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Pregnancy HY Flashcards

1
Q

Endometrial glands invades myometrium.
Symmetrical, soft large (globular), boggy uterus.
± Myometrial thickening on u/s
Dx/Tx & Definitive Tx?

A

Adenomyosis
Mirena IUD
(levonorgestrel-releasing intrauterine device)
Definitive tx: Hysterectomy

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2
Q

Irregularly enlarged uterus
Well-circumscribed masses in the myometrium on u/s
Dx?

A

Uterine leiomyoma - Fibroma

(Elevated risk of spontaneous abortion)

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3
Q

1 hour Oral Glucose Tolerance test done at

A

24w visit

(if abnormal do 3hr test)

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4
Q

When 1st dose of Rhogam if pt is Rh (–) & no antibodies

A

28w

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5
Q

when do all pregnant women get the Tdap vaccine?
Other recommended vaccines in pregnancy?

A

T-Dap (27w–)
HepB (if non-immune)
Flu vaccine (non-live)

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6
Q

1st Prenatal Visit (~10w) screening (5):

A

HIV, HBVsAg, Syphillis
UA/Ucx (Asymptomatic Bacteuria- test of cure)
Rh Status check (Indirect Coombs if blood type is Neg)

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7
Q

Anal Vaginal GBS swab indicated when

A

35-37w

(if premature labor, do it at that time)

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8
Q

Pre-Term Labor <32w
what is given

A

Magnesium
Betamethasone
Ampicillin/Amoxicillin
± Indomethacin (tocolytic)

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9
Q

Pre-Term Labor <34w
what is given

A

2 doses Betamethasone
Ampicillin/Amoxicillin
± Nifedipine (tocolytic )

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10
Q

Premature rupture of Membrane <34w
Mom or Fetus have compromise (like infection, bleed, etc)
NBSIM

A

Immediate Delivery

(Mg if <32w +Betamethasone + Ampicillin/Amoxicillin)

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11
Q

Premature Rupture of Membrane <34w
Mom & Fetus have no infection, bleeding, or distress
NBSIM?

A

Betamethasone
Ampicillin/Amoxicillin
Fetal Monitoring
Expectant management

<32w Magnesium

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12
Q

3 days post-partum what care does the mother receive?

A

2nd RhoGam dose (if no Abs)

(Baby should get 1st HBV vaccine and Vit K)

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13
Q

at 10w visit if mom is Rh (–) NBSIM?

NBSIM: If results (–) or (+)?

A

Indirect Coombs test
(check for ABs)

Negative ABs → RhoGAM at 28w (& again 3d PP)

Positive ABs → Check Father’s Rh status

FYI (out of test’s scope)
if father Rh + baby will need Doppler u/s of MCA for anemia

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14
Q

Polyhydraminos happens when baby pees a lot
or isn’t swallowing/drinking enough.
Causes (4)?

A

Twins
Diabetic Mother
Anencephaly (can’t swallow)
obstruction to swallowing (esophageal/intestinal atresias)

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15
Q

Oligohydraminos happens when baby can’t pee.
List 3 causes & feared complication?

A

Renal Agenesis
Urinary Obstruction (PUV/VUR)
Mom used ACE-I/ARBs (teratogens)

Urinary tract anomaly→olygohydraminos→Fetal Compression→ Potter Sequence:

Lung Hypoplasia/NRDS, Limb deformities, Face deformities

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16
Q

2 mcc of new born seizures:

A

Hypoglycemia → Diabetic mom, Beckwith Wiedemann
Hypocalcemia → Digeorge syndrome

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17
Q

Belly Size and Baby Age size discrepancy
NBSIM? Interpret outcome.

A

NST (Non-invasive Stress Test)
──
Reactive= 2 acceleration in 20 minutes → GOOD
Non-Reactive= get a BPP (or try waking baby up)

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18
Q

Non-Reactive Stress Test
NBSIM? Interpret Outcome.

A

Biophysical Profile (BPP)
──
Sore 0-2 = C-section now
Score 4,6 = Contraction Stress Test
──
(BPP Score will be given on test!!!)
(CST Results out of scope)

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19
Q

11 weeks gestation (< 20w)
Hyperemesis gravidarum
HTN
Heavy vaginal bleeding
Huge Size >Date discrepancy
± theca lutein cysts

Note: The NBME may mention these as speculum blue lesions indicating vaginal mets.

Dx?

A

Gestational trophoblastic Dz

(MolarPregnancy)

Theca lutein Cystic mass causing size discrepancy

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20
Q

30F at 35 weeks
2 day (ACUTE) history of N/V
RUQ Abd Pain + Jaundice
Hypoglycemia
Leukocytosis, Normal/↓PLTs
↑PT/PTT/Fibrin degradation
↑ ↑ AST/ALT ± ↑ GGT
Indirect Bilirubin > direct Bilirubin
↑ Creatinine
Dx/TX?

A

Acute fatty liver of pregnancy
(DIC like picture)

Tx: immediate delivery

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21
Q

30F at 35 weeks
2 week (chronic) history of Itchiness
RUQ Abd Pain/ Jaundice
Leukocytosis, Normal PLTs
↑ Total serum bile acid
↑ /nl Bilirubin
↑ AST/ALT
Dx/Tx?

A

Intrahepatic Cholestasis of Pregnancy
Tx: Ursodeoxycholic acid + Deliver at 36w
(or immediately if 37w)

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22
Q

Pre-eclampsia/Eclampsia patient with MAHA (schistocytes) with HTN, Anemia & low PLTs
↑AST/ALT
Evidence of hemolysis
(↑LDH, ↓ Haptoglobin, ↑Indirect Bilirubin)
Dx/Tx?

A

HELLP syndrome
Immediately Deliver
+ Magnesium (mom) + Hydralazine (for HTN)
─

Hemolysis (↓ Hb/Haptoglobin, ↑ LDH, ↑ Indirect Bili)
Elevated Liver enzymes (↑ AST/ALT)
Low Platelets

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23
Q

How to differentiate between HELLP syndrome and Acute Fatty Liver of Pregnancy?

A

AFLP → has hypoglycemia &↑ PT/PTT/ fibrin degradation product. (DIC like)

HELLP → Normal PT & PTT (no fibrin degradation)

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24
Q

(classic presentation)
Severe SOB, cough, hemoptysis, and weight-loss 3 weeks after an abortion.
Dx?

A

Choriocarcinoma

Hematogenous spread loves to go to the lungs!

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25
Q

MC kind of vaginal malignancy:
BRF for primary vaginal carcinoma:
Treatment/Cx:

A

vaginal malignancy → Squamous cell cancer
BRF → HPV 16/18/30s
Tx: Surgery & Radiation (adhesions/ vaginal stenosis)

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26
Q

Glandular cell vaginal malignancy.
Dx?

A

Clear Cell Adenocarcinoma of the Vagina

(fetus exposed to DES = T-shaped uterus)

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27
Q

B-HCG cutoff to see a gestational sac on an ultrasound.
bHCG > ____

A

> 2000

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28
Q

Pap-smear guidelines for pts after a Hysterectomy
(s/t endometrial hyperplasia/cancer)

A

Keep doing pap-smears of vaginal cuff

(only stop if hysterectomy was s/t benign reasons)

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29
Q

4ft tall female with amenorrhea.
Dx?
Classify the hypogonadism

A

Turner’s Syndrome
Hypergonadotropic Hypogonadism

Hypergonadotropic (↑ FSH/LH & ↑ GnRH)
Hypogonadism (↓ Estrogen) s/t streak ovaries

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30
Q

18F with Tanner 5 breasts & pubic hair with Amenorrhea
No uterus.
Dx?

A

Mullein agenesis (MRKH syndrome)

Breast present = Estrogen is okay
Pubic hair present = Testosterone/Progesterone is okay

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31
Q

Supermodel having a BMI of 17 with amenorrhea.
Classify the hypogonadism?
GnRH FSH LH E2 levels?

