Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Med II - Exam 5 > Paulson - Preconception Counseling, Infertility, Abortion, and Maternal-Fetal Physiology > Flashcards

Paulson - Preconception Counseling, Infertility, Abortion, and Maternal-Fetal Physiology Flashcards

1
Q

complications that increase morbidity/mortality to mother and/or fetus occur in __% of pregnancies

A

5-20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what does preconception counseling include

A

likelihood of pregnancy in ALL reproductive age women

desire to become pregnant AND when

contraception

quit smoking

healthy weight and diet

limit etoh

review meds

infectious dz

genetic screening options

partner violence

travel hx

ask about drug use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

is marijuana safe in pregnancy

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

are varicella/rubella vaccines safe in pregnancy

A

no →

live vaccines are not safe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

2 vaccines that are safe in pregnancy

A

pertussis

hep B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

infertility is defined as no pregnancy after __ months of trying w. normal sexual activity w.o contraception

A

12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

risk for infertility increases at what age

A

35 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is ART

A

assisted reproductive technologies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

3 types of ART

A

ovulation induction

insemination w. sperm

in vitro fertilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

3 types of infertility

A

female

male

unexplained

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

5 causes of female infertility

A

anovulation

endometriosis

fibroids

tubal factor

cervical factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

work up for male infertility should include (4)

A

hx

PE

semen analysis

chromosomal studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what might you see on hx for male infertility (6)

A

sexual dysfxn

etoh/drug use

STDs

cryptochordism/orchiectomy/mumps

DM

neurologic dz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what might you find on PE for male w. infertility

A

varicocele

absence of vas deferens

systemic illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

semen analysis includes (3)

A

concentration

motility

morphology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

female infertility work up includes (5)

A

hx/PE

ovulation monitoring

hormone analysis

hysterosalpingogram

chromosomal studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

cardiac changes associated w. pregnancy (4)

A

increased CO

lower BP

increased HR

increased venous pressure in LE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

HR in pregnant women increases by ~__ over the course of pregnancy

A

15 beats/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

heme changes associated w. pregnancy (5)

A

50% increased plasma volume

20-30% RBC increase

WBC increase

decreased platelets

hypercoaguable state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

GI changes associated w. pregnancy

A

n/v

GERD

constipation

delayed gallbladder emptying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

endocrine changes associated w. pregnancy (2)

A

increased estrogen and thyroid activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

renal changes associated w. pregnancy

A

kidneys enlarge

GFR increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

pulmonary changes associated w. pregnancy

A

increased tidal volume and inspiratory capacity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

derm changes associated w. pregnancy

A

spider angiomas and palmar erythema

hyperpigmentation: nipples, umbilicus, linea nigra, melasma/cholasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

__% of women experience first trimester bleeding

A

25

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

5 causes of first trimester bleeding

A

implantation into endometrium

abortion

ectopic pregnancy

molar gestation

infxn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

termination of pregnancy before 20 weeks

A

abortion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

2 types of abortion

A

spontaneous (SAB)

therapeutic (TAB)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

sx of abortion (5)

A

bright red bleeding

low back pain

abd pain/cramps

cervical dilation

passage of conception products

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

lab/imaging findings associated w. abortion

A

bHCG levels falling/inadequately rising

US: empty gestational sac/lack of cardiac activity/growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

all products of conception expelled before 20 weeks

cervical os closed

A

complete abortion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

management of complete abortion

A

obs for bleeding

monitor HCG

send conception products to path

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

pregnancy can not be saved

cervical os dilated

products of conception NOT passed

A

inevitable abortion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

inevitable abortion has a __ prognosis,

and management includes (3)

