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obstetrics Flashcards

1
Q

pelvis uterus a t what age of pregnancy

A

12 weeks

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2
Q

cardiovascular changes in pregnancy(4)

A

Increase cardiac output
increase haert rate
increase stroke volume
decrease BP

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3
Q

systolic murmur and S3 during pregnancy

A

normal

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4
Q

diastolic murmur in pregnancy

A

abnormal

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5
Q

thyroid hormone in pregnancy

A

high total and bound T3 T4

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6
Q

role of HPL human placental lactogen

A

acts as insulin antagonist to maintain fetal glucose levels

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7
Q

why acid reflux during pregnancy

A

decrease gastro esophageal sphincter tone

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8
Q

why constipation in pregnancy(2)

A

decrease large bowel motility

increase water reabsorbtion

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9
Q

why pregnant women are prne to gallstones

A

because of high biliary cholesterol saruration

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10
Q

anemia in pregnant women

A

because of increase plasma volume

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11
Q

wbc in pregnant women

A

10,5 million

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12
Q

leading nonobstetric cause of postpartum death

A

thromboembolic disease

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13
Q

hb < 11 in pregnant woman

A

it’s pathologic

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14
Q

respiratory in pregnant women(2)

A

high alveolar and arterial P02

decrease alveolar and arterial PCO2

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15
Q

kidney function in pregnancy(2)

A

dilation of the collecting system

high GFR

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16
Q

Skin changes in pregnancy (3)

A

spider angiomas
palmar erythema
hyperigmentation

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17
Q

quid of chloasma in pregnancy

A

hyperpigmentation of the face

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18
Q

diastasis recti in pregnancy

A

separation of rectus muscles in the midline

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19
Q

weight gain during pregnancy

A

25 a 35 lbs

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20
Q

kilocalorie needed /day

A

300 kcal/day

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21
Q

supplement during pregnancy

A

1 mg acide folique

iron 30- 60 mg par jour

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22
Q

importance of folic acid

A

to prevent neural tube problem

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23
Q

Nagele’s rule or due date

A

last menstrual period+nine months +seven days

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24
Q

MAternal alpha feto protein date pour screenMSAF

A

15-20 weeks

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25
Q

who produce alpha feoto protein

A

baby

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26
Q

quid of High AFP

A

> 2,5 MoMs

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27
Q

cause of high AFP(6)

A 
neural tube defects
abdominal wall dec=fect
multiple gestation
fetal death
incorrect gestationnal dating
placental abnormalities
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28
Q

quid of abdominal wall defect(2)

A

gastrochisis

omphalocel

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29
Q

quid of neural tube defect(2)

A

spina bifida

anencephaly

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30
Q

low AFP

A

< 0,5 Mom

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31
Q

next step denvant low AFP

A

rule out chromosomal abnormalities

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32
Q

role of triple screen

A

to detect chromosomal abnormalities

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33
Q

elements in triple screen(3)

A

Bhcg
estriol
MSAF

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34
Q

triple screen high

A

trisosmie 18

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35
Q

triple screen in down

A

low AFP
low estriol
high BHCG

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36
Q

best test to detect trisomies

A

triple test

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37
Q

indication of amniocentesis(2)

A

> 35 ans et grossesse

to evaluate lung maturity

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38
Q

mature lung

A

lecithin/sphingomyeline> ou egal 2,5

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39
Q

time to perform amniocentesis

A

15 -17 semaines

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40
Q

risk in amniocentesis(2)

A

maternal hemorrage

fetal loss

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41
Q

disavantages of chorionic villus sampling(2)

A

1% risk of fetal loss

inability to dx neural tube defects

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42
Q

latent phase of labor

A

entre 3 et 4 cm

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43
Q

first stage of labor(2)

A

latent

active

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44
Q

active labor

A

4 cm to complet dilation

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45
Q

duration of latent phase in primi

A

6-11 h

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46
Q

duration of latent phase in multi

A

4-8 hrs

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47
Q

duration of active phase in primi(2)

A

4-6 h

1,2 cm par heure

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48
Q

duration of active phase in multi(2)

