Quiz 3 Flashcards
What is the precipitating cause of hydrops fetalis ?
Cardiac response to severe fetal anemia
In cases of fetal Rh isoimmunization, increased fetal hepatic RBC production results in ?
decreased oncotic pressure in the fetal vasculature
when liver produces RBCs, production of other proteins decreases
initial Ab devel. will occur in approx what % of index pregnancies inv. Rh-D neg mother and Rh-D positive fetus?
15%
anti-D immunglobulin given at 28wks reduces the risk of sensitization to what level?
the standard 300mg dose will neutralize how many mLs of fetal RBCs?
0.2%;
15
this test is used to detect fetal erythrocytes in maternal circulation
Kleihauer-Betke test
severe fetal anemia is indicated by a Hct less than?
30
women has a child that was born w severe anemia, at 24wks she has an Ab screen positive for anti-D and anti-C, next step in mngmt? if fetus has higher then nml flow velocity, do umbilical blood sampling to assess fetal..?
perform U/S for MCA doppler studies ;
Hct
initial prenatal labs show a Hgb of 9, next step?
empiric try of prenatal vit/mineral supplement containing iron sulfate
women w sickle cell trait (HbSA disease) have incr risk of?
UTIs
In oral iron therapy for iron-def. anemia, an incr in reticulocyte count can be observed within?
1 wk
Anemia in preg is defined as a Hct less than?
30%
a fetus with no copies of the alpha-globulin gene will likely result in?
intrauterine fetal demise
a pt. that loses urine when she coughs or sneezes most likely has what type of prolapse?
urethral
A “Q-tip” test is used to evaluate?
incontinence is usually assoc with upward rotation of?
urethral mobility;
30 degrees
Cervix/uterus descent below the vulva known as?
Procidentia
% of women that will have a UTI at some pt in their lives?
60%
ASx bacteruria is found in what % of postmenopausal women?
20
transducer placed in vagina to measure intra-abdominal P as part of what test?
MULTIchannel urodynamic testing
Recurrence of UTIs is MC in what group of women?
postmenopausal
Most UTIs occur through what route?
ascending contamination from urethra
woman w a lower UTI is LEAST likely to experience?
fever
nml bladder capacity?
600cc
event most assoc w onset of puberty is?
achieving a critical body weight
sequ of secondary sex devel
growth spurt, thelarche, pubarche, menarche
earliest sign of delayed puberty is lack of?
breast budding by age 13
what may cause precocious puberty in girls?
ovarian neoplasm
MC cause of primary amenorrhea?
imperforate hymen
precocious puberty, h/o bone fractures and cafe-au-late spots likely due to?
McCune-Albright Sy
complete uterine and vaginal agenesis,Dx?
MC cause of?
can have their own genetic child through?
Mayer-Rokitansky-Kuster-Hauser Sy;
primary amenorrhea in women w nml breast devel;
ovum donation (to surrogate)
8yo w breast budding, pubic and axillary hair; most likely source of girls androgenic changes?
next step in eval?
next step in management of this girl?
adrenal gland androgens;
no additional eval necessary;
reassurance only
15yo underweight girl w failure to menstruate, next step in mngmt?
OCPs
22yo never had a period, well developed breasts, scant pubic/axillary hair, short vagina and no ovaries or uterus, Dx?
androgen insensitivity
frequent menstrual bleeding (ie menses every 19 days, Dx?)
polymenorrhea
most likely finding of endometrial Bx of pt with polycystic ovary Sy (presents w high BMI, incr hair, acne)
endometrial hyperplasia !
heavy bleeding, mild constipation, incr abdominal girth, and pelvic heaviness suggest
uterine leiomyoma
blood test most consistent w supporting polycystic ovary Sy ?
androstenedione at upper limits of nml or incr
high BP, irregular menses, facial hair, normal Na and K..
most likely has elevation of?
desoxycorticosterone
OCPs given in PCOS supposed to improve Sxs through?
suppression of androgen production
testosterone cnvtd to dihydrotestosterone in?
hair follicles
you suspect 11beta-hydroxylase deficiency, what finding would support your Dx?
severe hirsutism
PCOS pt lost to follow up for yrs, this lack of care has increased pts risk for?
endometrial ca
