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OB 1 Flashcards

1
Q

What system has the earliest changes inside mom and also has the most dramatic changes?

A

Cardiovascular system

Goal: increase fetal oxygenation and nutrition

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2
Q

Increased RBC mass, relative less than plasma volume in maternal-fetal physiology

A

physiologic anemia

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3
Q

Pregnancy in of itself is a ______ state

A

HYPERCOAGULABLE

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4
Q

Pregnancy has a ____ risk for thromboembolism

A

2 times higher in pregnancy

5.5 times higher in postpartum period with increased risk lasting at least 6 weeks!!

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5
Q

Normal finding in pregnant women’s urine

A

Gluocsouria! Due to increased GFR

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6
Q

Also see what other urinary sx in pregnant women?

A

Stress incontinence

Urinary stasis causing an increased frequency of pyelonephritis

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7
Q

Common GI system sx of pregnant women (5)

A
  1. N/V (likely due to increased hormones)
  2. Hyperemesis gravidarum (when N/V causes electrolyte imbalances and weight loss)
  3. Phyalism (perception of excessive salivation)
  4. food cravings/aversions, including pica
  5. Constipation (uterus compressing colon)
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8
Q

Other strange GI system sx of pregnant women (4)

NEED TO KNOW THESE ONES

A
  1. pruritus (stasis of liver)
  2. hemorrhoids (constipation)
  3. gingival disease
  4. increased ALP, cholesterol, no LFT changes
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9
Q

MSK system changes of pregnant women (2)

A
  1. lumbar lordosis to maintain center of gravity

2. separation of symphysis pubis mediated by relaxin

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10
Q

Integumentary system changes of pregnant women (4)

A
  1. spider angiomata on torso, face, arms due to increased estrogen/progesterone
  2. striae gravidarum (stretch marks) occur on lower abdomne, breasts, thighs
  3. Melsasma (hyperpigmented face)
  4. linea nigra (dark line down the belly)
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11
Q

Common hair changes of pregnant women

A
  1. Anagen (more hair)

2. Telogen (less hair) during postpartum

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12
Q

uterine softening after about 6 weeks’ gestation

A

Ladin’s sign

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13
Q

softening of uterine isthmus after 6-8 weeks’ gestation

A

Hegar’s sign

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14
Q

palpable lateral bulge or softening of the uterine conus at 7-8 weeks’ gestation

A

Piskacek’s sign

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15
Q

cervical softening due to increased vascularization at about 4-5 weeks’ gestation
during abdominal/bimanual exam

A

Goodell’s sign

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16
Q

bluish discoloration of cervix and vulva noted at about 8-12 weeks’ gestation during abdominal/bimanual exam

A

Chadwick’s sign

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17
Q

thick yellow fluid expressed from nipples in late pregnancy

A

Colostrum

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18
Q

Composition of umbilical cord

A

2 arteries

1 vein

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19
Q

shunts blood from pulmonary artery into the aorta

A

ductus arteriosus

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20
Q

pathway around hepatic circulation in the fetus

A

ductus venosus

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21
Q

GPA classification - what does each stand for?

A

G: gravida - # times pregnant (whether to term or not)

P: para - # of births (viable or not, >20wks) (twins are counted as 1)

A: abortions - # lost pregnancies

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22
Q

What’s the ashkenazi jews panel?

