Brainscape's Knowledge GenomeTM

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


See full index

P&T Block 5 Renal > L72 + 73 > Flashcards

L72 + 73 Flashcards

1
Q

Most common site for ectopic pregnancy

A

Tube - ampulla

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

RFs ecoptic

A 
Use assisted repro tech
Prev tube surg // ectopic 
Infections (PID)
Endometriosis
Smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Presentation of ectopic

A

Ab pain + skipped period + vag bleeding

Symptoms/vitals will depend on amt of blood loss

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

How should BhCG change during a normal preg

A

Double every 48 hrs (66%)

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

What BhCG means you should be able to see a fetus in the uterus?

A

> 1500

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

Treat ectopic

A 
MTX - f/u for BhCG fall
Lapro = treat
1. Salpingostomy = remove ectopic
2. Salpinectomy = remove tube
D&C - certain det of uterine preg (when don't see fetus on US)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What molecule normally suppresses delivery?

A

Progesterone -> increase CRH in bound form

Suppress production of ACTH (pit) and cortisol + DHEA (adrenal cortex)

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

Describe physiology of contractions

A 
Less CRH
More ATCH from ant pit -> says adrenals produce 
1. Cortisol -> PGE
2. DHEA -> E (now E > P)
Changes in the myometrium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does pre-term birth happen?

A

Some inflam triggers the normal physiology to start early

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

TESTQ: what is the def of pre-term labor

A

Regular uterine contractions causing cervical change before 37 wks

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

RF pre-term birth

A

Prev pre-term birth
Multiple kids
Bleeding in preg

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

What is fetal fibronetin

A

Swab vagina - amniotic fluid will form crystals on slide
High NEGATIVE predict value - don’t see it, you’re not having pre-term labor
Positive doesn’t tell you anything

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

Treat pre-term birth

A

Delay to 34 wks

  1. IV fluid bolus - if dehydrated, will start contractions
  2. Tocolysis
  3. Steroid - promote lung maturity
  4. Mg - neuro protective in baby
  5. Grp B strep if you’re moving towards delivery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Meds to stop pre-term labor

A

Tocolysis
Mg
Nifedipine = Ca CB
Indomethacin = block PG, going to close PDA

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

CI to tocolysis

A

Infection - just deliver
Sig vag bleeding
After 34 wks - just deliver

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

What is PPROM

A

Preterm premature rupture of membranes

Dx by fluid coming out of the vagina

17
Q

2 tests to confirm PPROM

A

pH (nitrazine) - amniotic fluid should be basic

Ferning - shows crystals on slide

18
Q

Risks of PPROM

A

Infection - opening in the cervix!
Cord prolapse
Abruption
Pulm hypoplasia - depends on how early the rupture

19
Q

Treat PPROM

A

Antibiotics - also helps to stop contractions
Steroids
Tocolysis if contracting

20
Q

Describe the 4 different types of HTN you might see in preg

A

> 140/90
Chronic HTN - existing that continues in preg (pre-20 wks)
Gestation HTN - BP returns to normal after delivery
Pre-eclampsia
Eclampsia = seizures during or after delivery

21
Q

Presentation of pre-eclampsia

A

HTN + proteinuria or if no proteinuria then one symptom of HTN

22
Q

What are signs of severe pre-eclamp

A 
Care b/c change management
Higher BP
TCP
↑LFTs
↑Cr > 1.1
Pulm edema
23
Q

What is HELLP syndrome

A

Variant of severe pre-eclamp

Hemolysis + ↑LFTs + TCP

24
Q

RF pre-eclamp

A

Never preg before
AA
Twins +

25
Q

Pathophys of pre-eclamp

A

Blasts didn’t invade enough into the myometrium

Don’t lose arterial smooth muscle as should

26
Q

What triggers pre-eclamp

A

Placenta dysfxn secretes factors that bind ligands normally protective
Endothelial dysfxn -> vessels constrict -> ↑BF velocity -> ↓O2 to fetus

27
Q

4 organs in addition to placenta effected by pre-eclamp

A

Kidney - ↑Cr, proteinuria
Brain - swelling = ↑seizures
Liver - swelling, RUQ pain, ↑LFT, TCP
Microvasc hemolysis

28
Q

Treat pre-eclamp

A

Get to 34 wks if at all possible

+ Mg = delay delivery + prevent seizure

29
Q

Long term effects of pre-eclamp

A

Lifelong ↑vasc risk

Metabolic syndrome or HTN

30
Q

2 possible causes of bleeding during preg + 1st dx step

A

Placenta privia or abruption (+pain)

TESTQ: do US, NOT PE b/c you’d increase bleeding risk if privia

31
Q

Most common complication of twin + pregnancies

A

Pre-term delivery

32
Q

Name the 4 types of twin possibilities + what see on US

A
  1. Dichor diamnio = 2 separate preg (fraternal twins) lamda sign
  2. Monochor diamnio = 1 placenta, 2 sacs (identical twins) T sign
  3. Monochor monoamnio = 1 placenta, 1 sac (identical twins) see no membrane
  4. Conjoined twins
33
Q

TESTQ: RF for adherent placenta (placenta privia)

A

Prev C section - increasing C section rate means this problem is on the rise
Uterine infection
HTN
Smoking

P&T Block 5 Renal (30 decks)

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