Brainscape's Knowledge GenomeTM

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


See full index

Gynecology and obstetrics > NAGY OBS > Flashcards

NAGY OBS Flashcards

1
Q

Definition of gestational hypertension

A

BP over 140/90 measured two times four hours apart OR BP measured over 160/110 one time

After week 20

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

Rh isoimmunization

A

When mixing of maternal and fetal blood occur, and they are not compatible: placental abruption, bleeding during pregnancy, during labor

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

What to do with pregnant patients with type 1 DM?

A
  • Don’t do OGTT, it can kill the patient
  • Monitor blood glucose and HbA1c
  • Offer an abortion if patient gets pregnatn and has poorly controlled diabetes
  • Risk for the baby: congenital malformations, IUGR, hypoglycemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When do you diagnose IUGR in fetus? What do you look for?

A
  • Week 30-32
  • You have to compare with previous US
  • Head circumference, abdominal circumference, limb length
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do you do Leopold manouver?

A
  1. Fundal grip: feel the fundis, height of the fundus, breech or cephalic?
  2. Umbilical grip: localize fetal back
  3. Pelvic grip: fetal presenting part, breech or cephalic?
  4. Second pelvic grip: facing womans feet, attemt to locate brow with both hands, assess degree of flexion of fetal head
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What type of delivery in placenta previa?

A

C-section

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which CV disease are of highest risk in pregnancy?

A
  • Postpartum CMP
  • Eisenmenger syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What medications to use in induction and augmentation of labor?

A
  • Oxytocin
  • Intravaginal prostaglandin E2
  • Together with amniotomy, membrane sweep or balloon catheter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Whats the difference between umbilical cord prolapse and umbilical cord presentation?

A

In umbilical cord prolapse, the membrane has ruptured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What abnormal presentation and position of the fetus causes dystocia?

A
  • Persistent occipitotransverse or occipitoposterior presentation
  • Breech
  • Sholder presentation
  • Transverse lie
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the degrees of perineal tears and what anatomical structure is affected?// Can you mention a birth canal lesion?

A

1: Only perineal mucosa, no need to suture
2: Perineal mucosa and muscles (no sphincter), need to suture
3: External anal sphincter
4: Internal anal sphincter and rectal mucosa

Worst outcome: complete continuity between vaginal opening and opening to anal canal.

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

What prophylaxis for PPROM?

A
  • AB: 48 hr IV ampicillin+erythromycin, followed by po amoxicillin and erythromycin
  • If before 34 wog., use corticosteroids (bethamethasone) to promoote lung maturity
  • IV magnesium sulfate if before 32 weeks
  • Tx of chorioamnionitis: amp+genta
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Fetal head movements during labor

A
  1. Flexion
  2. Internal rotation
  3. Extension
  4. External rotation

??

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

How long does each of the 4 stages of labor last?

A

Stage 1: longest stage, around 20 hours
Latent: 0-3 cm
Active: 3-10 cm
Stage 2: 30-90 min
Propulsive stage (full dilation, descend to pelvic floor)
Expulsion stage (from pelvic floor to delivery of the baby)
Stage 3: shortest stage, 5-30 min
Expulsion of placenta and membranes
Stage 4: 2 hours
High risk of bleeding
Repair lacerations
RhoGAM: Rh D immune globulin is given to RhD negative mothers to prevent TTP

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

What to do if placenta took longer than 30 minutes to deliver, but you are not in a hospital?

A

NO TOUCH TECHNIQUE
Do not do uterine massage unless in the hospital with OB/GYN specialists due to risk of placental retention and PPH

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

What is the most common gastric malformation?

A

Ophalocele, gastroschisis, anal atresia

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

Advice to give pregnants to avoid toxoplasmosis

A

If the female has a cat, avoid any contact with the cat, either the husband takes care of it or leave it someplace else. Advice to wash her hand everyday the cat is in the house.

Avoid raw meat and unpasturised milk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do you measure AFI? And what is the cutoff values?

A

4 quadrant measurement of amnitic fluid, take the deepest pockets and add them together.

< 6 oligo
> 24 poly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What NYHA stage is contraindication to get pregnant?

