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OB-GYNE Flashcards

1
Q

Nullipara is a woman who has never completed a pregnancy beyond

  • 10 weeks
  • 20 weeks
  • 30 weeks
A

20 weeks

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2
Q

a woman who been delivered only once of a fetus or fetuses born alive or dead with an estimted AOG of at least 20 weeks

  • primipara
  • multipara
  • grand multipara
A
  • primipara
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3
Q

a woman who has completed 2 or more pregnancies to 20 weeks’ gestation or more

  • primipara
  • multipara
  • grand multipara
A
  • multipara
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4
Q

a woman who has had at least 5 births (live or still born) that are at least 20 weeks age of gestation

  • primipara
  • multipara
  • grand multipara
A

gran multipara

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5
Q

time of fertilization until 8 weeks (10 weeks gestational age)

  • embryo
  • fetus
  • infant
  • term
  • postterm
A

embryo

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6
Q

after 8 weeks until time of birth

  • embryo
  • fetus
  • infant
  • term
  • postterm
A

fetus

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7
Q

between delivery to 1 year

  • embryo
  • fetus
  • infant
  • term
  • postterm
A

infant

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8
Q

37 weeks - 42 weeks

  • embryo
  • fetus
  • infant
  • term
  • postterm
A

term

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9
Q

beyond 42 weeks

  • embryo
  • fetus
  • infant
  • term
  • postterm
A

postterm

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10
Q

up to completion of 14 weeks

  • first trimester
  • second trimester
  • third trimester
A

first trimester

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11
Q

up through 28 weeks

  • first trimester
  • second trimester
  • third trimester
A

second trimester

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12
Q

through 42

  • first trimester
  • second trimester
  • third trimester
A

third trimester

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13
Q

AOG is usually _______ more than the DA

  • 1 week
  • 2 weeks
  • 3 weeks
A

2 weeks

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14
Q

primigravida quickening

  • 16-18 weeks
  • 18-20 weeks
  • 20-22 weeks
A

18-20 weeks

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15
Q

multigravida quickening

  • 16-18 weeks
  • 18-20 weeks
  • 20-22 weeks
A

16-18 weeks

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16
Q

Naegele Rule

A

subtract 3 months, add 7 days to the first day of the last period

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17
Q

conditions with very high hCG

A
  • multiple pregnancy
  • molar pregnancy
  • exogenous injection
  • impaired renal clearance
  • hCG-secreting tumors from GI, ovary, bladder lungs
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18
Q

mnemonic of gynecologic history

MIDAS

A
  • menarche
  • interval
  • duration of flow
  • amount
  • symptoms
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19
Q

parts of OB score

A

Gravidy, Parity followed by (term, preterm, abortion, living children)

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20
Q

the height of the uterine fundus in cm correlates with the AOG in weeks between ________

A

20-34 weeks AOG

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21
Q

identifies which fetal pole occupies the uterine fundus

  • first leopold
  • second leopold
  • third leopold
  • fourth leopold
A

first leopold

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22
Q

palms are placed on either side of the maternal abdomen

  • first leopold
  • second leopold
  • third leopold
  • fourth leopold
A

second leopold

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23
Q

determines whether the presenting part is engaged or not

  • first leopold
  • second leopold
  • third leopold
  • fourth leopold
A

third leopold

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24
Q

the examiner faces the mother’s feet and with the tips of the first three fingers of each hand, exerts deep pressure in the direction of the axis

  • first leopold
  • second leopold
  • third leopold
  • fourth leopold
A

fourth leopold

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25
Q

Doppler ultrasound

  • 10 weeks
  • 22 weeks
  • 30 weeks
A

10 weeks

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26
Q

stethoscope in 80% of women

  • 10 weeks
  • 22 weeks
  • 30 weeks
A

22 weeks

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27
Q

heart sounds are expected to be heard in all

  • 10 weeks
  • 22 weeks
  • 30 weeks
A

22 weeks

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28
Q

weight gain with normal bmi

A

11.5 to 16 kg overall
25 to 35 lb overall
1 lb/week in 2nd and 3 trimester

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29
Q

laboratory test on first ob visit

A
  • CBC
  • blood typing
  • pap smear
  • FBS
  • urine culture
  • hepatitis B surface antigen
  • rubella antibody screening
  • syphilis serology (RPR or VDRL)
  • HIV serology offered
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30
Q

laboratory test at 24-28 weeks

A
  • CBC

- 75-gram OGTT

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31
Q

immunization in pregnancy (3)

