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Obstetrics and Gynecology > OB Clinical > Flashcards

OB Clinical Flashcards

1
Q 
Vasospasm
Endothelial cell activation
Inc pressor response
Prostaglandin and NO
Endothelin
Angiogenic and antiangiogenic proteins
A

Preeclampsia

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2
Q

Eclampsia =

A

Pre-Eclampsia + Convulsion/Coma

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3
Q

Difference bet preeclampsia and HTN

A

Proteinuria

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4
Q

Signs of impending Eclampsia

A

Headache
BOV
Epigastric pain
Pulmonary edema

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5
Q

HELLP

A 
Hemolysis
Elevated 
Liver enzyme
Low 
Platelet Count
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6
Q

Vasospasm causes

A

Compromised uteroplacental perfusion

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7
Q

Most common cause of CP

A

Perinatal asphyxia

Fetal hypoxia

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8
Q

Drugs used for seizure in Eclampsia

A

Magnesium sulfate

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9
Q

Anti hypertensive of choice for HTN in pregnancy

A

Hydralazine

Ca ch blocker

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10
Q

Stable pre eclampsia medication

A

Methyldopa

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11
Q

Methyldopa side effect

A

Positive coombs test

Hemolytic anemia

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12
Q

Methyldopa
Procainamide
Hydralazine
Isoniazid

Positive

A

Drug induced lupus

anti-histone

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13
Q

anti hypertensive CI in pregnancy bec of fetal renal agenesis

A

ACEI

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14
Q

Magnesium toxicity

A

BP Decrease
UO decrease
Respiratory decrease
Patellar reflex absence

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15
Q

Worst prognosis in mag sul toxicity

A

Dec respiratory rate

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16
Q

Normal magnesium levels

A

4-7 meq/L

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17
Q

Mg >10 meq/L

A

Patellar reflex absent

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18
Q

Mg 12 meq/L

A

Respi paralysis and depression

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19
Q

Mag sul toxicity antidote

A

Cal gluconate

Cal chloride

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20
Q

Goal in eclampsia

A

Early termination of pregnancy

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21
Q

Proliferative trophoblast abnormality

Both syncytio and cytotrophoblast

A

GTD

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22
Q

Degeneration and partly hyperplastic changes in chorionic villi

Benign neoplasia of chorion with malig potential

A

H Mole

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23
Q

Hydropic degeneration
Villous edema
Absent villous blood vessel
Proliferation of trophoblastic epithelium
Absence of embryonic elements (fetus, amnion)

A

H Mole

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24
Q

1-2 mo amenorrhea
Nausea and vomiting
Uterine bleeding
Uterine growth

A

GTD

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25
Q

UTZ finding H Mole

A

Snowstorm pattern

multiple echoes

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26
Q

Most common mets by GTN

A

Lung

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27
Q

On x ray GTN mets may present as

A

cannon ball appearance

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28
Q

Marker for GTN

A

HCG

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29
Q

HCG exerts

A

thyrotropin like effect leading to elevated thyroxine levels and dec TSH

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30
Q

A large mole may be assoc with

A

Early onset pre eclampsia

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31
Q

Elevation of BHCG beyond 48 h after evacuation and the succeeding weeks, there may be

A

persistent trophoblastic disease

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32
Q

More tendency to be malig

High index of suspicion

A

Complete H mole

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33
Q

H Mole Tx

A

Suction curettage
Hysterectomy
Prophylactic single agent chemo: large uterus poor follow up

