of the head can you palpate?)

26
Q

What do you say when inspecting a pregnanct abdomen

A

Distended abdomen consistent with pregnancy
Cannot see any fetal movments at this time
Striae/everted umbilius/linea nigra

27
Q

Where do you place the doppler probe for the fetal heartbeat?

A

Over the fetus’ shoulder

O&G (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions