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Clin Med Final Material 5 > Preconception Counseling, Infertility, Abortion- Paulson > Flashcards

Preconception Counseling, Infertility, Abortion- Paulson Flashcards

1
Q

What is the purpose of prenatal care and why is it important?

A

Purpose is to have a successful pregnancy and mothers receiving prenatal care have lower risk of complications

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2
Q

Is marajuana safe to use in pregancy?

A

No

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3
Q

What is an important question to consider in preconception counseling?

A

Discuss a patient’s desire to become pregnant and when

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4
Q

All patients thinking about becoming pregnant should take what?

A

Folic acid supplements because it may be beneficial in reducing neural tube defects and cardiac anomalies

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5
Q

Are pregnant women able to get live vaccines?

A

No so it is good to get them done during preconception counseling

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6
Q

Organ development occurs at approx what part of gestational age?

A

3-10 weeks so in the first trimester

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7
Q

________ is defined as no pregnancy after trying for 12 months with normal sexual activity without contraception

A

Infertility

Can try IVF in this case

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8
Q

Due date is calculated how?

A

40 weeks from the first day of the last LMP

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9
Q

What are some common things to expect when pregnant?

A
  • Thyroid issues
  • Gerd, constipation, gallstones
  • N/V throughout the day
  • Decreased BP and inc HR which is why women shouldn’t lay flat on back at night
  • Anemia
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10
Q

Supplemental _____ is encouraged during pregnancy because of anemia during pregnancy

A

iron

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11
Q

What are some cardiac manifestations of being pregnant?

A

increased CO, lower BP, inc HR, increased venous pressure in lower extremities from compression of IVC by uterus

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12
Q

What are some hematologic manifestations of pregnancy?

A

-Anemia and hypercoag state (DVT, PE)

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13
Q

Renal manifestations of pregnancy?

A

-Increased size and increased GFR

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14
Q

Respiratory manifestations of pregnancy?

A

Increase in tidal volume, inc in inspiratory capacity

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15
Q

Derm manifestations of pregnancy?

A

Spider angiomas and hyperpigmentation (melasma)

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16
Q

_______ refers to termination of pregnancy before 20 wks

A

Abortion (spontaneous or therapeutic)

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17
Q

A patient comes in complaining of bright red vaginal bleeding, low back pain and a bHCG level that is falling or not adequately rising. WHat should we be concerned about?

A

Abortion

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18
Q

This is when all products of conception are expelled before 20 weeks, cervical os is closed.

A

Complete abortion

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19
Q

This is whsen a pregnancy can not be saved and the treatment is D&C

A

inevitable abortion

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20
Q

What is the tx for threatened abortion?

A

Recommended pelvic rest

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21
Q

What is a threatened abortion? And what constitutes a good prognosis?

A

Possible pregnancy loss

*less cramping/pain have better outcomes typically

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22
Q

This is when only some products of conception are passed before 20 weeks

A

Incomplete abortion

23
Q

What is the tx for incomplete abortion?

A

D& C, methotrexate, expectant management

24
Q

This is when the embryo is not viable prior to 20 weeks and products of conception are retained in the uterus

A

Missed abortion

25
Q

Tx for missed abortion?

A

D& C, methotrexate, expectant management

26
Q

A patient presents with uterine bleeding, fever, increased leukocytosis, abdominal pain and foul smelling d/c. She is pregnant. What might this be and what is the best way to dx it?

A

septic abortion: where the fetus hasn’t survived and there’s also an infection

Abdominal X-ray, U/S and labs

27
Q

Treatment for septic abortion?

A

Hospitalization and broad spectrum IV abx. May need D& C for retained POCs (products of conception).

28
Q

What are three drugs used in elective first trimester abortions?

A

The three M’s (mmm…. abortion)

-Mifepristone, misoprostol, methotrexate

29
Q

How to do an elective abortion in the 2nd trimester?

A

Dilation and evacuation

30
Q

What is the safest and most effective method for terminating pregnancy of 12 weeks gestation or less?

A

Suction cutterage

31
Q

This is when there are 3 or more consecutive spontaneous abortions before 20 weeks

A

recurrent pregnancy loss

32
Q

Previously called a “blighted ovum” and when an embryo fails to develop or is resorbed after loss of viability?

A

Anembryonic pregnancy

33
Q

How is an Anembryonic pregnancy diagnosed?

A

U/S will show empty gestational sac w/o a fetal pole

34
Q

This is the leading cause of pregnancy related death in the first trimester?

A

Ectopic pregnancy

35
Q

Where is the mc site of ectopic pregnancy?

A

Fallopian tubes

36
Q

These are symptoms of what?

Pain, bleeding, amenorrhea, syncope

A

Ectopic pregnancy

37
Q

What imaging should you do for an ectopic pregnancy and what should the bHCG level be at?

A

Transabdominal U/S and bHCG <1500

38
Q

What is the tx of choice for ending early ectopic pregnancy?

A

Methotrexate 500 mg IM

39
Q

What is the second line tx for ending early ectopic pregnancy?

A

Surgical-Labroscopy

40
Q

Snowstorm pattern

A

Gestational Throphoblastic disease

41
Q

This is an umbrella term for a group of pregnancy related tumors

A

Gestational trophoblastic tumors

42
Q

Preeclampsia in the first or early second trimester may be pathognomonic for what?

A

Molar pregnancy

43
Q

A patient presents with uterine bleeding in the first trimester, rapid enlargement of the uterus and HCG titers greater than expected for gestational age. What condition should we think about?

A

Gestational Throphoblastic disease

44
Q

This is a benign neoplasm derived almost entirely from abnormal placental proliferation?

A

Hydatidiform mole (AKA molar pregnancy)

45
Q

What is a complete Hydatidiform mole?

A

Contains no fetal tissue and bHCG >50,000

46
Q

What is a partial Hydatidiform mole?

A

Contains some fetal tissue and bHCG <50,000

47
Q

What is the dx of choice for Hydatidiform mole?

A

U/S

48
Q

“snowstorm pattern” is described for _____ mole

A

complete hydatidiform mole

49
Q

Cystic changes in the placenta are a hallmark finding of _______ mole

A

partial hydatidiform mole

50
Q

This is characterized by multiple grapelike vesicles filling and distending the uterus

A

hydatidiform mole

51
Q

What is the treatment for a molar pregnancy?

A

suction and cutterage under GA

  • submit path
  • prophylactic chemotherapy
52
Q

What could be indicative of a malignancy after a molar pregnancy?

A

bHCG rise

-So we want to watch this closely to see if levels rise

53
Q

This is a malignant tumor usually of the placenta? What is the prognosis?

A

Choriocarcinoma - high cure rate

**Look for rise in bHCG

54
Q

What is the tx for choriocarcinoma?

A

Chemotherapy

Clin Med Final Material 5 (18 decks)

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