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EOR Womens Health > OBSTETRICS > Flashcards

OBSTETRICS Flashcards

1
Q

At what hCG level can you do a transvag US?

A

18,000

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2
Q

At what hCG level can you do a transabdominal US

A

35,000

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3
Q

Naegele’s rule for gestational age

A

+7day to LMP

- 3 months

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4
Q

When is the quad screen done? What does it assess?

A

15-20 weeks
MSAFP, Estriol, hCG, Inhibin A
Eval for neural tube defects, spina bifida, ancephaly, and Ter of Fallot, trisomy 21, and other chromosomal

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5
Q

What is “quickening”?

When does it start?

A

maternal awareness of fetal movement

16-20weeks

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6
Q

dystocia

A

failure to progress
3Ps: power (uterine contractions)
passenger (baby too big/ wrong angle)
passage (canal too small)

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7
Q

What changes are NOT normal during pregnancy

A

diastolic murmur
increased BP (after 20wks)
proteinuria

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8
Q

fetal viability=

A

20 weeks/ 500gms

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9
Q

term gestation

A

38-42 weeks

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10
Q

Preterm =

A

<37 weeks

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11
Q

early decelerations due to

A

head compression

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12
Q

variable decelerations due to

A

cord compression

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13
Q

late decelerations due to

A

uterine placental insufficiency

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14
Q

Rhogam in rh negative prego w/o sensitivity given at

A

28 weeks

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15
Q

Quad screen with decreased MSAFP & estriol

+ increased hCG and inhibin A

A

Trisomy 21 or 28 (or other chromosomal abnl)

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16
Q

Increased MSAFP (maternal serum alpha fetal protein) seen in

A

neural tube defects: spina bifida, ancephaly, etc

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17
Q

How much folic acid should prenatal provide

A

0.4 mg folic acid

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18
Q

Nausea tx

A

1st gen antihistamine first choice

Esp in 1st trimester

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19
Q

what happens during the 2nd stage of labor

A

“pushing stage”

from full cervical dilation to delivery of baby

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20
Q

what happened during 3rd stage of labor

A

delivery of placenta

21
Q

Mean time of 1st stage of labor

A

nulliparous: 12 hr with 8hr of latent
multiparous: 6.5 hr with 5 hr of latent

22
Q

Movements of labor

A 
Engagement- 0 station
Flexion
Descent
Internal rotation
Extension (of fetal head)
External rotation/restitution
Expulsion
23
Q

14 weeks gestation presents with vaginal bleeding and abdominal pain
next step

A

US to confirm IUP

must r/o ectopic

24
Q

16 weeks gestation
hyperemesis
US can not demonstrate fetal structure or HR
hCG is very elevated

A

Trophoblastic Disease

Hydatidoform Mole

25
Q

US shows focal cystic changes in the placenta and a “snow storm”

A

Hydatidoform Mole

26
Q

late vaginal bleeding in postpartum period with enlarged uterus and enlarged ovaries

A

r/o choriocarcinoma

27
Q

bleeding through a closed cervcical os

A

threatened abortion

28
Q

when do prego women get glucose screening

A

24-28 weeks

29
Q

SOC for gestational diabetes

A

insulin
more frequent office visits q2-3 weeks
meal planning

30
Q

HTN only during pregnancy and immed post partum

A

gestational HTN

31
Q

TOC HTN in pregnancy

A

Methyldopa or labetalol

32
Q

What HTN drugs contraindicated in prego

A

ACEI/ARB

33
Q

Post partum hemorrhage causes

A 
4 'T's:
 Tissue (retained placenta)
 Tone (uterine atony)
 Trauma (traumatic delivery, episiotomy)
 Thrombin (coagulation disorders, DIC)
34
Q

Dx for preeclampsia

A

BP >140/90

+proteinuria (>0.3g in 24hrs)

35
Q

Definitive tx for preeclampsia/eclampsia

A

Delivery

36
Q

Severe preeclampsia tx

A

magnesium sulfate
hospitalized modified bedrest
<34weeks- corticosteroids
plan delivery

37
Q

epigastric or RUQ pain and >20wks gestation

~HTN

A

r/o HELLP
hemolysis
elevated liver enzymes
low platelets

38
Q

Tx HELLP syndrome

A

magnesium sulfate
BP control
Stabilize mother
Definitive- delivery of fetus

39
Q

placenta previa vs abruption placentae

A

previa is PAINLESS

40
Q

sudden gush of fluid >20 weeks

next step

A

sterile speculum exam to r/o PROM

41
Q

how to dx PROM

A 
sterile speculum exam:
pooling of fluid in posterior fornix
nitrazine paper test pH 7.0-7.25
ferning
leak with valsalva
42
Q

PROM with chorioamniotis

A

delivery regardless of age

43
Q

PROM at 34 weeks gestation

A

Induce labor

44
Q

PROM 24-34 weeks gestation

A

abx
corticosteroids for lungs
magnesium sulfate for fetal neural protection
deliver once lungs mature

45
Q

PROM at 22-24 weeks gestation

A

terminate pregnancy vs abx and educate on risk

46
Q

Prego women hx premature labor and PROM

A

IM or intravag progesterone from week 16-36

47
Q

MCC postpartum hemorrhage

A

uterine atony

48
Q

post-partum fever
soft-tender uterus
leukocytosis

A

postpartum endometritis

abx- cefoxitin

EOR Womens Health (2 decks)

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