Brainscape's Knowledge GenomeTM

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


See full index

OB/GYN > Learnin on the Job > Flashcards

Learnin on the Job Flashcards

1
Q

Normal days in a menstrual cycle

A

Normal is 26-35

So 14 yo/31 days/5 days is normal…

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

3 risks of oxytocin

A
  1. tachysystole
    - baby doesn’t have enough time to recover btwn contractions bc uterus doesnt fully contract
  2. severe hyponatremia
    - 2/2 oxytocin cross-reactivity w/ ADH receptors
  3. neonatal hyperbilirubinemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

4 steps of resuscitation when you see a category 2 fetal heart tracing

A

3 things to increase blood flow to the baby (by increasing O2 to mother)

  1. turn mother on side: decrease compression of IVC
  2. IV fluid bolus (increase volume)
  3. O2 face mask (controversial)
  4. hold any augmentation (ex: pit)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a modified BPP?

A

Modified BPP = AFI + NST

Modified biophysical profile = measure amniotic fluid index and do nonfetal stress test

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

List the normal values for a OGTT

A 
OGTT: give 100g load
fasting: under 95
1 hr: 180
2 hr: 155
3 hr: 140
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Differentiate the two steps of induction of labor

A
  1. Cervical ripening
    -evaluate w/ Bishop score (favorable if over 6)
    Agents: foley balloon, cytotec, cervidel
  2. Augmentation of labor w/ Pit + AROM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Define a category III fetal heart tracing

A

Absent variability w/ repetitive variables OR repetitive late decels, or fetal bradycardia (under 110) or sinusoidal pattern

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

What is a prolonged decel?

A

Becomes a prolonged tracing (decel/accel) after lasting for over 2 minutes

If lasts over 10 minutes = change in baseline

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

Describe augmentation of labor

  • when indicated
  • 2 mechanisms
A

Augmentation of labor: once cervix is favoriable (Bishop over 6)

  1. Pit
  2. AROM
    - extremely effective in multips
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Lab abnormalities seen in infants born to GDM mothers

A

hypoglycemia
hypocalcemia
hyperbilirubinemia (jaundice)

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

Define a fetal heart rate acceleration

A

15 bpm above baseline for 15+ seconds

If under 32 weeks: 10bpm above baseline for 10+ seconds

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

Key measure of fetal pH status

A

FHR variability in the single best indicator of fetal acidemia

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

Where is AFP produced?

A

Towards end of pregnancy- AFP almost primarily produced by the fetal liver

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

GDMA2 at 38 wks w/ well controlled diabetes- what is the delivery plan?

A

Expectant management- if GDM is well controlled, don’t need to have a different than usual birth plan

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

Differentiate the 3 cervical ripening agents

A
  1. foley balloon- mechanically dilate to 3/4 cm to cause endogenous release of prostaglandins
    - only method indicated in TOLAC
  2. exogenous PGE1 = Cytotec (misoprostol)
    - tab placed vaginally
  3. exogenous PGE2 = Cervidel (Dinoprostol)
    - benefit that it is on a string

Both 2/3 are contraindcated in TOLAC pts 2/2 increased risk of uterine rupture

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

Risk of uterine rupture w. TOLAC

A

W. One prior c section- risk of uterine rupture is 1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Risk of post-term delivery to the fetus

A

The placenta expires! Calcifies => increased risk of fetal demise

18
Q

Define a category I fetal heart tracing

A

Normal baseline HR (110-160) w/ moderate variability (6-25)

  • w/ OR w/o accels (don’t need accels!)
  • NO late or variable decels (but there can be earlys!!)
19
Q

Goal blood glucose levels for GDM

A

Goals:

fasting under 95, 2 hr postprandial under 120

20
Q

List the normal values for a GCT

A

GCT (glucose challenge test) = GDM screening test

50g load: considered positive if one hr later blood glucose is over 130-140

21
Q

Why is methergine contraindicated in pts w/ h/o HTN?