A

Hypogonadotropic Hypogonadism

HPG axis shut down= ↓ FSH/LH, ↓ GnRH (gonadotropins) & ↓ Estrogen (gonads)

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32
Q

1º Amenorrhea with severe lower abdominal pain at the end of the month. Bulge in vaginal vault on exam.
Dx?

A

Imperforate hymen
Transverse vaginal septum (rare, 2nd option)

Tx: Surgery

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33
Q

Treatment for Primary Dysmennorhea?
PE is normal

A

1st line: NSAIDs
2nd line: OCPs
s/t prostaglandins causing violent uterine contraction

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34
Q

25F Infertile w/Painful menses, painful poop, painful sex.
Dx/BRF/Temporary & Definitive Tx?

A

Endometriosis
(+) Family history
Temporary Tx: OCPs
Definitive Tx: Hysterectomy

Patho: Endometrial glands/stroma are outside the endometrium (mc in the ovaries chocolate cysts)

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35
Q

In Endometriosis
where is one common attachment point affected?
how is it definitively diagnosed & treated?

A

Can attach to utero-sacral Ligament (HY)
Definitive dx → Laparoscopy
Definitive tx → Hysterectomy

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36
Q

Heavy menstrual bleeding, symmetrically soft/tender uterus on bimanual exam.
Dx:
Tx:
Definitive dx:
Definitive tx:

A

Adenomyosis
Tx: Mirena IUD
Definitive tx: Hysterectomy
Definitive dx: Laparoscopy

(endometrial glands in myometrium)

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37
Q

Most effective emergency contraception.

A

Copper IUD

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38
Q

What kind of contraception should be avoided in a postpartum female?

A

Estrogen containing contraception

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39
Q

Contraception with the need for Vit D/Ca supplementation.

A

Depo-Provera
Reversible decr in bone mineral density
Delayed Return to fertility

(progestin injectable q3m)

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40
Q

23F abdominal pain, vaginal bleeding + Positive B-HCG
Dx/Tx?

A

Ectopic Pregnancy
Tx: Methotrexate

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41
Q

MTX contraindications
(2)

A

bHCG > 5000
Fetal cardiac activity present

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42
Q

If pregnancy is viable bHCG should

A

DOUBLE every 48hrs

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43
Q

PCOS patient desiring pregnancy.

A

Clomiphene
Letrazole

(Letrazole inhibits aromatase thus lowers E2)

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44
Q

PCOS criteria?
Must meet 2 for dx

Treatment of PCOS?

A
  1. Hyperandrogenism
  2. Irregular menses (Anovulation)
  3. Polycyctic ovaries on U/S

Tx: Weight-loss + OCPs

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45
Q

Mucopurulent vaginal discharge &
Lower Abdominal/ Adnexal tenderness
Dx/Tx?

Now has RUQ pain → dx?

A

Pelvic inflammatory Disease
CTX + Doxycycline (or Azithromycin)

RUQ pain → spread to liver capsule (Fitz Hugh Curtis Syndrome)

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46
Q

19F persents with AMS, Sudden high fevers, Red skin, + palmar exfoliating rash; recent h/o menses
Dx?

A

Toxic Shock Syndrome

(fyi emperic abx → Vanco + Clindamycin)

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47
Q

30F presents with Fever & Unilateral swelling/fluctuant mass in inferior labia.
Dx/Tx?

A

Bartholin Gland Abscess
Incise & Drain + WORD catheter

(for drainage & ↓recurrence)

48
Q

Increased UTI risk in pregnant women s/t

A

High Progestin
(relaxes smooth muscle in ureters →urinary stasis)

49
Q

NBSIM of Asymptomatic bacteriuria in a pregnant pt?

A

Amoxicillin
Cephalexin
or
Nitrofurantoin

→ Get urine Cx as TEST of CURE

50
Q

Severe nausea, vomiting, and weight loss in a 23 yo F at 11 weeks gestation.
Dx/Tx?