A

poor

D&C, type and screen, Rh

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

possible pregnancy loss

no products of conception passed

cervical os closed

pregnancy can continue w.o further problems

A

threatened abortion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

management of threatened abortion

A

pelvic rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

some products of conception passed

cervical os dilated

heavy bleeding

A

incomplete abortion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

management options for incomplete abortion

A

D&C

medical or expectant management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

embryo not viable prior to 20 weeks

products of conception retained in uterus

no cervical dilation

+/- bleeding

A

missed abortion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

management of missed abortion

A

D&C

medical or expectant management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

any embryonic or fetal demise w. uterine infxn

A

septic abortion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

sx of septic abortion

A

uterine bleeding

fever

increased leukocytes

abd pain

cervical motion tenderness

foul smelling d.c

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

septic abortion is usually caused by

A

retained products of conception

ascending polymicrobial infxn

44
Q

dx for septic abortion

A

CBC

UA

endocervical cultures/blood cultures

abd xray

US

45
Q

xray for septic abortion rules out

A

uterine perforation

46
Q

US for septic abortion rules out

A

retained products of conception (POC)

47
Q

tx for septic abortion

A

admit + IV broad spectrum abx

+/- D&C if retained POC

48
Q

work up for elective abortion must include

A

complete social and medical hx

PE

49
Q

what does PE include for elective abortion

A

uterine size/position

50
Q

3 meds used for elective abortion

A

mifepristone

misoprostol

methotrexate

51
Q

which elective abortion med inhibits progesterone

A

mifepristone

52
Q

which elective abortion med induces uterine contractions

A

misoprostol

53
Q

which elective abortion med stops fast growing cells

A

methotrexate

54
Q

methotrexate must be used in combo w.

A

misoprostol

55
Q

surgical options for elective abortion

A

suction or surgical curretage

dilation and evacuation

56
Q

which surgical option would you use for elective abortion in a second trimester pregnancy

A

dilation and evacuation

57
Q

mc, safest, and most effective method for terminating pregnancy of 12 weeks or less

A

suction curretage

58
Q

3 or more SABs before 20 weeks

A

recurrent pregnancy loss

59
Q

5 possible causes for recurrent pregnancy loss

A

genetic

AI

anatomic

endocrine

thrombophilic

60
Q

does recurrent pregnancy loss indicate low chance for successful pregnancy

A

no → ~60% have viable pregnancy

61
Q

embryo fails to develop or is reabsorbed after loss of viability

same-same “blighted ovum”

A

anembryonic pregnancy

62
Q

dx for anembryonic pregnancy

A

US showing empty gestational sac w.o fetal pole

63
Q

sx of anembryonic pregnancy

A

mild pain/bleeding

cervix closed

retained non-viable pregnancy

64
Q

sx of anembryonic pregnancy

A

mild pain/bleeding

cervix closed

retained non-viable pregnancy

65
Q

2 gestational disorders

A

ectopic pregnancy

gestational trophoblastic dz/dz of trophoblastic tissue

66
Q

gestational trophoblastic dz/dz of trophoblastic tissue includes (3)

A

hydatidiform mole

invasive mole

choriocarcinoma

67
Q

hydatidiform mole can be (2)

A

complete

partial

68
Q

implantation of the fetus in any site other than the endometrial cavity

A

ectopic pregnancy

69
Q

mc site of ectopic pregnancy

A

fallopian tubes → 95%

70
Q

rf for ectopic pregnancy (5)

A

prior ectopic

PID

smoking

anatomic abnormalities

IUD

71
Q

3 complications of ectopic pregnancy

A

tubal rupture

hemorrhagic shock

death

72
Q

leading cause of pregnancy related deaths in first trimester

A

ectopic pregnancy

73
Q

what do you think when you see: adnexal mass, uterine changes, hemodynamic instability/vitals

A

ectopic pregnancy

74
Q

nearly 100% of ectopic pregnancies are associated w.

