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OB/GYN > Prenatal and Postpartum Care > Flashcards

Prenatal and Postpartum Care Flashcards

1
Q

What does antepartum care include?

A
  • Education at every visit

- Screening

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2
Q

True or false: for women with regular menstrual cycles, a h/o one more more missed periods following a time of unprotected sex pretty much diagnoses pregnancy

A

True, for the most part

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3
Q

When does the softening and enlargement of the uterus begin after the LMP?

A

6 weeks after

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4
Q

When is the uterus enlarged enough to be palpable in the lower abdomen?

A

12 weeks

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5
Q

What is Chadwick’s sign

A

Bluish discoloration of the cervix

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6
Q

What is Hegar’s sign?

A

Softening of the cervix

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7
Q

What is Quickening? When does this occur?

A

Patient’s initial perception of fetal movement at 16-20 weeks

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8
Q

What do pregnancy tests measure? What produces this?

A

hCG produced by the syncytiotrophoblasts of the placenta

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9
Q

When do standard urine lab tests become positive for pregnancy (how long after LMP)?

A

about 4 weeks

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10
Q

When during the day is urine concentration of hCG the highest?

A

Morning

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11
Q

What allows the serum pregnancy test to be more sensitive and specific for pregnancy? When does this become positive?

A

Tests for unique beta subunit of hCG

Two weeks from ovulation

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12
Q

Can the serum pregnancy test detect a pregnancy before a missed period?

A

Yes

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13
Q

What is the doubling time of serum hCG?

A

2 days

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14
Q

How do you detect fetal heart tones? (2 methods) When are these detectable for each method?

A
  • Traditional acoustic fetoscope (18-20 weeks)

- electronic doppler (12 weeks)

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15
Q

When does the fundal height represent the gestational age of the fetus?

A

When the uterus grows in size so that it exits the pelvis

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16
Q

What is the correlation between the fundal height and gestational age?

A

Fundal height in cm represents that gestation age of the fetus to about 36 weeks (+/- 2 weeks)

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17
Q

What level of exercise should pregnant women get to? Why not more?

A

Speaking while jogging etc

Do not risk the fetus

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18
Q

What is gestational age, technically?

A

Number of weeks that have elapsed between the 1st day of LMP and the date of delivery (NOT the presumed time of conception)

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19
Q

What is the EDD? How is this calculated?

A

Estimated date of delivery

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20
Q

What is Naegele’s rule?

A

Rule to determine the date of expectancy:

Add 1 year + 7 days to first day of LMP andn subtract 3 months

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21
Q

True or false: US established dates should take precedence over menstrual dates

A

True

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22
Q

When, in weeks gestation, can an abdominal US detect the gestational sac? What are the bhCG levels?

A

5-6 weeks

5000-6000

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23
Q

When, in weeks gestation, can an TVUS detect the gestational sac? What are the bhCG levels?

A

3-4 weeks

1000-2000

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24
Q

The embryo and cardiac activity should be seen if the hCG level is greater than what value?

A

4000

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25
Q

What are the components of the GTPAL?

A
  • Gravida
  • Parity (term/preterm)
  • Abortions
  • Living
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26
Q

What is the technical definition of abortion for the GTPAL system?

A

Any pregnancy loss before 20 weeks

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27
Q

What are the normal pregnancy PE intervals for prenatal care? (3)

A
  • q 4 weeks until 28 weeks
  • q 2 weeks until 36 weeks
  • q 1 week until delivery
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28
Q

What are the leopold maneuvers, and when can you perform these?

A

Feeling for the fetus

third trimester

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29
Q

What is the gestational age at which the fundal measurement is at the pubic symphysis

A

6 weeks

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30
Q

What is the gestational age at which the fundal measurement is at the umbilicus?

A

20 weeks

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31
Q

What is the gestational age at which the fundal measurement is at the xiphoid?

A

36 weeks

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32
Q

What is felt with leopold maneuvers? What is the sequence?

A
  • Head
  • buttocks
  • back
  • arms/legs
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33
Q

What are the infection screens that are done at the first prenatal visit? (6)

A
  • Rubella
  • HIV
  • Hep B and C
  • VDRL
  • GC/CT
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34
Q

When should glucose screen be performed at the first prenatal visit?

A

If BMI is greater than 30

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35
Q

What are the general labs that are obtained at the first prenatal visit? (4)

A
  • CBC
  • TSH
  • ABO/Rh
  • Urine culture
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36
Q

During what gestational weeks is rechecking for Hb necessary in patients with gestational DM?

A

24-28

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37
Q

When does GBS testing begin?

A

35-37 weeks

38
Q

What is the main lab that is obtained at postpartum day 1?

A

Hb to r/o anemia

39
Q

Uterus emerges from the pelvis at how many weeks?

A

12 weeks

40
Q

FHRs by doppler appear around what week?

A

12 weeks

41
Q

What is the definition of a threatened abortion?

A

Bleeding before 20 weeks

42
Q

When should the n/v of pregnancy subside?

A

After the first trimester

43
Q

What is done in the 2nd trimester? (4 labs)

A

2nd integrated screen

  • Hb
  • Estriol
  • Inhibin A
  • AFP
44
Q

What are the measurements on US that determine gestational age in the 2nd trimester?