A

B/c methergine is a vasoconstrictor => could cause crazy high dangerous BP

22
Q

Name the exact criteria for diagnosis of PCO

A

Rotterdan’s criteria: 2 of 3 = PCO

  1. clinical evidence of hyperandrogenism
  2. ultrasound finding of PCO (ex: pearl necklace- aka tons of follicles that haven’t been ovulated)
  3. abnormal menstrual cycle
23
Q

Quad screen results associated w/ gastrochiesis

A

Elevated AFP, normal beta-hCG estriol and inhibin A

24
Q

Quad screen results associated w/ increased risk of trisomy 21

(a) Another test to confirm quad screen results

A

Down’s: low AFP, elevated beta-hCG, low estriol, high inhibin A

(a) Do nucchal thickness, thicker nuccal translucency associated w/ Downs

25
Q

Give some etiologies of uterine size being larger than predicted for gestational age

A
  • error in measurement (medical student measured…)
  • polyhydramnios
  • twins
  • fibroids (often grow during pregnancy)
  • fetal macrosomia
  • full bladder
26
Q

What do the different types of decelerations indicate?

A

Early decels = fetal head compression
-mirror image of contractions, seeing compression of ICP

Late decels = sign of uteroplacental insufficiency => most concerning

Variable decels = umbilical cord compression

27
Q

Mother at 24 weeks p/w GBS UTI, when do you retest for colonization?

A

You don’t, GBS UTI is considered colonization => treat as GBS+ and don’t need to retest

28
Q

When do we treat GBS? Why then?

A

Give penicillin for GBS+ at labor- no point in treating mother earlier, b/c mother is colonized and she’ll just recolonize

29
Q

While responding to an obstetric hemorrhage team- why is it relevant is the pt had preeclampsia?

A

Preeclamptics don’t have nearly as large an increase in their blood volume during pregnancy => they tolerate a smaller amount of blood loss

Ex: Preeclamptic F may increase blood volume by only 10-20% (instead of the average 50%), so a EBL of 1,200L may cause much more severe consequences

30
Q

Etiologies of AFP elevation

A

Elevated maternal serum AFP:

  • neural tube defects
  • abdominal wall defects: gastrochiesis (no sac) and omphalocele (sac)
  • anything that increases fluid around baby: esophageal atresia etc
31
Q

Mechanism by which HPL can induce gestational diabetes

A

HPL (human placental lactogen) induces lipolysis => increased free fatty acids = increased substrate for gluconeogenesis

32
Q

When is the quad screen perfromed

A

At 15-20 weeks

33
Q

Contraindications to induction of labor

A
  • abnormal lie (traverse/breech)
  • vasa previa/ placenta accreta
  • prior classical incision, uterine rupture, or or transmural incision on myomectomy
34
Q

Mechanism by which gestational diabetes causes fetal macrosomia

A

Maternal glucose (not maternal insulin!) crosses the placenta => induces fetal hyperinsulinemia, and insulin is an anabolic/growth stimulating hormone => macrosomia

35
Q

Medically- why aim for TOLAC over C-sxn

A

When all is said and done C-sxn holds a higher rate of maternal mortality

36
Q

4 parts of the quad screen

A
  1. beta-hCG
  2. inhibin
  3. AFP
  4. estradiol
37
Q

Postpartum follow up for GDM mothers

A

OGTT at 6-12 weeks postpartum

38
Q

Quad screen results associated w/ increased risk of trisomy 18

A

Edward’s: low AFP, low beta-hCG and low estriol, normal inhibin A

39
Q

Define tachysystole

A

Tachysystole =more than 5 contractions in 10 minutes averaged over 30 minutes

40
Q

Bishop score

  • components
  • utility
A

Bishop score = ‘cervix’ score to predict cervical favorability for labor
-predict need for cervical ripening agents

Bishop score of 6 or under predicts needing cervical ripening agents (foley balloon, cervidel, cytotec)

5 components, each gives 0-2 pts

  1. cervical dilation
  2. cervical effacement
  3. fetal station
  4. cervical consistency
  5. cervical position

OB/GYN (10 decks)

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