Brainscape's Knowledge GenomeTM

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


See full index

EndoRepro II Exam I > Important Clinical Medicine Parameters > Flashcards

Important Clinical Medicine Parameters Flashcards

1
Q

Women ___ years of age or greater should receive annual mammograms.

A

40

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

If a cyst reappears or does not resolve with fine needle aspiration, what should occur?

A

If cyst reappears or does not resolve with aspiration, diagnostic mammogram/ultrasound and perform biopsy.

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

What are the guidelines for screening for cervical cancer in the following ages?

Under 21

21-29

30-65

65 and over

After Hysterectomy

A

Under 21 = NO SCREENING

21-29 = Cytology alone every 3 years

30-65 = HPV and cytology COTESTING every 5 years

65 and over = No screening folowing adequate negative prior screening

After Hysterectomy = NO screening

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

You receive results of someone who has an ASC-US pap, how do you proceed?

A

-look for hpv (preferred method)
-if hpv negative, repeat co testing in 3 years
if hpv positive, send for colposcopy

or…
you can repeat cytology in one year

if you get asc again –> colp
if normal now –> go back to routine

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

You receive results of someone who has a LSIL pap, how do you proceed?

A

low grade with neg HPV (almost never happens) –> cytology in one year

low grade with unknown hpv or positive hpv –> colp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

You receive results of someone who has a HSIL pap, how do you proceed?

A

culp or just go ahead and treat their cervix

wootton tends to colp so she can check the inside cells bc if those are bad she must do the cone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Excisional techniques to the uterus are done when….

A

~Endocervical curettage positive (needs cold knife
cone)
~Unsatisfactory colposcopy (No SCJ)
~Substantial discrepancy between pap and biopsy
(i.e. High grade pap and negative colposcopy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

If the endocervical curretage is positive, what is the next step?

A

Cold knife cone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the guidelines for HPV testing?

A

Three injection series- first dose, second dose 2 months later, third dose 6 months from first (can still give doses if interval varies)

ACIP recommends a routine 2 dose HPV vaccine schedule in adolescents less than 15 years of age separated by 6-12 month intervals

Recommended routine vaccination for all girls and boys ages 9-26
( October 5, 2018 FDA approved for use in men and women ages 27-45)

Can receive if already have abnormal pap

Not for use in pregnancy but safe in breastfeeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the “discriminatory level” of hCG where a gestational sac be seen with transvaginal ultrasound (TVUS)?

A

1500-2000 mIU/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which abnormal rise of hCG in 48 hours confirms a nonviable IUP or ectopic pregnancy?

A

Abnormal rise in hCG of <53% in 48 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which weeks constitute the first, second, and third trimesters?

A
  • First = first day of last menstrual period - 13 + 6 weeks
  • Second = 14 weeks - 27 + 6 weeks
  • Third = 28 weeks - 42 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Recurrent abortions are defined as what?

A
  • Defined as 3 successive SAB

- Excluding (ectopic and molar pregnancies)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How many cigarettes a day and alcoholic beverages a week are associated with a 4-fold increased risk for SAB?

A
  • 20-cigs a day

- 7 alcoholic drinks/week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which fetal MCA value peak systolic velocity for gestational age is predictive of moderate to severe fetal anemia?

A

> 1.5 MOM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which Hct level is considered severe fetal anemia?

When are intrauterine transfusions done and with what?

A
  • Hct is below 30% or 2 standard deviations below the mean Hct for the gestational age
  • Intrauterine transfusions using fresh group O, Rh-negative packed RBC’s performed between 18-35 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the most valuable tool for detecting fetal anemia?

How often should it be performed?

A
  • Doppler assessment of peak systolic velocity in the fetal MCA in cm/sec
  • Should perform this test q 1-2 wks from 18-35 wks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

In addition to serial ultrasounds with MCA dopplers, what other 2 tests should be used in the management of Rh-isoimmunization?

A
  • Antepartum testing: 2x weekly non-stress test or biophysical profiles
  • Serial growth scans q 3-4 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How much should a baby move every 2 hours?

