OB Hx Taking Flashcards
What are variables that influence the status of the px?
Patient: age, hpi, attitude and perception, sex orientation, habits
Fam: px status, caregiving, siblings, hx
Environment: social, economic status, religion, culture and ethnic bg, career
In communication, foundation is based on what 4 key skills?
Empathy
Attentive listening
Expert knowledge
Ability to est rapport
What is the number of times the woman has been or is pregnant?
Gravidity
What is the number of times the woman has delivered a fetus 20 weeks and above, dead or alive?
Parity
For multifetal pregnancy, delivery counts as how many in the parity score?
One
How do you get the OB score?
GP (- - - -)
G - preggy (dead or alive
P - preggy but >20wks (dead or alive)
Full term, pre term, abort, living)
In the AOG based on quickening, how many weeks will be added if primigravidas?
20 weeks
In the AOG based on quickening, how many weeks will be added if multigravidas?
16 weeks
How do you calculate the EDC using Naegele’s rule?
Add 7 days to first day LMP
Subtract 3 months
Add 1 year
EDC responds to what week of gestation?
40th week
How many weeks is considered as full-term?
37-42 weeks
How do you assess previous pregnancies in successful deliveries?
Date Length of gestation Duration of labor Mtd of delivery and where BW Sex of infant Cx
How do you assess previous pregnancies in abortion?
Date
AOG
Date of D&C (if done)
Spontaneous or induced
OB hx, what will you add in present pregnancy?
LMP
AOG
EDC
Usual chief complaint
Labor pains Vaginal bleeding Painless vaginal bleeding Rupture of membranes (watery discharge) Abdominal pain Absence of fetal movements
HPI: Labor pains
Hypogastric pain Crampy Uterine contractions onset Severity (PS) Frequency Interval Duration Ass s/s
HPI: Vag bleeding
Onset Associated pain and/or contractions Est amt Consistency Odor Color
Painless vaginal bleeding characterizes what?
Placenta previa
HPI: rupture membranes
Onset in hrs/days prior to examination Amt Character of fluid Associated contractions Bleeding
HPI: Abd pain (OB)
Ectopic pregnancies Uterine rupture Abruption of placenta Ass loss of consciousness Pallor Bleeding
Gyne px
Menstrual hx
Common: irregular menses
PCOS (food, stress)
HPI for gyne: abdominal pain
Onset Char Loc Duration and freq Radiation Aggravating Relieving Meds Ass s/s
HPI for gyne: abdominal mass
Onset Loc Initial size to present Char/description Mobility of mass (will it elicit pain) Ass s/s (e.g early satiety, urination)
HPI for gyne: abnormal uterine bleeding
- heavy mens
- intermenstrual bleed
- postcoital bleed
- postmenopausal bleed
Onset Char Amnt Interval Duration Ass s/s Aggravating Relieving Meds (eg hormones) - compliance - example progestin irreg, amenorrhea, spotting
HPI for gyne: abn vaginal discharge
Onset Duration Char Amt Ass s/s Meds/home remedies
HPI for gyne: vulvar pruritus
Onset Duration Ass s/s Recurrence Aggravating Relieving Meds/home rem
HPI for gyne: vag bleed
Onset Loc Dur Ass ss Agg relieving Possible causes like trauma meds/home remedies
HPI for gyne: others
Retained IUD
Foreign body
Postcoital laceration/bleeding/pain
Amenorrhea
What must yield the correct diagnosis in 98% of cases?
A complete medical hx and thorough PE
What clinch the diagnosis and make up 2%?
Ancillary procedures (labs, radiography, sonography, CT scans, MRI, etc.)
HRT (hormonal tx)
Menopausal
Vaginismus
Discomfort when touching the vag
Psychological
Dyspareunia
Discomfort or pain
Immunizations in pregnancy
TT
TdaP
Hepa B
Flu vaccine
Mass
Cystic - indent using fingers
Firm (common) - as hard as nose
Solid - as hard as your forehead
Mass
Bartholin cyst