If admitted, what is the tx?

A

Hyperemesis Gravidarum

Doxylamine + Vit. B6

Inpatient tx→ N Saline + Thiamine + Odansetron

51
Q

Causes of increased MSAFP (2)

A

Incorrect Dating
Neural Tube Defects

52
Q

NBSIM if pt has ↑Maternal AFP?

NBSIM if pt has (+) cell Free DNA?

A

For both 1st get an Ultrasound

→Amniocentesis, After u/s

53
Q

NRST with a normal FHR but no accels and the child is not moving.
What is your NBSIM?

A

Vibro-acustic stimulation
(fetus is sleeeping)

54
Q

Teratogenic drugs causing fetal:
Renal Anomalies/failure:
Ashen gray newborn + cardio collapse:
R sided heart/Tricuspid valve problems:
Poor Bone development:
Limb hypoplasia:
Intracranial hemorrhage + IUGR:
Aminoglycosides → Ototoxicity
Valproate → neural tube/spine defects
Phenytoin → cleft palate, phalanx/fingernail hypoplasia

A

Renal failure: ACE/ARBs

Ashen gray newborn: Chloramphenicol

R sided heart problems: Lithium

Bone development: Tetracycline

Limb hypoplasia: Thalidomide

ICH + IUGR: Warfarin

55
Q

BRF for preterm labor.

A

Prior h/o Pre-term labor

56
Q

Ultra HY
Obstetric complication associated with:
Bacterial vaginosis
Asymptomatic bacteriuria
Ureaplasma infection

A

Pre-Term Labor
Pre-Term Delivery

57
Q

Woman with Recurrent 2nd trimester (13-24w) pregnancy losses
Dx/ Risk Factor/ Emergent Tx/ Ppx?

A

Cervical incompetence

H/o Conization or LEEP

Emergent tx: Cervical Cerclage

Ppx: Vaginal Progestin Suppositories
––––

memory device: second trimester = cervical cerclage

58
Q

Pregnant pt with h/o Eclampsia
NBSIM?

A

Start Aspirin
(stop at 32w)

59
Q

Preventive measure to reduce risk of neonatal/fetal infection in women with prolonged rupture of membranes:

A

↓ # of digital vaginal exams

60
Q
  1. NBSIM of prolonged rupture of membranes at >37 weeks (full term)?
  2. NBSIM if prolonged rupture of membranes > 18 hrs?
A
  1. give Oxytocin
  2. give Ampicillin or Amoxicillin (for GBS ppx)
61
Q

Criteria for prophylactic C section in an Infant of DM?

A

if estimated fetal weight is > 4,500g
> 9.15 lbs

62
Q

Gestational HTN is diagnosed after ___
and at what BP?

A

≥ 20 weeks
140/90

63
Q

Pre-Eclampsia
vs
Eclampsia

A

Preeclampsia = gestational HTN + Proteinuria
Eclampsia = gestational HTN + Proteinuria + Seizure

64
Q

Management of Eclamptic Seizure (2)?

A

IV Magnesium
Immediate Delivery (after seizure is done)

65
Q

Antihypertensives in pregnancy (4)

A

(Hypertensive moms love nifedipine)
Hydralazine
Methyl-dopa
Labetalol
Nifedipine

66
Q

34F with AMS and decreased DTRs being treated for pre-eclampsia.
Dx/Tx?

A

Hypermagnesemia (toxicity)
CALCIUM GLUCONATE
( & stop Mg)

67
Q

Gestational DM pathophysiology s/t ____ that causes insulin resistance

A

Human Placental Lactogen
(placental hormone)

68
Q

Drug of choice for tx of Gestational DM?

A

Insulin

2nd line: METFORMIN
3rd line: Glyburide (Sulfonylurea)

69
Q

Newborn with Respiratory Distress born to mom with gestational diabetes. Explain Pathophysiology?