A

10 movements every 2 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What scores on the components of the reassuring biophysical profile guidelines are:

~Reassuring

~Equivocal

~Nonreassuring

A

Reassuring = 8-10

Equivocal = 6

Nonreassuring = 4 or less

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the definition of labor?

A

Progressive cervical dilation resulting from regular uterine contractions that occur at least every 5 minutes and last 30-60 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the characteristics of a biophysical profile?

A

x

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are parameters of a contraction stress test (CST)?

A

—Contraction stress test (CST)
—Give oxytocin to establish at least 3 contractions in a 10 min period.
If late decelerations are noted with the majority of contractions the test is positive and delivery is warranted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the characteristics of a nonreactive stress test? What is considered reactive?

A

Nonstress test (NST)
—Reactive- 2 accelerations of at least 15 beats above baseline lasting at least 15 seconds during 20 minutes of monitoring
If this successfully occurs, called reactive
—If test is nonreactive further evaluation is warranted with a contraction stress test or biophysical profile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is the diagonal conjugate?

A

DIAGONAL CONJUGATE
Is approximated by measuring from the inferior portion of
the pubic symphysis to the sacral promontory
If > 11.5 cm the anterioposterior (AP) diameter of pelvic
inlet is adequate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is the obstetric conjugate?

A

OBSTETRIC CONJUGATE
Is then estimated by subtracting 2.0 cm from the diagonal
conjugate
Is the narrowest fixed distance through which the fetal head
must pass through during a vaginal delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What occurs at the 20 weeks office visit, the 28 week office visit, and the 35 week office visit?

A

—20 weeks
—Obtain fetal survey ultrasound
Find out the gender!

—28 weeks
Screening for gestational diabetes & repeat hemoglobin and hematocrit
—Rhogam injection to Rh negative patients
—Tdap (Tetanus, diptheria, & acellular pertussis) give between 27-36 weeks

—35 weeks
—Screening for group B strep carrier with vaginal culture - treat in labor if positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the duration of the first stage of labor?

A

Duration of first stage:
Primiparas- typically 6-18 hours
Multiparas- typically 2-10 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the rate of cervical dilation?

A

Rate of cervical dilation:
Primiparas- 1.2 cm per hour
Multiparas- 1.5 cm per hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the duration of the second stage of labor in primiparas vs multiparas?

A 
Duration:
Primapara without epidural- 2 hours
Primapara with epidural- 3 hours
Multipara without epidural- 1 hour
Multipara with epidural- 2 hours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the classic signs of placental separation?

A 
Classic signs of placental separation
Gush of blood from the vagina
Lengthening of the umbilical cord
Fundus of the uterus rises up
A change in shape of the uterine fundus from discoid to globular
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is the bishop score? what is the highest score? what is considered unfavorable?

A

x

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is considered normal vs. tachysystole for uterine contractions when monitoring?

A
  • Normal = 5 contractions or less in 10 minutes, averaged over 30 mins
  • Tachysystole = >5 contractions in 10 minutes, averaged over 30 mins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is considered an acceleration of FHR at ≥ 32 weeks and at <32 weeks gestation?

A
  • ≥ 32 weeks: HR ≥ 15 bpm above baseline for 15 sec or more (but <2 mins)
  • <32 weeks: HR ≥ 10 bpm above baselines for 10 sec or more (but <2 mins)
35
Q

What is the normal amount of variability in amplitude with FHR?

A

Moderate (normal) = range of 6-25 bpm

36
Q

How do variable decelerations of FHR appear on monitor; what is the criteria?

A
  • Abrupt ↓ in FHR ≥ 15 bpm lasting ≥ 15 sec and <2 min (looks like big ‘V’)
  • Can occur before, during, or after the contraction
37
Q

What seen on fetal heart rate tracing would be considered category III?

A
  • Recurrent late decelerations or variable decels or bradycardia
  • Sinusoidal pattern
38
Q

When & How do we diagnose PTL?

What symptoms are expected?

