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Obstetrics Flashcards

0
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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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 is Vernix?

A

Cheesy baby skin

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3
Q

What is Meconium?

A

Green baby poop

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4
Q

What is Lochia?

A

Endometrial slough

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5
Q

What is normal blood loss during a vaginal delivery?

A

500 mL

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6
Q

What is normal blood loss during a C- section?

A

1L

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7
Q

How do you treat A1 Gestational DM?

A

Diet

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8
Q

How do you treat A2 Gestational DM?

A

Insulin

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9
Q

What are identical twins?

A

Egg split into perfect halves “monochorionic”

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10
Q

What are fraternal twins?

A

Multiple eggs fertilized by different sperm

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11
Q

What is ovarian hyperstimulation syndrome?

A

Weight gain and enlarged ovaries after clomiphene use

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12
Q

Who makes the trophoblast?

A

Baby

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13
Q

Who makes the cytrophoblast?

A

Mom=> GnRH, CRH, TRH, Inhibin

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14
Q

Who makes the Syncitotrophoblast?

A

Mom and baby => HCG, HPL

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15
Q

When does implantation occur?

A

1 week after fertilization

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16
Q

When is B-HCG found in urine?

A

2 weeks after fertilization

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17
Q

What is the function of Estrogen?

A

Muscle relaxant, constipation , ^protein production, irritability, varicose veins

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18
Q

What is the function of Progesterone?

A

^ appetite, ^acne, dilutional anemia, quiescent uterus, pica, hypo TN, melasma

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19
Q

What makes progesterone <10wk old?

A

Corpus luteum

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20
Q

What makes progesterone > 10 wk old?

A

Placenta

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21
Q

What is the function of B-HCG?

A

Maintains corpus luteum, sensitizes TSHr => act hyperthyroid (to ^BMR)

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22
Q

What makes B -HCG?

A

Placenta

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23
Q

How fast should B-HCG rise?

A

Doubles every 2 days until 10 wks (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

^TBG => ^bound t4, normal free t4 levels

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30
Q

When can you first detect fetal heartones?

A

Week 20

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31
Q

When can you tell the sex of a fetus by US?

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

Wht pelvis type 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 -> add 1 wk

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 again?

48
Q

When should intercourse be avoided during pregnancy?

A

3rd trimester b/c PG-F 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 ( 4cm cervical dilation
2) Active Phase (<12h): 4-10 cm cervical dilation (1cm/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 rotte
7. Expulsion: LDA most common presentation
52
Q

What is Stage III of labor?

A

Delivery of placenta (due to PG-F)

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 fontanel (triangle shape) presents firts, normal

58
Q

What is a sinciput presentation?

A

Anterior fontanel (diamond shape) presents first

59
Q

What is a face presentation?

A

Mentum anterior -> forceps delivery

60
Q

What is 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 Double footling breech?

A

Two feet sticking out of cervical os

66
Q

What is a transverse lie?

A

Head is on one side, butt on the other

67
Q

What is a Shoulder dystocia?

A

Head out, shoulder stuck

68
Q

Can you try vaginal delivery on a woman who has had a Classic horizontal C/Spreviously?

A

No, must have C/S for all future pregnancies

69
Q

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

70
Q

What is early deceleration?

A

Normal, due to head compression

71
Q

What is late deceleration?

A

Uteroplacental insufficiency b/c placenta can’t provide O2 /nutrients

72
Q

What is a variable deceleration?

A

Cord compression

73
Q

What is increased beat-to-beat variability?

A

Fetal hypoxemia

74
Q

What is decreased beat-to-beat variability?

75
Q

What is 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

H/A, changes in vision , epigastric pain

79
Q

What is the treatment for eclampsia?

A

4mg Mg sulfate as seizure prophylaxis

80
Q

What is a chorioamnionitis?

A

Fever, uterine tenderness, lower fetal HR

81
Q

What are the symptoms of amniotic fluid emboli?

A

Mom just delivered baby and has SOB -> PE, death (amniotic fluid-> 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/ al the signs and symptoms

86
Q

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

A

Ectopic pregnancy

87
Q

Whatis the most common cause of 1st trimester espontaneous abortions?

A

Chromosomal abnormalities

88
Q

Whatis the most common cause of 3rd trimester espontaneous abortions?

A

Anti-cardiolipin Ab, placenta problems, infection, incompetent cervix

89
Q

What is 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, fetal remnants (Tx: D&C to prevent placenta infection)

92
Q

What is a missed abortion?

A

Cervix closed, no fetal remnants (Tx: D&C)

93
Q

What is a complete abortion?

A

Cervix open, no fetal remnants (test B-HCG)

94
Q

What is a septic abortion?

A

Fever >100 degress F, malodorous discharge

95
Q

What is Placenta Previa?

A

Post-coital bleeding, placenta covers cervical os; ruptures placenta arteries

96
Q

What is vasa previa?

A

Placenta aa. Hang out of cervix

97
Q

What is Placenta Accreta?

A

Placenta attached to superficial lining

98
Q

What is placenta increta?

A

Placenta invades into myometrium

99
Q

What is Placenta percreta?

A

Placenta perforates through myometrium

100
Q

What is Placenta abruptio?

A

Severe pain, premature separation of placenta

101
Q

What is velamentous cord insertion?

A

Fetal vessels insert between chorion and amnion

102
Q

What is a uterus rupture?

A

Tearing sensation, halt of delivery

103
Q

What is an Apt test?

A

Detects HbF in vagina

104
Q

What is Wrights stain?

A

Detects nucleated fetal RBC in Mom’s vagina

105
Q

What is Kleihauer-Betke test?

A

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

106
Q

What is maternity blues?

A

Post-partum crying, irritability

107
Q

What is post partum depression?

A

Depression > 2 weeks

108
Q

What is post partum psychosis?

A

Hallucinations, suicidal, infanticidal

PPClues (24 decks)

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