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My board exam flashcards > OBGYN general concepts > Flashcards

OBGYN general concepts Flashcards

1
Q

Estrogen from ovaries

A

Estradiol

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2
Q

Estrogen from placenta

A

Estriol

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3
Q

Estrogen from adrenal cortex and converted in thecal cell

A

Estrone

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4
Q

Estrone and testosterone converted in theca cells

A

Estradiol

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5
Q

2 cells in testes

A

Leydig and Sertoli

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6
Q

2 cells in ovary

A

Theca cells and Granulosa cells

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7
Q

Sequence of puberty

A

1 thelarche 2 pubic hair growth 3 growth spurt 4 menarche

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8
Q

How many hours does the egg have to be fertilized

A

24 hours

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9
Q

How many days does the sperm have to fertilize the egg

A

1 to 5 days

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10
Q

Progesterone production in pregancy

A

1st trisem CORPUS LUTEUM 2nd and 3rd trisem PLACENTA

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11
Q

Growth hormone of pregnancy

A

human placental lactogen or human chorionic somatotrophin

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12
Q

Functional unit of ovary

A

ovarian follicle

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13
Q

oocytes at fetal period at birth at onset of puberty

A

oocytes at fetal period 6 TO 7 MILLION at birth 1 TO 2 MILLION at onset of puberty 400 000

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14
Q

2 arrests in fetal gameteogenesis

A

primary oocyte arrested ON 5th months AOG at PROPHASE I secondary oocyte arrested at METAPHASE II

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15
Q

Mid cycle pain

A

Mittelschmerz caused by Corpus hemorrhagicum

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16
Q

Luteal cells of the corpus luteum

A

Theca cells and Granulosa cells

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17
Q

After ovulation we get 9 to 11 days of corpus luteum releasing progesterone to maintain anticipated pregnancy until

A

It notes the absence of pregnancy

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18
Q

earliest histological sign of progesterone action

A

BASAL VACUOLATION

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19
Q

Menstrual cycle phase with LOW progesteron SLOWLY RISING estrogen levels

A

early follicular phase

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20
Q

Menstrual cycle phase with LOW progesteron RAPIDLY RISING estrogen levels

A

Late follicular phase

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21
Q

Elevated level of progesterone

A

Luteal phase and pregnancy

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22
Q

PREOVULATORY PHASE of ovarian cycle

A

follicular

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23
Q

PREOVULATORY PHASE of endometrial cycle

A

proliferative

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24
Q

PREOVULATORY PHASE length

A

variable 7 to 21 days

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25
Q

PREOVULATORY PHASE beginning and end

A

day 1 to ovulation

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26
Q

PREOVULATORY PHASE basal body temp

A

low basal

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27
Q

PREOVULATORY PHASE dominant hormone and source

A

estrogen from Follicular granulosa cells

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28
Q

PREOVULATORY PHASE histology

A

straight tubular glands

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29
Q

PREOVULATORY PHASE cervical mucus

A

thin and watery

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30
Q

PREOVULATORY PHASE function

A

replacement of the endometrial cells lost during menses

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31
Q

POSTOVULATORY PHASE of ovarian cycle

A

Luteal phase

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32
Q

POSTOVULATORY PHASE of endometrial cycle

A

Secretory

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33
Q

POSTOVULATORY PHASE length

A

constant 14 days

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34
Q

POSTOVULATORY PHASE beginning and end

A

day of ovulation til start of menses

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35
Q

POSTOVULATORY PHASE basal body temp

A

elevated over baseline

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36
Q

POSTOVULATORY PHASE dominant hormone and source

A

progesterone from Corpus luteum

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37
Q

POSTOVULATORY PHASE histology

A

tortuosus glands with secretions

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38
Q

POSTOVULATORY PHASE cervical mucus

A

thick and sticky

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39
Q

POSTOVULATORY PHASE function

A

prepares the uterus for implantation

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40
Q

what happens to the endometrium when you get pregnant

A

secretory endometrium turn into the DECIDUA the endometrium of pregnancy

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41
Q

Layers of decidua

A
  1. decidua basalis 2 decidua capsularis 3 decidua parietalis
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42
Q

decidua that is part of the placenta invaded by trophoblasts with spiral arteries that are non responsive to vasoactive agents

A

Decidua basalis

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43
Q

decidua layer with spiral arteries and called the DECIDUA VERA lining the uterus

A

decidua parietalis

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44
Q

what enters uterine cavity blastocyst or morula

A

Morula on day 3 post conception AND this becomes the blastocyst

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45
Q

Blastocyst inner cell mass becomes

A

embryoblast

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46
Q

Blastocyst outer cell mass becomes

A

trophoblast with outer layer SYNCITIOTROPHOBLAST producing HCG and CYTOTROPHOBLAST