A

20-37 weeks w/ a CERVICAL EXAM, External Monitoring, FHR

Must have: Uterine Contractions, Cervical Dilation of 2cm (80% effacement)

Menstraul like cramping, Backache, Pelvic Pressure, Discharge (bloody), Uterine Contractions

39
Q

What is the model is used to evaluate breast cancer risk? from woottons abn breast lecture

A

gail model

40
Q

In cases of potential invasive breast carcinoma, when would you order an MRI for your patient?
from woottons abn breast lecture

A

Diagnostic in SUSPICIOUS MASSES

Too expensive to use as a screening method.

Use for women at high risk for breast cancer, like BRCA carriers

41
Q

a mammogram can be both screening and _____

A

diagnostic

42
Q

what are ultrasounds useful for in regards to the breast?

A

Useful in evaluating inconclusive mammogram
findings

Best for evaluating young women (age <40) and
others with dense breast tissue

Allows to differentiate between cystic versus solid
lesions as well as show solid tissue within or adjacent
to a cyst that may be malignant

Used for guidance when performing core needle
biopsies

43
Q

what occurs after a thin needle aspiration biopsy if the breast cyst DISAPPEARS? what is it REAPPEARS?

A

Return for clinical breast exam in 4-6 months if cyst completely disappears with aspiration

If cyst reappears or does not resolve with aspiration diagnostic mammogram/ultrasound and perform biopsy

44
Q

what can be used for symptom relief in mastalgia?

A

Symptom relief: Properly fitting bra, weight reduction,
exercise, decrease caffeine intake and vitamin E
supplementation, evening of primrose oil

45
Q

what is the treatment follow up after getting officially diagnosed with breast cancer?

A

First 2 years after diagnosis- every 3-6 months

Annually after first 2 years

Most reoccurrences will happen within first 5 years after treatment

46
Q

what are the some of the epithelial cell abnormalities that can come back to you, the doc, on a path report after a pap smear?

A

Epithelial Cell Abnormalities that can come back to you, the doc, after a pap smear:

  • -Atypical squamous cells of undetermined significance (ASC-US)
  • -cannot exclude high grade (ASC-H)
  • -Low grade squamous intraepithelial lesion (LSIL)
  • -High grade squamous intraepithelial lesion (HSIL)
  • -Squamous cell carcinoma
47
Q

What are the risks of excisional procedures in treating the cervix?

A

Increased risk of cervical incompetence and resultant
second trimester pregnancy loss

Increased risk of preterm premature rupture of
membranes (PPROM)

cervical stenosis

operative risks- bleeding, infection

48
Q

How do you characterize Mild Preeclampsia without severe features?

A

BP <140/90 (less than 160/110)

Proteinuria >300mg over 24 hour urine collection (but less than 5 grams)

ASYMPTOMATIC

49
Q

What are the main symptoms we see with Pre-eclampsia?

A

Scotoma – vision disturbances

Blurred Vision

Epigastric/ RUQ pain

Headache (that doesnt improve with ibuprofen)

50
Q

How do you characterize Severe Preeclampsia with Severe Features?

A

BP >160/>110 (must be 2 occasions)

Proteinuria >5 grams per 24 hour

Liver Enzymes – 2x the upper limit / epigastric pain refractory to tx

Pulmonary Edema

Thrombocytopenia

Cerebral/Visual Disturbances

SYMPTOMATIC

51
Q

How do you assess for mom and baby in the case of chronic HTN?

A

Assess for maternal end-organ damage
CBC, glucose, complete metabolic profile, 24 hour urine
collection for total protein (or a spot urine protein to
creatinine ratio) , EKG and possibly echocardiogram

Assess for fetal well being
-Initial ultrasound for accurate dating
-Screening ultrasound
-Growth ultrasounds monthly after 28 weeks gestation
-Antepartum fetal testing to begin between 32-34 weeks
gestation

52
Q

How is mild hypertension managed in pregnant mommas?

A

Mild hypertension (BP less than 160/110 mmHg)
Begin aspirin therapy 81 mg daily at 12 weeks till
delivery
􄡧 Initiate antihypertensive if reach threshold value
􄡧 Prenatal visits every 2-4 weeks until 34-36 weeks
gestation and then weekly
􄡧 Antepartum fetal monitoring
􄡧 Delivery between 39-40 weeks gestation

53
Q

How is severe hypertension managed in pregnant mommas?

