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Women's Health > Miscellaneous > Flashcards

Miscellaneous Flashcards

1
Q

N/V up to 16 weeks is considered _____.

A

Morning sickness

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2
Q

Severe, excessive N/V associated with weight loss and electrolyte imbalance that persists > 16 weeks is known as _____.

A

HEG- Hyperemesis Gravidarum

*Multiple gestations and molar pregnancies are RFs

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3
Q

Acidosis (from starvation) and metabolic hypochloremic alkalosis (from vomiting) are associated with ____.

A

HEG

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4
Q

1st line antiemetics during pregnancy are:

A
  • Pyridoxine (Vitamin B6)
  • Doxylamine (antihistamine)
  • Promethazine
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5
Q

Fetal Hydrops is fluid accumulation in 2 or more spaces including:

*May be associated with effects of Rh alloimmunization on subsequent newborns

A
  • pericardial effusion
  • ascites
  • pleural effusion
  • subcutaneous edema
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6
Q

Rhogam is given at ___ weeks gestation AND within ___ hours of delivery of an Rh positive baby OR after any potential mixing of blood.

A

RhoGAM given at 28 weeks and within 72 hours of delivery

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7
Q

How is erythroblastosis fetalis treated?

A

Antigen-negative RBCs through US-guided umbilical vein transfusion

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8
Q

When do you screen for gestational DM?

A

24-28 weeks gestation through 50g oral glucose challenge test

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9
Q

If blood glucose is ≥ ____ mg/dL after 1 hour then you should perform 3 hour oral GTT.

A

140

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10
Q

_____ is the gold standard for diagnosing gestational DM.

A

3 hour 100g oral GTT

Positive if:

  • Fasting > 95
  • 3 hour > 140
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11
Q

_____ is treatment of choice for gestational DM.

A

Insulin (doesn’t cross placenta)

*Glyburide doesn’t cross placenta but there’s a higher risk of eclampsia

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12
Q

Treatment goal for gestational DM is fasting glucose < ____.

A

95 mg/dL

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13
Q

If gestational DM is uncontrolled/macrosomia then labor induced at ___ weeks. If it is controlled and there is no macrosomia then at ___ weeks.

A

Uncontrolled- 38 weeks

Controlled- 40 weeks

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14
Q

Mothers with gestational DM have a ___ chance of developing DM post-baby and a ___ chance of recurrence with subsequent pregnancies.

A

50%

*Mothers should be screened at 6 weeks postpartum for DM and yearly afterwards

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15
Q

HTN with NO proteinuria AFTER 20 weeks gestation is known as _____.

A

Gestational (Transitional) HTN

*Resolves 12 weeks postpartum

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16
Q

HTN with proteinuria +/- edema AFTER 20 weeks gestation is known as _____.

A

Preeclampsia

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17
Q

Mild preeclampsia defined by a BP ≥ ___ / ___.

A

140/90

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18
Q

Severe preeclampsia defined by a BP ≥ ___ / ____.

A

160/110

  • May have thrombocytopenia +/- DIC
  • *May have HELLP Syndrome–> Hemolytic anemia, Elevated Liver enzymes, Low Platelets
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19
Q

Management of mild and severe preeclampsia…

A

Mild: Delivery @ 37 weeks gestation

Severe: PROMPT DELIVERY ONLY CURE + Mag Sulfate to prevent eclampsia szs

BP Meds: Hydralazine and Labetalol

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20
Q

Preeclampsia + Seizures is known as ____.

A

Eclampsia

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21
Q

Management of eclampsia…

A

ABCDs

  • Mag sulfate for szs
  • Deliver fetus once patient is stabilized
  • BP meds!
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22
Q

HTN BEFORE 20 WEEKS gestation or before pregnancy is known as ____.

A

Chronic HTN

23
Q

How is mild HTN monitored?

A

Weekly NST during 3rd trimester, serial BP, and urine protein

24
Q

How is moderate/severe HTN managed?

A

Meds if BP ≥ 150/100

  • METHYLDOPA is treatment of choice
  • Labetalol good option too
25
Q

3 categories of abnormal labor progression include:

*Hint: think 3 P’s

A
  1. Power- uterine contraction
  2. Passenger- presentation size or position of fetus
  3. Passage- uterus or soft tissue abnormalities
26
Q

The ____ maneuver is a non-manipulative approach to the treatment of shoulder dystocia. It helps to increase the pelvic opening with hip hyperflexion.

