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OME Flashcards

1
Q

When is amniocentesis normally done?

CVS?

A

> 16 weeks

10-12 weeks

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2
Q

What is Gestational HTN?

A

Elevated BP after 20 weeks in absence of proteinuria

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3
Q

What drugs do you give for hyperthyroidism that are safe in pregnancy during 1st trimester?

2nd and 3rd?

A

PTU

Methimazole

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4
Q

What is a + 3 hour glucose tolerance test?

A

2 of 4 following is
(+)

Fasting > 95
1 hour > 180
2 hour > 155
3 hour > 140

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5
Q

Empiric coverage of pregnant woman w/UTI is what 1st line?

2nd line?

A

Amoxicillin (PO) or Ceftraixone (IV)

Nitrofurantoin/Amoxicillin

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6
Q

HTN is pregnancy is BP greater than what values?

What is considered Pre-E w/severe features bc of BP?

A

140 / 90

> 160/110

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7
Q

Asx bacteriuria pregnant pts are at risk for what?

A

Acute pyelonephritis

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8
Q

What’s the order of getting out the placenta if there is prolonged 3rd stage of labor?

A

Uterine massage
Oxytocin
Manual Retrieval

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9
Q

What defines adequate contractions?

A

3 in 10 minutes

200 Montevideo units in 10 minutes

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10
Q

What is Preeclampsia?

A

BP > 140/90
AND
proteinuria > 300 mg/dL

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11
Q

What are the 4 available tocolytics?

A

Magnesium (for < 32 weeks)
CCB (Nifedipine)
PGE-I (not used in > 32 weeks)
B-agonists

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12
Q

BMI of 18.5 - 24.9 should gain how much weight during pregnancy?

25-29.9?

A

25-35

15-25

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13
Q

Monozygotic monochorionic diamniotic twins are at risk for what?

When do they separate?

A

Twin-twin transfusion

Blastocyst stage days 4-8

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14
Q

What can cause an elevated AFP?

What is the MC cause?

A

NTD, ABD wall defect, multiple gestation, ERROR in gestational age

ERROR

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15
Q

When do you give RHOGAM-D?

Mother is what?

A

28 wks and w/in 72 hours of delivery

Rh-Ag (-) and Rh-Ab (-)

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16
Q

what is the DDx for PPH?

A

Tone - atonic uterus (MC)
Trauma - laceration, hematoma, inversion, rupture
Tissue - retained POC, invasive placenta
Thrombin - coagulopathies

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17
Q

When should you never give RHOGAM-D to a mom?

A

When she is already Rh-Ab(+)

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18
Q

When do pts w/HIV deliver via c/s?

A

Not on HAART

Viral load > 1,000

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19
Q

Describe the Hips and knees in footling Breech

A

Hips extended

knees ANY

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20
Q

What happens to MAP in pregnancy?

CO?

SVR?

A

Dec

Inc

Dec

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21
Q

What Abx tx for chorioamnionitis and Endometritis?

A

IV Amp, Gent, Clinda

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22
Q

Why does the small twin do better in twin-twin transfusion?

A

Reduced bilirubin load

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23
Q

What are the main SE of combined OCPs?

A

HTN
VTE
Liver cyst

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24
Q

What presents with lesions that are preceded by a painful, burning prodrome?

A

HSV1/2

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25
Q

Monozygotic/chorionic/amniotic twins are at risk for what?

When do these separate?

If conjoined?

A

Cord entanglement

Days 9-12

After day 12

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26
Q

What does cephalopelvic disproportion mean?

Requires what?

Presents how?

A

Macrosomic baby

C section

Station 0

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27
Q

What is pre-term labor?

A

20-37 weeks

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28
Q

How does congenital toxoplasmosis present as?

A

Diffuse intracranial calcification, hydrocephalus, chorioretinitis

Toxo - think TOTAL calcification

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29
Q

What is prolonged ROM?

What is the biggest risk?

A

> 18 hours

GBS infection

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30
Q

A paracervical block may initially present how when local lidocaine is used?

What is it used for?

A

Fetal bradycardia

Decrease the pain of cervical dilation

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31
Q

Monozygotic, dichorion, diamniontic twins are at risk for what?

A

Breech
C/S
Pre-term

32
Q

US should show NT less than what?

A

5mm

33
Q

Pain of stage I labor comes from what?
What type?

Stage II?

A

T10-T12, visceral pain

S2-S4, somatic

34
Q

What are the indications for cerclage?

When is it placed?

A

Cervical insufficiency: PID, STI, D&C

2nd trimester

35
Q

How does endometritis present?

A

Foul smelling discharge
High fever
Leukocytosis
Tender uterus

36
Q

What is the 1st step in the ER for acute ABD?

A

CT w/IV contrast

37
Q

Firm uterus and bleeding most likely means what?

Degree?

A

Retained POC

AIP - EMS

38
Q

If there is a risk of alloimmunization, what is the 1st step?

If < 32 weeks do what?
> 32 weeks?