A

Low Surfactant

(Baby has a lot of insulin suppresses surfactant synthesis)

70
Q

Newborn with Small Brain (microcephaly) + Sensory Neural Hearing Loss + Periventricular Calcifications
Dx?

A

CMV

71
Q

Newborn with Macrocephaly (Hydrocephalus) + Chorioretinitis (eye-problems) + diffuse Intracranial Calcifications
Dx?

A

Toxoplasmosis

72
Q

pt w/ hx of Herpes
NBSIM:
If visible genital lesions during Labor?
If no visible genital lesions?

A

(+) Lesions = C-Section

No lesions = Vaginal delivery

73
Q

NBSIM if Hep BSAg (+) mom is delivering a newborn?

A

Give baby:
HepB vaccine + HepB Ig

(active and passive immunity)

74
Q

Biggest NBME RF for fetal tachycardia?

A

Maternal Fever

(Nl: 110-160)

75
Q

Baby’s anterior shoulder is stuck during delivery (Dystocia).
NBSIM?

A
  1. Apply Suprapubic pressure
  2. If that doesn’t work do McRoberts Maneuver
    Put woman knee to chest position & apply suprapubic pressure
76
Q

Pregnant pt with High Fever + Fetal HR 190
Uterine tenderness, foul smelling vaginal d/c on exam
Dx/Tx/NBSIM?

A

Chorioamnionitis
Tx: Amp-Gentamicin
Immediate Delivery

77
Q

Preterm labor management <37w
Uncomplicated
NBSIM?

A

Betamethasone
Ampicillin/Amoxicillin (<35w or GBS unk/+)

78
Q

MCC of postpartum hemorrhage & treatment

A

Uterine Atony
Oxytocin

79
Q

3 days postpartum + uterine tenderness.
Dx/Tx/BRF?

A

Endometritis
Clindamycin + Gentamicin
BRF → C-Section

(gently clean the uterus)

80
Q

When do you admit pt with Post Partum Depression (2)?

A
  1. PP Psychosis
    (hearing voices, Seeing things; delusions)
  2. Physical evidence of suicide or infanticide
    (bought a gun, Harmed baby on purpose)
81
Q

Work up for pulmonary embolism in pregnant women?
First dx test:
2nd dx test if 1st normal →
3rd dx test if 2nd test low risk →

A
  1. Ultrasound compression (+DVT → Heparin)
  2. V/Q scan (high probability → Heparin)
  3. Low probability → CT Angiography chest
82
Q

Algorithm on NBMEs for determining the cause of 3rd trimester (≥27w) vaginal bleeding.

1st Ask yourself → Painful or Painless
2nd Ask yourself → FHRT normal or abnormal
3rd Ask yourself → drugs, trauma or C-section?

A

Painless
1. vasa previa (Fetal HRT abnormalities present)
2. placenta previa (No Fetal HRT abnormalities)

Painful
1. Placental abruption (cocaine or trauma)
2. Uterine Rupture (h/o C-section → Loss of fetal station or palpable fetal parts in abdomen)

*loss of station = # becoming more +
*fetal parts are felt as bumps on abdomen or uneven abdomen)

83
Q

Contraindicated exams with vasa/placenta previa.
What mode of evaluation is okay?

A

Digital Vaginal Exam
Speculum Exam
—-
Transvaginal ultrasound
—-
Vasa Previa → C-section
Placenta Previa → C-section if low lying

84
Q

Mgt of placenta previa in unstable mom in active labor + FHRT abnormalities
versus
Mgt of placenta previa in an asymptomatic mom not in labor

A

Unstable → C-section immediately
Stable → Pelvic Rest (no sex) /Supportive care

85
Q

Management of vasa previa & uterine rupture

A

C-section
(immediate)

86
Q

31F at 29 weeks gestation presents with a 3 hr history of painful contractions that occur every 3-4 mins.
Consistent Contractions occurring at <37w is Pre-Term labor
Tocolysis for pts >32w
Tocolysis for pts <32w
2 protective medications:
Antibiotic:

A

Tocolysis >32w → Nifedipine
Tocolysis <32w → Indomethacin

Protective medications
<32w: Magnesium (neuroprotective)
<34w: Betamethasone

Antibiotic: → Amoxicillin or Ampicillin
(GBS ppx for anyone in pre-term labor)

87
Q

1hr Glucose Tolerance test for GDM screening is recommended between what weeks?

