midterm Flashcards
How can HcG be measured and what are the timeframes?
urine or blood
Urine: 9 days after missed period
Blood: 9 days after ovulation
*quantitative hcg just to see if pregnant
How do you determine if a pregnancy is viable?
TVUS at 6 weeks
looking for heartbeat
What are specific reasons to do an US in first trimester?
to get an accurate due date
Why do you want to know the specific due date?
so you know if baby is growing properly
uncertain about dates
if signs and symptoms don’t make sense for due date
eligibility for out of hospital birth
If someone has vaginal bleeding in pregnancy, what questions would you ask?
- how long
- how much? Soaking pad, how many, what kind?
- color of blood
- cramping?
Differential dx for vaginal bleeding?
cervicitis from infection ectropian vaginal lesions polyps ectopic pregnancy threatened miscarriage intercourse
What would you do for cramping at 7 weeks?
TVUS would rule out or in miscarriage
what would cause a spontaneous abortion?
chromosomal abnormalities congenital abnormalities trama teratogens uterine abnormality endocrine problems
diff dx for new pregnancy with LRQ pain?
appendicitis
ectopic
ovarian cyst
where is the most common place for an ectopic pregnancy?
fallopian tube
what increases the risk of having an ectopic pregnancy?
IUD
previous or current STI
tubal pathology
DES exposure
At what point in gestation do you see ectopic pregnancy?
6-8 weeks
8-12 weeks is when they rupture
How do you rule out an ectopic pregnancy?
US
How do you treat ectopic pregnancy?
surgery or methotrexate
when do you want to establish prenatal care?
by end of first trimester or earlier (better)
What are two tests that you would run during first workup?
CBC Hep Rubella titer HIV syphyllis TSH Urine culture
Why would you do blood type?
If Rh negative would need to do Rogan if she miscarries
What advice would you give about weight gain in pregnancy?
25-35lbs is normal
If she is heaver, then less
If she is lighter, than more
About 1lb a week is normal
When does implantation occur?
5-7 days after fertilization
5 weeks into pregnancy
Why is smoking dangerous?
placental abruption
premature
still birth
decreased birth weight
Why is there nausea in pregnancy?
When does it end?
increased Hcg
increased progesterone
decreased peristalsis and hcl
* resolves when placenta takes over at beginning of 2nd trimester
List 2 vitamins for nausea
B6
K
vit c
List 2 herbs for nausea
mint
ginger
catnip
raspberry leaf
homeopathy to help nausea
ipecac
sepia
symphoricarpus
what remedy would you use for weepiness
pulsatilla
sepia
hyperemesis graviderum
severe intractable nausea and vomitting
in weeks 8-12 and usually over by 16.
2 ddx for stomach pain
appendicitis
kidney infxn
2 herbs for SOB with anemia
teraxacum
rumex crispus
2 risks with anemia
post partum hemorrhage
preterm birth
preeclampsia
When is a person susceptible to teratogens
week 5-10 during organogenesis
neonate
breast in luteal phase
adolescents
best way to release oxytocin
low lights
relax
privacy
what causes sleepiness in first trimester?
progesterone
herbs for insomnia
skutellaria
passaflora
valerian
how do you diagnose fetal alcohol syndrome?
pre/post delay in head circumference
narrow lip without groove
cognitive impairment
when are babies most susceptible to teratogens that cause neural tube defects?
neural tube defects
anencephaly wk 5-6
mental retardation wk 18
CNS problems 34-40
when are babies most susceptible to teratogens that cause heart defects?
septal defects wk 5-8
heart defects wk 8.5-10
