Physical Examination Flashcards
1
Q
Clinical fundal height
A
- Xiphisternum (36 weeks); Umbilicus (22 weeks); Suprapubic bone (12 weeks)
- Divide the area above umbilicus (24 weeks) to xiphisternum into 3 part corresponding to about 4 weeks
- If >34 weeks, feel for the subcostal space (differentiate 34/ 38 and 36/ 40 weeks)
2
Q
Symphysio-fundal height
A
- After 20-36 weeks of gestation, the fundal height will reflect weeks of pregnancy +- 2cm
- Around 37-40 weeks, fundus height move down about 4cm, body is preparing for birth
3
Q
Engagement description
A
- Floating (5/5 palpable),
- Not engaged (3/5 or 4/5)
- Engaged and no longer movable (1/5 or 2/5)
4
Q
Physical examination for ovarian tumor
A
- Pelvic and abdominal examination: characteristic of mass
- Neck and groin examination: enlarged supraclavicular node
- Bimanual examination: cervix does not move with vaginal finger
- Chest examination: pleural effusion
5
Q
Ovarian mass that moves during bimanual examination
A
- Ovary Ca
- Adhesion
- Endometrioma
6
Q
Adenomyosis vs Fibroid in PE
A
> Adenomyosis
- Soft in consistency
- Uterus may be tender
- Rarely exceed size of 12 weeks
7
Q
Adenomyosis vs Fibroid in Ultrasound
A
> Adenomyosis
- Asymmetric thickening of myometrium
- Linear striation radiating out from the endometrium
- Loss of clear endomyometrial border
> Fibroid
- Hypoechoic
- Well-circumscribed round masses
- Frequently with shadowing
8
Q
SGA vs IUGR
A
- SGA: birth weight <10%-tile or -2SD; Doppler normal
- IUGR: presence of pathological process that inhibit foetal growth; Doppler: hemodynamic redistributed
9
Q
REDD is used in which situation
A
- Menstrual cycle are irregular (vary by >=7 days)
- LMP is unknown or uncertain
- The patient conceived while using hormonal contraception
- Uterine size on PE differ from predicted by LMP
10
Q
How to determine age during dating scan
A
- Gestational sac size
- Embryo size (eg: CRL)
- Size of fetal parts (eg: cranium, long bones, abdomens)
