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Quarter 4 finals > WH- lecture 3 > Flashcards

WH- lecture 3 Flashcards

1
Q

Ectopic

A

usually Ampullary portion of Fallopian tube

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2
Q

Most common sx of Ectopic

A

1st trimester bleeding
abd pain

breasts tender
orthostatic dizzy/faint
back pain
shoulder pain

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3
Q

Ecotpic preg sx

A

Rebound and guarding with Abdominal pain

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4
Q

Normal prog level of pregnancy

A

> 20

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5
Q

Prog level reflecting abnormal pregnancy

A

<5

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6
Q

Discriminatory zone

A

Above a certain hCG, the landmarks of a normal pregnancy should be visible on US

3,500

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7
Q

Transvag US at 5 wks, should see

A

Double ring

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8
Q

Transvag US at 5.5-6 wks, should see

A

Fetal pole w cardiac activity

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9
Q

Tx for Ectopic

A

Expectant: follow hCG
Meds: MTX
Surgery: SalpinECTOMY vs OSTOMY

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10
Q

How often hCG measured for expectant mgmt of ectopic

A

every 48-72 hours

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11
Q

if beta hcg is <200

A

most pts with experience Resolution of preg

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12
Q

MTX

A

Folate antagonist

affects ACTIVELY REPLICATING TISSUE

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13
Q

SE of MTX

A

Abdominal pain

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14
Q

How long does MTX take to work

A

2-4 weeks, maybe up to 8 weeks

if not decreased by 15% on day 4-7, may need more MTX or Surgery instead

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15
Q

Salpingostomy

A

leaving the fallopian tube in tact

just removing the ectopic

RISK for future ectopic

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16
Q

SalpingECTOMY

A

removing the ectopic preg AND the fallopian tube

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17
Q

Hydadiform mole

A

the MOST COMMON form of gestational trophoblastic dz

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18
Q

Complete hydadi Mole

A

Paternally derived
NO Fetus

sx:
vaginal bleeding
enlarged uterus

dx:
HIGH beta hCG
“Snow storm”

definitive:
need tissue pathology

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19
Q

Tx for Complete hydadi Mole

A

REMOVE uterine tissue
immediately w suction dilation and curettage

birth control

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20
Q

Partial mole

A

mom and dad derived
Presence of a fetus

sx:
delayed period

Dx:
“swiss cheese”

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21
Q

Partial mole tx

A

Immediate removal with suction dilation and currettage

if normal preg also present: may continue to term

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22
Q

Invasive Mole

A

Following evacuation of molar pregnancy

persistent uterine bleeeding with plateau or rise in hCG after tx

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23
Q

US shows Intrauterine mass and increased vascularity

A

Invasive Molar Pregnancy

24
Q

Tx for Invasive Molar Pregnancy

A

Single agent

MTX or Actinomycin-D

25
Q

Choriocarcinoma

A

malignant necrotizing tumor

wks to years after pregnancy

Tx: single agent MTX or multi agent EMACO

26
Q

Placental site trophoblastic tumor

A

arises from placental

Tx: Hysterectomy

27
Q

1st line tx for Hyperemesis

A

Vit B6 and Doxylamine

28
Q

RH incompatible

A

Mom is negative

Baby is +

29
Q

Goal of RH tx

A

Keep mom from becoming sensitized

30
Q

RhoGAM

anti-D immunoglobulin

A

0.3 mg of Rhogam will eradicate 15 mL of fetal RBCs

31
Q

Titer 1:16 or greater is at risk for

A

Fetal hydrops

32
Q

If greater than 1:16

A

may need Amniocentesis to determine fetal blood type

33
Q

If fetal blood type +

A

Screen for fetal anemia

34
Q

How do you screen for fetal anemia?

A

Middle Cerebral Artery dopplers

MCA doblers

35
Q

If fetal anemia suspected

A

proceed w Percutaneous Umbilical Blood Sampling

PUBS

36
Q

Leading cause of mom morbidity and death in developed nations

A

HTN

37
Q

Chronic HTN

A

dx before 20 wks gestation

38
Q

Gestational HTN

A

after 20 wks gestation (didnt have it before)

> 140/90

Severe: >160/110

39
Q

Pre-ecamplsia

A

HTN after 20 wks and PROTEINURIA or if not proteinuria

thrombocytopenia
renal insuff
impaired LFT
pulm edema
HA
40
Q

Pre-eclampsia pathophys

A

Failure to establish adequate uteroplacental blood flow

41
Q

Dx of Pre-ecamp

A

TWO readings of >140/90 more than four hrs apart

42
Q

dx of Pre-examp

A

Persistent BP >160/110 requiring tx with IV

43
Q

Pre-ecamp with NO severe features tx

A

Delivery at 37 wks

44
Q

Pre-ecamp with severe features tx

A

Deliver at 34 weeks

In the meantime: 
IV Labetolol, hydralazine, 
PO Nifedipine
Mg sulfate
Steroids
45
Q

HELLP syndrome

A

Hemolysis
Liver enzymes
Low platelets

” a severe form of Pre-ecamp”

46
Q

Tx of HELLP

A

all the same things
+
PLATELET TRANSFUSION

47
Q

IU growth restriction

A

below the 10th percentile in second half of preg

48
Q

Estimated fetal weight determined by

A

Biparital diameter
head circum
abdominal
femur

49
Q

Screening for IUGR

A

Fundal height at every prenatal visit after 16 wks

50
Q

When to deliver IUGR with no complications

A

38-39 weeks

51
Q

When to deliver IUGR with abnormal uterine doppler

A

32-37 weeks

52
Q

When to deliver IUGR with other conditions

A

34-37

53
Q

When to screen for DM

A

24-28 weeks

with 1 hr test

54
Q

If measure is >140, proceed to 3 hours test

A

if >200, diagnosed

55
Q

3 hour test

A

must be fasting for 8 hrs

56
Q

1 hour postprandial

<140

A

2 hours post prandial goals

<120

57
Q

1st line tx for Dm

A

Insulin

Quarter 4 finals (11 decks)

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