A
  • Head circumference

- Biparietal diameter

45
Q

When is movement perceived (nulliparous/multiparous)?

A

18-20 weeks in nulliparous or 16 weeks in multiparous

46
Q

What are the components of the quad screen?

A
  • Hb
  • Estriol
  • Inhibin A
  • AFP
47
Q

What is the key screening test in the 3rd trimester?

A

Rh test and rhogam administration

48
Q

When is Rh screening needed?

A

28 weeks

49
Q

What are the four majors tests obtained at 28 weeks?

A
  • Rh status
  • Glucose GDM screen
  • Repeat H&H
  • Repeat ab screen
50
Q

How should a seat belt be worn for a pregnant woman?

A

Below the uterus

51
Q

When documenting GTPAL, do twins count as a P1 or P2?

A

P1

52
Q

If a patient on medicaid desires sterilization the consent forms must be signed more than (__) days in advance, but no more than (__) days in advance.

A

60

120

53
Q

Bleeding in the 3rd trimester should always be suspicious for what?

A

Rh cross reactivity–get Rh type!

54
Q

What is placental abruption, and how does it present?

A

The placental lining has separated from the uterus of the mother prior to delivery

Extremely painful

55
Q

When does placenta previa usually present?

A

Around 32-34 weeks

56
Q

Why do you not want to do a cervical exam if you do not know where the placenta is?

A

Do not want to stick fingers into the placenta, and damage it.

57
Q

What tests are ordered at 36 weeks?

A
  • H and H
  • GC/chlamydia
  • GBS
58
Q

How can you confirm fetal presentation in the 3rd trimester?

A

Leopold maneuvers or US

59
Q

What is the difference between PROM and PPROM?

A

Premature and preterm premature ROM

60
Q

How many calories a day are needed for pregnant women?

A

400

61
Q

How many lbs should a pregnant woman gain during pregnancy?

A

25-35 lbs

62
Q

When should folic acid supplementation begin and end?

A

4 weeks preconception to at least 12 weeks gestation

63
Q

Why should soft cheeses and uncooked lunchmeat be avoided by pregnant women?

A

Concern for listeria monocytogenes

64
Q

Is sushi okay for pregnant women to eat

A

No

65
Q

Why should pregnant women avoid fish?

A

Hg

66
Q

What happens to moles and skin tags in pregnancy?

A

Darken/grow

67
Q

What is PUPP?

A

Pruritic urticarial papules of pregnancy an intense pruritus that occurs in pregnancy

68
Q

What causes the linea nigra to form?

A

Migration of melanocytes to the umbilicus

69
Q

What happens to hair in pregnancy?

A

Gets longer, does not fall out as easily

70
Q

What causes the erythema of the palms with pregnancy?

A

Dilation of the peripheral blood vessels

71
Q

What is the treatment for diastasis recti that may occur with pregnancy?

A

Usually resolves on its own, but may need surgery

72
Q

Why does GERD occur with pregnancy?

A

Estrogen makes the pyloric sphincter less competent

73
Q

What happens to the kidneys with pregnancy?

A

Pressure on the ureters from the growing uterus may cause them to enlarge

74
Q

Why is peristaltic activity decreased in pregnant women?

A

Colon is displaced upward, and posteriorly

75
Q

What causes the urinary frequency and urgency with pregnancy?

A

Pressure from the enlarging uterus

76
Q

What are the eye changes with pregnancy?

A

Changes in refractive power and increased lysozyme may cause clouding of contact lenses

77
Q

True or false: pregnant patients are more at risk for mastitis even before giving birth

A

True

78
Q

What causes the nasal stuffiness with pregnancy?

A

Increase capillaries of the nose, pharynx etc

79
Q

What happens to the functional residual capacity in pregnancy? Vital capacity? RR? MInute ventilation?

A
  • Decreased FRC
  • Increased Vc
  • Normal RR
  • Min vent increases
80
Q

True or false: dyspnea is common in prego

A

True

81
Q

What happens to HR ans SV with prego?

A

Increase

82
Q

What happens to the position of the heart with pregnancy?

A

Shifts into a more longitudinal position

83
Q

Systolic murmurs are not uncommon over which listening post in pregnancy?

A

Pulmonic

84
Q

What happens to systemic vascular resistance with prego?

A

Decreases

85
Q

What causes hemorrhoids and dependent edema with pregnancy?

A

Compression of the IVC by baby

86
Q

When do uterine contractions begin? What are the early ones called?

A

As early as the third month of gestation

Braxton Hicks

87
Q

What is the effect of relaxin on the pelvic cartilage?

A

Softens to prep for delivery

88
Q

True or false: any vaginal discharge in the 3rd trimester is concerning?

A

False– very common, and physiologic

89
Q

What causes carpal tunnel syndrome in pregnancy?

A

D/t fluid retention

90
Q

What is the most common site of back pain for pregnant women?

A

SI joint

91
Q

True or false: Migraine headaches are more common in pregnancy

A

True

OB/GYN (33 decks)

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