A

Absolute CI: stage 4
Relative CI: stage 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Screening on cardiovascular patient that wants to get pregnant

A

NYHA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Hormonal changes in pregnancy

A
  • Increased production of TBG
  • Increased total T hormone, but T3 and T4 is the same
  • Increased BMR
  • Increased blood flow to the pituitary
  • Increased cortisol, ACTH
  • Increased prolactin, hCG and oxytocin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What UTIs do you not want in pregnancy?

A

Asymptomatic bacteruria can cause premature labor, PROM and low birth weight. Increased perinatal mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Why can breech cause dystocia?

A

Breech position can cause complications like:
- Umbilical cord prolapse
- Decreased O2 supply to fetus
- Head entrapment
- Injury to fetal brain and skull

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the connection between intrauterine fetal death and postterm pregnancy?

A

Postterm pregnancy is associated with higher perinatal mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the signs that the placenta has detatched in the 3rd stage of delivery?

A
  • Fresh blood from vagina
  • Umbilical cord lengthens outside vagina
  • Fundus rises up and uterus becomes firm and globular
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is to be said about smoking in pregnancy?

A
  • Dont do it
  • Causes hypoxia and vasoconstriction of vessels, can cause IUGR in fetus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How to treat 1-2 stage of labor?

A
  • Externally: Leopold manuver
  • Internal: CTG, BP, infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Which antihypertensives are contraindicated in pregnancy?

A

Propanolol, ACEi, ARBs, diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Why is cordocentesis done nowadays?

A
  • Percutaneous umbilical blood sampling
  • Just done in case you want to give blood transfusions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What maternal parameters help to determine potential cephalopelvic disproportion?

A

Maternal height/size -> short means higher chance of dystocia

But pelvic size and shape is also important

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What fetal parameters help to determine potential cephalopelvic disproportion?

A

Biparietal diameter ca 10 cm
Head circumference

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

How to do respiratory resucitation on a newborn?

A
  • Place newborn in warm environment, stimulate breathing by rubbing on chest
  • Positive pressure ventilation should be started if the HR is less than 100 after 30 sec and there is no breathing or gasping
  • If HR is still low after 60 sec, consider endotracheal intubation
  • If HR remais low besides adequate ventilation for 30 sec, start chest compressions (3:1 ratio)
  • If HR remains low despite adequate ventilation and chest compressions, give IV epinephrine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Common factor and difference between SGA and IUGR?

A

Both are in the lower 10th percentile of fetus size, but SGA is usually physiological while IUGR is always pathological.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Extragenital causes of pathological pueriperium?

A
  • Mastitis
  • UTI
  • Thromboplebitis
  • Atelectasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Which patients can get IVF immediately?

A

When they have tubal ligation (strictures)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is HEELP syndrome? How much thrombocytopenia do they have?

A
  • Hemolysis, elevated liver enzymes, low platelets
  • Missisippi classification of low platelets:

M3: Less than 150 G/L
M2: Less than 100 G/L
M1: Less than 50 G/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Does chomosomal abnormality cause symmetrical or asymmetrical IUGR?

A

Symmetrical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What hormones are responsible for onset of labor?

A

Cortisol in fetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

First stages after conception and how many cells?

A

Zygote (-1)
Morula (16)
Blastocyst (+32)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

When can we see thrombocytopenia in pregnancy?

A

TTP
HUS
HELLP
DIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Differentiation between placental abruption and placenta previa

A

The emphasis is on the rock hard uterus in abruption, not the pain, because all women will be stressed and pain is not a proper indication.

Abruption: painful, hard uterus
Previa: painless, CTG normal

42
Q

Drugs you can’t give during pregnancy

A

Antiepileptics, ACEi, folic acid inhibitors, coumarin

43
Q

Types of IUGR

A

Symmetric (fetal causes) and asymmetric (maternal and placental causes)

44
Q

What fetal position enables vaginal delivery of twins?

A

Only if the first fetus is in the proper position and no breech at all!

45
Q

What are some maternal causes of dystocia?

A
  • Cephalopelvic disproportion; inlet, outlet and midpelvis contraction
  • Pelvic shape: gynecoid, android, anthropoid, platypolloid
  • Trauma
46
Q

Cause of oligohydramnios

A

Decreased urine production of the fetus (renal agenesis)

47
Q

Definition of eclampsia

A

Unexplained generalized seizures in a patient with preeclampsia (>140/90 BP, > 300 mg/day proteinuria)

48
Q

Which classification do you use for pregnant women with cardiovascular disease?

