Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Women's Health > OB Gyn Case Files Cases 7-12 > Flashcards

OB Gyn Case Files Cases 7-12 Flashcards

1
Q

What’s the MC causes of abnormal serum screening tests? What should you do?

A

wrong dates or multiple gestations
Do an ultrasound! If still abnormal and 16 wks, repeat soon, if 20 wks - genetic counseling and referral for amniocentesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What’s the msAFP cutoff?

A

2.0 or 2.5 MOM (multiples of the median)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

At 16 wks gestation, where would the fundus be located? 20 weeks?

A

16 wks: midway btwn symphysis pubis and umbilicus

20 wks: level of umbilicus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What’s alfa-fetoprotein and what’s it analogous to?

A

gylcoprotein made first by the fetal yolk sac then later by the fetal liver and GI tract. It deffuses thru the chorioamniotic membranes
analogous to adult albumin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What’s frist trimester screening? When can it be done?

A

Biochemical markers: PAPP-A & B-hCG +/- transvaginal US to measure posterior neck (nuchal translucency) to give risk of down syndrome & trisomy 18
10-13 wks gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What’s neural tube defects and what can it lead i?

A

failure of embryonic neural fold closure leads to absent cranium & cerebral hemispheres (anencephaly) or nonclosure of vertebral arches (spina bifida)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What tests are done for second trimester screening? When do you do it?

A

msAFP, hCG, inhibin-A, unconjugated estriol

Btwn 15-21 weeks gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some causes of elevated msAFP?

A

neural tube defects, underestimation of gestational age, multiple gestations, abdominal wall defects, cystic hygroma, fetal skin defects, sacrococcygeal teratoma, decreased maternal weight, oligohydramnios

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the screening serums for a pt with trisomy 21?

A

decreased AFP, unconjugated estriol (uE3), PAPP-A
increased hcG and inhibin A
Would also have thickened nuchal translucency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the screening serums for a pt with trisomy 18?

A

Decreased AFP, unconjugated estriol (uE3), hCG, PAPP-A

Inhibin: N/A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the screening serums for a pt with trisomy 13?

A

Decreased PAPP-A and B-hCG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some causes of low msAFP?

A

overestimation of gestational age, chromosomal trisomies, molar pregnancy, fetal death, increased maternal weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some US findings for a pt with down syndrome?

A

thickened nuchal fold, shortened femur length, or echogenic bowel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What can an amniocentesis be used for in elevated msAFP?

A

Test amniotic fluid for AFP, can also obtain fetal karyotype to identify fetal aneuploidy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What’s MPSS?

A

Massively parallel shotgun sequencing which analyzes and amplifies cell free fetal DNA (cffDNA) in matneral blood btwn 10-22 wks gestation to detect excessive fetal chromosomes (trisomy 21,18,13)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Name some teratogens

A

Androgens, alcohol, phenytoin (dilantin), lithium carbonate, methotrexate, retinoic acid (vit A), ACEi, warfarin, valproic acid, carbazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What effects do androgens have on embryo?

A

teratogen that can cause masculinization of female fetus and labial fusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what effects does alcohol have on an embryo?

A

fetal alcohol syndrome, IUGR, microcephaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What effects does phenytoin (dilantin) have on an embryo?

A

fetal hydantoin syndrome, IUGR, micocephaly, facial defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What effects does lithium carbonate have on an embryo?

A

heart and great vessel defects (epstein anomaly)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What effects does methotrexate have on an embryo?

A

skeletal defects, limb defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What effects does retinoic acid (vit A) have on an embryo?

A

facial defects, neural tube defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What effects does ACEi have on an embryo?

A

skull anomalies, limb defects, miscarriage; renal tubule dysgenesis, renal failure in neonate, oligohydramnios

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What effects does warfarin have on an embryo?

A

CNS and skeletal defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What effects does valproic acid and carbamazepine have on an embryo?

A

neural tube defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What’s a teratogen’s effect in the first 2 weeks of gestation?

A

All of nothing effect - embryo is killed or recovers from the exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

when could malformation occur from teratogen exposure?

A

during organogenesis - days 15-60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Pregnancies with elevated msAFP which after eval are unexplained are at an increased risk for what?

A

stillbirth, growth restriction, preeclampsia and placental abruption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are some maternal effects of pregnancy with twin gestation?

A

increased N/V, > physiological anemia, > increased of BP after 20 wks, > increase in size and weight of uterus, increased DVT, postpartum hemorrhage, need for C-section, gestational diaetes, preeclampsia

30
Q

What are twin gestations without a dividing membrane at a higher rate for and why?

A

stillbirth due to cord entanglement

31
Q

Does mono or dizygotic twins have a higher rate of anomalies and maternal complications?

A

mono

32
Q

What’s velamentous cord insertion?

A

umbilical vessels separate before reaching the placenta, protected by a thin fold of amnion instead of by the cord or placenta itself
these vessels are susceptible to tearing after rupture of membrane

33
Q

What’s vasa previa?

A

umbilical vessels that aren’t protected by cord or membranes that cross internal cervical os in front of the fetal presenting part

34
Q

With what does vasa previa MC occur with?