A
  • tetanus-diptheria-acellular pertussis (TDaP)
  • influenza vaccine
  • hepatitis B
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32
Q

contraindicated immunization in pregnancy

A
  • measles
  • mumps
  • rubella
  • varicella
  • HPV
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33
Q

prenatal visit schedule

A
  • every 4 weeks until 28 weeks
  • every 2 weeks until 36 weeks
  • weekly thereafter
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34
Q

most common presentation of abortion

A

vaginal bleeding and abdominal pain

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35
Q

what is recurrent pregnancy loss

A

when a woman who has had 3 or more consecutive spontaneous abortions

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36
Q

diagnostics for abortion

A
  • urine or serum beta-hCG
  • CBC, blood typing
  • transvaginal ultrasound
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37
Q

cervix closed

  • threatened
  • missed
  • incomplete
  • inevitable
  • complete
A

threatened, missed, complete

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38
Q

cervix open

  • threatened
  • missed
  • incomplete
  • inevitable
  • complete
A

incomplete, inevitable

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39
Q

compatible uterus

  • threatened
  • missed
  • incomplete
  • inevitable
  • complete
A

threatened, missed

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40
Q

uterus incompatible

  • threatened
  • missed
  • incomplete
  • inevitable
  • complete
A

incomplete, inevitable, complete

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41
Q

bed rest, tocolysis

  • threatened
  • missed
  • incomplete
  • inevitable
  • complete
A

threatened

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42
Q

cervical ripening +/- curettage

  • threatened
  • missed
  • incomplete
  • inevitable
  • complete
A

missed

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43
Q

curettage

  • threatened
  • missed
  • incomplete
  • inevitable
  • complete
A

incomplete

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44
Q

expectant, oxytocin, curettage

  • threatened
  • missed
  • incomplete
  • inevitable
  • complete
A

inevitable

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45
Q

observe

  • threatened
  • missed
  • incomplete
  • inevitable
  • complete
A

complete

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46
Q

abortion medical management less than 12 weeks

A

prostaglandin, methotrexate

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47
Q

abortion medical management more than 12 weeks

A

prostaglandin, methotrexate, oxytocin

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48
Q

classic triad of symptoms in ectopic pregnancy

A
  • amenorrhea
  • abdominal pain
  • vaginal bleeding/spotting
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49
Q

presentation of ruptured ectopic pregnancy

A

hypotension, tachycardia, or signs of peritoneal irritation secondary to hemoperitoneum

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50
Q

most common type of ectopic pregnancy

A

tubal pregnancy

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51
Q

types of ectopic pregnancy

A
  • tubal pregnancy
  • heterotropic pregnancy
  • cervical pregnancy
  • ovarian pregnancy
  • abdominal pregnancy
  • cesarean scar pregnancy
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52
Q

most to least common types of tubal pregnancy

A

ampulla, isthmic, fimbrial, and interstitial

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53
Q

most common medical management for ectopic pregnancy

A

methotrexate (MTX)

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54
Q

mechanism of action of mtx

A

folic acid antagonist; binds to dihydrofolate reductase which reduces dihydrofolate to tetrahydrofolate, the active form of folic acid > arrested DNA, RNA and protein synthesis of rapidly proliferating tissue such as trophoblasts

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55
Q

patient selection for mtx

A
  • asymptomatic, compliant, hemodynamically stable patient
  • low initial b-hCG (usually <5,00- mIU/mL)
  • small ectopic pregnancy size (<3.5 cm)
  • no cardiac activity
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56
Q

used to remove unruptured pregnancy that is <2 cm in size; 10 to 15 mm linear incision is made at the antimesenteric border; products of conception will extrude or will be flushed out; incision will not be sutured

  • salpingostomy
  • salpingotomy
  • salpingectomy
A

salpingostomy

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57
Q

same as salpingostomy except that the incision is closed with delayed-absorbable suture

  • salpingostomy
  • salpingotomy
  • salpingectomy
A

salpingotomy

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58
Q

complete excision of the fallopian tube

  • salpingostomy
  • salpingotomy
  • salpingectomy
A

salpingectomy

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59
Q

risk factor of hydatidiform mole

A
  • extremes in maternal age
  • paternal age
  • OB history
  • racial factors
  • diet and nutrition
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60
Q

46 XX karyotype

  • complete h. mole/CHM
  • partial h. mole/PHM
A

chm

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61
Q

initial hCG level >100k mIU/mL

  • complete h. mole/CHM
  • partial h. mole/PHM
A

chm

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62
Q

theca lutein cysts 25/30%

  • complete h. mole/CHM
  • partial h. mole/PHM
A

chm

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63
Q

rate of subsequent GTN 15-25%

  • complete h. mole/CHM
  • partial h. mole/PHM
A

chm

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64
Q

embryo-fetus absent

  • complete h. mole/CHM
  • partial h. mole/PHM
A

chm

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65
Q

villous edema widespread

  • complete h. mole/CHM
  • partial h. mole/PHM
A

chm

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66
Q

moderate to severe trohpoblastic proliferation

  • complete h. mole/CHM
  • partial h. mole/PHM
A

chm

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67
Q

negative p57(KIP2) immunostaining

  • complete h. mole/CHM
  • partial h. mole/PHM
A

chm

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68
Q

paternal chromosome only plus empty ovum

  • complete h. mole/CHM
  • partial h. mole/PHM
A

chm

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69
Q

gives rise to generalized swelling of placental villi with marked trophoblastic proliferation and absent fetal component