A

New York Heart association (when do you feel short of breath?)

49
Q

What manuver is used in malpresentation?

A

Leopold

50
Q

In what stage of labor do the membrane rupture?

A

Late in the first stage, earliest 1 hour before labor starts.

51
Q

Why is it important to repair the cervix after lesions of birth canal and uterine rupture?

A

For possible future pregnancies

52
Q

What is important to determine with suspected IUGR?

A

Make sure you compare to the previous US to see if it might just be wrong estimation of gestational week or actual IUGR.

53
Q

What does a normal CTG look like?

A

1) Base frequency 110-160

Bradycardia< 110 for more than 3 min
Tachycardia > 160 for more than 10 min

2) Oscilliation/Variability should be > 5 per minute.

If there is a line the baby dies within 24-48 hours.

3) Accelerations are compared to BF. Elevations of 10-30 mm in 10-30 min

4) No deccelerations (asynchronized deccelerations means hypoxia)

54
Q

Drugs used in first and second stage of labor

A

??

55
Q

Advices during pregnancy.
What advice would you give?
Would you recommend physical exercise during 1st and 2nd trimester?

A
  • Exercise is recommended to continue as usual, rest when tired
  • No drugs, smoking, drinking!!
  • Folate supplement
  • Eat protein, healthy diet, weight can influence birth weight of infant!!
  • Avoid cats
  • Take into consideration thromboembolic events when flying
  • Proper use of seatbelt !!

( FROM YONI)

56
Q

Different types of transverse lie

A

Left-right
Facing up-down
Backwards-forwards

57
Q

Causes of macrosomia

A

Maternal diabetes
Maternal obesity
Genetic
Gestational age > 40 w

58
Q

What is the problem of cervical implantation?

A

Ectopic pregnancy -> high chance of life threatening bleeding

59
Q

What malpresentation requires c-section?

A

Transverse lie

60
Q

Gestational week of GDM screening

A

24-28th week

61
Q

Definition of abortion

A

Induced: Medical or surgical termination of pregnancy before 24th gestational week

Spontaneous: non-induced embryonic or fetal death or passage of products of conception before 24th gestational week

62
Q

Types of placenta previa and complications

A

Types:
- Total
- Partial
- Marginal
- Low-lying

Complications:
- Fetal malpresentation
- Vasa previa
- PPROM
- IUGR

63
Q

How often does a doctor or a nurse need to check on a woman in the 2nd stage of labor?

A

Continously

64
Q

Neonatal death from what week?

A

24th week

65
Q

Perinatal mortality rate

A

Number of late intrauterine deaths (from w24) + number of neonatal deaths (168h after) per 1000 live births

66
Q

How long does physiological pueripurim period last?

A

6 weeks

67
Q

What anesthesia do you use in C-section?

A

Spinal

68
Q

How to diagnose CMV infection?

A

Amniocentesis and look for viral genome

69
Q

What is the problem with PROM?

A
  • Infections
  • Abnormal presentation
  • Placental abruption
70
Q

What is the problem with UTI during pregnancy?

A

Ascending infection can lead to premature birth and PROM

71
Q

What could be the cause of dystocia even though position and presentation is normal?

A
  • Macrosomia
  • Shoulder dystocia
  • Maternal pelvic alterations
72
Q

What is a worrying sign in prolonged labor?

A
  • If the woman suddenly feels a sense of relief after straining a lot
  • If the baby is unable to pass through the birth canal and the uterus ruptures
73
Q

What is a sign of missed abortion?

A

See retained fetus in uterine cavity during routine prenatal care, absent fetal movements, risk of DIC

74
Q

What do you do in a patient with asymptomatic gallstones?

A

Wait and do elective cholecystectomy after pregnancy

75
Q

Causes of postpartum hemorrage

A
  • Trauma: laceration
  • Tone: atony
  • Tissue: placental part left in uterus
  • DIC: thrombin
76
Q

Superimposed preeclampsia?