A

24–28w

88
Q

pt is 17w pregnant and has abnormal Quad Screen Results. NBSIM?

A

Amniocentesis for Karyotype Analysis
(only if 15-18w)

89
Q

Pregnant pt with hx of 3rd Trimester IUFD.
NBSIM?

A

Obtain NST in 3rd Trimester

90
Q

Syndrome that presents with pheochromocytomas or medullary thyroid cancer

A

MEN 2A & 2B

91
Q

____ is generally the first manifestation of MEN 2A

A

medullary thyroid carcinoma
(Hypocalcemia)

92
Q

FMH of neuroendocrine tumors
↑ Calcitonin
↓ Calcium
Dx?

A

Medullary Thyroid Carcinoma

(Men 2A >2B)

93
Q

27M h/o Ulcerative Colitis (on infliximab) presents with severe bloody diarrhea, LLQ abdominal pain, and malaise.
Colonoscopy: erythematous mucosa & superficial ulcers continuously from rectum to proximal descending colon. Biopsy: Intracellular inclusion bodies.
Dx/Tx?

A

CMV Colitis
Ganciclovir

94
Q

Excessive vomiting causes metabolic _____
Excessive Diarrhea causes metabolic ____

A

vomiting = Hypokalemic, Hypochloremic metabolic alkalosis
Diarrhea = Hyperchloremic metabolic acidosis (non-anion gap)

95
Q

Female s/p abortion or miscarriage presents with rising bHCG levels
(± levels were initially decreasing)
Dx/Tx?

A

Gestational Trophoblastic dz (neoplasia)
Tx: Resection + Chemo

vs Choriocarcinoma → presents with hemoptysis ± multiple theca cysts.
Monitor hCG for 1 year ± Hysterectomy

FYI: new-onset HTN, proteinuria, or end-organ dysfunction at < 20 weeks gestation suggests GTDz

96
Q

Fever + diffuse maculopapular rash in hands and feet.
Dx/Tx?

A

2º Syphilis
Penicillin

97
Q

Baby’s born to mom’s with SLE or Sjogrens at risk for what defect?

A

Complete AV Block

98
Q

Gestational hypertension
Pregnancy-induced hypertension (SBP ≥ 140 or DBP ≥ 90)
w/o proteinuria or end-organ dysfunction
Diagnosed at ____ weeks

A

≥ 20 weeks

99
Q

Preeclampsia
Gestational HTN (≥20w) + ____ or ____.

Eclampsia
Gestational HTN (≥20w) + new-onset seizures

A

end-organ dysfunction (i.e. lab abnormalities: LFTs etc)
proteinuria
─

Occurrence of new-onset HTN, proteinuria, or end-organ dysfunction at < 20 weeks gestation is suggestive of gestational trophoblastic disease.

100
Q

Fetal heart Rate Tracings Mnemonic
VEAL CHOP

A

Variable decels → Cord compression
Early decels → Head compression
Accelerations → Okay
Late decels → Placental insufficiency/ischemia

101
Q

Fetal lung maturity by amniocentesis
→ Check ___:___ ratio
Mature if > ___:___

A

Lecithin to Sphingomyelin
>2:1

102
Q

Contraindications to
Estrogen HRT
E2 Contraceptives
(6)

A

≥35 F who actively smokes
Severe HTN
h/o VTE dz → DVT, PE, Stroke, MI
h/o Breast Cancer
h/o Migraines with Auras
Hepatic Adenoma

103
Q

Symmetric IUGR causes (3)
(small Head & Body)

A

TORCH infections
Chromosomal Abnormality
Small/Skinny mother

104
Q

Asymmetric IUGR causes (4)
(normal Head + small Body)

A

HTN
Diabetes
SLE/APLS
Pre-Eclampsia

(s/t placental insufficiency or anomalies)

105
Q

Fundal height from pubic symphysis to belly button =
___ weeks EGA

A

30 weeks

106
Q

Order of reproductive development in girls:

A

TAM
Thelarchy (boobs 8 yo) → Adrenarche (Pubes 9 yo) →
Menarchy (10 yo)

107
Q

Contraception associated with delayed return of fertility.