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47
Q

Implantation occurs on day ____ at _______________

A

day 7 at the posterior superior wall of uterus in the functional layer during the secretory phase

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48
Q

Embryoblast divides into ___ and ___ at week 2 post conception

A

EPIBLAST which will form the amniotic cavity and the HYPOBLAST which will form the yolk sac

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49
Q

Process establishing the 3 primary germ layers

A

gastrulation 1 ectoderm 2 endoderm 3 mesoderm

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50
Q

Ectoderm derivatives or outer layer

A

1 CNS neuroectoderm 2 PNS neural crest 3 SPECIAL SENSES hearing seeing 4 INTEGUMENT layer

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51
Q

Endoderm or internal layer

A

lining of Respiratory tract and Gastrointestinal tract

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52
Q

Mesoderm or middle layer 5

A

1 Muscles 2 Cartilages 3 CVS 4 Urogenital system 5 RBC

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53
Q

FDA category drug. Contraindicated in pregnancy. Fetal risk which outweighs any possible benefits

A

FDA CATEGORY X

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54
Q

FDA CATEGORY. No evidence of risk in humans. Controlled studies shows no risk to humans despite adverse findings in animals.

A

FDA CATEGORY B

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55
Q

FDA CATEGORY. Positive evidence of risk. Studies demonstrate risk but potential benefits may outweigh the risk.

A

FDA CATEGORY D

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56
Q

FDA CATEGORY. Controlled studies show no risk. Adequate studies show no risk to fetus in pregnancy.

A

FDA CATEGORY A

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57
Q

FDA CATEGORY. Risk cannot be ruled out. Control studies are lacking in humans and animals.

A

FDA CATEGORY C

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58
Q

Only part of fetus exposed to mothers blood

A

Syncitiotrophoblast

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59
Q

Abortion

A

20 weeks or less AOG with UTZ regardless of weight

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60
Q

What is the ovulation age of a fetus that is 8 weeks AOG

A

6 weeks. Subtract 2 weeks from AOG

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61
Q

Determine age of fetus 1st trisem

A

CRL

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62
Q

Determine age of fetus 2nd and 3rd t trisem

A

BPD

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63
Q

Functional closure of foramen ovale

A

minutes after birth

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64
Q

Anatomical closure of foramen ovale

A

1 year after birth

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65
Q

Functional closure of ductus arteriosus

A

10 to 12 hours after birth

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66
Q

Anatomical closure of ductus arteriosus

A

2 to 3 weeks after birth

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67
Q

Stage oflung development when surfactant detectible in amniotic fluid

A

Saccular stage 24 to 36 weeks

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68
Q

Completion of alveolar development

A

8 yrs old

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69
Q

Genetic or chromosomal sex dependent on

A

Y chromosome

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70
Q

Gonadal sex differentiation start at 6 weeks secondary to

A

SRY gene

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71
Q

Phenotypic sex

A

Hormones produced

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72
Q

Pregnancy hormone

A

HCG by syncitiotrophoblast. It maintains the corpus luteum.

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73
Q

HCG detectible at __ and doubles every

A

7 to 9 days post fertilization and doubles every 1.4 to 2 days

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74
Q

Progesteron production

A

Corpus luteum until 6 - 8 weeks PLACENTAL syncitiotrophoblast thereafter

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75
Q

Largest organ in fetus

A

adrenals

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76
Q

Softening and compressibility of isthmus at 6 to 8 wks AOG

A

Hegars sign PROBABLE EVIDENCE 6 to 8 wks AOG

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77
Q

softening of the cervix at 6 to 8 wks AOG

A

Goodels sign PROBABLE EVIDENCE 4-8 wks AOG

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78
Q

Bluish or purplish discooration of vagina at 6 wks aog due to inc vascularity

A

Chadwicks sign PRESUMPTIVE EVIDENCE 6 wks AOG

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79
Q

period when uterus is an abdominal organ and NOT a pelvic organ

A

2nd trisem ONLY becomes pelvic organ again near term

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80
Q

Are there gland in the vagina

A

None

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81
Q

Non STD female findings on cervical swab or pap smear

A

candidiasis and bacterial vaginosis. No need to treat partner

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82
Q

All coagulation factors increased during pregnancy except

A

Factor 11 and 13

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83
Q

unit similar between hCG and TSH

A

Alpha unit causing hyperplasia of thyroid gland during pregnancy

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84
Q

weight gain 1st 2nd and 3rd trimester

A

weight gain 1st T 2 LBS 2nd T 11 LBS 3rd T 11 LBS

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85
Q

Definitive evidence of pregnancy

A

1 identification of fetal heart action 2 perception of fetal movement by examiner 3 recognition of embryo or fetus by sonographic exam