A

2-3 hres

1.5 cm par heure

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49
Q

prolongation of active phase

A

cephalopelvic disproportion

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50
Q

second phase of labor

A

complete dilation to delivery of baby

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51
Q

second phase in primi duration

A

0,5 a 3 h

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52
Q

second phase in multi duration

A

5 a 30 mn

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53
Q

third phase

A

from delivery of infant to delivery of the placenta

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54
Q

third phase in primi and Multi

A

0-0,5 h

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55
Q

profil biophysique Test the Baby MAN

A 
Tone fetal
Breathing fetal
Movement fetal
Aminiotic fluid
Nonstress test
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56
Q

hyperglycemia in the first trimester quid of that

A

diabete in Mom

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57
Q

Dx of gestationnal diabetes

A

fasting serum glucose>126 mg/dl
random glucose> 200
abnormal glucose challenge test> 140

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58
Q

when perform screening for gestationnal diabetes

A

24 -28 semaines

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59
Q

test routinely used to screen gestationnal diabetes

A

glucose challenge test

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60
Q

next step if glucose challenge test is > 140(confirmation)

A

3 hour glucose tolerance test

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61
Q

value to confirm gestationnal diabetes in 3 hour glucose tolerance test(4)

A

fasting > 95
one hour>180
2 hours> 155
3 hours> 140

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62
Q

maternal complication of diabete type 2(8)

A 
DKA (type 1) or HHNK (type 2) Macrosomia
Preeclampsia/eclampsia
Cephalopelvic disproportion
Preterm labor 
Infection 
Polyhydramnios
Postpartum hemorrhage 
Maternal mortality
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63
Q

fetal complication of gestationnal diabetes(11)

A 
Macrosomia
 Cardiac and renal defects
 Neural tube defects (e.g., sacral agenesis)
hypocalcemia
 Polycythemia
Hyperbilirubinemia
Intrauterine growth restriction (IUGR)
Hypoglycemia from hyperinsulinemia
 Respiratory distress syndrome (RDS)
Birth injury (e.g., shoulder dystocia)
Perinatal mortality
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64
Q

Gestational hypertension quid

A

idiopathic hypertension without significant proteinuria (< 300
mg/L)

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65
Q

when gestationnal hTA begins(3)

A

second half of pregnancy,
during labor, or
within 48 hours of delivery

66
Q

can a patietn patient with gestationnal HTA develops preecclampsia

67
Q

Chronic hypertension(2)

A

before conception and at < 20 weeks of gestation

or may persist for > 12 weeks postpartum

68
Q

effect negatif of ACE I on mother

A

uterine ischemia

69
Q

quid of oligoamnios

A

amniotic fluid index

(AFI) < 5 on ultrasound

70
Q

etiologies of oligoamnios(3)

A

fetal urinary tract abnormalities
chronic uteroplacental insufficiency
ROM

71
Q

urinary tract abnormalities assocciated with oligoamnios(3)

A

renal agenesis,
polycystic kidney disease,
GU obstruction

72
Q

categorisation of preecclampsia

A

Mild

severe

73
Q

Mild precclampsia

A

BP > 140/90 on two occasions

> 6 hours apart

74
Q

proteinuria in mild precclampsia

A

Proteinuria > 300 mg/24 hrs

75
Q

severe precclampsia

A

BP > 160/110 on two occasions > 6 hours apart

76
Q

proteinuria in severe preecclampsia

A

Proteinuria > 5 g/24 hrs

77
Q

alcool teratogenicity

A

fetal alcohol syndrome

78
Q

quid of fetal alcohol syndrome(5)

A 
microcephaly, 
midfacial hypoplasia, 
mental retardation, 
IUGR,
 cardiac defect
79
Q

Cocaine teratogenicity(3)

A

Bowel atresias,(jejunal)
IUGR,
microcephaly

80
Q

Streptomycin teratogenicity(2)

A

CN VIII damage/

ototoxicity

81
Q

Tetracycline teratogenicity(4)

A

Tooth discoloration,
inhibition of bone growth,
small limbs,
syndactyly.

82
Q

Sulfonamides teratogenicity

A

Kernicterus.

83
Q

Quinolones teratogenicity

A

Quinolones Cartilage damage.

84
Q

Isotretinoin teratogenicity(4)

A

Isotretinoin Heart and
great vessel defects,
craniofacial dysmorphism,
deafness.