A

Tay-Sachs, Neimann-Pick, Gaucher, Canavan disease

Familial dysautonomia, fanconia anemia, CF, Bloom syndrome

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23
Q

live virus vaccinations during pregnancy

A

should be avoided

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24
Q

influenza vaccination during pregnancy

A

strongly recommended

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25
MC preventable cause of mental retardation
maternal alcohol consumption during pregnancy
26
softening of the cervix
hegar's sign
27
Morning sickness treatments
best to eat smaller, more frequent foods that are bland can try H1 receptor blockers, phenothiazines, vitamin B6 + doxylamine
28
Hyperemesis gravidarum duration
develops during 1st/2nd trimester and extends beyond 16 weeks gestation
29
Difference between Morning sickness and hyperemesis gravidarum
HG commonly requires hospitalization for IV fluids and electrolyte correction HG has a >5% weight loss from prepregancy weight
30
antiemetics of hyperemesis gravidarum
pyridoxine (B6) + doxylamine treatment of choice
31
What is a common precursor to preeclampsia that requires monitoring?
Edema! Watch BP and urine protein May be a sign of preeclampsia after 20 weeks gestation
32
vaginal discharge needs to be distinguished from...
infections and ruptured membranes
33
Naegele's rule:
LMP + 7 days - 3 months = Expected due date
34
Triple screening for Trisomy 21 (down's), open neural tube defect, and trisomy 18 is done when?
15-20 wks
35
warfarin in pregnancy
Late exposure during gestation causes hydrocephalus in the child
36
Heparin and LMWH use in pregnancy
not teratogenic
37
valporic acid use in pregnancy
spina bifidia and other neural tube defects
38
Lithium use in pregnancy
cardiac defects (Ebstein's anomaly) limit exposure after 8 weeks
39
tetracycline use in pregnancy
discoloration of teeth
40
what drug can you use during pregnancy
ACETAMINOPHEN
41
Growth restriction CNS dysfunction (microcephaly, mental retardation) Behavioral disorders Facial abnormalities (low-set ears, midfacial hypoplasia, shortened palprebral fissures, smooth philtrum, and a thin upper lip)
Fetal alcohol syndrome
42
Risks include intrauterine growth restriction, low birth weight, and fetal mortality
tobacco use in pregnancy
43
screening for gestational diabetes mellitus
screen with 50-gram 1 hour glucose tolerance test at 24-28 weeks Abnormal result (glucose >130 or 140) requires further testing with fasting 100gram 3 hour glucose tolerance test
44
MC surgical complication of pregnancy
appendicitis
45
MCC of neonatal sepsis
GBS (group B strep)
46
Treatment of GBS
penicillin/ampicillin
47
Congential heart defects (patent ducts arteriosus), mental retardation, deafness, cataracts present in infant suggests....
rubella infection during pregnancy
48
routine prophylactic opthalmic ABX ointment for all neonates
erythromycin for gonorrhea
49
neonatal conjunctivitis 5 days to 5 weeks after birth suggests infection with...
Chlamydia trachomatis
50
``` Blueberry muffin rash hepatosplenomegaly chorioretinitis periventricular calcification sensorineural hearing loss intrauterine growth restriction ``` these sx are present with congenital infection of...
CMV
51
Fifth disease | Slapped face
Parvovirus B-19
52
Leading cause of maternal death in first trimester
Ectopic pregnancy
53
triad of ectopic pregnancy
amenorrhea pain vaginal bleeding
54
MCC of spontaneous abortion (miscarriage) in first trimester
chromosomal abnormalities
55
infectious causes of spontaneous abortion
Chlamydia | Listeria
56
Endocrine factors of spontaneous abortions
thyroid autoABs | T1DM
57
bleeding in 1st trimester w/o loss of fluid or tissue
indicates a threatened abortion 50% of these develop into a spontaneous abortion
58
Vagina bleeding and/or gross rupture of membranes in presence of cervical dilation
inevitable abortion
59
Internal cervical os opens and allows passage of blood and some tissue
incomplete abortion
60
Documented pregnancy that spontaneously passes all the products of conception Before 10 weeks’ gestation, fetus and placenta commonly expelled as one unit
complete abortion
61
Retention of a failed intrauterine pregnancy for extended period of time (usually for more than 2 menstrual cycles) Absence of uterine growth
Missed abortion
62
More common type of molar pregnancy Also more likely to undergo malignant transformation to choriocarcinoma No identifiable embryonic or fetal stuctures
complete mole of molar pregnancy
63
Painless vaginal bleeding around 6 weeks to 4th or 5th month gestation Uterine size/date discrepancies Hyperemesis gravidarum Choriocarcinoma: METS to lungs most common
molar pregnancy (hydadatidform mole)
64
Ultrasound shows "snowstorm" or "cluster of grapes"
molar pregnancy
65
Dizygotic
fraternal twins (non-identical)
66
Monozygotic
identical twins

OBGYN (12 decks)

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