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OBGYN > OB 1 > Flashcards

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
Q

MC preventable cause of mental retardation

A

maternal alcohol consumption during pregnancy

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26
Q

softening of the cervix

A

hegar’s sign

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27
Q

Morning sickness treatments

A

best to eat smaller, more frequent foods that are bland

can try H1 receptor blockers, phenothiazines, vitamin B6 + doxylamine

28
Q

Hyperemesis gravidarum duration

A

develops during 1st/2nd trimester and extends beyond 16 weeks gestation

29
Q

Difference between Morning sickness and hyperemesis gravidarum

A

HG commonly requires hospitalization for IV fluids and electrolyte correction

HG has a >5% weight loss from prepregancy weight

30
Q

antiemetics of hyperemesis gravidarum

A

pyridoxine (B6) + doxylamine treatment of choice

31
Q

What is a common precursor to preeclampsia that requires monitoring?

A

Edema! Watch BP and urine protein

May be a sign of preeclampsia after 20 weeks gestation

32
Q

vaginal discharge needs to be distinguished from…

A

infections and ruptured membranes

33
Q

Naegele’s rule:

A

LMP + 7 days - 3 months = Expected due date

34
Q

Triple screening for Trisomy 21 (down’s), open neural tube defect, and trisomy 18 is done when?

A

15-20 wks

35
Q

warfarin in pregnancy

A

Late exposure during gestation causes hydrocephalus in the child

36
Q

Heparin and LMWH use in pregnancy

A

not teratogenic

37
Q

valporic acid use in pregnancy

A

spina bifidia and other neural tube defects

38
Q

Lithium use in pregnancy

A

cardiac defects (Ebstein’s anomaly)

limit exposure after 8 weeks

39
Q

tetracycline use in pregnancy

A

discoloration of teeth

40
Q

what drug can you use during pregnancy

A

ACETAMINOPHEN

41
Q

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)

A

Fetal alcohol syndrome

42
Q

Risks include intrauterine growth restriction, low birth weight, and fetal mortality

A

tobacco use in pregnancy

43
Q

screening for gestational diabetes mellitus

A

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
Q

MC surgical complication of pregnancy

A

appendicitis

45
Q

MCC of neonatal sepsis

A

GBS (group B strep)

46
Q

Treatment of GBS

A

penicillin/ampicillin

47
Q

Congential heart defects (patent ducts arteriosus), mental retardation, deafness, cataracts present in infant suggests….

A

rubella infection during pregnancy

48
Q

routine prophylactic opthalmic ABX ointment for all neonates

A

erythromycin for gonorrhea

49
Q

neonatal conjunctivitis 5 days to 5 weeks after birth suggests infection with…

A

Chlamydia trachomatis

50
Q 
Blueberry muffin rash
hepatosplenomegaly
chorioretinitis
periventricular calcification
sensorineural hearing loss
intrauterine growth restriction

these sx are present with congenital infection of…

A

CMV

51
Q

Fifth disease

Slapped face

A

Parvovirus B-19

52
Q

Leading cause of maternal death in first trimester

A

Ectopic pregnancy

53
Q

triad of ectopic pregnancy

A

amenorrhea
pain
vaginal bleeding

54
Q

MCC of spontaneous abortion (miscarriage) in first trimester

A

chromosomal abnormalities

55
Q

infectious causes of spontaneous abortion

A

Chlamydia

Listeria

56
Q

Endocrine factors of spontaneous abortions

A

thyroid autoABs

T1DM

57
Q

bleeding in 1st trimester w/o loss of fluid or tissue

A

indicates a threatened abortion

50% of these develop into a spontaneous abortion

58
Q

Vagina bleeding and/or gross rupture of membranes in presence of cervical dilation

A

inevitable abortion

59
Q

Internal cervical os opens and allows passage of blood and some tissue

A

incomplete abortion

60
Q

Documented pregnancy that spontaneously passes all the products of conception

Before 10 weeks’ gestation, fetus and placenta commonly expelled as one unit

A

complete abortion

61
Q

Retention of a failed intrauterine pregnancy for extended period of time (usually for more than 2 menstrual cycles)

Absence of uterine growth

A

Missed abortion

62
Q

More common type of molar pregnancy

Also more likely to undergo malignant transformation to choriocarcinoma

No identifiable embryonic or fetal stuctures

A

complete mole of molar pregnancy

63
Q

Painless vaginal bleeding around 6 weeks to 4th or 5th month gestation

Uterine size/date discrepancies

Hyperemesis gravidarum

Choriocarcinoma:
METS to lungs most common

A

molar pregnancy (hydadatidform mole)

64
Q

Ultrasound shows “snowstorm” or “cluster of grapes”

A

molar pregnancy

65
Q

Dizygotic

A

fraternal twins (non-identical)

66
Q

Monozygotic

A

identical twins

OBGYN (12 decks)

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