A

McRoberts

27
Q

The _____ maneuver is a 180 shoulder rotation for shoulder dystocia.

A

Woods (Corkscrew)

28
Q

______ test is used to diagnose PROM. It turns blue if pH > 6.5.

A

Nitrazine Paper Test

normal amniotic fluid is 7.0-7.3 and vaginal pH is 3.8-4.2

29
Q

Crystallization of estrogen and amniotic fluid is seen through the ____ test to diagnose PROM.

A

Fern Test

30
Q

How is PROM managed?

A

Await for spontaneous labor and monitor for infxn (chorioamnioitis or endometritis)

31
Q

Umbilical cord prolapse

A

See study guide

*C-section in many cases

32
Q

Regular uterine contractions (>4-6/hr) with progressive cervical changes before __ weeks gestation is known as Premature Labor.

A

37

*MC cause of perinatal mortality

33
Q

PTL defined as cervical dilation > ___ cm and ≥ ___ % effacement.

A

> 3cm and ≥80% effacement

34
Q

Presence of fetal ____ between 20-34 weeks strongly suggests PTL.

A

Fibronectin

35
Q

_____ is given to enhance fetal lung maturity if L:S ratio < 2:1 and <34 weeks gestation.

A

Betamethasone

*Tocolytics can be given for up to 48hrs to delay delivery so steroids can take effect on fetus

36
Q

Tocolytics in labor…

A
  • Indomethacin: 24-32 wks
  • Nifedipine: 32-34 wks (or 2nd line for 24-32 wks)
  • Mag Sulfate
37
Q

_____ is given for abx prophylaxis in patients with GBS.

A

Ampicillin followed by PO Amoxicillin and Azithro

Allergy–> Cefazolin followed by PO Cephalexin and Azithro

38
Q

What are some contraindications to induction of labor?

A
  • prior uterine rupture
  • prior c-section
  • active genital herpes infxn
  • umbilical cord prolapse
  • placenta previa or vasa previa
  • transverse fetal lie
39
Q

Early induction v. late induction agents…

A

Early induction: promotes cervical ripening in women with unfavorable cervixes- Prostaglandin gel or balloon catheter

Later induction: if cervix is dilated < 1cm with some effacement-
IV Oxytocin (Pitocin)

*Amniotomy (artificially rupturing membranes with small hook) can be done if cervix is partially dilated and there is effacement

40
Q

Normal fetal HR is between ___ and ___.

A

120-160bpm

41
Q

Reactive NST is ___ (good/bad).

A

GOOD

42
Q

A positive CST is ____ (good/bad).

A

BAD

43
Q

The MC cause of postpartum hemorrhage is ____.

A

Uterine atony: uterus unable to contract to stop the bleeding.

PE- soft, boggy uterus with dilated cervix

44
Q

Management of postpartum hemorrhage entails:

A
  1. Bimanual uterine massage and treat underlying cause

2. Uterotonic agents like pitocin or misprostol (only if uterus is soft and boggy)

45
Q

_____ is the biggest RF for Endometritis (infxn of the uterine endometrium).

A

C-section

*also prolonged ROM >24hr, vaginal delivery, dilation and curettage (or evacuation)

46
Q

_____ + ______ is given for an endometritis infxn post c-section.

A

Clindamycin + Gentamicin (may add Ampicillin for GBS coverage)

47
Q

_____ + ______ is given for infxn after vaginal delivery or chorioamnionitis.

A

Ampicillin + Gentamicin

48
Q

Prophylaxis for endometritis involves what class of medication?

A

1st generation cephalosporin x 1 dose during c-section

49
Q

Fever + soft, tender uterus and lochia +/- foul odor after giving birth is associated with what dx?

A

Endometritis

50
Q

Hyperplasia due to continuous unopposed estrogen is known as ____ hyperplasia.

A

Endometrial hyperplasia

*Often occurs within 3 years of estrogen-only treatment and MC POSTMENOPAUSAL

51
Q

Common cause of postmenopausal bleeding is _______.

A

Endometrial hyperplasia

52
Q

Endometrial hyperplasia is diagnosed by what modality?

A

TVUS- endometrial stripe >4mm

*ENDOMETRIAL BX IS DEFINITIVE DX

53
Q

Treatment of endometrial hyperplasia WITHOUT atypia is:

A

Progestin (PO or Mirena)

*repeat endometrial bx in 3-6 mos

54
Q

Treatment of endometrial hyperplasia WITH atypia is:

A

Hysterectomy

Women's Health (8 decks)

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