Prenatal

Question 1

Gravidity

Answer 1

total number of pregnancies

Question 2

Parity

Answer 2

of pregnancies after 20 wks gestation

Question 3

Term

Answer 3

pregancies betwen 37-40 wks gestations

Question 4

abortions

Answer 4

of induced or sponteatnous terminations of pregnancy before 20 weeks

Question 5

pregnancy screening lab tests

Answer 5

CBC, blood type, Rh, antibody screen, urine dip, aueuploidy screen, rubella titer, syphilis serology, HBV suf antigen, pap smear, chlamydia, gonorrhea screening

Question 6

history dependent labs for pregnant patients

Answer 6

sickle cell screen for AA, TB screen, HIV test, urine toxicology, DM, herpes culture, serum iron, thyroid, toxoplasmosis titer, KOH wet prep

Question 7

nausea and vomiting in pregnancy

Answer 7

hyperemesis gravidarum, multiple gestation, hydatidiform gestation, molar pregnancy, intestinal obstrustion, gastroenteritis, choleycystitis, pancreatitis, hepatitis, diabetes, thyroid disfunction, mirain, food poisioning, emotional problems, eating disorders

Question 8

inherited thrombophilias

Answer 8

Factor V leiden, prothromin A20210, Antithrombin III, Protein C, Protein S, homocysteine

Question 9

acquired thrombophlias

Answer 9

pregnancy, imobilization, trauma, posterperative state, high estrogen, malignancy, nephrotic syndrome, heparin-induced, myeloproliferative DOs, paroxysmal nocturnal hematuria, CHF, afib,

Question 10

muscle cramps objective data

Answer 10

worrisome sx include + homan’s sign, unilateral swelling or tenderness, dim pulses in LE, erythema, numbness, or pale appearing calf or leg.

Question 11

muscle cramps differential dx

Answer 11

electrolyte imbalances, thromboembolic dz, varicosites, dehydration, arthritis, sciatica, nerve root compression

Question 12

numbness and tingling in the hands objective data

Answer 12

tinel’s sign and phalen’s test, upper extremity grip and finger strength, ability to oppose thumbs to fingers. evaluation for thenar atrophy and dry skin on the thumb, index and middle fingers (median nerve distribution).

Question 13

numbness/tingling in hands differential dx

Answer 13

carpal tunel syndrome, muskuloskel pain, arthritis, infection, cervical neck injury or dz, nerve damage, cardiac problems, thoracic outlet syndrome, hyperventilation

Question 14

Dyspnea in pregnancy

Answer 14

may be associated with activity, or may follow eating, drinking or potential allergy exposure,

Question 15

dyspnea differential dx

Answer 15

pregnancy related dyspnia, URI, nasal congestion, asthma, bronchitis, pneumonia, pulmonary embolus, cardiac disease, anemia, anxiety, hyperventilation, aspiration, anaphylaxis

Question 16

fatigue in pregnancy

Answer 16

usually occurs in first and third trimesters, screen with CBC, thyroid function tests

Question 17

fatigue differential diagnosis

Answer 17

fatigue d/t pregnancy, anemia, thyroid disorder, other pathological states

Question 18

urinary frequency considerations

Answer 18

check for cva or suprapubic tenderness, CBC, glucose levels, urine dip, UA/cx/sens

Question 19

urinary frequency diff dx

Answer 19

pregnancy related urinary frequency, UTI, pyelonephritis, kidney stone, diabetes

Question 20

urinary incontinence considerations

Answer 20

often with coughing, sneezing or laughing d/t intraabdominal pressure and enrlarged utureus, special attention to urine that doesn’t smell like urine, increased incontn. with lying down, or gush with initial standing which may indicate rupture of membranes

Question 21

urinary incont objective findings

Answer 21

r/o uterine contactions or irritability. R/o amniotic fluid pooling, nitrazine and fern tests differentiate between vag discharge and amniotic fluid,

Question 22

urinary incontinence diff dx

Answer 22

stress urinary incont, rupture of membranes, leukorrhea, vaginitis

Question 23

complications of pregnancy

Answer 23

anemia, gestational diabetes, hypertension, vaginal bleeding, vaginal infections, UTI, size not equal to dates, preterm labor

Question 24

vaginal infection differential dx

Answer 24

leukorrhea, vaginitis, cervicitis, gonorrhea, chlamydia, UTI, rupture of membranes, condyloma acuminatum, genital herpes or cervical dysplasia/neoplasia

Question 25

conditions assoc with intrauterine growth restriction

Answer 25

hypertension, multiple gestation, placental abnormality, intrauterine infection, fetal abnormalities, renal dz, DM, lupus, sickle cell anemia, tobacco, substance abuse, malnutrition, maternal heart disorders, thrombophilias, chronic lead poisoning