OB/GYN Exam Flashcards
What are the three goals of history taking with pregnancy?
- Risk assessment
2. Dating prego
When should a history be taken for OB/GYN pts?
At each visit
Why is it important to date a pregnancy?
Know the due date
Why is it important to know a the menstrual cycle with a pregnancy?
Affects how you date the pregnancy
When should women take folic acid during pregnancy?
Before getting prego if possible
What are the five immunizations that can be given in pregnancy?
Flu Tetanus Hepatitis MMR Varicella
What are the five immunizations that should be checked in pregnancy?
Flu Tetanus Hepatitis MMR Varicella
What does the G stand for in GPTPAL?
number of gravids
What does the first P stand for in GPTPAL?
Number of children with birth beyond 20 weeks
What does the T stand for in GPTPAL?
Number of term pregnancy
What does the second P stand for in GPTPAL?
Number of preterm pregnancies
What does the A stand for in GPTPAL?
number of abortions/miscarriages
What does the L stand for in GPTPAL?
Living pregnancies
What is Naegele’s rule for dating a pregnancy?
Subtract 3 months from the LMP and add 7 days
LMP is on which day first or last day)?
Day one of the LMP (start, not end)
When is an US performed for the prego?
First visit
How accurate is a OB US?
With 5 days if the crown-rump length if first 7 wks of prego
What is the relationship between US accuracy, and the length of the gestation?
Inversely related
When is the most accurate time of US (early, mid, late)?
Early
What are the two questions to ask yourself if a woman presents with an early pregnancy?
- Where is it (ectopic?)
2. Is it viable
How do you determine if a pregnancy is viable?
1 .Date
- Doppler for Heart sounds
- HCG
- US
What is a molar pregnancy?
Inviable pregnancy d/t chromosomal defect
When is a baby’s heart sounds first heard?
9-10 weeks
Why is a pelvic exam necessary for an OB/GYN exam?
Make sure baby can come out
Why is BP measured in an OB exam?
check baseline to compare for preeclampsia
What is checked at every visit?
- Fetal heart sounds
- weight
- BP
- urine glu/protein/nitrites
When is fetal activity perceived by the mother?
After 18-20 wks
When is the fundal height measured?
Each prenatal visit after 20 weeks
1 cm measurements from the symphysis pubis to the top of the fundus correlates with what?
Weeks gestation
True or false: hemorrhoids, pica, varicose veins, SOB, CP, and breast changes are all common physical changes in pregnancy?
All true except for CP
Why is carpal tunnel syndrome common in later pregnancy?
Edema in the forearm
What are the spider hemangiomas?
spider telangiectasia in pregnancy
What happens to RBC volume in pregnancy? Plasma volume? CO? Vascular resistance?
All increase except for vascular resistance–goes down
What is presentation?
Relation of the fetus to maternal spine (vertex, breech, transverse)
What is the position?
Relation of the fetal presenting part to the maternal pelvis
What are the leopold maneuvers?
Feeling the presentation of the fetus
Vertex position = ?
Baby’s head is straight down
What is cervical effacement?
Thinning of the cervix as pregnancy progresses
What is the first stage of labor?
Onset of labor until completely dialtated
What is the second stage of labor?
Complete cervical dilation to delivery
What is the third stage of labor?
Delivery of infant to delivery of the placenta
What is the difference in labor times between parous and nulliparous women?
Longer for cervical dilation
When are pap smears done in pregnancy?
After age 21
Why are urine cultures necessary in pregnancy?
GBS
What is the pathogenesis of GERD in pregnancy?
Changes in estrogen and progesterone levels affect the LES
What causes the MS changes in pregnancy?
Progesterone thought to play a role
Plasma volume in pregnancy increases by what percent?RBC volume? CO?
Plasma = 30%
RBC volume = 20%
CO = 30-50%
How is fetal position determined?
Vaginal exam
How is fetal presentation determined
Leopold maneuvers