A

velamentous cord insertion or placenta w/ one or more accessory lobes

35
Q

what do you call a placenta w/ 1+ accessory lobes?

A

bilobed or succenturiate-lobed placenta

36
Q

how does monozygot twins form?

A

1 egg, 1 sperm

37
Q

how does dizygotic twins form?

A

2 eggs, 2 sperm

38
Q

what’s chorionicity? what’s it in monozygotic and dyzgotic twins

A

the number of placentas
Monozygotic: can be monochorionic or dichorionic
Dyzygotic: always dichorionic

39
Q

what’s amnionicity? What’s it in monozygotic and dyzgotic twins?

A

the number of amniotic sacs
Monozygotic twins can be monoamnionic or diamniotic
Dyzgotic: always diamniotic

40
Q

what are potential complications of twin gestation?

A

higher rate of congenital malformations, preeclampsia, postpartum hemorrhage and twin-twin transfusion (TTT) syndrome

41
Q

When did monochoronic/diamniotic twins division occur?

A

Day 4-8

42
Q

when did monochorionic/monoamniotic twins dvision occur?

A

Day 8-12

43
Q

when did conjoined twins division occur?

A

after day 12

44
Q

How does clomiphene increase chance of multiple gestations?

A

induces ovulation and promotes that maturation of multiple follicles increasing the number of eggs released during ovulation and available for fertilization

45
Q

what are some fetal or placental complications during twins?

A

preterm delivery, IUGR, polyhydramnios, stillbirth, fetal anomalies, plcenta previa, abruption, twin-twin transufsion syndrome

46
Q

What’s twin-twin transfusion (TTT) syndrome?

A

one twin’s the donor, other is recipient. One’s larger w/ more amniotic fluid and other’s smaller with oligohydroamnios

47
Q

How do you treat TTT syndrome?

A

laser ablation of shared anastomotic vessels (dont at special centers) or serial amniocentesis for decompression

48
Q

What are risk factors for vasa previa?

A

bilobed/succenturiate-lobed or low-lying placenta, multifetal pregnancy, and pregnancy resulting from in vitro

49
Q

How do you identify vasa previa and what’s the proper treatment?

A

Color doppler ultrasound

Tx: planned C-section before ROM around 35-36 wks of gestation

50
Q

What’s a contraindicated test if someone has vasa previa?

A

digital vaginal exam

51
Q

How can you differentiate fetal from maternal blood?

A

Apt test and Kleihauer-Betke test

52
Q

What’s prodromal symptoms of HSV outbreak?

A

burning, itching or tingling of the perineal region prior to the classical vesicles

53
Q

What’s the biggest risk for a fetus born to a mom w/ HSV? How can you decrease this risk?

A

neonatal encephalitis

Decrease risk by delivering via C-section

54
Q

Which type of HSV usually causes gential warts and how do you treat it?

A

HSV-2
Tx: oral Acyclovir (covers HSV1 and 2), especially at 26 weeks to decrease viral shedding, decrease duration of lesions and frequency of outbreaks at term

55
Q

What’s chancroid and what causes it?

A

STD caused by GN bacterium H. ducreyi, causes painful genital vulvar lesions

56
Q

How does syphillis typically present?

A

first stage: small, round, painless chancre in area exposed to spirochete

57
Q

what’s antepartum vaginal bleeding?

A

vaginal bleeding occurring after 20 weeks gestation

58
Q

What’s complete placenta previa? how do you diagnose it?

A

placenta completely covers the internal os of the uterine cervix
diagnose it via US

59
Q

what’s placenta abruption? what’s it assoc w/?

A

premature separation of the placenta

Assoc w/ painful uterine contractions or excess uterine tone

60
Q

what would h/o postcoital spotting in pregnancy be a sign of?

A

possible placenta previa

61
Q

What’s the best treatment for someone with placenta previa?

A

expectant mangagment if hemodynamically stable and norm fetal HR, delivery via C-section at or after 34 weeks

62
Q

What are the types of placenta previa?

A
  1. complete
  2. marginal
  3. parital
  4. low-lying placentation
63
Q

what’s partial placenta previa?

A

placenta partially covers the internal cervical os

64
Q

what’s marginal placenta previa?

A

placental abuts against the internal oss of the cervix

65
Q

what’s low-lying placenta?

A

edge of the placenta is w/in 2-3 cm of the internal cervical os

66
Q

what are the 2 MC causes of significant antepartum bleeding?

A

placenta abruption and placenta previa

67
Q

what are some risk factors for placenta previa?

A

gran multiparity, prior c-section delivery, prior uterine curettage, previous placenta previa, multiple gestation

68
Q

what’s placenta accreta? What is it MC with?

A

invasion of the placenta into the uterus

MC w/ placenta previa esp with uterine scar after c-section

69
Q

What does painless antepartum vaginal bleeding suggestion?

A

placenta previa

70
Q

When placenta previa is diagnozed early in gestation (like second trimester) what’s the next move?

A

repeat US later because the placenta can transmigrate away from the cervix

Women's Health (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions