MT Flashcards
Earliest detection of serum HcG after ovulation?
9 d
In what case would you want a quantitative HcG?
Complications (ectopic preg)
To see if Hcg is rising or falling use this type of test
Serial beta HcG
How you determine if a pregnancy is viable?
TVUS at 6 weeks. Looking for heartbeat
Give some reasons for doing a 1st trimester US?
To get an accurate due date (premature, know that you are interpreting labs correctly, irregular menses or nursing), complications (pelvic pain, bleeding), eligibility for hospital birth
One reason for an accurate due date?
Know that you are interpreting labs correctly
Questions to ask in vaginal bleeding during pregnancy
How long? How much? Color? Size? Cramping?
DDx for vaginal bleeding during pregnancy
Cervicitis, vaginal lesions, polyps, threatened miscarriage, ectopic pregnancy, physiologic bleeding, intercourse
At 7 wks, would US rule in/out spontaneous abortion?
Yes, would expect heartbeat
Common etio for spontaneous abortion?
Chromosomal abnormality, progesterone deficiency, trauma, invasive procedure, uterine infx, teratogen, endocrine problem, thrombophilia, congenital abnormality
DDx for nagging RLQ pain?
appendicitis, ectopic preg, ovarian cyst, diverticulitis
Where do most ectopic pregnancies implant?
fallopian tube
Risks for ectopic preg?
Tubal surgery, tubal infx, DES exposure, infertility, previous PID, having IUD, previous STI infection
What are the risks to a woman who experiences a ruptured ectopic pregnancy at 6-12 wks?
Internal bleeding, shock, death.. medical emergency
How to Dx R/o ectopic preg
Repeated US and serum HcG
Tx options for ectopic preg
methotrexate or surgery
When should prenatal care begin?
By the end of the 1st trimester
What is the initial lab workup for a gravid female?
CBC, hepatitis, rubella, antibody screen, syphilis, HIV, urine culture, pap, gonorrhea, chlamydia, blood type testing
How much weight gain is advised during pregnancy?
Avg 25-35 lbs, depending on weight (gain more if lower weight)
1 lb per week, no dieting
Nutritional advice for pregnancy?
Increase protein, regular meals, eliminate deli meat and raw fish, increase veggies, take multivitamin
When does implantation occur?
1 wk after fertilization
Effects of smoking on fetus
Placental abruption, prematurity, stillbirth, decreased o2 to baby, SIDS, respiratory diseases in baby
What is responsible for nausea in pregnancy?
Increased bHcG, increased peristalsis, progesterone
What causes decrease in nausea?
Resolves as placenta takes over hormone secretion and secretes hormones more evenly
What are some remedies for nausea?
B6, K, C, ginger, mint, nux vomica, sepia, pulsatilla
Key symptom and DDx for hyperemesis gravederim
uncontrolled N/V
could be stomach flu, appendicitis, gall bladder disease
SSx of anemia
SOB, fatigue, lab values
remedies for anemia
rhumex, nettles, teraxicum
risks of anemia during pregnancy
post pardum hemorrhage
When in pregnancy is fetus most susceptible to teratogens?
5-10 wks
When else in life are you most susceptible to teratogens?
Neonate, newborn, adolescence, breast feeding
How to facilitate oxytocin release
relax, dim lights, silence, not being watched
What is likely cause of sleepiness during 1st trimester?
progesterone
Herbal remedies for insomnia
valerian, chamomile
How to Dx FAS, FAE
Prenatal or postnatal in weight or head circumference, flat nose, cognitive impairment, underdevelopment of genitalia