  • complete h. mole/CHM
  • partial h. mole/PHM
A

chm

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70
Q

1 maternal (23X) and 2 paternal chromosomes (23X, 23Y)

  • complete h. mole/CHM
  • partial h. mole/PHM
A

phm

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71
Q

maternal chromosome gives rise to fetal component

  • complete h. mole/CHM
  • partial h. mole/PHM
A

phm

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72
Q

paternal chromosome causes focal swelling of placental villi and milder form of trophoblastic invasion

  • complete h. mole/CHM
  • partial h. mole/PHM
A

phm

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73
Q

69 XXX or 69 XXY

  • complete h. mole/CHM
  • partial h. mole/PHM
A

phm

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74
Q

initial hCG <100k mIU/mL

  • complete h. mole/CHM
  • partial h. mole/PHM
A

phm

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75
Q

theca lutein cysts are rare

  • complete h. mole/CHM
  • partial h. mole/PHM
A

phm

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76
Q

rate of subsequent GTN is 0.4-5%

  • complete h. mole/CHM
  • partial h. mole/PHM
A

phm

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77
Q

embryo-fetus often present

  • complete h. mole/CHM
  • partial h. mole/PHM
A

phm

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78
Q

villous edema is focal

  • complete h. mole/CHM
  • partial h. mole/PHM
A

phm

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79
Q

throphoblastic proliferation is focal, slight to moderate

  • complete h. mole/CHM
  • partial h. mole/PHM
A

phm

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80
Q

positive p57(KIP2) immunostaining

  • complete h. mole/CHM
  • partial h. mole/PHM
A

phm

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81
Q

common presentation of h. mole

A
  • vaginal bleeding - most common
  • amenorrhea
  • (+) PT
  • uterus large for AOG
  • absence of FHT
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82
Q

first and second line chemoprophylaxis

A
  • first line: methotrexate

- second line: actinomycin D

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83
Q

normal fetal activity: ____ fetal movements in up to ___ hours is normal

A

10 fetal movements in up to 2 hours is normal

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84
Q

what is the contraction stress test (CST) a test of?

A

uteroplacental function

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85
Q

requirements for satisfactory CST (3)

A
  • 3 or more contractions
  • 40 seconds or more
  • 10 minute period
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86
Q

methods of CST

A
  • oxytocin infusion

- nipple stimulation

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87
Q

no late or significant variable decelerations

  • negative
  • positive
  • equivocal-suspicious
  • equivocal-hyperstimulatory
  • unsatisfactory
A

negative

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88
Q

later decelerations following 50% or more of contractions (even if there are fewer than 3 contractions in 10 min)

  • negative
  • positive
  • equivocal-suspicious
  • equivocal-hyperstimulatory
  • unsatisfactory
A

positive

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89
Q

intermittent late or significant variable decelerations

  • negative
  • positive
  • equivocal-suspicious
  • equivocal-hyperstimulatory
  • unsatisfactory
A

equivocal-suspicious

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90
Q

decelerations in the presence of contractions more frequent than every 2 min or lasting longer than 90 sec

  • negative
  • positive
  • equivocal-suspicious
  • equivocal-hyperstimulatory
  • unsatisfactory
A

equivocal-hyperstimulatory

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91
Q

less than 3 contractions in 10 min or uninterpretable tracing

  • negative
  • positive
  • equivocal-suspicious
  • equivocal-hyperstimulatory
  • unsatisfactory
A

unsatisfactory

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92
Q

what are the 4 BPS parameters

A
  • fetal tone
  • fetal movement
  • fetal breathing
  • fetal heart reactivity
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93
Q

CNS center is cortex-subcortical area

  • fetal tone
  • fetal movement
  • fetal breathing
  • fetal heart reactivity
A

fetal tone

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94
Q

CNS center is cortex-nuclei

  • fetal tone
  • fetal movement
  • fetal breathing
  • fetal heart reactivity
A

fetal movement

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95
Q

CNS center is ventral surface of 4th ventricle

  • fetal tone
  • fetal movement
  • fetal breathing
  • fetal heart reactivity
A

fetal breathing

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96
Q

CNS center is medulla & posterior hypothalamus

  • fetal tone
  • fetal movement
  • fetal breathing
  • fetal heart reactivity
A

fetal heart reactivity

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97
Q

in the hypoxia cascade, what is the order that BPS parameters are affected?

A

fetal heart reactivity > fetal breathing > fetal movement > fetal tone

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98
Q

normal fetal heart rate (fhr) patterns

A
  • baseline fetal heart rate: 110-160 bpm
  • moderate variability: amplitude 6-25 bpm
  • no late or variable decelerations
  • presence or absence of early decelerations
  • presence of absence of accelerations
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99
Q

what is accelerations of fetal heart rate?