85
Q

Iodide teratogenicity(3)

A

Congenital goiter,
hypothyroidism,
mental retardation.

86
Q

Methotrexate teratogenicity(3)

A

\CNS malformations,
craniofacial dysmorphism,
IUGR.

87
Q

DES teratogenicity(3)

A

Clear cell adenocarcinoma of the vagina/cervix,
genital tract abnormalities
cervical incompetence.

88
Q

genital tract abnormalities of DES(3)

A

cervical hood,
T-shaped uterus
hypoplastic uterus

89
Q

Thalidomide teratogenicity(5)

A 
Limb reduction (phocomelia), 
ear and nasal anomalies, 
cardiac and lung defects, 
pyloric or duodenal stenosis,
 GI atresia.
90
Q

Coumadin teratogenicity(4)

A

Stippling of bone epiphyses,
IUGR,
nasal hypoplasia,
mental retardation.

91
Q

ACEIs teratogenicity(2)

A

Oligohydramnios,

fetal renal damage.

92
Q

Lithium teratogenicity(2)

A

Ebstein’s anomaly,

other cardiac diseases.

93
Q

Carbamazepine teratogenicity(4)

A

Fingernail hypoplasia,
IUGR,
microcephaly,
neural tube defects

94
Q

Phenytoin teratogenicity(5)

A 
Nail hypoplasia,
 IUGR, 
mental retardation, 
craniofacial dysmorphism, 
microcephaly
95
Q

Valproic acid teratogenicity(3)

A

Neural tube defects,
craniofacial and
skeletal defects.

96
Q

quid of polyhydramnios

97
Q

etiologies of polihydramnios(6)

A 
maternal DM, 
multiple gestation,
 isoimmunization,
pulmonary abnormalities
twintwin transfusion syndrome.
fetal anomalies
98
Q

fetal anomalies causing poplihydramnios(3)

A

duodenal atresia,
tracheoesophageal fistula,
anencephaly

99
Q

pulmonary abnormalities causing polyhydramnios

A

cystic lung malformation

100
Q

4 parameters to consider in intrauterine growth restriction

A

Biparietal diameter
Head circumference
Abdominal circumference
Femur length

101
Q

symmetric growth restriction

A

all for parameters are affected

102
Q

asymmetric growth restriction

A

only abdominal circumference is decreased

103
Q

time of insult in symmetric growth restriction

A

early in pregnancy

104
Q

time insult in asymmetric growth restriction

A

late in pregnancy

105
Q

etiology in symmetric growth restriction

A

fetal problem

106
Q

fetal problem causing symmetric growth restriction(3)

A

Cytogenetic
Infection
Anomalie

107
Q

etiology in asymmetric growth restriction

A

Placenta mediated:

108
Q

placental problem causing asymmetric growth restriction(3)

A

Hypertension
Poor nutrition
Maternal smoking

109
Q

preecclampsia in the first trimester

A

mole hydatiforme

110
Q

genotype of complete mole

111
Q

genotype of incomplete mole

112
Q

particcularity of incomplete mole

A

contain fetal tissue

113
Q

clue for mole hydatiform(4)

A

first-trimester uterine bleeding (most common), hyperemesis gravidarum,
preeclampsia/eclampsia at < 24 weeks,
uterine size greater than dates

114
Q

ultrasound of mole hydatiform(complete)

115
Q

what to avoid during mole hydatiform

A

preventbpregnancy for one year

116
Q

quid of mole hydatiform

A

fertilization of an empty ovum

117
Q

quid of third trimester bleeding

A

after 20 weeks

118
Q

most common cause of 3 trimester bleeding(2)

A

Preavia

abruptio placentae

119
Q

3 types of preavia

A

Total: Placenta covers cervical os.
Marginal: Placenta extends to margin of os.
Low-lying: Placenta in close proximity to os.

120
Q

Total praevia

A

Placenta covers cervical os

121
Q

Marginal praevia

A

Placenta extends to margin of os.

122
Q

Low-lying praevia

A

Placenta in close proximity to os.