A

Depo-Provera

108
Q

The 3 polymicrobial OBGYN infections:

A

Bartholin Gland Abscess
Endometritis
Chorioamnionitis

109
Q

Female + breast mass just below the nipple.
Is breast feeding or was breast feeding.

END of STORY → Dx?
Classic location?

A

Galactocele
Subareolar mass

110
Q

Breast mass with recent breast trauma:
dx/tx?

A

Fat Necrosis
no tx

111
Q

Woman on OCPs gets pregnant while on
* st. John’s Wort
* griseofulvin (Tinea)
*carbamazepine (seizures, Trigeminal neuralgia, BPD)
*phenytoin (seizures)
* barbiturates
*rifampin

Why is that?

A

Cyp-P450 inducers
↑ enzymes that break down OCPs
so OCPs don’t work

112
Q

Lynch syndrome (AD)
aka Hereditary nonpolyposis colon cancer (HNPCC)

Affected pts develop a few small adenomas that rapidly progress to colorectal cancer at an early age.

Also at ↑ risk of _____ cancer (4)

Individuals are asymptomatic until they present with symptoms of advanced cancer.

Mutation in ______ gene.

A

Gastric, Endometrial, Colon, and Ovarian cancers
(GECkO)

DNA mismatch repair (MMR) gene

113
Q

Arrest of Labor (no cervical changes)
Protraction of Labor (inadequate rate of cervical change)
Management for both

A

Are contractions adequate (q2-3m + MVU>200)?
Yes → C-section
No → Oxytocin → C-section (if, oxy doesn’t work)

114
Q

Contractions are adequate, if both are true.
Contractions every ___ min
MVU > ___
—-
Calculating MVU

A

every 2-3 min
MVU >200
—-
(Amplitude of contraction) x (# of contractions in 10 min)

Example: 2 minutes = 1 contraction of 60mmHg
2 min x 5 = 10 min
60mmHg x 5 = 300 MVU → Adequate

115
Q

Respiratory distress in newborns
Preterm → NRDS
tx(2)/cx (3)
—
Term → Transient tachypnea of newborn
cause/notable finding/tx
—
Postterm (>42w) →
dx/tx

A

Surfactant deficiency = small lung volumes
Cx: Retinopathy, Broncho-dysplasia, ICH
Tx: oxygen + surfactant
—
fluid remains in lung fissures
s/t C-section
no hypoxia
Tx: Supportive care
—
Meconium aspiration syndrome
Tx: Supportive care

116
Q

Stages of labor
stage 1 (cervical ripening)
Latent ( ___ cm)
Null: <20h
Multi: <14h
Active (___ cm)
Null: ≥ __ cm/h
Multi: ≥ __ cm/h
stage 2 (fetal delivery)
Null: <3h
Multi: <2h
stage 3 (placental delivery)
Null + Multi: < 30min

A

stage 1 (cervical ripening)
Latent (0–6 cm)
Null: <20h
Multi: <14h
Active (6–10cm)
Null: ≥1.2cm/h
Multi: ≥1.5cm/h
stage 2 (fetal delivery)
Null: <3h
Multi: <2h
stage 3 (placental delivery)
Null + Multi: < 30min

117
Q

ToF
4 findings

A

Pulmonary stenosis
s/t Overriding aorta
RV hypertrophy (drains R & L ventricle)
s/t VSD

Step 2 (55 decks)

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