A

visually apparent abrupt increase (onset to peak in less than 30 sec) in FHR

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100
Q

mostly the onset, nadir, and recovery of deceleration are coincident with the beginning, peak, and ending of a contraction, respectively

  • early deceleration
  • late deceleration
  • variable deceleration
  • prolonged deceleration
  • sinusoidal pattern
A

early deceleration

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101
Q

most the onset, nadir, and recovery of deceleration occur after the beginning, peak, and ending of a contraction, respectively

  • early deceleration
  • late deceleration
  • variable deceleration
  • prolonged deceleration
  • sinusoidal pattern
A
  • late deceleration
102
Q

deceleration pattern due to umbilical cord occlusion

  • early deceleration
  • late deceleration
  • variable deceleration
  • prolonged deceleration
  • sinusoidal pattern
A

variable deceleration

103
Q

decrease in FHR >/= bpm, lasting for >/=2 min but < 10 min duration

  • early deceleration
  • late deceleration
  • variable deceleration
  • prolonged deceleration
  • sinusoidal pattern
A

prolonged deceleration

104
Q

visually apparent, smooth, sine wave-like undulating pattern in FHR baseline with a cycle frequency of 3-5 bpm which persists for >/= 20 min

  • early deceleration
  • late deceleration
  • variable deceleration
  • prolonged deceleration
  • sinusoidal pattern
A

sinusoidal pattern

105
Q

abnormal fetal heart rate assessment

A

Either:

  • absent baseline variability + any of the following:
  • recurrent late deceleration
  • recurrent variable deceleration
  • bradycardia
  • sinusoidal pattern
106
Q

Bishop score of 9

A

high likelihood for a successful induction

107
Q

Bishop score of = 4

A

unfavorable cervix and may be an indication for cervical ripening

108
Q

floating

  • 5
    0
    + 5
A

-5

109
Q

engaged

  • 5
    0
    + 5
A

0

110
Q

crowning

  • 5
    0
    + 5
A

+5

111
Q

pharmacological techniques for preinduction cervical ripening

A
  • dinoprostone
  • misoprostol
  • nitric oxide donors
112
Q

mechanical techniques for preinduction cervical ripening

A
  • transcervical catheter

- hygroscopic cervical dilator

113
Q

methods of labor induction (4)

A
  • membrane stripping
  • oxytocin
  • nipple stimulation
  • amniotomy
114
Q

relation of the long axis of the fetus to that of the mother

  • fetal lie
  • fetal presentation
  • fetal attitude or posture
  • fetal position
A

fetal lie

115
Q

presenting part foremost in the birth canal or in closest proximity with it

  • fetal lie
  • fetal presentation
  • fetal attitude or posture
  • fetal position
A

fetal presentation

cephalic, breech, shoulder

116
Q

fetus is flexed or extended

  • fetal lie
  • fetal presentation
  • fetal attitude or posture
  • fetal position
A

fetal attitude or posture

117
Q

relationship of an arbitrarily chosen presenting part to the right or left side of the maternal birth canal

  • fetal lie
  • fetal presentation
  • fetal attitude or posture
  • fetal position
A

fetal position

118
Q

stage of cervical effacement and dilation

  • 1st stage
  • 2nd stage
  • 3rd stage
A

1st stage

119
Q

stage of fetal expulsion

  • 1st stage
  • 2nd stage
  • 3rd stage
A

2nd stage

120
Q

stage of placental separation and expulsion

  • 1st stage
  • 2nd stage
  • 3rd stage
A

3rd stage

121
Q

divisions of labor (3)

A
  • preparatory division
  • dilational division
  • pelvic division
122
Q

cervix dilate little but connective tissue components change

  • preparatory division
  • dilational division
  • pelvic division
A

preparatory division

123
Q

dilation proceeds at its most rapid rate, unaffected by sedation

  • preparatory division
  • dilational division
  • pelvic division
A

dilational division

124
Q

cardinal fetal movements take place in this division

  • preparatory division
  • dilational division
  • pelvic division
A

pelvic division

125
Q

prolonged latent phase of > 20 hours

  • nullipara
  • multipara
A

nullipara

126
Q

prolonged latent phase of >14 hours

  • nullipara
  • multipara
A

multipara

127
Q

rate of cervical dilation for nullipara

  • 1.2 cm/hr
  • 1.5 cm/hr
  • 1.8 cm/hr
A

1.2 cm/hr

128
Q

rate of cervical dilation for multipara

  • 1.2 cm/hr
  • 1.5 cm/hr
  • 1.8 cm/hr
A

1.5 cm/hr

129
Q

Median duration of 2nd stage of cardinal movements (nullipara, multipara)

A
  • nullipara: 50 min

- multipara: 20 min

130
Q

what are the cardinal movements

A
  • engagement
  • descent
  • flexion
  • internal rotation
  • extension
  • external rotation
  • expulsion
131
Q

biparietal diameter passes through the pelvic usually either transversely or obliquely

  • engagement
  • descent
  • flexion
  • internal rotation
  • extension
  • external rotation
  • expulsion
A
  • engagement
132
Q

first requisite for birth of the newborn

  • engagement
  • descent
  • flexion
  • internal rotation
  • extension
  • external rotation
  • expulsion
A

descent

133
Q

the chin is brought into more intimate contact with the fetal thorax

  • engagement
  • descent
  • flexion
  • internal rotation
  • extension
  • external rotation
  • expulsion
A

flexion

134
Q

the occiput gradually moves toward the symphysis pubis anteriorly from its original position

