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Obstetrics Flashcards

1
Q

Why do pregnant women get anemia?

A

Dilutional effect
RBC rises 30% but volume rises 50%

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2
Q

What are the degrees of vaginal lacerations?

A

1st degree: skin
2nd degree: muscle
3rd degree: anus
4th degree: rectum

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3
Q

What is vernix?

A

Cheesy baby skin

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4
Q

What is meconium?

A

Green baby poop

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5
Q

What is Lochia?

A

Endometrial slough

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6
Q

What is normal blood loss during a vaginal delivery?

A

500 mL

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7
Q

What is normal blood loss during a C-section?

A

1 L

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8
Q

How do you treat A1 gestational DM?

A

Diet

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9
Q

How do you treat A2 Gestational DM?

A

Insulin

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10
Q

What are identical twins?

A

Egg split into perfect halves
“Monochorionic”

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11
Q

What are fraternal twins?

A

Multiple eggs fertilized by different sperm

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12
Q

What is Ovarian hyperstimulation syndrome?

A

Weight gain and enlarged ovaries after Clomiphene use

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13
Q

Who makes the trophoblast?

A

Baby

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14
Q

Who makes the cytotrophoblast?

A

Mom =>
GnRH
CRH
TRH
Inhibin

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15
Q

Who makes syncytiotrophoblast?

A

Mom and baby =>
hCG
HPL

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16
Q

When does implantation occur?

A

1 week after fertilization

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17
Q

When is ß-hCG found in urine?

A

2 weeks after fertilization

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18
Q

What is function of estrogen?

A

Muscle relaxant
Constipation
Incr protein production
Irritability
Varicose veins

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19
Q

What is the function of progesterone?

A

Incr appetite
Incr acne
Dilutional anemia
Quiescent uterus
Pica
Hypotestosterone
Melasma

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20
Q

What makes progesterone <10 week gestation?

A

Corpus luteum

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21
Q

What makes progesterone >10 week gestation?

A

Placenta

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22
Q

What is the function of ß-hCG?

A

Maintains corpus luteum
Sensitizes TSH receptor => acts hyperthyroid (to incr basal metabolic rate)

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23
Q

How fast should ß-hCG rise?

A

Doubles every 2 days until 10 weeks
(When placenta is fully formed)

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24
Q

What is the function of AFP?

A

Regulates fetal intravascular volume

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25
Q

What is the function of HPL?

A

Blocks insulin receptors
-> sugar stays high

(Baby’s stocking up on stuff needed for the journey)

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26
Q

What is the function of inhibin?

A

Inhibits FSH => no menstruation

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27
Q

What is the function of oxytocin?

A

Milk ejection
Baby ejection

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28
Q

What is the function of cortisol in pregnancy?

A

Decreases immune rejection of baby
Lung maturation

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29
Q

What are the thyroid hormone levels during pregnancy?

A

Elev TBG => elev bound T4
Normal free T4 levels
Elev Total T4

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30
Q

When can you first detect fetal heart tones?

A

Week 20

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31
Q

When can you tell the sex of a fetus by U/S?

A

Week 16

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32
Q

What does an AFI <5 indicate?

A

Oligohydramnios
(Cord compression)

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33
Q

What does an AFI >20 indicate?

A

Polyhydramnios
(DM)

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34
Q

How fast should fundal height change?

A

Uterus grows 1cm/wk

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35
Q

What is the Pool Test?

A

Fluid in vagina

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36
Q

What is Ferning?

A

Estrogen crystallizes on slide

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37
Q

What is Nitrazine?

A

Shows presence of amniotic fluid

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38
Q

What is the risk of chorionic villus sampling?

A

Fetal limb defects

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39
Q

What is the risk of amniocentesis?

A

Abortion (2% risk)

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40
Q

What is a normal biophysical profile?

A

> 8

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41
Q

What is a biophysical profile?

A

“Test the Baby, MAN!”
- Tones of the heart
- Breathing
- Movement: BPD, HC, AC, FL
- AFI
- Non-stress test (normal = “reactive”)

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42
Q

What pelvis types are better for vaginal delivery?

A

Gynecoid
Anthropoid

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43
Q

What pelvis types will need C/S?

A

Platypelloid
Android

44
Q

How do you predict a due date with Nägele’s Rule?

A

9 months from last menses and then add 1 week

45
Q

Why is Nägele’s Rule inaccurate?

A

B/c it does not start from ovulation date

46
Q

How do you correct Nägele’s Rule for cycles >28 days?

A

Add x days if cycle is x longer

47
Q

How much weight should a pregnant woman gain?

A

1 pound/week

48
Q

When should intercourse be avoided during pregnancy?

A

3rd trimester b/c PGF in semen may cause uterine contractions

49
Q

What are the Leopold maneuvers?

A

1) Feel fundus
2) Feel baby’s back
3) Feel pelvic inlet
4) Feel baby’s head

50
Q

What is Stage I of labor?

A

Up to full dilation

1) Latent phase (<20h)
- contractions -> 4cm cervical dilation
2) Active phase (<12h)
- 4-10 cm cervical dilation
- 1 cm/hr

51
Q

What is Stage II of labor?

A

Full dilation -> delivery

Station 0: baby above pelvic rim
(most uteri are anteverted)

  1. Engage
  2. Descend
  3. Flex head
  4. Internal rotation
  5. Extend head
  6. Externally rotate
  7. Expulsion: LOA most common presentation
52
Q

What is Stage III of labor?