A

Severe hypertension (BP greater than 160/110)
􄡧 Antihypertensive therapy
▫ Methyldopa
▫ Labetalol*
▫ Nifedipine*
▫ Others (non-first line) metoprolol, prazosin, minoxidil,
hydralizine, thiazide diuretics and clonidine
Close prenatal monitoring for medication
dosage change
! With associated renal disease- 24 hour urine
collection every trimester
! Observation for signs of developing
superimposed preeclampsia
! Antepartum fetal surveillance
􄡧 Growth ultrasounds every 3-4 weeks
􄡧 Non-stress tests and/or biophysical profiles
! Delivery after 38 weeks gestation

54
Q

when should gestational dm resolve?

A

12 weeks post partum

55
Q

bun:creatinine ratio of preeclampsia with mild features?

A

0.3

56
Q

bun:creatinine ratio of preeclampsia with severe features?

A

> 1.1

57
Q

what labs are elevated in preeclampsia? what labs are low?

A 
Laboratory findings
Increased:
▫ Hematocrit
▫ Lactate dehydrogenase
▫ Transaminases (AST,ALT)
▫ Uric acid

Low:
Thrombocytopenia (low platelets)

58
Q

what are the lab values associated with HELP syndrome?

A

Labs: LDH greater than 600 IU/L; AST/ALT elevated
twice the upper limit of normal; platelets less than
100,000
! Presence of hypertension and proteinuria are variable

59
Q

If pregnant patient w/ asthma has been using daily inhaled steroids or high potency oral for more than 3 weeks what is done during labor and delivery?

A

Stress dose of IV steroids to prevent adrenal crisis

60
Q

What is the most common HA during pregnancy; treated how?

A

tension - with acetaminophen

61
Q

Which serum creatinine level worsens the prognosis of chronic kidney failure during pregnancy?

A

Serum Cr. >1.5-2

62
Q

What drugs used in tx of thyroid storm during pregnancy?

A
  • Propranolol
  • Sodium iodide (blocks secretion of thyroid hormone)
  • PTU
  • Dexamethasone (halts peripheral conversion of T4 –> T3)
63
Q

What are 6 fetal complications assoc. w/ gestational diabetes?

A
  • Macrosomia
  • Neonatal hypoglycemia
  • Hyperbilirubinemia
  • Operative delivery
  • Shoulder dystocia
  • Birth trauma
64
Q

Intrahepatic cholestasis of pregnancy increase the risk of what complications?

A

Meconium stained amniotic fluid and fetal demise

65
Q

What is treatment for immune idiopathic thrombocytopenia during pregnancy?

A

All of this begin after platelets <50,000

  • Give prednisone
  • IV immunoglobulin if severe
  • Platelet transfusion
  • Splenectomy
66
Q

what is the antepartum management of gdm?

A

● Diabetic teaching
● Blood glucose monitoring
● Fetal testing weekly (biophysical profiles and/
or non-stress tests)
● Ultrasound for estimated fetal weight
◦ If weight greater than 4500 gm-recommend
cesarean delivery
● Can wait for spontaneous labor or estimated
due date if all testing, growth and glycemic
control are good

67
Q

what are the components of a fetal evaluation when the mother has PREEXISITING DM?

A

Fetal evaluation
◦ Early dating ultrasound
◦ Detailed fetal anatomy ultrasound including fetal
echocardiogram
◦ Biochemical testing for congenital malformations in first
trimester 11-13 weeks or quad screen at 16-21 weeks
◦ Fetal growth ultrasound every 2-4 weeks
◦ Fetal testing (NST/BPP) every week starting 32 weeks

● Delivery options depends on estimated fetal weight and
glycemic control

68
Q

what medications should be taken by a pregnant mother if she has hyperthyroidism? how can hyperthyroidism affect the fetus?