123
Q

C-section indication in placenta praevia(5)

A 
persistent labor,
 life-threatening bleeding
fetal distress, 
documented fetal lung maturity,
 36 weeks’ GA.
124
Q

complications of abruptio

A

hemorragic shock
DIC
fetal hypoxia
Recurrence risk is 5–16%

125
Q

probability for having abruptio after 2 episode of abruptio

126
Q

complication of placenta previa(7)

A 
risk of placenta accreta.
Vasa previa 
 premature rupture of membranes
preterm delivery
IUGR
congenital anomalies.
Recurrence risk is 4–8%.
127
Q

the most common fetal malpresentation

A

breech presentation

128
Q

3 types of breech

A

Frank breech (50–75%):
■ Footling breech (20%):
■ Complete breech (5–10%): Thighs and knees are flexed.

129
Q

frank breech

A

Thighs are flexed and knees are extended.

130
Q

footling breech

A

One or both legs are extended below the buttocks.

131
Q

Complete breech

A

Thighs and knees are flexed.

132
Q

failure to progress in prima in latent phase

133
Q

failure to progress in multi in latent phase

134
Q

failure to progress in active phase

A

Active Failure to have progressive cervical change

after reaching 3–4 cm.

135
Q

arrest of fetal descent in primi

136
Q

arrest of fetal descent in multi

137
Q

post partum hemorrage

A

> 500 mL of blood for vaginal delivery or

> 1000 mL after C section

138
Q

Maternal factors for C section(4)

A

Prior classical C-section
Active genital herpes infection
Cervical carcinoma
Maternal trauma/demise

139
Q

most common cause of C section

140
Q

fetal and maternal factors for C swection(5)

A 
Cephalopelvic disproportion
Placenta previa/
placental abruption
Failed operative vaginal delivery
post date pregnancy(relative)
141
Q

fetal factors for C section(4)

A

fetal malposition
fetal distress
cord compression
erytroblastose fetalis

142
Q

fetal malposition for c section(3)

A

posterior chin
transverse lie
shoulder presentation

143
Q

post partum infection

A

≥ 38°C for at least two of the

first ten postpartum days (not including the first 24 hours)

144
Q

most common cause of post partum hemorrage

A

uterine atony

145
Q

3 causes of post partum hemorrage

A

UTERINE ATONY
GENITAL TRACT TRAUMA
RETAINED PLACENTAL TISSUe

146
Q

causes of uterine atony(4)

A 
Uterine overdistention
Exhausted myometrium
Uterine infection.
Conditions interfering with
contractions
147
Q

cause of uterine over distension(3)

A

macrosomie
multiple gestation
polyhydramnios

148
Q

causes of exhausted myometrium(2)

A

prolonged labor

oxytocin stimulation

149
Q

Conditions interfering with

contractions(3)

A

anesthesia,
myomas,
MgSO4

150
Q

genital tract trauma causing post partum bleeding

A

Inadequate episiotomy repair.
Large infant.
Operative vaginal delivery
Precipitous labor

151
Q

quid of operative vaginal delivery(2)

A

vacuum

forceps

152
Q

cause retained placental tissue(5)

A 
Previous C-section/curettage.
Preterm delivery.
Uterine leiomyomas.
Placenta previa
Placenta accreta/increta/percreta
153
Q

rx of uterine atony(4)

A

uterine massage
oxytocin
methergin
prostin(PGF 2@)

154
Q

cause of post partum fever 7 w

A 
Womb
(endomyometritis)
Wind (atelectasis,
pneumonia)
Water (UTI)
Walk (DVT, pulmonary
embolism)
Wound (incision,
episiotomy)
Weaning (breast
engorgement,
abscess, mastitis)
Wonder drugs (drug
fever
155
Q

rx of mastitis(2)

A

antibio

continue breasfeeding

156
Q

complete abortion

A

all POC are expelled

OS is closed

157
Q

incomplete abortion

A

some POC expelled

OS is open

158
Q

threatened abortion(2)

A

No POC expelled

OS is closed

159
Q

nevitable abortion(3)

A

bleeding
No POC expelled
OS is open

160
Q

Missed abortion(3)

A

No POC expelled
Pregnancy has ceased to develop
Os is closed

161
Q

quid of reccurent abortion

A

> ou egal a 2 consecutives spontaneous abortions

162
Q

what to evaluate in reccurent abortion(2)

A

karyotyping of both parents

incompetent cervix

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