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86
Q

Beading pattern

A

due to high PROGESTERONE during LUTEAL phase and PREGNANCY

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87
Q

Ferning pattern

A

due to high ESTROGEN during PRE OVULATORY phase of menstrual cycle

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88
Q

Phases of Ovarian cycle

A

1 Follicular or preovulatory phase 2 Ovulation 3 Luteal or postovulatory phase

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89
Q

Endometrial cycle

A

1 proliferative phase 2 secretory phase

90
Q

What is detected by the pregnancy test

A

BETA subunit of B Hcg recall that it has the same alpha subunti as tsh

91
Q

peak of B HCG at

A

8 to 10 weeks at 100 000

92
Q

doubling of B Hcg

A

doubles every 1.5 to 2 days. Detected 8 to 9 days post ovulation.

93
Q

Fetal heart action by ultrasound vaginal probe

A

5 weeks AOG

94
Q

HR by doppler

A

10 wks AOG

95
Q

HR by stethoscope

A

19 weeks AOG in all but can start at 17 wks

96
Q

Quickening or fetal movement noted at

A

16 to 20 wks AOG OR 4 to 5 months

97
Q

Braxton Hicks contractions

A

28 wks AOG

98
Q

Oral glucose challenge test

A

75g OGCT at 24 to 28 wks AOG

99
Q

Average weight gain during pregnancy

A

27.5 lbs

100
Q

Variables to check for MATERNAL WELL BEING

A

1 BP 2 Weight gain 3 Uterine size

101
Q

correlation of AOG to uterine size at

A

20 to 31 weeks AOG

102
Q

12 weeks AOG at the level of

A

symphysis pubis

103
Q

16 weeks AOG at the level of

A

midway between symphysis pubis and umbilicus

104
Q

20 weeks AOG at the level of

A

umbilicus T10 dermatome

105
Q

fetal kick counting

A

start of 28 weeks Normal is 8 to 10 kicks per 2 hours

106
Q

screening for NTDs or chromosomal abn

A

18 to 18 wks BEFORE 20 wks AOG

107
Q

Dilutional anemia at

A

28 TO 32 weeks AOG

108
Q

GBS screening

A

35 to 37 wks AOG

109
Q

Leupold maneuver

A

35 to 37 wks AOG

110
Q

non stress test

A

GREATER than 41 wks

111
Q

Test of fetal condition

A

NST

112
Q

test of uteroplacental function

A

Contraction stress testing

113
Q

What is Biophysical profile

A

UTZ plus electronic fetal tracing

114
Q

test that measures reaction of fetal HR agains uterine contraction induced by oxytocin or nipple stimulation

A

Contraction stress testing

115
Q

5 components of fetal well being BPP I Hear TAMBourines

A

FETAL 1 HR based on NST 2 tone flexion 3 AFI > 2 amniotic fluid index 4 movements 5 breathing

116
Q

NST Acceleration

A

Fetal movement

117
Q

NST Early deceleration

A

HEAD COMPRESSION. Deceleration simultanous with contraction duration. Vasovagal response.

118
Q

NST Variable deceleration

A

UMBILICAL CORD COMPRESSION. Oligohydramnios or multiple pregnancy.

119
Q

NST Late deceleration

A

UTEROPLACENTAL INSUFFICIENCY indicating comrpession of vessels. Delayed dec in HR in relation to uterine contraction.

120
Q

Normall MSAFP

A

2 to 2.5 MoM

121
Q

Prenatal test at 14 to 20 wks

A

amniocentesis for karyotyping

122
Q

Prenatal test at 11 to 14 wks

A

early amniocentesis SE club foot

123
Q

Prenatal test at 9 to 12 wks

A

chorionic villus sampling for karyotyping

124
Q

Assessment of red cell anemia or alloimmunization at > 20 wks AOG

A

percutaneous umbilical cord sampling

125
Q

Baterial vaginosis

A

Metronidazole 500mg tab_1 tab BID for 7 days

126
Q

GBS prophylaxis intrapartum DOC and allergy alternative

A

DOC Pcn G IV. Alternative for allergy Cefazolin or Erythromycin or Clindamycin

127
Q

Phases of parturition QASI

A

PHASE 1 Quiescence 2 Activation 3 Stimulation 4 Involution

128
Q

prelude to parturition makes up 95 percent of pregnancy and refers to

A

Phase 1 Quiescence. PROGESTERONE high. From implantation to few wks before delivery.