  • engagement
  • descent
  • flexion
  • internal rotation
  • extension
  • external rotation
  • expulsion
A

internal rotation

135
Q

base of the occiput is in direct contact with the inferior margin of the symphysis pubis

  • engagement
  • descent
  • flexion
  • internal rotation
  • extension
  • external rotation
  • expulsion
A

extension

136
Q

rotation of the fetal body and serves to bring its biacromial diameter into relation with the anterposterior diameter of the pelvic outlet

  • engagement
  • descent
  • flexion
  • internal rotation
  • extension
  • external rotation
  • expulsion
A

external rotation

137
Q

gentle downward traction to deliver the anterior shoulder > upward traction to deliver the posterior shoulder > the rest of the body

  • engagement
  • descent
  • flexion
  • internal rotation
  • extension
  • external rotation
  • expulsion
A

expulsion

138
Q

pelvic planes are (3)

A
  • inlet
  • midplane
  • outlet
139
Q

landmarks: promontory, alae of the sacrum, linea terminalis, pubic rami, symphysis pubis

  • inlet
  • midplane
  • outlet
A

inlet

140
Q

landmark: at the level of the ischial spines

  • inlet
  • midplane
  • outlet
A

midplane

141
Q

landmark: ischial tuberosities

  • inlet
  • midplane
  • outlet
A

outlet

142
Q

diameters: diagonal conjugate (dc), obstetric conjugate, true/anatomic conjugate

  • inlet
  • midplane
  • outlet
A

inlet

143
Q

diameters: anterposterior diameter, interspinous diameter

  • inlet
  • midplane
  • outlet
A

midplane

144
Q

diameters: pubic arch, interberous diameter

  • inlet
  • midplane
  • outlet
A

outlet

145
Q

during labor, engagement is defined by the fetal BPD passing through this plane

  • inlet
  • midplane
  • outlet
A

inlet

146
Q

plane of least dimensions

  • inlet
  • midplane
  • outlet
A

midplane

147
Q

seldom obstructs vaginal delivery

  • inlet
  • midplane
  • outlet
A

outlet

148
Q

promontory, alae of the sacrum

  • posterior inlet landmark
  • lateral inlet landmark
  • anterior inlet landmark
A

posterior inlet landmark

149
Q

linea terminalis

  • posterior inlet landmark
  • lateral inlet landmark
  • anterior inlet landmark
A

lateral inlet landmark

150
Q

pubic rami, symphysis pubis

  • posterior inlet landmark
  • lateral inlet landmark
  • anterior inlet landmark
A

anterior inlet landmark

151
Q

> 11.5 cm

  • diagonal conjugate (DC)
  • obstetric conjugate
  • true/anatomic conjugate
A

diagonal conjugate

152
Q

promontory to lower margin of symphysis

  • diagonal conjugate (DC)
  • obstetric conjugate
  • true/anatomic conjugate
A

diagonal conjugate

153
Q

> 10 cm

  • diagonal conjugate (DC)
  • obstetric conjugate
  • true/anatomic conjugate
A

obstetric conjugate

154
Q

shortest distance between the promontory and symphysis pubis

  • diagonal conjugate (DC)
  • obstetric conjugate
  • true/anatomic conjugate
A

obstetric conjugate

155
Q

11 cm

  • diagonal conjugate (DC)
  • obstetric conjugate
  • true/anatomic conjugate
A

true/anatomic conjugate

156
Q

promontory to upper margin of symphysis

  • diagonal conjugate (DC)
  • obstetric conjugate
  • true/anatomic conjugate
A

true/anatomic conjugate

157
Q

signs of placental separation (4)

A
  • sudden gush of blood
  • globular and firmer fundus
  • lengthening of umbilical cord
  • rise of uterus into the abdomen
158
Q

unang yakap/essential newborn care (DOH) (4)

A
  • immediate and thorough drying
  • early skin-to-skin contact
  • properly timed cord clamping
  • non-separation for early breastfeeding
159
Q

First-line uterotonic

A

high-dose oxytocin

160
Q

Second-line uterotonic

A
  • methylergonovine maleate
  • carbetocin
  • carboprost
161
Q

surgical repair relatively easy

  • midline episiotomy
  • mediolateral episiotomy
A
  • midline episiotomy
162
Q

faulty healing is rare

  • midline episiotomy
  • mediolateral episiotomy
A
  • midline episiotomy
163
Q

anatomical results is excellent

  • midline episiotomy
  • mediolateral episiotomy
A
  • midline episiotomy
164
Q

less blood loss

  • midline episiotomy
  • mediolateral episiotomy
A
  • midline episiotomy
165
Q

dyspareunia is rare

  • midline episiotomy
  • mediolateral episiotomy
A
  • midline episiotomy
166
Q

extensions are common

  • midline episiotomy
  • mediolateral episiotomy
A
  • midline episiotomy
167
Q

surgical repair

  • midline episiotomy
  • mediolateral episiotomy
A
  • mediolateral episiotomy
168
Q