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34
Q

Chemotherapeutic drug used

A

Methotrexate

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35
Q

Uterus volume at term

A

5L 20L

1100g

36
Q

Unpredictable
Sporadic
Nonrhythmic
Intensity bet 5-25mmHg

A

Braxton Hick contraction

37
Q

FH is related to AOG

A

18-20 to 34 w
Monitors fetal growth and AFV

Limitations in measurement when obese and uterine myoma

38
Q

At symphysis pubis

39
Q

When internal cervical os lining goes out to vagina during pregnancy

40
Q

Cervica mucus in pregnant due to progesterone

A

Beading pattern

41
Q

Cervical mucus ferning

A

Ammiotic fluid leakage

42
Q

Softening of uterus

43
Q

Softening of cervix

44
Q

Surgical removal of ovary before 7 weeks

Fall of progesterone

A

Spontaneous abortion

45
Q

When oophorectomy is needed but pregnancy, do surgery

A

After 14 weeks AOG

46
Q

pH of vagina

A

3.5-6 by Lactobacillus acidophilus during metabolism of glycogen

47
Q

Growth hair phase

Lengthens during pregnancy

48
Q

Involution phase

Inc postpartum

49
Q

Excessive hair loss in puerperium

A

Telogen effluvium

50
Q

BMR inc in pregnancy by

Wt

A

20%

12.5kg or 27.5lbs

51
Q

Carb metab in pregnant

A

Mild fasting hypoglycemia
Postprandial hyperglycemia for sustained fetal glucose supply
Hyperinsulinemia due to progesterone PIGH prolactin cortisol

52
Q

Hematologic change in preg

A

Pregnancy induced hypovolemia

40-45% higher than nonpregnant after 32-34 w

53
Q

Hemoglobin at term ave

54
Q

IDA in pregnancy

55
Q

Dec slightly due to inc plasma

Whole blood viscosity dec

A

Hemoglobin

56
Q

Iron req for normal pregnancy

A

1000mg
300 transfer to fetus
200 lost through excretion
500 for inc erythrocyte

57
Q

Iron requirement is highest at

A

2nd half of pregnancy

58
Q

Creates barrier to ascending infection

A

Ig rich cervical mucus plug

59
Q

Transferred to developing fetus in 3rd tri as passive immunity

60
Q

Vaccine should be given 27w onward bec antibodies formed is short lived

61
Q

WBC in pregnancy

A

Physiologic leukocytosis

15,000 - 25,000

62
Q

Clotting factors in pregnancy are inc except

63
Q

Fibrin activity in pregnancy

64
Q

Neutralizes factor Va and VIIIa

Resistancr inc due to drop of

A

Protein C

Protein S

65
Q

Platelet level in pregnancy

A

Decline slightly

Borderline normal due to hypersplenism and hemodilution

66
Q

CO at pregnancy

A

inc at 5th week

67
Q

Expands bet 10-20w AOG

68
Q

All CV functions inc except

A

Systemic vascular resistance (decreased)

69
Q

Heart changes in pregnancy

A

Displaced to left
Apex moved laterallt
Larger cardiac silhouette on xray
ECG: L axis deviation, Q waves, inverted T waves

70
Q

Hypovolemia
Gravid uterus compressing on aorta and cava

lie

A

Supine hypotensive syndrome

Lateral decubitus

71
Q

All respi capacity increased except

All respi volumes dec except

72
Q

Kidneys

GFR and renal blood flow

A

1cm increase

Inc in early pregnancy

73
Q

Hyperfiltration is inc in pregnancy bec of

A

Hypervolemia induced hemodilution

Renal plasma flow inc by 80%

74
Q

Boosts renal NO production and inc vascular gelatinase

75
Q

Renal vessels

A

Renal vasodilation
dec artery resistance
Inc filtration

76
Q

Serum crea in pregnants

A

Dec (0.5-0.7 mg/dl)

77
Q

Gallbladder in pregnancy

A

Contractility reduced
Inc residual volume
Impaired emptying

78
Q

Gallbladder contraction by CCK is inhibited by

A

Progesterone

79
Q

TSH level in first tri

A

80% in women decreased

80
Q

Parathyroid gland activity in pregnancy

A

Favors skeletal formation at expense of mother

Pregnancy is vulnerable for osteoporosis

81
Q

Pregnancy effect on androgens

A

Production rates of maternal testosterone and androstenedione are increased

82
Q

T/F: Maternal Androgens cannot enter fetus during pregnancy

83
Q

Memory in pregnancy

A

Decline limited to 3rd tri

Transient and quickly resolved

84
Q

IOP during preg

A

Dec due to greater vitreous outflow

Corneal sensitivity dec

85
Q

Brownish red opacity on posterior surface of cornea inc pigmentation due to hormone effect

A

Krukenberg spindle

86
Q

Artery that courses round ligament

A

Sampson artery

Obstetrics and Gynecology (18 decks)

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