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OB > Physiology of pregnancy -Table 1 > Flashcards

Physiology of pregnancy -Table 1 Flashcards

1
Q

What causes a hypercoagulable state in pregnancy?

A

estrogen

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2
Q

What is the mask of pregnancy?

A

hyperpigmentation of face, Malasma

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3
Q

Folate recommended in wormen with PNTD?

A

1mg po

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4
Q

what does the fetal spine develope?

A

5-6 weeks GA

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5
Q

what are 3 NTD we check for?

A

spina bifida, encephalocele, anencephaly

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6
Q

What is spina bifida occulta?

A

open vertebral canal, but spinal cord is in canal.

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7
Q

What is meningocele?

A

intact neural tube with cyst containing meninges

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8
Q

Myeloschisis is?

A

type of spina bifida, neural tube is open

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9
Q

Sickle cell crisis manemanet?

A

hydration, pain medication, possible tranfusion - monthly CBC’s, change to medications, serial US, induced labor @37 weeks

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10
Q

what is myelomingocele?

A

lumbar level dome shaped cyst- contents vary

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11
Q

what additional IZ are needed with aplenia

A

pneumococcal, H. flu, miningococcal

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12
Q

what should pregnant women brush with post vomit?

A

1 tsp baking soda in 8 ox water

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13
Q

What is epulis gravidarum?

A

lobar growth on gumline, benign

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14
Q

what is the normal amount of wt to gain during pregnancy?

A

25-35lbs, twins is 37-54lbs

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15
Q

when does mornign sickness typically occur?

A

first trimester: 4-14 weeks

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16
Q

How do you treat morning sickness?

A

ice chips, candied ginger, preggy-pops, acupressure bands

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17
Q

what rx medicaiton can be given to women with severe emesis?

A

Doxylamine succinate and B6

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18
Q

What could you give for hyperemesis gravidarum?

A

D5W, lactated ringers,

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19
Q

What is hyperemesis Gravidarum?

A

wt loss >5% pre-pregnancy value, protracted vomiting, ketonuria

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20
Q

appendicitis in pregnancy women presents as?

A

N/V, RLQ pain, (no bleeding=r/o abruption)

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21
Q

Cholelithiasis in pregnancy?

A

RUQ pain, F/V, (r/o HELLP)

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22
Q

Intrahepatic cholestasis in pregnancy?

A

build up of bile acids in liver- usual itching, but in hands and feet, dark colored urine, clay feces, anorexia

23
Q

How do you tx intrahepatic cholestatis in pregnancy?

A

Ursodeoxycholic acid, monitor serum bile and LFTs, NST

24
Q

What is the most common trauma with pregnant women?

A

MVA, DV/IPV

25
Q

How do you manage a pregnant women post trauma?

A

maternal stabilization, then work on fetus: US, electronic monitoring 2-6 hrs s/p mild trauma up to 24hrs

26
Q

Kleihauer betke test is?

A

checks for fetal cells in maternal circulation= Rh sensitization.

27
Q

Asymptomatic bacterirria?

A

In pregnant women can develope into UTI or pyelonephritis. Do clean catch and culture and sensitivity=>10x5 colonies bacteria on culture

28
Q

how do you treat uti in pregnancy?

A

cephalosporin or macrodantin

29
Q

How is pyelonephritis treated in pregnancy?

A

in patient! risk for premature labor

30
Q

No fever, CVA tenderness and blood in urine…you think?

A

Renal calculi

31
Q

Drug of choice for epilepsy with pregnancy?

A

there is not one. Want to weigh risk versus benefit here. there is a lot of fetal montoring.

32
Q

Bell’s treatment with pregnancy?

A

rx: steroids, better if after first trimester

33
Q

What is a common peripheral neuropathy in pregnancy?

A

CTS- d/t fluid retention

34
Q

How do you treat carpel tunnel syndrome in pregnancy?

A

wrist splints at night

35
Q

what are some psychiatric screening tools you use with pregnancy?

A

CBT, stress management, coping skills/support system, screening questionnaire, social workers

36
Q

Postpartum blues?

A

hormonal shift= high estrogen and progesterone through L and D followed by large decrease w/in 48 hrs.

37
Q

Post partum depression?

A

major depression, more prevalent, anhedonia(not enjoying baby), crying spells, ADL’s interference,

38
Q

Postpartum psychosis?

A

preexisting bipolar or schizophrenia, with s/sx of disassociation, hallucinations, EMERGENT!!

39
Q

What are some tools you can use to monitor pp behavioral health?

A

beck depression scale, edinburgh postnatal depression scale, case finding questions -have you been bothered by having litlle interest or pleasure in doing things?

40
Q

Hypothyroidism and pregnancy treatment?

A

Levothyroxine, dose will be boosted then go back to normal adult dose post birth

41
Q

How often should you monitor TSH in hypothyroidism in pregnancy?

A

every month for first 20 weeks, then once for 2nd and 3rd trimester

42
Q

Hyperthyroidism in pregnancy ?

A

Propylthiouracil(PTU)- hepatic risk

43
Q

Why do you not want to use MMI in first trimester of pragnancy with hyperthyroidism?

A

fetal scalp defects/aplasia cutis that occurs in first trimester

44
Q

risks with preganancy and DM1?

A

risk of hyperglycemia, glycosuria, ketoacidosis, elecrolyte imbalance

45
Q

Can glucose be a teratogen?

A

yes, leads to most anomalies in 1st 42 days of gesgation

46
Q

DM2 treatment in pregnancy?

A

metformin, glyburide9c)

47
Q

characteristics of GDM?

A

Insufficient insulin secretion to counteract pregnancy related fall in insulin sensitivity

48
Q

HPL?

A

human chorionic somatomammotropin- anti insulin properties, physiologically meant to shunt nutrients to fetus

49
Q

Sacral agenesis?

A

risk of GDM-

50
Q

what is the 1 step glucose screening for pregnant women?

A

first- fasting bg (75g) draw post prandial(fasting, 1h, 2hr), if >92,>180,>153 or fasting >125

51
Q

what is the 2 step glucose tst for pregnant women?

A

Non-fasting- drink 50g oral soln, 1 hr. postprandial- if abnormal >130 then continue with GTT(100g po) then draw blood (1,2,3 hr)

52
Q

what is the desired fasting glucose for pregnant women?

A
53
Q

Why do you get us for pregnant women with GDM?

A

to check for fetal wt. may have to opt for cesarian (>4500g)

OB (11 decks)

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