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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
Low PAPP-A (serum pregnancy associated plasma protein A) could indicate
fetal Down syndrome
26
Nuchal translucency checked by ultrasound at 10-13 weeks, what would indicate abnormality?
increased thickness
27
If uterine size and gestation is abnormal, what two tests could you perform on your patient around 10-13 weeks?
chorionic villus sampling (CVS) or amniocentesis
28
When can you find fetal heartbeat on ultrasound?
5-6 weeks
29
What instances would you offer a woman chorionic villus sampling at 10-13 weeks?
prior child with chromosomal abnormalities maternal age > 35 abnormal 1st or 2nd trimester maternal screening test abnormal ultrasound prior pregnancy losses
30
What is the advantage of chorionic villus sampling?
allows option of early termination of pregnancy if find abnormalities
31
What is the disadvantage of chorionic villus sampling?
performing it increases the risk of spontaneous abortion
32
What weeks are first trimester?
weeks 1 - 12
33
What weeks are second trimester?
weeks 13-27
34
What weeks are third trimester?
week 28 - birth
35
What is triple screening measured at 15-20 weeks?
a-fetoprotein, B-hCG, estradiol
36
Diagnosis? | Low a-FP, High B-hCG, Low estradiol
Down syndrome
37
Diagnosis? | High a-FP, No B-hCG, No estradiol
Open neural tube defects (ex. spina bifida) | or multiple gestation
38
Diagnosis? | Low a-FP, Low B-hCG, Low estradiol
trisomy 18
39
High levels of Inhibin A indicate?
chromosomal abnormalities
40
Test to check amniotic fluid levels, fetal viability, and growth for gestational age
ultrasound
41
If you are going to perform amniocentesis, when is the best time?
15-18 weeks gestation
42
When do you screen for gestational diabetes?
24-28 weeks
43
When should unsensitized Rh negative mohters receive RhoGAM?
at 28 weeks and within 72 hours after childbirth
44
What screening/tests do you perform in the third trimester?
``` gestational diabetes repeat antibody titers group B streptococcus screening Hemoglobin and Hematocrit Biophysical profile Non Stress Testing ```
45
What 5 variables are looked at in biophysical profile? | How many points is each and what is the max score?
fetal breathing, fetal tones, amniotic fluid levels, NST and gross fetal movements 2 points each = 10 points total
46
What is baseline fetal heart rate in non stress testing?
120-160 bpm
47
In Reactive Non Stress Test, what would indicate fetal well being?
> 2 accelerations are seen in 20 minutes | increase in fetal HR > 15 bpm from baseline lasting > 15 seconds
48
In Nonreactive Non Stress Test, what would indicate the fetus is sleeping, immature, or compromised?
no fetal heart rate accelerations | increase in fetal HR < 15 bpm lasting < 15 seconds
49
Way to measure fetal response to stress at times of uterus contraction
contraction stress test
50
No late decelerations in the presence of 3 contractions in 10 minutes would indicate
negative contraction stress test - fetal well being
51
Repetitive late decelerations in the presence of 3 contractions in 10
positive contraction stress test - worrisome (esp if nonreactive NST)
52
What defines infertility?
failure to conceive after 1 year
53
what percentages of instances are males the cause of infertility?
40%
54
What is the test to diagnose infertility?
hysterosalpingography
55
What does hysterosalpingography evaluate?
tubal patency or abnormalities
56
Medical management that can induce ovulation
clomiphene
57
Three management options for infertility
clomiphene intrauterine insemination IVF

Obstetrics (17 decks)

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