A

Transcranial Doppler of MCA

PUBS
C-section

39
Q

What are the f/u recommendations based on gestational age?

A

Q4 weeks until 28 weeks

q2 weeks until 36 weeks

Q1 week until birth

40
Q

What is the main SE of the copper IUD?

A

Heavier/crampier periods

41
Q

What presents with painful bleeding, shows fetal stress, w/loss of contractions and loss of fetal station?

A

Uterine RUPTURE

42
Q

What can cause PE in mom?

Presents how?

What causes DIC?

A

amniotic fluid embolism

Hypoxia w/Tachycardia

Placental embolism

43
Q

Large boggy uterus means what?

A

Uterine atony

44
Q

What is the preferred HAART therapy in pregnancy?

A

Truvada

Aka Tenofovir + Emtricitabine

45
Q

What are the 3 MAIN consequences of diabetic mother?

A

Macrosomia
Premature delivery
Transposition of the Great Vessels

46
Q

What is an O’Leary stitch?

B-Lynch compression?

A

Suture around uterine aa. At the level of INTERNAL OS

Compression suture on the uterus

47
Q

What confirms that there has been a rupture of membranes (ROM)?

A

Nitrazine test (turns BLUE)
+ Ferning sign
Speculum exam shows pooling

48
Q

1st trimester screening can be done when?

A

10 weeks to 14 weeks

49
Q

What is normal weight gain per week?

A

.5 to 1 pound

50
Q

What is considered a macrosomic baby?

A

> 4000g or 8lb and 8oz

51
Q

Premature pROM and less than 24 weeks do what?

A

Abort

52
Q

What uterotonic drug is contraindicated in HTN?

What drug is contraindicated in asthma pts?

A

Methergine

Carboprost (PGF2-a)

53
Q

If a pt has a UTI in pregnancy what medication is best to use?

What is CI?

A

Nitrofurantoin

TMP/SMX

54
Q

Describe TSH in pregnancy?
Total T4?
Free T4?

A

Normal
High
Normal

55
Q

What has the triad of ROM, painless bleeding, and fetal bradycardia?

A

Vasa previa

56
Q

At what time does the nadir in pregnancy occur?

How low?

A

28-30 weeks

10

57
Q

What is the biggest concern for baby when they are post-date term?

A

Oligohydramnios

58
Q

When is screening for GDM done?

What is the 1 hour GCT?

A

24-28 weeks

50g oral glucose load
> 140 is (+)

59
Q

What are ALL the first trimester labs taken during pregnancy?

A 
ABO type, Rh Ag
Hgb/Hct
Rubella
Varicella
HIV
RPR
HepB
Pap
UA/UCx
Protein
GC/Chlamydia
60
Q

What happens to the minute ventilation in pregnancy?

TV?

RR?

FRC?

FEV1?

A

INC by 50%

Inc

no change

Dec by 20%

No Change

61
Q

An epidural cannot be placed if the platelets are below what value?

A

80-100 K

62
Q

An epidural cannot be placed in what condition?

A

Platelets below 80-100 K

63
Q

When is the triple screen done?

Best?

A

15-23 weeks

16-18

64
Q

What are the severe features seen in pre-eclampsia w/severe features?

A 
BP > 160/110
Cr > 1.1 or 2x baseline
Plt < 100K
Inc AST or ALT 2x uln
RUQ/epigastric pain
Pulmonary edema
HA or Visual disturbance
65
Q

What presents w/painless bleeding and has RF of multiparity and multiple gestations?

Tx?

A

Placenta previa

C/s

66
Q

What is Hgb?

What increases more?

A

[rbc] / [plasma]

Plasma volume

67
Q

What is the major SE of an epidural placed too deeply?

A

Vasodilation and HoTN (neurogenic shock)

- paralysis of the diaphragm

68
Q

Describe the Hips and knees in Frank Breech

A

Hips - Flexed

Knees - Extended

69
Q

Describe the 7 movements of the baby through the pelvis

A 
Engagement
Descent
Flexion
IR
Extension
ER (aka Restitution)
Expulsion —> Ant. Shoulder FIRST

EDF IEEE

70
Q

What defines chronic HTN?

Treatment?

A

> 140/90 BEFORE 20 weeks

A-methyldopa

71
Q

Gravida - TPAL stands for what?

A

Term - 37 weeks or greater

Preterm < 37 weeks

Abortions (< 20 weeks)

Living

72
Q

Cell-free DNA can screen for aneuploidy as early as when?

Done in whom?

A

10 weeks

High risk women (> 35 y/o)

73
Q

Before giving RHOGAM D, what must you do first?

A

Type and screen mom

74
Q

What is the main feature of Levonorgestrel IUD?

A

Can cause periods to disappear after initial spotting

75
Q

Every gestation beyond 1 baby alters the due date how?

A

By 4 weeks early

76
Q

What is the process of turning around baby inside of mom called?

A

External Cephalic Version

77
Q

Describe the Hips and knees in Complete Breech

A

Hips flexed

Knees flexed

OB (1 decks)

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