OBGYN Flashcards
What separates normal hemodilution of pregnancy from other anemias
hemodilution does not effect MCV
Thalassemias, Iron, and folate deficiencies do change MCV
The increased minute ventilation during pregnancy causes an acid base what?
compensated respiratory alkalosis
ph ↑ co2 and bicarb ↓ (RO)
The Resp rate does not change in pregnancy, but the ______ is increased which increases the minute ventilation, which is responsible for the _______ (acid base)
Tidal volume up
respiratory alkalosis in pregnancy is normal acid base status
Use of ______ increases the susceptibility of pulmonary edema, especially with the use of isotonic fluids.
multiple tocolytics
The cardiac output increases up to 33% due to _______ in pregnant people.
increases in both the heart rate and stroke volume
Up to 95% of women will have a systolic murmur due to the increased volume.
Diastolic murmurs are always abnormal.
_____ murmurs are always abnormal in prego
Diastolic
what is the symmetry `of hydronephrosis of pregnancy
The dilation is unequal (R > L)
sigmoid cushions left ureter
right ureter compressed by uterus and right ovarian vein complex
the _______ are the most common site of metastatic disease in patients with gestational trophoblastic disease (molar prego)
lungs
weight gain in pregnancy for underweight (BMI
total weight gain 28 – 40 pounds;
weight gain in pregnancy for normal weight (BMI 18.5 – 24.9 kg/m2)
total weight gain 25 – 35 pounds; pounds.
weight gain in pregnancy for overweight (BMI 25 – 29.9 kg/m2)
total weight gain 15 - 25 pounds
weight gain in pregnancy for obese (BMI > 30 kg/m2)
total weight gain 11 - 20 pounds.
How would you screen a couple for sickle cell?
HgB electrophoresis
smear likely wont show sickling, esp. in carriers
Valproic acid in prego is is associated with an increased risk for ____________________
neural tube defects, hydrocephalus and craniofacial malformations.
Women with poorly controlled DM immediately prior to conception/ during organogenesis have a 8 fold risk of having a fetus with _______________-
central nervous system (neural tube defects) and the cardiovascular defects
Chorionic villus sampling (CVS) is a prenatal test that diagnoses ________ by sampling placenta chorionic villi
genetic disorders (tri-21, CF, etc)
If there is a history of a FDR with colon cancer before age 60, then begin screening with colonoscopy at age ________, and repeat every five years.
40, or 10 years before the youngest relative diagnosis
Bone density screening is recommended for women beginning at age _____ unless they have pre-existing risk factors which warrant earlier screening.
65
Unless they have pre-existing risk factors
Risk factors for osteoporosis are:
early menopause glucocorticoid therapy sedentary lifestyle alcohol consumption hyperthyroidism hyperparathyroidism anticonvulsant therapy vitamin D deficiency family history of early or severe osteoporosis chronic liver or renal disease.
______________ is the number one killer of women
Heart disease
__________ is the most effective screening test for Down syndrome.
Cell-free DNA screening
Associated risks of gestational diabetes.
Shoulder dystocia metabolic disturbances preeclampsia polyhydramnios fetal macrosomia
According to ACOG, the recommended dose of folate for non-high risk patients is at least ______
0.6 mg/day.
women with a previous pregnancy complicated by a fetal neural tube defect should ingest _____ daily before conception and through the first trimester
4 mg of folic acid
Incorrect dating, specifically _________, is the most common explanation for an elevated MSAFP.
under-estimation of gestational age
Ibuprofen is safe to take until around ___________, when premature closure of the ductus arteriosis is a risk.
32 weeks gestation
All women with + cultures for GBS/ hx of baby with GBS should receive antibiotics in this time frame?
antibiotics in labor always.No culture nessiciary ever
no ab’s if a c-section is performed before onset of labor in a woman with intact amniotic membranes.
If the fetal heart rate cannot be confirmed using external methods, then the most reliable way to document fetal well-being is to?
apply a fetal scalp electrode
ultrasound is good, but can’t do continuous monitoring
Umbilical cord prolapse occurs in 1% of births and shows _________ on fetal monitoring
Sustained fetal bradycardia is usually observed.
Late decelerations are associated with ___________
uteroplacental insufficiency.
Once an umbilical cord prolapse is diagnosed, what do you do?
expeditious cesarean section.
do not replace the umbilical cord into the uterus or allow the patient to continue to labor or perform a forceps-assisted vaginal delivery.
_____________ babies are more common with type 1 diabetes than with gestational diabetes
Small
_______________ is a warning sign that the infant may be septic.
Fetal tachycardia coupled with minimal variability
A septic infant will typically appear pale, lethargic and have a high temperature.
A septic infant will typically appear ____________
pale, lethargic and have a high temperature.
Infants born to diabetic mothers are at increased risk for developing?
polycythemia hyperbilirubinemia hypoglycemia, hypocalcemia a respiratory distress.
How do you treat the baby of HIV + moms?
Treat the infant with zidovudine (AZT) immediately after delivery
define uterine atony
floppy uterus that wont contract
major cause of postpartum hemorrhage
The safest method to suppress lactation is ____________
breast binding, ice packs, and analgesics.
After delivery, large amounts of prolactin continue to be secreted, milk is produced after the inhibitory action of ___________ is lifted.
estrogen and progesterone
The discriminatory zone for hCG is?
the serum level above which a gestational sac should be visualized by ultrasound examination if an IUP is present
usually= 2000
Beta-hCG in a normal pregnancy level should rise by at least ______ until the pregnancy is ____ old
50% every 48 hours
42 days
Criteria for methotrexate therapy for treatment of an ectopic pregnancy.
- hemodynamic stability
- non-ruptured ectopic pregnancy
- size of ectopic mass
What are the 2 treatments for ectopic
ruptured/ no follow up= laparoscopy
safe/ reliable = methotrexate
