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ObGyn Lecture > Lecture 12 > Flashcards

Lecture 12 Flashcards

1
Q

What type vaccines do you not give pregnant women?

A

Live virus vaccines

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2
Q

What is the goal of preconception counseling

A

Optimize a woman’s health pre-pregnancy

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3
Q

What is one of the first things that change with pregnancy?

A

Breast tenderness

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4
Q

When does softening and enlargement of the uterus happen?

A

6 weeks into pregnancy

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5
Q

What is when the vagina seems congested and is blueish?

A

Chadwick sign

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6
Q

WHat is the sign associated with softening of the cervix?

A

Hegar sign

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7
Q

What test is used to confirm pregnancy?

A

Urine or serum hCG (human chorionic gonadotropin)

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8
Q

The hCG beta quant should do what in early pregnancy?

A

Double about every day

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9
Q

Which is more sensitive, urine or serum hCG?

A

Serum

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10
Q

TVUS can detect pregnancy at how many weeks?

A

3-4 weeks gestation Beta HCG 1000-2000)

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11
Q

When can you visualize the fetus via abdominal US?

A

5-6 weeks (can see a gestational sac)

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12
Q

B/w what weeks is there doppler detection fo fetal haert tones?

A

10-12 weeks

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13
Q

What is EGA?

A

Estimated gestation age

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14
Q

What is EDD?

A

Estimated date of delivery

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15
Q

When is CVS performed?

A

> 10 weeks

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16
Q

When is amniocentesis usually performed?

A

15-20 weeks

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17
Q

When is cordocentesis performed?

A

> 20 weeks GA

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18
Q

What 3 tests are performed in the first timester (10-13 weeks)?

A

HcG (quantitative)
PAPP-A
CVS

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19
Q

What does a decrease in PAPP-A indicate?

A

Aneuploidy (abnormal chromosome number)

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20
Q

What makes up the triple test (what do you add for quad)?

A

AFP (alpha fetal protein)
Estriol
Hcg
(inhibin A- only quad)

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21
Q

Do values in the triple/ quad screen vary by race?

A

Yes

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22
Q

How often do you see women under 28 weeks?

A

Every 4 weeks

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23
Q

What is the normal range for fetal heart tones?

A

120-160 bpm

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24
Q

What maneuvers are used to determine fetal presentation?

A

Leopold maneuvers

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25
Q

What do you look for on urine in a normal ob exam?

A

Glucose

Protein (albumin)

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26
Q

What is external cephalic version (ECV)?

A

Where you turn the baby so they don’t present breech. Done at 36-38 weeks

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27
Q

If the fundal height is at the umbilicus, what week are they probably at?

A

20 weeks

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28
Q

What are some routine labs?

A 
CBC
RPR?FTA
glucose
blood type/ rH
urinalysis
Group B strep
BMP
STD: gc, chlamydia, hep B
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29
Q

What is associated with genetic defects and you need to get a profile on?

A

Rubella

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30
Q

At what week does the 3rd trimester start?

A

28 weeks

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31
Q

What is an indirect way to measure fetal activity?

A

Fetal kick counts

32
Q

How many fetal kick count should there be in an hour?

A

4-10 kicks an hour

33
Q

What is the biophysical profile

A

Get an NST, look at breathing movement, look for gross body movements (GSM) on US, look at fetal tone, amniotic fluid index

34
Q

What is the normal range for biophysical profile

A

8-10

35
Q

What is a concerning number for biophysical profile?

A

Under 6

36
Q

What happens in breast in the first 8 weeks?

A

Nipple/ areola enlarge
Prominence montgomery tubercles
Ductal growth
Increased blood flow

37
Q

When is colostrum produced?

A

Later in pregnancy

leakage is common

38
Q

What happens to total serum calcium for the mom?

A

Decrease total serum calcium

39
Q

What is the hormone that leads to ligament laxity and joints loosen?

A

Relaxin

40
Q

What happens with the eyes to pregnant women?

A

Can have blurred vision due to cornea thickness.

Increased intraocular pressure due to fluid retention

41
Q

What happens to the thyroid hormone in pregnancy?

A

Gets larger

42
Q

What hormone becomes more prevalent in early pregnant?

A

free T4 (should level down after 14 weeks)

43
Q

Does Mom’s TSH cross the placenta?

A

No

44
Q

Does aldosterone synthesis increase or decrease?

A

Increase

45
Q

Does DHEA increase or decrease?

A

Decrease (favor estrogen)

46
Q

What is Ptyalism?

A

Feeling of excess saliva

47
Q

Why do pregnant women have heart burn?

A

Decreased esophageal sphincter, increased gastric pressure and delayed gastric emptying

48
Q

Why are women more constipated when pregnant?

A

Takes longer for food to go from stomach to cecum

49
Q

What happens with a lipid profile in pregnant women?

A

All levels go up

50
Q

What may happen with total albumin?

A

Serum decreases (not really decreases, just over a larger volume)

51
Q

What GI conditions are pregnant women more at risk for?

A

Cholecystitis and gallstone

52
Q

What happens with glucose levels in pregnant women?

A

blunted response to glucose load  postprandial hyperglycemia

53
Q

What increases in the CV in the first part of pregnancy?

A

Increased stroke volume

54
Q

After increased stroke volume, what happens to the heart?

A

Heart rate increases (more circulating blood volume and less PVR)

55
Q

How much does cardiac output increase by?

A

30-50%

56
Q

Where does the heart shift with pregnancy?

A

Up and left

57
Q

Women who are pregnant are in what type state hematologically?

A

Hyper-coagulable state w/ increased risk of DVT

58
Q

in pregnancy, the dilutional affect on the RBCs leads to a decreased H and H known as what?

A

Physiologic anemia

59
Q

What do the kidneys increase the excretion of to compensate for decreased PCO2?

A

Serum bicarb

60
Q

Do the kidneys enlarge?

A

yes

61
Q

What levels will decreased with renal values?

A

BUN
creatinine
Uric acid

62
Q

GFR increases by how much in pregnancy?

A

50%

63
Q

What 2 things will be excreted more in pregnant women?

A

Vitamin B12

Folic Acid

64
Q

What is the only antibody going across the placenta?

A

IgG

65
Q

What hormone does the placenta produce?

A

human placental lactogen (HPL)

66
Q

when does fetal bone marrow begin production?

A

Weeks 21-22

67
Q

Where does surfactant secretion begin?

A

Week 26

68
Q

What is the name for fetal waste?

A

meconium

69
Q

How is bilirubin eliminated in womb?

A

Placenta

70
Q

Birth defect where infants intestines are born outside the abdominal cavity.

A

gastroschisis

71
Q

What makes a male, male?

A

Gene trigger

72
Q

When does the thyroid develop?

A

End of 1st trimester

73
Q

What weeks does the 4 chamber heart form?

A

5-8 weeks

74
Q

When are lungs able to breathe without assistance?

A

28 weeks

75
Q

When does meconium begin to accumulate?

A

18 weeks

76
Q

When are gonads differentiated?

A

6-8 weeks

77
Q

When do the fetal kidneys produce urine? And how much urine do they produce

A

11-12 weeks; 400-1200 ml urine/day

ObGyn Lecture (21 decks)

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