faulty healing is more common

  • midline episiotomy
  • mediolateral episiotomy
A
  • mediolateral episiotomy
169
Q

postoperative pain is common

  • midline episiotomy
  • mediolateral episiotomy
A
  • mediolateral episiotomy
170
Q

anatomical results occasionally faulty

  • midline episiotomy
  • mediolateral episiotomy
A
  • mediolateral episiotomy
171
Q

more blood loss

  • midline episiotomy
  • mediolateral episiotomy
A
  • mediolateral episiotomy
172
Q

occasional dyspareunia

  • midline episiotomy
  • mediolateral episiotomy
A
  • mediolateral episiotomy
173
Q

extensions uncommon

  • midline episiotomy
  • mediolateral episiotomy
A
  • mediolateral episiotomy
174
Q

fourchette, perineal skin, and vaginal mucous membrane but not the underlying fascia and muscle

  • 1st degree perineal laceration
  • 2nd degree perineal laceration
  • 3rd degree perineal laceration
  • 4th degree perineal laceration
A

1st degree

175
Q

aside from skin and mucous membrane, the fascia and muscles of the perineal body are involved

  • 1st degree perineal laceration
  • 2nd degree perineal laceration
  • 3rd degree perineal laceration
  • 4th degree perineal laceration
A

2nd degree

176
Q

lacerations extend through skin, mucous membrane, perineal body and anal sphincter (EAS) is torn

  • 1st degree perineal laceration
  • 2nd degree perineal laceration
  • 3rd degree perineal laceration
  • 4th degree perineal laceration
A

3rd degree

177
Q

extension of laceration through the rectal mucosa to expose lumen of the rectum

  • 1st degree perineal laceration
  • 2nd degree perineal laceration
  • 3rd degree perineal laceration
  • 4th degree perineal laceration
A

4th degree

178
Q

<50% of the external anal sphincter (EAS) is torn

  • 3a lacerations
  • 3b lacerations
  • 3c lacerations
A

3a

179
Q

> 50% of EAS is torn, internal anal sphincter (IAS) is intact

  • 3a lacerations
  • 3b lacerations
  • 3c lacerations
A

3b

180
Q

EAS and IAS are torn

  • 3a lacerations
  • 3b lacerations
  • 3c lacerations
A

3c

181
Q

what are the indications for operative vaginal delivery (OVD)

A
  • maternal indications
  • prolonged second stage
  • suspicion of immediate or potential fetal compromise
  • shortening of 2nd stage for maternal benefit
182
Q

how is prolonged second stage defined for nulliparous

A

> 3 hours with regional anesthesia

>2 hours without regional anesthesia

183
Q

how is prolonged second stage defined for multiparous

A

> 2 hours with regional anesthesia

>1 hour without regional anesthesia

184
Q

criteria for outlet forceps extraction (OFE) (5)

A
  • scalp is visible at introitus without separating the labie
  • fetal skull has reached pelvic floor
  • sagittal suture is in AP diameter or ROA/LOA or ROP/LOP
  • fetal head is at or on perineum
  • rotation does not exceed 45 degrees
185
Q

prerequisites (forceps)

A
  • fully dilated cervix
  • occiput/vertex presentation
  • ruptured membranes
  • CPD not suspected
  • engaged head, experience operator, emptied bladder
  • position known, painless (adequate anesthesia)
  • size (fetal weight) estimated
186
Q

where is the flexion point for vacuum extraction?

A

approximately 3 cm in front of the posterior fontanel and approximately 6 cm from the anterior fontanel

187
Q

risk factors

A
  • extremes of amniotic fluid volume
  • multifetal gestation
  • hydrocephaly
  • anencephaly
  • structural uterine abnormalities
  • placenta previa
  • pelvic tumors
  • prior breech delivery
188
Q

fetus is expelled entirely without any traction or manipulation other than support of the newborn

  • spontaneous breech delivery
  • partial breech extraction
  • total breech extraction
A

spontaneous breech delivery

189
Q

fetus is delivered spontaneously as far as the umbilicus, but the remainder of the body is delivered by provider traction and assisted maneuvers, with or without maternal expulsive efforts

  • spontaneous breech delivery
  • partial breech extraction
  • total breech extraction
A

partial breech extraction

190
Q

entire fetal body is extracted by the provider

  • spontaneous breech delivery
  • partial breech extraction
  • total breech extraction
A

total breech extraction

191
Q

cardinal movements in breech presentation

A
  • engagement and descent
  • internal rotation
  • lateral flexion
  • external rotation
  • internal rotation
  • expulsion
192
Q

maternal indications for cesarean delivery

A
  • prior cesarean delivery
  • abnormal placentation (e.g. placenta accrete)
  • prior classical hysterotomy
  • unknown uterine scar type
  • uterine incision dehiscence
  • select prior surgeries (full-thickness, myomectomy, trachelectomy, pelvic reconstructive surgery)
  • genital tract obstructive mass (e.g. tumor previa)
  • invasive cervical cancer
  • HIV or HSV infection
  • perimortem delivery
193
Q

maternal-fetal indications for cesarean delivery

A
  • CPD
  • failed OVD
  • placenta previa or placental abruption
194
Q

fetal indications for cesarean delivery

A
  • nonreassuring fetal status
  • malpresentation
  • macrosomia
  • congenital anomoly
  • abnormal umbilical cord doppler study
  • thrombocytopenia
  • prior neonatal birth trauma
195
Q

