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Obstetrics > Uncomplicated Pregnancy - PANCE Pearls > Flashcards

Uncomplicated Pregnancy - PANCE Pearls Flashcards

1
Q

How early can serum B-hCG detect pregnancy?

A

early as 5 days after conception

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2
Q

How early can urine B-hCG detect pregnancy?

A

14 days after conception

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3
Q

Sign of uterus softening after 6 weeks

A

Ladin’s sign

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4
Q

sign of uterin isthmus softening after 6-8 weeks of gestation

A

Hegar’s sign

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5
Q

palpable lateral bulge or softening of uterine cronus 7-8 weeks gestation

A

Piskacek’s sign

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6
Q

cervical softening due to increased vascularization around 4-5 weeks gestation

A

Goodell’s sign

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7
Q

bluish coloration of the cervix and vulva around 8-12 weeks

A

Chadwick’s sign

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8
Q

When do you normally hear fetal heart tones and what is the normal ranges?

A

10-12 weeks

120-160 bpm

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9
Q

When can you detect fetus on pelvic ultrasound?

A

5-6 weeks

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10
Q

When is quickening (fetal movement) first experienced?

A

16-20 weeks

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11
Q

Gravida is ….

A

of times pregnant (regardless if carried to term)

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12
Q

Para is …

A

of births (>20 weeks) - includes viable and nonviable births

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13
Q

If a patient had one set of twins, what would be the para value?

A

1

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14
Q

3 pregnancies and 3 births

A

G3P3

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15
Q

4 pregnancies, 3 births, 1 miscarriage

A

G4P3A1

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16
Q

Gestational age if you feel the fundal height above the public symphysis

A

12 weeks

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17
Q

Gestational age if you feel the fundal height midway between the pubis and umbilicus

A

16 weeks

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18
Q

Gestational age if you feel the fundal height at the umbilicus

A

20 weeks

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19
Q

Gestational age if you feel the fundal height 2-3 cm below the xiphoid process

A

38 weeks

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20
Q

What is Naegele’s Rule?

A

estimated date of delivery

1st day of LMP + 7 days - 3 months

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21
Q

What is EDD for a LMP on 8/7/2016?

A

5/14/17

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22
Q

What routine tests are ordered at the first prenatal visit?

A 
BP,
blood type & Rh 
CBC
UA 
random glucose
HBsAg
HIV & syphilis 
rubella titer 
screen for sickle cell and CF
pap smear
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23
Q

Three markers that can be tested in Down syndrome screening

A

free B-hCG, PAPP-A, Nuchal translucency

24
Q

What free B-hCG level may indicate abnormalities?

A

abnormally high or low

25
Q

Low PAPP-A (serum pregnancy associated plasma protein A) could indicate

A

fetal Down syndrome

26
Q

Nuchal translucency checked by ultrasound at 10-13 weeks, what would indicate abnormality?

A

increased thickness

27
Q

If uterine size and gestation is abnormal, what two tests could you perform on your patient around 10-13 weeks?

A

chorionic villus sampling (CVS) or amniocentesis

28
Q

When can you find fetal heartbeat on ultrasound?

A

5-6 weeks

29
Q

What instances would you offer a woman chorionic villus sampling at 10-13 weeks?

A

prior child with chromosomal abnormalities
maternal age > 35
abnormal 1st or 2nd trimester maternal screening test
abnormal ultrasound
prior pregnancy losses

30
Q

What is the advantage of chorionic villus sampling?

A

allows option of early termination of pregnancy if find abnormalities

31
Q

What is the disadvantage of chorionic villus sampling?

A

performing it increases the risk of spontaneous abortion

32
Q

What weeks are first trimester?

A

weeks 1 - 12

33
Q

What weeks are second trimester?

A

weeks 13-27

34
Q

What weeks are third trimester?

A

week 28 - birth

35
Q

What is triple screening measured at 15-20 weeks?

A

a-fetoprotein, B-hCG, estradiol

36
Q

Diagnosis?

Low a-FP, High B-hCG, Low estradiol

A

Down syndrome

37
Q

Diagnosis?

High a-FP, No B-hCG, No estradiol

A

Open neural tube defects (ex. spina bifida)

or multiple gestation

38
Q

Diagnosis?

Low a-FP, Low B-hCG, Low estradiol

A

trisomy 18

39
Q

High levels of Inhibin A indicate?

A

chromosomal abnormalities

40
Q

Test to check amniotic fluid levels, fetal viability, and growth for gestational age

A

ultrasound

41
Q

If you are going to perform amniocentesis, when is the best time?

A

15-18 weeks gestation

42
Q

When do you screen for gestational diabetes?

A

24-28 weeks

43
Q

When should unsensitized Rh negative mohters receive RhoGAM?

A

at 28 weeks and within 72 hours after childbirth

44
Q

What screening/tests do you perform in the third trimester?

A 
gestational diabetes
repeat antibody titers
group B streptococcus screening
Hemoglobin and Hematocrit 
Biophysical profile
Non Stress Testing
45
Q

What 5 variables are looked at in biophysical profile?

How many points is each and what is the max score?

A

fetal breathing, fetal tones, amniotic fluid levels, NST and gross fetal movements
2 points each = 10 points total

46
Q

What is baseline fetal heart rate in non stress testing?

A

120-160 bpm

47
Q

In Reactive Non Stress Test, what would indicate fetal well being?

A

> 2 accelerations are seen in 20 minutes

increase in fetal HR > 15 bpm from baseline lasting > 15 seconds

48
Q

In Nonreactive Non Stress Test, what would indicate the fetus is sleeping, immature, or compromised?

A

no fetal heart rate accelerations

increase in fetal HR < 15 bpm lasting < 15 seconds

49
Q

Way to measure fetal response to stress at times of uterus contraction

A

contraction stress test

50
Q

No late decelerations in the presence of 3 contractions in 10 minutes would indicate

A

negative contraction stress test - fetal well being

51
Q

Repetitive late decelerations in the presence of 3 contractions in 10

A

positive contraction stress test - worrisome (esp if nonreactive NST)

52
Q

What defines infertility?

A

failure to conceive after 1 year

53
Q

what percentages of instances are males the cause of infertility?

A

40%

54
Q

What is the test to diagnose infertility?

A

hysterosalpingography

55
Q

What does hysterosalpingography evaluate?

A

tubal patency or abnormalities

56
Q

Medical management that can induce ovulation

A

clomiphene

57
Q

Three management options for infertility

A

clomiphene
intrauterine insemination
IVF

Obstetrics (17 decks)

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