UWise Question Review Flashcards
How does the use of tocolytics (mag, nifedipine) affect respiratory system?
Can worsten pulmonary edema. Plasma osmolarity is already decreased during pregnancy, worstened with mag use. Causes crackles and shit.
Cardiac changes during pregnancy
SV and HR increase by a lot, CO increases by about 33%
What causes hydronephrosis in pregnancy?
Compression of the ureter by dextrorotation of the uterus.
Effect of estrogens on thyroid function
Increased estrogen increases TBG, so while total thyroid hormone levels increase, free thyroid levels remain constant.
How to treat shoulder dystocia
McRoberts Maneuver- hyperflex maternal hips to straighten sacrum, apply pressure so shoulders can pass under symphysis pubis
Most common sign of uterine rupture?
Fetal heart rate abnormality
Mag toxicity, treatment?
Hyporeflexia and respiratory suppression. Treat by giving calcium gluconate.
Treatment for hellp syndrome after 34 weeks?
Induce labor for vaginal delivery
When to suction newborn if amniotic fluid is stained with meconium?
Nose, mouth and glottis if the infant is depressed (not vigorous)
Size of baby in type I diabetes vs gestational diabetes?
Small in type I and large in gestational diabetes
HCG level below which a transvaginal ultrasound isn’t useful for assessing intrauterine pregnancy?
2000, should just trend HCGs and assess if double in 48 hours
Most common cause of spontaneous abortion?
Chromosomal abnormalities (mostly autosomal trisomies)
Medical risk factor for spontaneous abortion?
Diabetes
How to further decrease risk of vertical HIV transmission in addition to giving neonate zidovudine?
Give intrapartum IV zidovudine to mom
Most common cause of sepsis in pregnancy?
Pyelonephritis
Which SSRI cannot be used in pregnancy?
Paroxetine causes fetal cardiac abnormalities and PPH
Which complication of severe preeclampsia is an indication to deliver immediately?
Thrombocytopenia
Sinusoidal fetal tracing suggestive of?
Fetal anemia
What does Rh disease cause in newborn?
Hydrops, so fluid collection (can cause pericardial effusion)
Finding in amniotic fluid that suggests Rh disease?
High bilirubin
Vital lab test to order after missed abortion?
Type and screen for ruling out isoimmunization and to give rhogam if necessary
How to medically evacuate missed abortion?
Misoprostol
How to induce before giving pitocin?
Give misoprostol to ripen cervix
Important drug to give in preterm labor?
Ampicillin because GBS status likely unknown
What drug reduces the risk of premature labor?
17 alpha hydroxyprogesterone
Which drug should NOT be given to patients with uterine atony and preeclampsia?
Methergine because it’s a vasocontrictor and can worsten hypertension
Which drug should NOT be given to patients with uterine atony and asthma
PGF2Alpha – potent bronchoconstrictor
Lots of c-sections increases risk for
Placenta accreta
Amnioinfusion
Saline into amniotic sac reduces repetitive variable decelerations
How to induce in unfavorable cervix?
Give prostaglandins
Difference in cancer risk between combined OCP and progesterone IUD?
Both protect against endometrial cancer but combined OCP decreases risk of ovarian cancer as well.
Is factor V leiden associated with recurrent first trimester pregancy loss?
No, only APLA
Treatment for APLA
Aspirin and heparin
Most common cause of IUGR?
Uteroplacental insufficiency
Triad of cervical cancer?
Back pain, sciatic leg pain, hydroureter
Risk factor for polyhydramnios?
Maternal diabetes!
Funneled lower uterine segment means?
Cervical incompetence
How to work up suspected TB in pregnancy?
Get a CXR, benefits outweigh risk
Common other abnormality in mullerian agenesis?
Renal problems
Asymmetric vs symmetric IUGR
Asymmetric IUGR is a maternal issue like HTN or diabetes. Symmetric IUGR is due to fetal factor like aneuploidy or early intrauterine infection.
Risk of choriocarc higher or lower in partial mole compared to complete?
Lower
How do OCPs improve dysmenorrhea
By inducing endometrial atrophy, which reduces the amount of prostaglandins produced in the endometrium.
Enlarged soft boggy uterus with dysmenorrhea suggestive of?
Adenomyosis
What should be given in preterm labor
Steroids for lung maturity and mgso4 for neuroprotection (CP)
