Practice Qs Flashcards
In women, the TSH screening test should be preformed at what interval starting at what age?
Every 5 yrs after age 50
A cholesterol/lipid profile should be performed at what interval in women w/o risk factors?
Every 5 yrs after age 45
In sexually active women age 25 or younger, how often should they be screened for chlamydia?
annually
The pt. should be given what is “due” most closely matches what principle?
justice
Respect for the pts right to make choices based on her beliefs and values
Autonomy
The duty to promote the well-being of the pt.
Beneficence
The concept of informed consent best relates to the principle of?
Autonomy
Paternalism violates the ethical principle of?
Autonomy
This type of speculum works well for most nulliparous women and for postmenopausal women w narrowed vaginas
Pederson
Speculum appropriate for most pre-menstrual parrous women
Graves
A fasting blood glucose test is recommended for women without risk factors starting at what age? how often thereafter?
45yrs;
every 3 yrs
Annual HTN screening in girls should begin at?
13yo
Most medical errors are assoc with what?
the use of medications
Glucose crosses placenta by?
facilitated diffusion
Amino acids cross the placenta by?
active transport
Transit time in the stomach and small bowel increases by what percent in 2nd/3rd trimesters?
15-30
During pregnancy, total body O2 consumption increases by what % of nonpregnant levels?
20
By term in a normal singleton pregnancy, maternal blood volume increases by?
35%
Iron supplementation is mainly to?
prevent iron deficiency in the mother
increased nasal stuffiness is assoc with?
mucosal hyperemia
when do changes in maternal CO begin?
first trimester
Compared to nonpreg state, the overall increase in maternal CO is about?
30-50%
During preg, maternal circulating blood volume increases how much over non-preg levels?
when does the increase reach its peak?
45%;
32 weeks
what percent of CO does the uterus receive at term?
20%
During a nml preg, maternal BP will initially?
then by term it will?
decrease to a nadir at 24-32 wks ;
return to nonpreg levels
how much does maternal heart rate normally increase?
10-18 bpm
During LABOR, what changes in maternal CO occur?
40% increase from late pregnancy
At the time of uterine contractions during labor, MABP
increases by approx 10mmHg
Increased CO following delivery is due to?
release of vena cava obstruction
The TV in preg increases by what %?
30-40
During preg, what is the nml effect of progesterone on the ureters?
more dilation of the R ureter than the L
how do serum creatinine and BUN change?
both levels decrease
The change in facial pigmentation during preg?
Chloasma
hair will return to nml about how long after delivery?
6-12 months
Umbilical BF represents what % of combined output from both fetal ventricles?
40%
Fetal kidney near term forms urine at what rate?
400-1,200 mL/day
risk of PE increases by ___ times the nml risk in the pueperium
5.5
[fibrinogen] during preg?
300-600 mg/dL
True labor is assoc w contractions that the pt feels where?
uterine fundus
optimal time to auscultate fetal heart tones during labor?
immediatly following a contraction
When does the greatest rate of descent occur?
2nd stage of labor
Uterine inversion is assoc w what aspect of postpartum management?
Traction on the umbilical cord
what degree is an OB laceration that extends to the rectal sphincter but not into rectal mucosa?
3rd
which technique of labor induction allows greatest variability in dosing?
oxytocin
a preg woman w history of a classical cesarean delivery requests a TOLAC, tell her that?
TOLAC is CI with previous classical c-section
Labor abnormalities are considered this type if labor is slow to progress
Protraction disorder
multiparous woman has been pushing for 2 hrs with no descent of the presenting part, this would be known as
An arrest disorder (labor ceases to progress, occurs only in the active phase of labor)
for a labor pattern to be considered optimal, contractions must generate peak intrauterine pressures of at least how many mmHg?
25
incidence of shoulder dystocia increases markedly if fetus has an estimated weight over?
4000g
normal FHR variability has an amplitude range of?
6-25bpm
marked FHR variability has an amplitude of?
greater than 25bpm
This presentation usually resolves spontaneously as labir continues?
Compound
In a nulliparous pt, the latent phase is considered prolonged if it lasts more than?
what about multiparous pts?
20hrs;
if more than 14 hrs
what % of singleton term deliveries are breech ?
2%
Outlet forceps assisted vaginal delivery is appropriate w. the fetal head at what station?
at the pelvic floor
Low forceps assisted vaginal delivery occurs when the when the fetal skull is?
At the +2 station
or more
amnioinfusion is useful in cases of
variable FHR deceleration
In high risk cases, intermittent FHR auscultation should be at least how often: in active phase of labor?
in the 2nd stage of labor?
every 15mins ;
every 5 mins
MC cause of fetal tachy? (greater than 160)
chorioamnionitis
baseline fetal brady is a HR less than?
less than what is an omnious sign that may presage fetal death?
110 bpm;
80bpm
Late FHR decelerations are assoc w?
uteroplacental insuff
pt is having repetitive late decelerations, what maneuver may help resucitate the fetus in utero?
change maternal position to Left lateral
“adequate labor” is how many contractions in 10mins?
3
puerperium lasts about?
6-8 wks
Tx of dyspareunia in postpartum period?
topical estrogen
mean time to ovulation in nonlactating postpartum woman is?
45days
how many NON-nursing women are fertile at 6wks postpartum
15%
incidence of postpartum blues is?
incidence of postpartum depression?
incidence of postpartum psychosis?
70-80%;
10-15%;
0.1-0.2%
surgical management of postpartum hemrrhoids may be considered after?
6mos postpartum
how many weeks does it take for uterus to return to: prepreg position in true pelvis ?
pre-preg size?
2;
6
when does elevated pulse rate of pregnancy decrease?
approx 1 hr after delivery
when is the endometrium re-est. after delivery in most pts?
Third week
normal weight of fluid lost from diuresis and loss of extravascular fluid?
5kg
GFR decreases to nml after how long?
several weeks after delivery
Lochia rapidly decreases in amt. over the first ____ days postpartum
2-3
heavy postpartum bleeding assoc w paaing of placental eschar MC begins btwn what days postpartum?
best management?
what % of pts will have delayed postpartum hemorrhage?
8-14;
reassurance;
1%
Colostrum is replaced by milk around the ____ postpartum day
5th
breast engorgement in non-breastfeeding mother is best managed by?
a breast binder
Vit NOT found in human breast milk?
Vit K
abnormal vaginal bleeding for 5 days, no abnormalities on PE, Bx where?
endometrium