Types of suprapubic transverse incision

A
  • Pfannenstiel
  • Maylard
  • Joel-Cohen
  • Misgav Ladach
196
Q

Skin incised in a transverse, slightly curvilinear manner 3cm above the border of the symphysis

  • Pfannenstiel
  • Maylard
  • Joel-Cohen
  • Misgav Ladach
A

Pfannenstiel

197
Q

main difference with Pfannenstiel is that rectus abdominis muscle bellies are transected in this technique

  • Pfannenstiel
  • Maylard
  • Joel-Cohen
  • Misgav Ladach
A

Maylard

198
Q

greater use of blunt dissection; a straight 10cm transverse skin incision is made 3cm below the ASIS

  • Pfannenstiel
  • Maylard
  • Joel-Cohen
  • Misgav Ladach
A

Joel-Cohen

199
Q

differs from Joel-Cohen in that the peritineum is entered bluntly

  • Pfannenstiel
  • Maylard
  • Joel-Cohen
  • Misgav Ladach
A

Misgav Ladach

200
Q

low transverse cesarean incision

  • Kerr
  • Kronig
A

Kerr

201
Q

preferred and most common uterine incision

  • Kerr
  • Kronig
A

Kerr

202
Q

associated with less bleeding and risk of rupture

  • Kerr
  • Kronig
A

Kerr

203
Q

low-vertical incision

  • Kerr
  • Kronig
A

Kronig

204
Q

confined to the lower uterine segment (LUS)

  • Kerr
  • Kronig
A

Kronig

205
Q

periurethral glands

  • skene’s glands
  • bartholin’s glands
A
  • skene’s glands
206
Q

lesser vestibular glands

  • skene’s glands
  • bartholin’s glands
A
  • skene’s glands
207
Q

homologous of prostrate

  • skene’s glands
  • bartholin’s glands
A
  • skene’s glands
208
Q

tubulo alveolar gland type

  • skene’s glands
  • bartholin’s glands
A
  • skene’s glands
209
Q

adjacent to the urethra

  • skene’s glands
  • bartholin’s glands
A
  • skene’s glands
210
Q

common pathology is urethral diverticulum

  • skene’s glands
  • bartholin’s glands
A
  • skene’s glands
211
Q

vulvovaginal glands

  • skene’s glands
  • bartholin’s glands
A
  • bartholin’s glands
212
Q

greater vestibular glands

  • skene’s glands
  • bartholin’s glands
A
  • bartholin’s glands
213
Q

compound alveolar/compound acinar gland type

  • skene’s glands
  • bartholin’s glands
A
  • bartholin’s glands
214
Q

4 and 8 o’clock of the vagina

  • skene’s glands
  • bartholin’s glands
A
  • bartholin’s glands
215
Q

supplied by the cervico-vaginal branch of uterine artery

  • upper 1/3
  • middle 1/3
  • lower 1/3
A
  • upper 1/3
216
Q

external and internal iliac nodes

  • upper 1/3
  • middle 1/3
  • lower 1/3
A
  • upper 1/3

- middle 1/3

217
Q

innervated by sympathetic via hypogastric plexus; parasympathetic via S2-S4 (low density)

  • upper 1/3
  • middle 1/3
  • lower 1/3
A
  • upper 1/3

- middle 1/3

218
Q

supported by upper portion of cardinal ligaments

  • upper 1/3
  • middle 1/3
  • lower 1/3
A
  • upper 1/3
219
Q

inferior vesical artery blood supply

  • upper 1/3
  • middle 1/3
  • lower 1/3
A
  • middle 1/3
220
Q

supported by levator ani muscle and lower portion of cardinal ligaments

  • upper 1/3
  • middle 1/3
  • lower 1/3
A
  • middle 1/3
221
Q

supplied by middle rectal and internal pudendal artery

  • upper 1/3
  • middle 1/3
  • lower 1/3
A
  • lower 1/3
222
Q

drained by inguinal nodes

  • upper 1/3
  • middle 1/3
  • lower 1/3
A
  • lower 1/3
223
Q

innervated by general somatic via the pudendal nerve

  • upper 1/3
  • middle 1/3
  • lower 1/3
A
  • lower 1/3
224
Q

supported by the urogenital and pelvic diaphragm

  • upper 1/3
  • middle 1/3
  • lower 1/3
A
  • lower 1/3
225
Q

what are the segments of the fallopian tube?