A

pelvic or abd pain

75
Q

other sx of ectopic pregnancy

A

amenorrhea

syncope

76
Q

labs to order for ectopic pregnancy dx (3)

A

CBC

bHCG

type and screen/Rh

+/- progesterone

77
Q

intrauterine pregnancy at beta HCG level of 1500-2000

A

transvaginal US findings associated w. ectopic pregnancy

78
Q

what is the discriminatory zone

A

bHCG levels 1500-2000

79
Q

the discriminatory zone for bhcg refers to

A

the point at which a gestational sac can be visualized

80
Q

progesterone < __ suggests non viable pregnancy

A

5

81
Q

first line pharm for ectopic pregnancy

A

methotrexate

82
Q

what labs need to be monitored w. methotrexate

A

LFTs

Cr

close f.u up bHCG

83
Q

what level should bHCG be after MTX tx

A

0

84
Q

s.e of MTX

A

abd pain

bleeding

n/v

85
Q

sx of tubal rupture and need for emergent care for pt on MTX

A

severe pain

dizziness

syncope

86
Q

2 surgical options for ectopic pregnancy

A

salpingostomy

salpingectomy

87
Q

group of rare pregnancy related tumors

A

gestational trophoblastic dz

88
Q

sx of gestational trophoblastic dz

A

abnormal fertilization

absence of fetal heart tones/structures

HCG higher than expected for gestational age

rapid enlargement of uterus

89
Q

what do you think when you see preeclampsia in first trimester or early second trimester

A

molar pregnancy

may be pathognomonic

90
Q

benign neoplasm derived almost entirely from abnormal placental (trophoblastic) proliferation

A

hypatidiform mole → molar pregnancy

91
Q

neoplasm contains no fetal tissue

diffuse trophoblastic proliferation

46xx or 46xy

BHCG > 50,000

A

complete molar pregnancy

92
Q

neoplasm contains some fetal tissue

focal trophoblastic proliferation

69xxx OR 69xxy

BCHG < 50,000

A

partial molar pregnancy

93
Q

molar pregnancy is mc in what pt populations

A

early teens

perimenopausal

94
Q

molar pregnancy may precede

A

choriocarcinoma

95
Q

dx for hypatidiform mole (molar pregnancy)

A

US

96
Q

labs hypatidiform mole (molar pregnancy)

A

BHCG

97
Q

snowstorm pattern

normal gestational sac/fetus not present

+/- theca lutein cysts

A

US findings for complete molar pregnancy

98
Q

focal areas of trophoblastic changes

+/- fetal tissue

focal cystic changes in the placenta

A

partial molar pregnancy

99
Q

hallmark US finding for partial molar pregnancy

A

focal cystic changes in placenta

100
Q

multiple grapelike vesicles filling and distending the uterus

edema of villous stroma, avascular villi, nests of proliferating trophoblastic elements

A

histology findings from dilation and evacuation of molar pregnancy

101
Q

tx for confirmed molar pregnancy

A

suction and curretage

pathologic evaluation of tissue

+/- prophylactic chemo

surveillance w. HCG labs

102
Q

invasion and/or perforation of myometrium

locally destructive

+/- emboli to distant sites

persistent elevated HCG

A

invasive mole

103
Q

complication of invasive mole

A

uterine rupture

malignant choriocarcinoma

104
Q

malignant tumor, usually of the placenta

abnormal proliferation of cytotrophoblastic and syncytiotrophoblastic cells that produce BHCG

A

choriocarcinoma

105
Q

choriocarcioma arises from:

50%:

50%:

A

pre-existing molar pregnancy

retained placental cells post abortion or placenta retention after normal pregnancy

106
Q

choriocarcinoma is very sensitive to __

and has a __ prognosis

A

chemo

good

107
Q

choriocarcinoma may be diagnosed in the setting of (4)

A
  1. rise in HCG of 10% or more for 3 or more values over 2 weeks
  2. plateau in 4 or more HCG values over 3 weeks
  3. HCG levels elevated at 6 mo post evacuation
  4. tissue dx

Clin Med II - Exam 5 (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions