Nov 21 test Flashcards
Patients with sickle cell disease are at increased risk of what during pregnancy?
Acute pain episodes, preeclamspia -> placental abruption, fetal growth restriction, preterm delivery
What is indicated for pregnant patients with sickle cell disease?
- more frequent prenatal care
- 24 hour baseline protein
- low dose aspirin for preeclamspia prophylaxis
how is a hydatidiform mole managed?
-suction currettage, and serial monitoring of hcg until it’s no longer detectable
patients with a hydatidiform mole are at increased risk of which cancer?
choriocarcinoma
Postmenopausal women with endometrial cells on cervical smear require…
Endometrial biopsy
A pregnant patient with mild thrombocytopenia with no symptoms likely has?
gestational thrombocytopenia
Platelet range for gestational thrombocytopenia?
100 000 - 150 000
Treatment of gestational thrombocytopenia?
reassurance and observation
what is the most likely cause of gestational thrombocytopenia?
dilution effect of pregnancy
If a pregnant patient has <100 000 platelets, what is required?
evaluation for diagnosis (TTP, ITP, etc.)
Clinical features of abruptio placentae
- Sudden-onset vaginal bleeding
- abdominal pain
- high-frequency contractions
- tender, firm uterus
Do all patients with abruptio placentae have vaginal bleeding?
No - 20% have a concealed abruption
Risk factors for abruptio placentae
tobacco and cocaine use (factors leading to ischemia, vasoconstriction, hemorhage, etc)
Is placenta previa associated with painful or painless vaginal bleeding?
painLESS
Risk factors for placenta previa?
- prior placenta previa
- multiple gestations
- prior Ceasarian section
Diagnosis of placenta previa?
-transabdominal followed by transvaginal sonogram
Treatment of acute cholangitis?
- Antibiotics
- biliary drainage by ERCP within 24-48 hours
how do you treat asymptomatic patients with endometriosis?
reassurance and observation only
presentation of magnesium toxicity?
Mild - nausea, flushing, headache, hyporeflexia
Mod - areflexia, hypocalcemia, somnolence
Severe - resp paralysis, cardiac arrest
treatment of magnesium toxicity?
stop infusion of magnesium, start calcium gluconate
How do you know if someone who is pregnant has chronic hypertension?
-hypertension> 140 / 90 prior to conception or PRIOR to 20 weeks gestation
when does gestational hypertension onset?
> 20 weeks gestation
what are the maternal risks of hypertension in pregnancy?
- superimposed preeclampsia
- postpartum hemorhage
- gestational diabetes
- placental abruption
- C section delivery
what are the fetal risks of hypertension in pregnancy?
- FGR
- perinatal mortality
- preterm delivery
- oligohydramnios
what tests are done at the initial prenatal visit?
- RhD antibody screening
- hemoglobin/hct/MCV
- HIV, VDRL/RPR, HBsAg
- rubella and varicella immunity
- pap test if indicated
- chlamydia PCR
- urine culture
- urine protein
the inactivated influenza vaccine is safe throughout pregnancy TRUE OR FALSE
TRUE
what tests are done at the 24-28 week visit?
- hemoglobin/hct
- antibody screen if Rh-
- 50g 1h glucose tolerance test
what tests are done at the 36-38 week visit?
-group B strep culture
can you give the live intranasal vaccine during pregnancy?
NO
