Brainscape's Knowledge GenomeTM

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


See full index

MS3 > OBGYN 1 > Flashcards

OBGYN 1 Flashcards

1
Q

What do the GP numbers stand for.

E.g. G3P1234

A 
G = total pregnancies
P1 = term pregnancies
P2 = preterm pregnancies
P3 = abortion/miscarriage/molar pregnancies/etc
P4 = living children
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the structural causes of abnormal uterine bleeding

A

PALM
• P = polyp
o Vascular, glandular, fibromusclar, connective tissue
• A = adenomyosis
o Endometrial cells growing within the myometrium
• L = leiomyoma (fibroid)
o Benign neoplastic proliferation of smooth muscle arising from myometrium
• M = malignancy and hyperplasia

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

What are the nonstructural causes of abnormal uterine bleeding

A 
COEIN
•	C = coagulopathy
•	O = ovulatory dysfunction
•	E = endometrial
•	I = iatrogenic 
•	N = not yet classified
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Definition of labor

A

Regular contractions + cervical changes

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

What are the 2 hormones of normal labor

A

Oxytocin and prostaglandin

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

Effects of oxytocin

A

• Released by the posterior pituitary and responsible for uterine contractions, let-down reflex in a breastfeeding mother, and bonding behavior

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

Effects of prostaglandin

A

• Released in tissue throughout the body and responsible for smooth muscle contraction of the uterus and the biophysical changes associated with ripening of the cervix

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

What is the 1st stage of labor

A

• From the onset of labor (closed cervix) to complete dilation of cervix

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

What are the 2 phases in the 1st stage of labor

A
  • Latent phase (closed cervix to 6 cm)

- Active phase (6 cm to complete dilation)

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

What is the 2nd stage of labor

A
  • Pushing and delivery of baby
  • Complete dilation of the cervix
  • Often accompanied by an urge to bear down
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the 3rd stage of labor

A 
•	Placental delivery
•	Signs of separation
- Lengthening of the cord
- Bleeding
- Uterus becomes firm and globular
•	Delivery of placenta with gentle cord traction and counter pressure on uterus above symphysis pubis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the fourth stage of labor

A
  • The first hour immediately after delivery of infant
  • Close observation of vital signs
  • Monitor fundus for firmness
  • Monitor perineum for bleeding/ lochia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe fetal heart rate decelerations

A

♣ V = variable decelerations . . . C = cord compression
♣ E = early decelerations . . . H = head compression
♣ A = acceleration . . . O = oxygenation
♣ L = late decelerations . . . P = placental insufficiency

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

Normal blood loss for vaginal birth

A

< 500 cc

>500 = hemorrhage

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

Normal fetal heart rate baseline

A

110-160

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

Normal frequency of contractions

A

5 or fewer contractions in 10 minutes, averaged over a 30 minute window (Q2 minutes)

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

What are 3 broad categories of dystocia

A

Dystocia = difficult labor

♣ Power - are the contractions strong enough?
♣ Passenger – what is the position of the fetus?
♣ Pelvis - what are the pelvic diameters?

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

Common causes of labor dystocia

A 
♣	Abnormal fetal position
♣	Congenital Anomalies
♣	Hypotonic uterine contraction
♣	Excessive Conduction Anesthesia
♣	Cephalopelvic disproportion (CPD) 
♣	Macrosomia (>4500 gm)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the 4 components we care about in fetal heart rate

A
  • baseline
  • variability
  • accelerations
  • decelerations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does FHR variability tell you

A

• It is an indication of central nervous system development and oxygenation.

21
Q

What is normal FHR variability

A

Moderate = 6-25

22
Q

What does absent FHR variability indicate

A

o Can be associated with sleep cycles, medication effects, fetal acidosis

23
Q

What does marked FHR variability indicate

A

> 25 bpm

o Mild hypoxia, fetal activity, medications

24
Q

What does a sinusoidal FHR pattern mean

A

• Shows a very regular pattern
o Fetal anemia, fetal bleeding, fetal isoimmunization, TTTS, cord occlusion, CNS malformations
o Requires immediate delivery

25
Q

What do FHR accelerations indicate

A

• Indicates normal fetal acid-base status. Fetus is well-oxygenated

26
Q

What does FHR early decelerations look like and indicate

A

o Nadir (largest point of trough) simultaneous with peak of contraction.

