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EORs > OB > Flashcards

OB Flashcards

1
Q

define spontaneous abortion

A

b4 20 weeks

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2
Q

fetal RF for spont abortion

A

chromosomal abornamlities MC is trisomy

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3
Q

materal RN for spont abortion

A 
-smoking**** 
STIs 
trauma 
BMI under or over 
celiac dz
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4
Q

which type of spont aortion is viable

A

threatened

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5
Q

bloody vaginal discharge
cervical os closed
POC intact

A

thereatened abortion

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6
Q

tx for threatened abortion

A

supportive—observation at home, bedrest, close follow up

serial BHCG to if

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7
Q

POC intact

cervical os dilated without passage of tissue

A

inevitable abortion

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8
Q

some POC expelled

os is dilated

A

incomplete

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9
Q

all POC expelled from uterus

os is usually closed

A

complete

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10
Q

POC intact

cervical os closed

A

missed

***fetus died before 20 weeks and POC remain intrauterine

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11
Q

medical abortion

A

mifepristone (antiprogestin) 1st

misoprostol (prostaglandin) 2nd

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12
Q

mifepristone

A

progesterone recp antagonist

-leads to dilation and softening of cervix and placental detachement

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13
Q

misopristol

A

prostaglandin E1 analog (caues uterine contractions)

-

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14
Q

three times we give RHOGAM

A
  1. at 28 weeks
  2. within 72 hours of birth
  3. after any mixing of blood– ectopic, abortion, amniocentesis etc
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15
Q

define PP hemorrhage

A 
vaginal = >500 
CS= >1000
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16
Q

etiologies for PP hem

and whih is MC

A

FOUR T’s

  1. TONE–uterine atony– MC– uterus cannot contract
  2. TISSUE–retained placental tisssue
  3. TRAUMA–to cervix, perineum or vagina, uterine rupture, lacerations
  4. THROMBIN—coag abnorm (hem A/B, von willie, ITP or DIC)
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17
Q

RF for uterine atony

A 
prolonged labo 
overdistended uterus 
CS 
anesthesia 
retained placenta
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18
Q

soft flaccid boggy uterus with dilated cervix

A

uterine atony

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19
Q

tx for PP Hem

A
  1. uterine massage and compression
  2. IV oxytocin
  3. Metagen (methylergonovine) if not HTN
  4. IM Hemobate (Carboprost tromethamine) if no asthma
  5. TXA
  6. Cytotec or misoprostol
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20
Q

define ectopic pregnnacy

A

implantation outside uterine cavity

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21
Q

locations for ectopic

-mc

A

98% FT—– ampulla

abdomen (`1.4%)

ovary and cervix (.3%)

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22
Q

strongest RF for ectopic

-others

A

previous ectopic **

others: 
PID causing salpingitis 
IUD 
previous tubual suregyre 
endometriosis 
IVF
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23
Q

abd pain, left shoulder pain, vag bleeding

A

Ectopic

***shoulder pain= Kehr sign

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24
Q

US findings for ectpic

A

absence of gestational sac with bHCG >1500 or 2000

25
Q

tx for ectopic

A

IM methotrexate –destroys trophoblastic tissue

Only if beta HCG < 5,000, ectopic mass is < 3.5 cm, no fetal heart tones, hemodynamically stable, no blood disorders, no pulmonary disease, no peptic ulcer, normal renal function, normal hepatic function, compliant pt that can return for follow up

RH- mom gets rhogam

26
Q

contra for methrotexate

A
  • currently BF
  • active pulm dz
  • allergy
27
Q

mc cause of third trimester bleeding

A

placenta abruption

28
Q

painful bright red bleeding

A

placental abruption

29
Q

placental abruption

A

partial or complete premature separation of placenta from uterus wall
-blood can be concealed within uterine cavity or external

**BV in decidus basalis

30
Q

MC RF for placental abruption

A

maternal HTN—-chonic, pre or eclp
smking
prior abruption
cocaine

31
Q

sudden onset of painful third trimester vaginal bleeding

severe abd pain

A

abruption

32
Q

uterus is tender rigid hypertonic

A

abruption

33
Q

what not to do if PT has placental abruption

A

pelvic exam

34
Q

painless vaginal bleeding in 3rd tri + soft nontender uterus

A

previa

35
Q

painful vaginal bleeding in third tri + abd pain + firm tender utuerus

A

aprution

36
Q

tx for abruption

A

delvery of fetus and placenta= definitive

blood type

corticosteroids if prematue lungs

37
Q

RF for previa

A

prior cS
multiple gestations
multiple induced abortions
adv maternal age

38
Q

what is contraindicated to do with a previa case

A

vaginal exam

–can cause futehr separation

39
Q

time pd for pre eclampsia to coccur

A

20 weeks gestation to 6 wks PP

40
Q

triad for pre eclampsia

A

HTN + proteinuria + edema after 20 wks gestation

MUST HAVE HTN AND PROTEINURIA the edema is +/-

41
Q

BP 140/90 to 160/110
PU >300 in 24 hrs or +1
edema hands face feet

A

mild

42
Q

when do we give betamethasone for lung maturtion

A

26-30 weeks

43
Q

define severe preeclampsia

A

> 160/110
PU >5 grams or +3
cerebral visual change
pulm edema

44
Q

tx for severe pre eclampsia

A

IV MAG

BP meds if >180/110—– methyldopa, labtealol, nifidepine—– hydralazine is apparently alternative

45
Q

HELLP syndrome

A

heomlytic anemia
elevated liver zynes
low platetes

46
Q

tx for eclampsia

A

mag for seizures
delivery of fetus
BP meds=hydralazine IV or labetalol

give lorazepam for seixures if refractory to mag

47
Q

total weight gain range for normal BMI

A

25-35 pounds

48
Q

obese women preggo weight gain

A

<15 pounds

49
Q

Naegeles rule

A

1st day of last menstrual period + 7 days -3 months +1 year= expectant due date

50
Q

triple screen

A

AFP
HCG
estriol

51
Q

quad screen

A

AFP
estriol
HCG
Inhibin A

52
Q

when is chorionic villus sampling done

A

10-12 weeks

53
Q

amniocenteiss done?

A

15-18 weeks

54
Q

when is 72 hour glucose test done

A

26-28 weeks

55
Q

GBS done?

A

35-37 weeks

56
Q

high AFP

A

neural tube defect
ancephaly
spinal bifida

57
Q

ow afp

A

down syndrome

58
Q

MCC for abnormal AFP

A

unknown/incorrect dats of LMP

59
Q

trisomy 18

A

edwards syndrome

EORs (15 decks)

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