129
Q

preparation for labor

A

Phase 2 Activation. ESTROGEN high. Last 6 to 8 weeks of pregnancy. Prep for delivery.

130
Q

process of labor

A

Phase 3 Stimulation

131
Q

parturient recovery

A

Phase 4 Involution

132
Q

Phase 3 or Stimulation refers to

A

Active Labor Stage I Stage II Stage III

133
Q

Stage 1 of labor refers to

A

Latent LESS than 4cm. Active GREATER than 4 cm until 10 cm.

134
Q

Stage 2 of labor refers to

A

10 cm to delivery of fetus

135
Q

Stage 3 of labor refers to

A

from delivery of fetus to delivery of placenta lasting 5 minutes

136
Q

Main hormone mediator of Phase III and IV

A

oxytocin

137
Q

Source of PGE2 and OXYTOCIN during pregnancy

A

Amnion

138
Q

Source of ENDOTHELUM 1 and PROSTAGLANDIN during pregnancy

A

Chorion

139
Q

Most common fetal position

A

Occiput anterior left

140
Q

FUNDAL GRIP

A

Leopolds Maeuver 1

141
Q

Leopolds Maeuver 1

A

fetal part lying in the fundus

142
Q

Leopolds Maeuver 2

A

location of fetal back or POSITION

143
Q

Pawlicks maneuver

A

Leopolds Maeuver 3

144
Q

Leopolds Maeuver 3

A

determine engagement of presenting part. ENGAGEMENT

145
Q

Leopolds Maeuver 4

A

attitude or habitus of fetus. To determine the degree of flexion of fetal head.

146
Q

BISHOP score criteria Cervix DEPS

A

1Consistency 2Dilatation 3Effacement 4Position 5Station GOOD SCORE at least 8

147
Q

Cardinal movements of labor 7 EDFIEEE

A

1Engagement 2Descent 3Flexion 4Internal rotation 5Extension 6External rotation 7Expulsion

148
Q

what movement is the PREREQUESITE for birth

A

Descent

149
Q

CARDINAL MOVEMENT Allowing the narrowest fetal head diameter to pass through birth canal

A

Flexion

150
Q

CARDINAL MOVEMENT allowing the fetal shoulder to present

A

External rotation

151
Q

Duration of LATENT PHASE in Nullipara

A

LESS or EQUAL 20 hrs

152
Q

Duration of LATENT PHASE in Multipara

A

LESS or EQUAL 14 hours

153
Q

Duration CERVICAL DILATATION in ACTIVE PHASE Nullipara

A

LESS or EQUAL than 1.2 cm per hour

154
Q

Duration of CERVICAL DILATATION in ACTIVE PHASE Multipara

A

LESS or EQUAL 1.5 cm per hour

155
Q

Phases of ACTIVE PHASE

A

1 Acceleration phase 2 Phase of maximum slope 3 Deceleration phase

156
Q

Descent begins at ___ cm

A

7 to 8 cm. fastest after 8 cm.

157
Q

Duration of second stage of labor

A

Nulli 50 minutes. Multi 20 minutes.