o Often vagal response from head compression

27
Q

What does FHR late decelerations look like and indicate

A

o Nadir after peak of contraction.
o Placental insufficiency. Excessive uterine contractions, maternal hypotension, maternal hypoxemia, reduced maternal placental exchange as in hypertensive disorders, diabetes, IUGR abruption

28
Q

What doe FHR variable decelerations look like and indicate

A

o Abrupt onset.
o <30 seconds from onset to beginning of nadir lasting > 15 seconds but < 2 minutes, depth >15 bpm
o Cord compression, movement in the premature fetus

29
Q

Describe Non-stress test (NST)

A

♣ Gather all previous data and determine if the FHR is REACTIVE or NON-REACTIVE
♣ A Reactive NST
• An increase of 15 BPM above baseline for 15 second duration (from baseline to baseline) twice in a 20 minute period.
• Only 65% of fetuses at 28 weeks are reactive by this criteria.
• By 34 weeks 95% of fetuses are reactive.

30
Q

Describe components of category I FHR (baseline, variability, decelerations, acceleration)

A 
Cat I = good!
o	Baseline rate: 110-160 beats per minute (bpm)
o	Baseline FHR variability: moderate
o	Late or variable decelerations: absent
o	Early decelerations: present or absent
o	Accelerations: present or absent
31
Q

Describe components of Category III FHR (baseline, variability, deceleration, acceleration)

A 
Cat III = bad!
o	Absent baseline FHR variability and any of the following:
♣	Recurrent late decelerations
♣	Recurrent variable decelerations
♣	Bradycardia
o	Sinusoidal pattern
32
Q

How does HPV cause cancer? (activation of oncogenes)

A

E6 increases degradation of p53

E7 inactivates the RB gene, which leads to increased synthesis of he intracellular protein p16

33
Q

What are the cardinal movements of labor

A

Descent –> flexion –> internal rotation –> extension –> external rotation –> expulsion

34
Q

When during pregnancy do you give RhoGAM to an Rh neg mom

A

28 weeks

35
Q

What is the range that is considered term pregnancy

A

37-42 weeks

36
Q

Why is magnesium given in pregnant patients

A

Seizure prophylaxis for pre-eclampsia

37
Q

Signs of magnesium toxicity

A

Loss of deep tendon reflexes, HA, vision changes, SOB/chest pain (pulmonary edema), RUQ pain

38
Q

Most accurate clinical indicator of resolution of pre-ecclampsia

A

Diuresis (good urine output)

39
Q

What are the 3 P’s to think about when there is arrest of labor

A
  • Power (contractions)
  • Passenger (
  • Pelvis (pelvis is too small or baby is too large)
40
Q

What is tachysystole

A

Uterine contractions > 5/10 min (> every 2 min)

41
Q

Intervention for tachysystole

A

Decrease or stop oxcytocin, or administer beta-mimetic agent (e.g. Terbutaline) for uterine relaxation

42
Q

Intervention for low BP following epidural or spinal

A

IV fluid bolus, or administer vasopressor agent such as ephedrine

43
Q

Intervention for umbilical prolapse (cord through cervix)

A

Elevate presenting part and emergency C-section

44
Q

Intervention for placental abruption

A

Support BP, stabilize patient, consider C-section if progressive

45
Q

Intervention for uterine rupture

A

Emergency C-section

46
Q

Definition of arrest of active labor

A

• No progress in the active phase of labor (>6 cm) with ruptured membranes for 4 hours without adequate contractions, or 6 hours of inadequate contractions

47
Q

Treatment of repetitive deep variable decelerations

A

Variable decel = cord compression

Tx = amnioinfusion to help alleviate cord compression

48
Q

Tx of repetitive late decelerations after epidural

A

Epidural can lead to hypotension in mom –> placental insufficiency

Tx = IV fluids, then vasopressor (e.g. Ephedrine - causes vasoconstriction of the peripheral vasculature but spares the uterine arteries)

49
Q

What are the 4 signs of placental separation

A

(1) Gush of blood
(2) Lengthening of cord
(3) Firm and globular shape of uterus
(4) Uterus rises up to anterior abd wall

MS3 (88 decks)

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