Uwise Qbank Flashcards

0
Q

Idiopathic cardiomyopathy that presents with heart failure secondary to LV systolic dysfunction that occurs during the end of pregnancy or within several months of delivery.

A

Peripartum Cardiomyopathy

Symptoms: fatigue, SOB, palpitations, edema.

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1
Q

Tachycardia, tachypnea, hypoxia, chest pain, and signs of DVT during pregnancy.

A

Pulmonary Embolism of Pregnancy

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2
Q

Common causes of acute pulmonary edema (4)

A

1) tocolytic use
2) cardiac dz
3) fluid overload, especially isotonic fluids (NS, D5W, LR)
4) preeclampsia

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3
Q

Why is there greater dilation in the R>L ureter during pregnancy?

A
  • cushioning provided by sigmoid colon to L ureter
  • greater compression of R ureter due to dextrorotation of uterus
  • compression by the uterus and R ovarian vein
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4
Q

What is the most common site of metastasis with gestational trophoblastic dz?

A

Lungs

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5
Q

Recommended guidelines for weight gain during pregnancy?

A

Underweight (<18.5) = 28-40 lbs
Normal (18.5-24.9) = 25-35 lbs
Overweight (25-29.9) = 15-25 lbs
Obese (30+) = 11-20 lbs

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6
Q

Genetic dz risks for Ashkenazi Jews (7)

A

1) Fanconi anemia
2) Tay-Sachs
3) CF
4) Niemann-Pick dz
5) Canavan dz
6) Bloom syndrome
7) Gaucher’s dz

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7
Q

Beta-Thalassemia anemia is more common in which population?

A

Mediterranean

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8
Q

What fetal defect is noted with valproic acid use during pregnancy?

A

Neural tube defects

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9
Q

What is the risk of poorly controlled diabetes immediately prior to conception?

A

Increased risk for fetal structural anomalies, especially neural tube defects and CV system defects.

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10
Q

Chorionic villus sampling (CVS)

A

10-12 wks gestation

Samples chorionic frondosum which contains most mitotically active villi in the placenta

Used to assess: fetal chromosomal abnormalities and DNA mutations

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11
Q

MCC of inherited mental retardation?

A

Fragile X syndrome–most cases of Down syndrome are not heritable

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12
Q

Goals for blood sugar management during pregnancy?

A

fasting <120

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13
Q

Risk factors for developing gestational diabetes (4)

A

1) hx of a big baby (+9 lbs)
2) hx of abnormal glucose tolerance
3) pre-pregnancy weight of 110% or more of ideal BW
4) American Indian or Hispanic descent

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14
Q

Risks of gestational diabetes (4)

A

1) polyhydramnios
2) neonatal hypoglycemia
3) preeclampsia
4) macrosomia

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15
Q

Recommended dose of folic acid for non-high risk pregnant women? For high-risk pregnant women?

A

Non-high risk pregnant women = 0.4 mg/day

High risk pregnant women = 4 mg/day

16
Q

Warnings of Labor (3)

A

1) ctx q5 minutes for one hour
2) fetal movements less than 10 per 2 h
3) vaginal bleeding

17
Q

What to do during an umbilical cord prolapse?

A

Elevate the fetal head with a hand in the pt’s vagina and perform a c/s.

Elevating the fetal head is an attempt to avoid compression of the umbilical cord.

18
Q

Definition of postpartum hemorrhage in a vaginal delivery? c/s?

A

vaginal delivery = >500 ml

c/s = >1000 ml

19
Q

Significant blood loss during delivery causes anterior pituitary necrosis, leading to loss of gonadotrophin, TSH, and ACTH production.

A

Sheehan syndrome

Sx: slow mental function, weight gain, fatigue, difficulty staying warn, no milk production, hypotension, amenorrhea

Tx: E2 and P replacement and supplementation with thyroid and adrenal hormones

20
Q

Tx of Sheehan syndrome

A

1) E2 and P replacement
2) Thyroid supplementation
3) Adrenal hormone supplementation

21
Q

Inflammation of the endometrium, the inner lining of the uterus.

A

Endometritis

22
Q

MCC of endometritis?

23
Q

Symptoms of endometritis?

A
  • lower abdominal pain
  • fever
  • vaginal bleeding
  • vaginal discharge
24
Risk factors for endometritis? (6)
- c/s - prolonged ROM - prolonged labor with multiple vaginal examinations - internal fetal monitoring - manual removal of the placenta - low SES
25
MCC of postpartum fever?
Endometritis
26
Most causative agents of postpartum endometritis?
- Staph aureus | - Streptococcus
27
MC type of bacterial infection in postpartum endometritis?
Polymicrobial--a mix of aerobic and anaerobic bacteria in the genital tract.
28
Signs and symptoms of depression that lasts for <2 wks postpartum.
postpartum blues
29
Depression occurring within 2 wks to 6 months after delivery?
Postpartum depression
30
How to distinguish postpartum blues from postpartum depression?
ambivalence toward the newborn
31
Most significant risk factor for developing postpartum depression?
prior hx of depression
32
Breastfeeding is associated with a decreased incidence of...?
ovarian cancer
33
Risk factors for using hormonal interventions to prevent lactation?
Bromocriptine is associated with HTN, stroke, and seizures. Hormonal interventions predispose to thrombotic events.