A
  • intramural interstitial
  • isthmus
  • ampulla
  • infundibulum
226
Q

1 to 2 cm in length and is surrounded by myometrium

  • intramural interstitial
  • isthmus
  • ampulla
  • infundibulum
A
  • intramural interstitial
227
Q

ectopic pregnancy at this area result in severe maternal morbidity

  • intramural interstitial
  • isthmus
  • ampulla
  • infundibulum
A
  • intramural interstitial
228
Q

the narrow portion of the tube that adjoins the uterus, passes gradually into the wider, lateral portion

  • intramural interstitial
  • isthmus
  • ampulla
  • infundibulum
A

isthmus

229
Q

narrowest portion

  • intramural interstitial
  • isthmus
  • ampulla
  • infundibulum
A

isthmus

230
Q

preferred portion for applying clips and tubal ligation

  • intramural interstitial
  • isthmus
  • ampulla
  • infundibulum
A

isthmus

231
Q

it is wider and more tortuous in its course than other segments

  • intramural interstitial
  • isthmus
  • ampulla
  • infundibulum
A

ampulla

232
Q

most common site of fertilization

  • intramural interstitial
  • isthmus
  • ampulla
  • infundibulum
A

ampulla

233
Q

tunnel shaped opening of the distal end of the fallopian tube

  • intramural interstitial
  • isthmus
  • ampulla
  • infundibulum
A

infundibulum

234
Q

ligaments of the ovary

A
  • mesovarium
  • ovarian ligament
  • infundibulopelvic ligament
235
Q

attaches to the anterior border of the ovary

  • mesovarium
  • ovarian ligament
  • infundibulopelvic ligament
A

mesovarium

236
Q

contains the arterial anastomotic branches of the ovarian and uterine arteries, a plexus of veins, and the lateral end of the ovarian ligament

  • mesovarium
  • ovarian ligament
  • infundibulopelvic
  • ovarian ligament
  • infundibulopelvic ligament
A
  • mesovarium
237
Q

narrow, short, fibrous band that extends from the lower pole of the ovary to the uterus

  • mesovarium
  • ovarian ligament
  • infundibulopelvic ligament
A
  • ovarian ligament
238
Q

contains the ovarian artery, ovarian veins, and accompanying nerves

  • mesovarium
  • ovarian ligament
  • infundibulopelvic ligament
A
  • infundibulopelvic ligament
239
Q

attaches the upper pole of the ovary to the lateral pelvic wall

  • mesovarium
  • ovarian ligament
  • infundibulopelvic ligament
A
  • infundibulopelvic ligament
240
Q

blood supply of the ovaries

A
  • ovarian arteries

- ovarian veins

241
Q

left ovarian vein drains into

  • renal vein
  • inferior vena cava
A

left renal vein

242
Q

right ovarian vein drains into

  • renal vein
  • inferior vena cava
A

inferior vena cava

243
Q

diaphragms and ligaments of the ovaries

A
  • pelvic diaphragm
  • urogenital diaphragm
  • broad ligament
  • cardinal ligament
  • uterosacral ligament
  • round ligament
244
Q

important in the control of urination, in parturition, and in maintaining fecal continence

  • pelvic diaphragm
  • urogenital diaphragm
  • broad ligament
  • cardinal ligament
  • uterosacral ligament
  • round ligament
A

pelvic diaphragm

245
Q

facilitates equal distribution of intrabdominal pressure during activities such as coughing

  • pelvic diaphragm
  • urogenital diaphragm
  • broad ligament
  • cardinal ligament
  • uterosacral ligament
  • round ligament
A

pelvic diaphragm

246
Q

divide the pelvic cavity into anterior and posterior compartments

  • pelvic diaphragm
  • urogenital diaphragm
  • broad ligament
  • cardinal ligament
  • uterosacral ligament
  • round ligament
A

broad ligament

247
Q

carries the reproductive structures, ovarian arteries and ligaments, and uterine arteries and ligaments

  • pelvic diaphragm
  • urogenital diaphragm
  • broad ligament
  • cardinal ligament
  • uterosacral ligament
  • round ligament
A
  • broad ligament
248
Q

provide the major support of the uterus and cervix

  • pelvic diaphragm
  • urogenital diaphragm
  • broad ligament
  • cardinal ligament
  • uterosacral ligament
  • round ligament
A

cardinal ligament

249
Q

from posterolateral to the supravaginal portion of the cervix encircling the rectum then inserts into the fascia over S2 and S3

  • pelvic diaphragm
  • urogenital diaphragm
  • broad ligament
  • cardinal ligament
  • uterosacral ligament
  • round ligament
A

uterosacral ligament

250
Q

Extend from the lateral portion of the
uterus, arising below and anterior to origin of the oviducts, that is continuous with the broad ligament, outward and downward to the inguinal canal terminating at upper portion of labia majora

  • pelvic diaphragm
  • urogenital diaphragm
  • broad ligament
  • cardinal ligament
  • uterosacral ligament
  • round ligament
A

round ligament

TN Gen (2 decks)

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