Keppler - 6 Flashcards

1
Q

2 types of bleeding during pregnancy

A

pregnancy related

non-pregnancy related

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

pregnancy-related causes of first trimester bleeding

A

ectopic

spontaneous abortion

subchorionic bleeding

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

when should you be able to see viable fetus in uterus

A

6-7 weeks

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

what is the discriminatory zone

A

level of hcg that you expect to see viable fetus → 2000-3000

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

how do you localize/find location of fetus

A

US

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

next step if you don’t see fetus on US

A

order hcg → is it w.in discriminatory zone?

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

suspect __ on any pregnant pt. that comes in w. pain and bleeding in the first trimester

A

ectopic pregnancy

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

tx for ectopic pregnancy

A

methotrexate → inhibits folate

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

contraindication for methotrexate

A

hemodynamic instability

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

evaluation of spontaneous abortion

A

US findings

hcg for change/discriminatory zone

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

diagnostic criteria for spontaneous abortion

A

empty gestational sac 2.5 cm or unchanged

HCG above discriminatory zone w.o viable fetal pole

previous viable fetus w. no cardiac activity

fetal pole > 7 weeks by CRL w.o cardiac activity

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

management of spontaneous abortion (3)

A

expectant

medical (misoprostol)

surgical (d&c)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

obstetric causes of second/third trimester bleeding

A

labor

abruption

placenta/vasa previa

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

2 major causes of 2nd/3rd trimester bleeding to know

A

placental abruption

placenta previa

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

rf for placental abruption

A

HTN

nicotine/tobacco, amphetamines, caffeine

trauma

rupture of membranes

prior hx

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

dx for for placental abruption

A

clinical → painful bleeding in 2nd/third trimester

17
Q

management of placental abruption

A

acute blood loss protocol (type and screen)

fetal monitoring

+/- steroids

consider timing and mode of delivery

18
Q

major rf to know for placenta previa

A

prior uterine surgery

19
Q

painless vaginal bleeding in 3rd trimester is highly suggestive of

A

placenta previa

20
Q

major differentiating sx between placental abruption and placenta previa

A

abruption: painful bleeding
previa: painless bleeding

21
Q

exam to avoid for placenta previa

A

digital exam

22
Q

t/f: speculum exam is ok in placenta previa

A

T!

just not digital

23
Q

management of placenta previa

A

acute blood loss protocol (type and screen)

+/- steroids

inpt vs outpt (3 strikes rule)

consider timing of delivery

24
Q

2 common causes of early pregnancy bleeding

A

ectopic pregnancy

spontaneous abortion

25
miscarriage management (3)
expectantly medically surgically
26
ectopic pregnancy management (2)
medical surgical
27
2 major causes of 2nd/3rd trimester bleeding
placental abruption → painful placenta previa → painless
28
2 major rf for postpartum bleeding
happened before atony
29
what is atony
loss of tone of uterus
30
mc cause of postpartum hemorrhage
atony!
31
big warning sign for postpartum hemorrhage
bleeding gets heavier a week after delivery
32
initial management of PPH
uterotonics