A

Has chronic HTN before week 20 and gets >300mg/day proteinuria after week 20

77
Q

Consequences of hyperthyroidism in pregnancy

A
  • IUGR
  • Mental retardation
  • Elevation of BP
  • Abruption
78
Q

Physiological changes of thyroid during pregnancy

A
  • Increase in hCG may function as TSH
  • Elevation of TBG
  • Concentration of free thyroid hormone and TSH stays the same (but total T hormone increases)
79
Q

What is PPROM and what are the causes?

A
  • Preterm premature rupture of the membranes
  • Cause: ascending vaginal and cervical infections
80
Q

How would you diagnose interuterine death?

A

US

81
Q

Which of the breech malpresentations can be delivered vaginally?

A

Frank breech

82
Q

Who would you screen for DM?

A

Everyone should be screened w24-w28

83
Q

What are some physiological changes of pregnancy and CV changes?

A
  • Increase of HR, CO
  • Increase in plasma volume
  • Increase of RBF and GFR, decreased serum creatinine
84
Q

How to diagnose placental abruption/ What examination should you do first?

A

Physical exam, feel the fetal hypertonic uterus.

85
Q

How to diagnose uterine rupture?

A
  • Loss of fetal station
  • Nature of patient complain changes to diffuse abdominal pain in stead of contractions
86
Q

What is difficult with GI disorder in pregnancy?

A

Pregnancy may imitate symptoms such as leukocytosis and constipation (appendicitis, ileus, gallstone) and nause and vomiting, making them difficult to diagnose.

87
Q

What drugs do you give in preterm labor?

A

Bethametasone and AB prophylaxis

88
Q

What BP-drugs can you give in pregnancy?

A

Labetalol
Nifedipine
alpha-methyldopa

89
Q

Treatment of toxoplasmosis

A
  • Affected women during pregnancy: spiramycin
  • Infected fetus: pyrimethamine and sulfadiazine
90
Q

How to check if a fetus is infected with toxoplasmosis?

A

Do amniocentesis and check viral DNA

91
Q

Classification of C-section indications

A

ELECTIVE INDICATIONS
- Maternal: previous CS, underlying disease
- Fetal: threatened asphyxia
- Maternofetal: dystocia, prolonged labor, twin pregnancy

VITAL INDICATIONS
- Maternal: DIC, severe hemorrage
- Fetal: asphyxia, transverse lie, umbilical cord prolapse
- Maternofetal: eclampsia, uteroplacental insufficiency, placenta previa, placental abruption, uterine rupture

92
Q

How can you get toxoplasma?

A

Household cats

93
Q

How to differentiate dizygotic from monozygotic twins?

A

If the twins are of different sex they are for sure dizygotic

94
Q

Why is appendicitis hard to diagnose in pregnancy?

A

Leukocytosis may occur in pregnancy

95
Q

Cause of post partum hemorrage

A

Tissue : Retained placenta
Tony: Uterine atony
Trauma: Vaginal laceration, macrosomy
Thrombin: DIC

96
Q

Spontaneous abortion symptoms and diagnosis

A

Hx: Pain and bleeding
DX: check cervix, US and hCG

97
Q

Contraindication to tocolytics

A

Obstetric: severe abruption, ruptured membranes, chorioamnionitis

Fetal: lethal anomaly, fetus is dead already, fetal jeaopardy

Maternal: Eclampsia, advanced dilation

98
Q

History taking

A

Surgical history
Allergy to medications
Obstetric history
Illnesses, drugs
Naegels rule

99
Q

Signs of pregnancy

A

Presumptive: Chadwick
Probable: home urine pregnancy test, uterine enlargement and breast engorgement

Piskacek: prominence over implantation site
Goodell: softening of cervix
Hegar: softening of cervical isthmus

Positive sign: detection of fetal HR, recognition of fetal movement

100
Q

Vitamin supplements in pregnancy

A

Preconception: folic acid 400 microgram per day for 6 weeks

2nd trimester: low dose iron and iodine 250 microgram per day

101
Q

When does prenatal care start?

A

Before conception! Advice etc, change lifestyle

102
Q

Techniques of C-section

A

Abdominal wall: Transverse (pfannenstiel) and Vertical (midline)

Uterus: Lower segment incision (Transverse), Classical (Vertical)

Gynecology and obstetrics (2 decks)

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