Ob Gyn Crash Course Book Questions Flashcards
All questions and answers from obgyn crash course book
What is spontaneous abortion?
Miscarriages occurring before 20th week of gestation.
What is fetal demise?
Death after 20 weeks gestation in utero
What is another name for vulva?
Pudendum
Borders of the vagina?
Mons pubis anterior
Rectum posterior
thigh folds lateral
What is the main support muscles etc of the vagina?
What is anterior to the vagina?
Where does it drain?
What is the blood supply?
Endopelvic fascia - perrineal membrane teenagers personal muscl and urethral spinchter
Anterior to vagina is bladder
Drains to external Iliac nodes, common and internal iliac nodes and superficial inguinal nodes
Blood supply vaginal artetry from internal Iliac
Weight of uterus at different demographic stages
Non pregnant reproductive age 50 g
Pregnant
Post menopausal 40g
Previous pregnancy up to 110 g
Weight of uterus at different demographic stages
Non pregnant reproductive age 50 g
Pregnant
Post menopausal 40g
Previous pregnancy up to 110 g
Ligaments of the uterus
Broad ligament - cervix and body made from the pelvis peritoneum reflects on back of bladder to sides of uterus and sides of pelvis
Cardinal ligament
Recto uterine ligaments - from posterior cervix to sacrum
Round ligaments - xonnect uterus to anterolayeral abdominal wall located inside broad ligament
This is what docs think is hurting when they say ligamentous pain
What is the artery of Samson?
Located in round ligament and is lighted during a hysterectomy
What is uterine blood supply?
What is the lymph drainage?
What is the nerve supply?
Blood - Uterine aretry and ovarian arteries
Lymph - Lateral aortic lymph nodes
Pelvic nodes
Iliac nodes
Nerve- Hypogastroc nerve and ovarian plexus
Splamxhnic nerve
What is the length of the cervix
3-5 cm
Risk factors for ectopic?
Signs of ectopic?
RISK FACTORS History of previous tubal pregnancy HX of or current PID Fallopian tube disease Use of IUD before pregnancy Previous tubal ligation Fertility treatments ⁶666⁶⁶⁶⁶⁶⁶⁶⁶⁶⁶⁶⁶⁶⁶⁶⁶⁶⁶⁶666676⁶6⁶666666666666666⁶66766766676667⁶666⁶6666⁶6⁶⁶66
SIGNS Vaginal bleeding Pelvic pain Elevated beta HCG empty uterus on U/S
Hagar sign
Softening of the cervix at 6 weeks
At 12 weeks where xo a uterus be palpated?
Behind the public symphysis
Causes of positive hcg with no pregnancy
- **Pituitary hcg produced in postmenopausal women with Hugh GNRH
- **Enxogenous intake of HCg
- **placental site trophoblastic cancer
- **gestational trophoblastic cancer
- ** stomach cancer liver cancer lung cancer bladder cancer testicular cancer
- **
- **
What fetal pole yields heartbeat on ultrasound?
5mm
At What gestational age is fetal pole seen on transvaginal ultrasound?
5-6 weeks gestation
Home urine pregnancy test has what kind of testing?
Immuno metric assayv
Importance of finding a decidua at 6 weeks?
Confirms intrauterine pregnancy but does not rule out ectopic occurring concurrently
Different hcg levels occur around the time when different structures can be seen on transvaginal ultrasound
Around 1800- 2000 mIU/ml you should be able to see a gestational sac in the uterus. If you don’t see anything in yje uterus then there may be an ectopic pregnancy
Physiological changes due to pregnancy
CARDIAC
- **HYPERDYNAMIC CIRCULATION STATE
- **Cardiac output increases 30-50%
- **Decrease in CO due to aortocaval xompression when laying down
- **Heart rate increases from 70 to 90
- **Pulse pressure widens die to decreased vascular resistance
- **BP drops in 2nd trimester then normal in 3rd
- ** oxygen consumption goes up
- ** benign murmurs, premature ventricular and aortic contractions
HEMATOLOGY
- **blood volume goes up
- ** plasma 50% rbc 30% so results in dilutions anemia
- **wbc increases
- **iron requirements go up - supplements
- **BUN goes down
URINARY TRACT
- **GFR increases 30%
- ** BUN & CREATININE go down
- **distension of the ureter due to ureter response to elevated levels of progesterone during pregnancy and direct pressure from uterus
- **greater effect of postural movements on kidneys
RESPIRATORY
- **progesterone lowers co2 in blood
- **Respi rate increases
- **Oxygen demands increase
- **Increases in residual lung volume and lung capacity
- **Increase in thoracic circumference
- ** edema and hyperemia of the lung tissue
- **may have voice changes and SOB
GI and hepatobiliary
- ** decrease in motility - progesterone relaxes smooth muscles
- ** delayed gastric emptying
- **decrease in acid secretion
- **ALP increases in 3rd trimester due to placental production
ENDOCRINE
- **beta hcg increases levels of estrogen and progesterone
- ** at 10 weeks placenta produces its own hormones
- ** produces Bhcg which is similar to tsh so causes Thyroid gland hyperplasia
- **true hyperthyroidism in pregnancy is rare
- **estrogen increase production of thyroid binding globulin in liver cells so free levels are normal
- ** Increased corticosteroid production and increase in placental progesterone cause increased insulin resistance along withh increase HPL
- **MSH increases skin pigmentation
- **Increased prolactin levels to stimulate lactation
What causes pigment changes in skin of pregnant woman
Melanocyte stimulating hormone produced by placenta
Prolactin levels at term are?
Pregnant women at term have 10 tomes the prolactin of a normal woman
Cause of peripheral oedema in pregnancy
Increase jn water and salt uptake by kidneys increased aldosterone and corticosterois levels due to production or corticosteroid releasing hormone produced by the placenta
Breast engorgement and tenderness during early pregnancy is caused by?
Elevated estradiol levels after missed period
What is the definition the purpureum?
The time. From the delivery of the placenta 26 weeks