A

Delivery of placenta
D/t PGF
Blood gush -> cord lengthens -> fundus firms

53
Q

How do you monitor baby’s HR?

A

Doppler
Scalp electrode

54
Q

How do you monitor uterus?

A

Tocodynamics
Uterine pressure catheter

55
Q

What Bishop’s score predicts delivery will be soon?

56
Q

What are Braxton-Hicks contractions?

A

Irregular contractions w/ closed cervix

57
Q

What is a vertex presentation?

A

Posterior fontanelle (triangle shape) presents first
Normal

58
Q

What is a sinciput presentation?

A

Anterior fontanelle (diamond shape) presents first

59
Q

What is a face presentation?

A

Mentum anterior -> forceps delivery

60
Q

What is a compound presentation?

A

Arm or hand on head -> vaginal delivery

61
Q

What is a complete breech?

A

Butt down, thighs and legs flexed

62
Q

What is a Frank breech?

A

Butt down, thigh flexed, legs extended (~ pancake)

63
Q

What is a Footling breech?

A

Butt down, thigh flexed, one toe is sticking out of cervical os

64
Q

What is a double footling breech?

A

Two feet sticking out of cervical os

65
Q

What is a Transverse Lie?

A

Head is on one side, butt on the other

66
Q

What is Shoulder Dystocia?

A

Head out, shoulder stuck

67
Q

Can you try vaginal delivery on a woman who has had a Classic Horizontal C/S previously?

A

No, must have C/S for all future pregnancies

68
Q

Can you try vaginal delivery on a woman who has had a low transverse C/S previously?

69
Q

What is early deceleration?

A

Normal
Due to head compression

70
Q

What is late deceleration?

A

Uteroplacental insufficiency b/c placenta cannot provide O2/nutrients

71
Q

What is variable deceleration?

A

Cord compression

72
Q

What is increased beat-to-beat variability?

A

Fetal hypoxemia

73
Q

What is decreased beat-to-beat variability?

74
Q

What is Pre-eclampsia?

A

Ischemia to placenta
=> HTN (>140/90)

75
Q

What is the treatment for pre-eclampsia?

76
Q

What is HELLP syndrome?

A

Hepatic injury causing
- Hemolysis
- Elevated Liver enzymes
- Low Platelets

77
Q

What is eclampsia?

A

HTN & seizures

78
Q

What are the symptoms of eclampsia?

A

HA
Changes in vision
Epigastric pain

79
Q

What is the treatment for eclampsia?

A

4 mg magnesium sulfate as seizure prophylaxis

80
Q

What is chorioamnionitis?

A

Fever
Uterine tenderness
Decr fetal HR

81
Q

What are the symptoms of amniotic fluid emboli?

A

Mom just delivered baby and has SOB
-> PE, death

(Amniotic fluid in the lungs)

82
Q

What is endometritis?

A

Post-partum uterine tenderness

83
Q

What is an incomplete molar pregnancy?

A

2 sperm + 1 egg

(69, XXY)

Has embryo parts

84
Q

What is a complete molar pregnancy?

A

2 sperm + no egg

(46, XX -> both paternal)

No embryo

85
Q

What is pseudocyesis?

A

Fake pregnancy w/ all the signs and symptoms

86
Q

What is the most common cause of 1st trimester maternal death?

A

Ectopic pregnancy

87
Q

What is the most common cause of 1st trimester spontaneous abortions?

A

Chromosomal abnormalities

88
Q

What are the most common causes of 3rd trimester spontaneous abortions?

A

Anti-cardiolipin Ab
Placenta problems
Infection
Incompetent cervix

89
Q

What is a threatened abortion?

A

Cervix closed
Baby intact

(Tx: bed rest)

90
Q

What is an inevitable abortion?

A

Cervix open
Baby intact

(Tx: cerclage = sew cervix shut until term)

91
Q

What is an incomplete abortion?

A

Cervix open
No fetal remnants

(Test: ß-hCG)

92
Q

What is a missed abortion?

A

Cervix closed
No fetal remnants

(Tx: D&C)

93
Q

What is a septic abortion?

A

Fever >100F
Malodorous discharge

94
Q

What is placenta previa?

A

Post-coital bleeding
Placenta covers cervical os
Ruptures placental arteries

95
Q

What is vasa previa?

A

Placenta aa. hang out of cervix

96
Q

What is placenta accreta?

A

Placenta attached to superficial lining

97
Q

What is placenta increta?

A

Placenta invades into myometrium

98
Q

What is placenta percreta?

A

Placenta perforates through myometrium

99
Q

What is placenta abruptio?

A

Severe pain
Premature separation of placenta

100
Q

What is velamentous cord insertion?

A

Fetal vessels insert b/w chorion and amnion

101
Q

What is a uterus rupture?

A

Tearing sensation
Halt of delivery

102
Q

What is an Apt test?

A

Detects HbF in vagina

103
Q

What is Wright’s stain?

A

Detects nucleated fetal RBC in mom’s vagina

104
Q

What is a Kleihauer-Bette test?

A

Detects percentage of fetal blood in maternal circulation (dilution test)

105
Q

What is maternity blues?

A

Post-partum crying
Irritability

106
Q

What is post-partum depression?

A

Depression >2 weeks

107
Q

What is post-partum psychosis?

A

Hallucinations
Suicidal
Infanticidal

PP Clues (27 decks)

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