158
Q

predicts outcome of labor

A

Acceleration phase

159
Q

measures overall efficiency of the machine

A

Phase of maximum slope

160
Q

reflects fetopelvic relationship

A

Deceleration phase

161
Q

Functional division oflabor parts 3

A

1preparatory 2 dilatational 3 pelvic

162
Q

Preparatory

A

Latent phase PLUS acceleration phase of active labor

163
Q

Dilatational

A

Phase of maximum slope of active labor

164
Q

Pelvic

A

Fetopelvic relationship of active labor

165
Q

laceration involving fourchette perineal skin vaginal mucous membrane

A

1st degree

166
Q

laceration involving fascia and perineal muscles

A

2nd degree

167
Q

laceration involving rectal mucosa

A

4th degree

168
Q

laceration involving anal sphincter

A

3rd degree

169
Q

Source of pain stage 1 of labor

A

Frankenhauser ganglion plexus T11 to T12

170
Q

Location Frankenhauser ganglion plexus T11 to T12

A

Cervix 3 and 9 o clock pain fibers to uterus cervix and upper vagina

171
Q

pain during the 2nd and 3rd stage

A

pudendal nerve S 2 to S 4

172
Q

forceps used in nullipara delivery of fetus with molded head

A

sin son SIMPSON

173
Q

forceps for deep transverse arrest of head

A

Kielland

174
Q

forceps to deliver fetus with rounded head in multipara

A

Tucker mac lane

175
Q

mc indication for primary CS

A

dystocia

176
Q

mc indication for CS delivery

A

repeat CS

177
Q

Causes of postpartum fever

A

Day PPD 0 wind 1 water 2_3 womb 4_5 wound 5_6 walk 7_21 mastitis

178
Q

cause of 1st trisem abortion

A

fetus

179
Q

2nd trisem abortion

A

maternal cause

180
Q

Septic abortion etiology

A

clostridium serdeli

181
Q

UTZ snow storm pattern

A

complete mole

182
Q

UTZ swiss cheese pattern

A

incompelte mole

183
Q

differentials for HTN prior to 20 wks AOG

A

H mole vs chronic HTN of pregnancy

184
Q

differential for 1st trisem bleeding 3

A

abortion vs ectopic vs GTD

185
Q

gestational trophoblastic tumor will follow

A

molar pregnancy more than normal pregnancy more than abortion

186
Q

sites for GTT mets

A

lung then vagina

187
Q

3 types of GTT gestational trophoblastic tumor

A

1 invasive mole 2 choriocarcinoma 3 placental site trophoblastic tumor

188
Q

Rupture of tubal pregnancy isthmus vs ampulla vs cornual or interstitial

A

isthmus at LESS 2 mos AOG ampulla at GREATER than 2 mos cornua or interstitial at GREATER than 4 mos

189
Q

predictor of spontaneous resoprtion

A

Hcg level LESS than 1000

190
Q

MC risk factor of ecctopic pregnancy

A

tubal corrective surgery

191
Q

Most identified risk factor

A

previous PID

192
Q

presumptive evidence of ectopic pregnancy

A

b HCG of GREATER than 1500 miU per L with empty uterus

193
Q

gestation sac in uterus seen at B HCG of

A

Greater than 1500

194
Q

methrothrexate mgt of ectopic if

A

LESS than 6 wks AOG OR tubal mass LESS than 3.5 cm or B hCG LESS than 15000 OR no fetal heart sound

195
Q

ectopic pregnanacy B HCG normalize in ___ days

A

20 days

196
Q

UTZ retrochoreal hemorrhage

A

threatened or inevitable abortion

197
Q

UTZ retroplacental blood clot

A

abruptio placenta

198
Q

MCC 3rd trimester bleeding

A

abruptio placenta

199
Q

MCC 3rd trimester painful bleeding

A

abruptio placenta

200
Q

MCC 3rd trisemester painless bleeding

A

placenta previa

201
Q

Placenta covers the internal os completely

A

Complete placenta previa

202
Q

Placenta partially covers the internal os completely

A

Partial placenta previa

203
Q

Edge of the placenta is at the margin of the placental os

A

Marginal placenta previa

204
Q

Placenta is close to the opening of the cervical os but not touching it

A

low lying placenta previa. Vaginal possible

205
Q

Bloody amniotic fluid

A

abruptio placenta

206
Q

Anesthesia fo r stage II of labor

A

Pudendal block S2 to 4 using LIDOCAINE at ischial spine

207
Q

Anesthesia for stage 1 labor AND gyne OPD

A

Paracervical block using lidocaine to 3 and 9 o clock position cervix

208
Q

Anesthesia for eclampsia and pre eclampsia

A

Epidural anesthesia

209
Q

Anesthesia for Stage I and II of labor

A

Epidural anesthesia

210
Q

gold standard anesthesia in OB

A

Epidural anesthesia MC used

211
Q

anesthesia of choice vaginal delivery

A

Epidural

212
Q

anesthesia of choice in CS for complicated delivery

A

GA

213
Q

MC uterine anomaly

A

septate uterus

214
Q

MgSO4 dose hyporeflexic DTRs

A

6 to 12 mEq per ml

215
Q

MgSO4 dose respiratory depression

A

15 mEq per ml

216
Q

MC SE of MgSO4

A

flushing

217
Q

Tocolytics used

A

Ca Blockers MgSO4, Nifedipine. B2 receptor agonist Ritrodrine and Terbutraline.

218
Q

Dexamethasone dose

A

2 doses q12 hours apart DOS

219
Q

post term pregnancy at

A

42 wks AOG

220
Q

placental insufficiency due to aging and scarring

A

dysmaturity syndrome

221
Q

BHcg vs Prolactin

A

B hCG same alpha unit as TSH, LH, FSH

Prolactin

  • inhibited by Dopamine
  • activated by TRH, serotonin

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