A

Medications-Propylthiouracil (PTU)and methimazole
●Methimazole in 2nd and 3rd trimester (can cause
aplasia cutis and choanal atresia in 1st trimester)
●propylthiouracil- increased risk of liver toxicity so only
used in 1st trimester

●Monitor TSH levels throughout pregnancy
● Fetal effects
◦Medications cross placenta and fetal hypothyroidism and
fetal goiter can develop
◦ Increased risk of prematurity, IUGR, preeclampsia and
stillbirth

69
Q

Fetal complications of SLE

A 
◦ Fetal complications
●Preterm delivery
●Fetal growth restrictions
●Stillbirth
●Miscarriage
◦ 10% risk for neonatal lupus-passive transfer of anti-
Ro/SSA or anti-La/SSB
70
Q

what are the fetal complications of post renal transplant?

A

● Post renal transplant
◦ Not recommended

●May lose graft function or experience rejection; best
candidates are 1-2 years post transplant with stable
creatinine and proteinuria without severe hypertension

●Fetal complications
◦ Steroid induced adrenal and hepatic insufficiency
◦ Prematurity
◦ Intrauterine growth restriction

71
Q

what can increase miscarriage risk if

disease is active at time of conception?

A

inflamm bowel disease

72
Q

what are the symptoms and lab findings of acute fatty liver of pregnancy?

A 
Symptoms
●Abdominal pain
●Nausea and vomiting
●Jaundice
●Irritability
●Polydipsia/pseudodiabetes insipidus
●Hypertension/proteinuria in 50% of cases

◦ Lab findings
●Increase protrombin time and partial thromboplastin
time, elevated bilirubin, ammonia and uric acid, and
elevation of liver transaminases

73
Q

Severe asthma in pregnancy is associated with increased…

A 
◦ Severe asthma associated with increased
●Miscarriage
●Preeclampsia
●Intrauterine fetal demise
●Intrauterine fetal growth restriction
●Preterm delivery
74
Q

what type of HA is most prevalent in childbearing years?

A 
Migraines
●highest prevalence in childbearing
years
●most often improve during pregnancy
●neurology can be helpful in treatment
75
Q

Women on anti-epileptics should be on anywhere

from 1 mg to 4 mg of….

A

Women on anti-epileptics should be on anywhere
from 1 mg to 4 mg folic acid depending on which
agent is used

76
Q

When would you never do a Vacuum assisted Vaginal Delivery?

A

<34 weeks

Fetal Coag Disorder

Fetal Macrosomia

Breech presentation

77
Q

what are the time parameters of potential OVD in multiparous vs nulliparous?

A

• nulliparous:
>2 hours without regional anesthesia or
>3 hours with regional anesthesia

• multiparous:
>1 hour without regional anesthesia or >
2 hours with regional anesthesia

78
Q

What is Intrauterine Growth Restriction (IUGR)?

A

When the birth weight of a newborn is below the 10% for a given gestational age

79
Q

PUERPERAL SEPSIS

A

Febrile morbidity–is defined as temp> 100.4 (38oC) or higher that occurs for more then 2 consecutive days (exclusive of the first 24 hrs) during the first 10 postpartum days

80
Q

PUERPERAL SEPSIS

A

Febrile morbidity–is defined as temp> 100.4 (38oC) or higher that occurs for more then 2 consecutive days (exclusive of the first 24 hrs) during the first 10 postpartum days

CLINICAL FEATURES:
Postpartum fever & increasing uterine tenderness on postpartum day 2 to 3 are the key clinical findings
Purulent lochia, chills, malaise& anorexia may also be noted

81
Q

Septic Pelvic Thrombophlebitis PATHOGENSIS

A

Physiologic conditions in setting of SPT fulfill Virchow’s triad for the pathogenesis of thrombosis

Endothelial damage
As a result of intrapartum trauma to vascular structures
or a result of uterine infection

Venous stasis
As a result of pregnancy induced ovarian venous dilation

Hypercoagulable state of pregnancy

82
Q

Ovarian Vein Thrombophlebitis

A

Fever & abdominal pain within 1 week after delivery or surgery

Appear clinically ill

Fever, abdominal pain, localized to the side of the affected vein

20% of the time thrombosis of ovarian vein is seen radiographically

83
Q

Deep Septic Pelvic Vein Thrombophlebitis

A

Usually have unlocalized fever in the first few days that is non responsive to antibiotics

Do NOT appear clinically ill

No radiographic evidence of thrombosis

Diagnosis of exclusion

EndoRepro II Exam I (1 decks)

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