PHC revision Albany

Question 1

What is Nagele’s rule for estimating estimated date of delivery?

Answer 1

First day of the last menstrual cycle, count back 3 months from that date and then add 7 days

Question 2

What is the pre-embryonic period?

Answer 2

Fertilisation to week three?

Question 3

What is the embryonic period?

Answer 3

Week four- seven

Question 4

What is the fetal period?

Answer 4

week 8-birth

Question 5

The umbilical cord contains how many arteries and veins?

Answer 5

Two arteries-blood from fetus to placenta, one vein-gather blood returning from the villi and join to form the single umbilical vein, which enters the cord, returning blood to the fetus.

Question 6

What is the role of estrogen during pregnancy?

Answer 6

Stimulates uterine development by maintaining a suitable environment for the foetus

Question 7

What is the role of progesterone during pregnancy?

Answer 7

Reduces uterine muscle irritability and prevents spontaneous abortion of the fetus.

Question 8

What are the presumptive signs of pregnancy?

Answer 8

Amenorrhea- absence of menstruation. Other possible causes are emotional stress, strenuous physical exercise, endocrine problems, chronic disease, early menopause, anovulation, low body weight.

Nausea and vomiting- begins about 6 weeks after the last menstrual period and usually disappears by about 14w.

Breast changes- begins at about the 6th week of pregnancy. Breast tenderness, tingling, fullness, increase in size and pigmentation of the areaolae. Other causes are premenstrual changes, use of oral contraceptives.

Fatigue- other possible causes are illness, stress and sudden lifestyle changes.

Urinary frequency- UTI possible

Second trimester: Quickening- other possible causes are intestinal gas, peristalsis or pseudocyesis.

Increased skin pigmentation: Linea nigra (line of dark pigment on the abdo)- other causes are premenstraul changes and the use of oral contraceptives.

Striae gravidarum (red streaks on the abdomen).

Question 9

What are the probable signs of pregnancy?

Answer 9

First trimester- Chadwick’s sign (vagina changes colour from pink to violet)- can also be caused by hormonal imbalance

Goodell’s sign (cervix softens)- ?hormonal imbalance

Hegar’s sign (lower uterine segment softens)- can also be possible caused by hormonal imbalance.

Positive HCG- Hydatidiform mole

Second tri: Enlarged abdomen- could also be caused by abdominal or uterine tumours.

Braxton’s hicks contractions (periodic uterine tightening)- presence of myomas can cause false and painless contractions.

Ballottement (fetus can be felt to rise against abdominal wall when lower uterine segment is tapped on during bimanual examination)- other possible cause of this occurrence is the presence of uterine or cervical polyps.

Question 10

What are positive signs of pregnancy?

Answer 10

First tri- ultrasound evidence

Second- fetal heart tones, fetal movements, fetal outline, palpation of fetal movement through abdo.

Question 11

Name components of the acronym, which pregant women should be asked
G
T
P
A
L
M

Answer 11

Gravida- total number of pregnancies, including current
Term- number of pregnancies that have come to full term (after 37w)
Preterm deliveries (20-36w).
Abortions- surgical or spontaneous before 20W
Live births
Multiple births

Question 12

How many more calories to pregnant woman need throughout their pregnancy?

Answer 12

First tri: Essentially the same
2nd and 3rd tri: 300-400 more.
Need to be nutrient dense

Question 13

What are good sources of folic acid?

Answer 13

Fruit and veges

Question 14

Why should newborns receive vitamin K?

Answer 14

Newborns can’t synthesis vitamin K in the intestines without the presence of bacterial flora, hence they are deficient in clotting factors