Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Primary Care 3 > Women's Health Lecture 1 > Flashcards

Women's Health Lecture 1 Flashcards

1
Q

abdominal pain in primary care- you should always assume is what?

A

pregnancy until proven otherwise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

At what age do you refer a young female who has not had a period?

A

16 years old. Refer to endo or gyno

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Early onset of menses (7 or 8yo) is associated with what? What is important for these patients?

A

Early menses associated with increased body fat because increased body fat induces menses in women. Anticipatory guidance in relation to this is very important for parent and child.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

in regards to reproduction, what hormone does the hypothalamus release? where does it go?

A

hypothalamus releases GnRH “I want to get pregnant” hormone- gets sent to pituitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

pituitary then secretes what, which does what?

A

FSH, which “gets the eggs ready” so stimulates egg growth within follicles in the ovaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

meanwhile, estrogen is building up. What is its job? When it gets to ___ picograms, what happens?

A

Its job is to “get the nest ready” When it gets to 200 picograms, LH level surges which stimulates one egg/ follicle to leave the ovary and go to the uterus AKA ovulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

After ovulation what happens?

A

Surge in progesterone signaling that the body is “ready to support pregnancy until placenta is ready.” If sperm = pregnancy. If no sperm progesterone level falls and the whole process starts all over again

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how many days is a normal menstrual cycle?

A

28 days +/- 7 is normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the first phase of the cycle called and what is the predominant hormone of this phase?

A

1st phase is called the follicular phase-predominant hormone is estrogen (estrodial mostly)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the second phase of the cycle called and what is the predominant hormone of this phase?

A

2nd phase is called luteal phase- progesterone dominates in this phase- its roll is to support fertilized egg/ support the pregnancy until the uterus can take over.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what hormone level remains high throughout pregnancy?

A

progesterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

which phase of the menstrual cycle varies?

A

follicular phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the importance of a prenatal vitamin?

A

Need 400mcg of folic acid, ideally 3-6 months prior to conceiving to prevent neural tube defects.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Once pregnancy is confirmed, what is needed in the PNV?

A

DHA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which vaccines are recommended DURING pregnancy?

A

flu and pertussis (Tdap) Tdap booster recommended during EACH pregnancy (CDC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which vaccine is important to have BEFORE becoming pregnant?

A

MMR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Explain getting your basal body temperature.

A

Should take your temp. first thing in the morning, before even moving (have it at your bedside). Need to be consistent, need to look at retrospective data of past several months. We are looking for a rise of 0.5 degrees F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

The ovulation predictor kits that are sold OTC are monitoring what?

A

they detect a surge in LH (signals ovulation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What does gravida mean?

A

number of times pt has been pregnant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does para mean?

A

number of time pt has given birth past 22 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the thick egg- white mucous substance called that is expelled from the vagina? What does it signify?

A

“mittelschmerz” signifies that ovulation is imminent- occurs just before ovulation (temp lowers slightly, then spikes when ovulation occurs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the difference between a qualitative and quantitative hCG test?

A

Qualitative- gives you yes or no answer- simple urine dip that is sold OTC.
Quantitative- measures the serum level of hCG (level needs at least 50 to be read); used to test viability of pregnancy. (Hcg should double or triple in 48- 72hrs if pregnancy is viable)
these are equally as accurate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

presumptive/ probable/ positive signs of pregnancy

A

see cards on Chapter 19

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When does hCG peak?

A

60- 90 days post fertilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How does Plan B work?
Makes conditions unfavorable for implantation. 85% effective
26
What are the "M&M" abortion drugs?
Mifepristone- "antiprogestin" blocks endometrial growth, detaches Methotrexate- prevents placental villi proliferation Misoprostol (cytotec)- causes uterine contractions (used for ripening in labor)
27
Uterine sizing- non- pregnant
lemon; it is firm, non- tender
28
Uterine sizing- 8 weeks
tennis ball/ orange- Hegar, Goodell, CHadwick all +
29
Uterine sizing- 10 weeks
baseball- ***first FHT 10- 12 weeks
30
Uterine sizing- 12 weeks
softball- above symphysis pubis
31
Uterine sizing- 16 weeks
halfway to navel- ***quickening felt
32
Uterine sizing- 20- 36 weeks
20 weeks at umbilicus, then add 1 cm/ week gestation- concordant with gestational age + or - 1 (shouldn't be off by more than 3cm)
33
Uterine sizing- Term
head engaged "ballottement"- vertex position 95% by 36 weeks
34
What is the best predictor of gestational age?
crown- rump length. (length of head to tail on US)
35
What are reasons for needing an early referral in patients who are trying to conceive?
``` advanced age (30+) h/o miscarriage h/o medical conditions or Fhx obese/ overweight the "needy" ```
36
What is it called when pt is vomiting a lot during pregnancy? How can you treat it/ nausea in pregnancy?
hyperemesis gravidarum. If being triggered by PNV, prescribe less offensive ones or children "gummies" could prescribe ginger (500mg daily), could use peppermint, crackers, could prescribe Zofran if really bad (category C), IV hydration in the hospital if very severe
37
Interventions for constipation in pregnant women?
water, fiber, milk of magnesia, colace
38
How do you manage asthmatic patients who are pregnant?
"mama don't breath, baby don't breath" ***Need pt to do peak flow every morning (1st thing in the morning) should continue baseline regimen, and if they notice peak flow decreasing, step it up that day. Ex. inhaled steroid daily, but pt notices bad peak flow numbers- use higher dose of inhaled steroid (still better than it getting out of control and having to go on PO steroids)
39
Which is safe to use in pregnancy- Tylenol or Ibuprofen?
Tylenol. Can't use NSAIDS
40
What is OK to prescribe if pt is complaining of nasal congestion/ runny nose? What is the patho behind this common symptom?
Low dose claritin (5 or 10mg) is OK, saline nasal sprays are ok- antihistamines conservatively are OK but no sudafed (decongestant) esp during first trimester. Also benadryl is OK patho- hormones increase fluid of mucous membranes ie. cervix but also nose to protect from invading bacteria to prevent infection
41
Milestones throughout pregnancy include?
weeks 4- 12 baselines weeks 12- 16 genetic screening/ testing weeks 16- 20 US to look at anatomy/ find out sex weeks 20- 24 age of vitality, begin leopolds weeks 24- 28 prepare for OGTT and RhoGAM if need weeks 28- 32 repeat HgB, STI testing weeks 32- 36 Kickcounts, group beta- strep, manage TOBP
42
What does effacement mean?
thinning of the cervix
43
What is considered preterm labor?
cervical effacement/ dilation between 20-37 weeks
44
What is the #1 risk factor for preterm labor?
A h/o preterm labor, premature birth or repeated pregnancy loss
45
What is the name of the procedure that sews up the cervix so it is reinforced and can carry the baby?
Cerclage
46
Pregnancy category A
controlled studies show no risk to fetus. ex- synthroid
47
Pregnancy category B
no evidence of risk in human; either animal findings show risk or if no adequate human studies have been done and animal findings are negative
48
Pregnancy category C
Risk cannot be ruled out: human studies are lacking, and animal studies are either positive fetal risk or lacking as well. However, potential benefits may justify the potential risks
49
Pregnancy category D
positive evidence of risk: investigational or post marketing data show risk to fetus. Nevertheless, potential benefits may outweigh risks
50
Pregnancy category X
Contraindicated in pregnancy; studies on animals and/or post market reports on humans have shown fetal risk that clearly outweigh any possible benefits
51
As a PCP, which categories would you prescribe?
A,B, maybe C if experienced. (Flonase category C)
52
New FDA pregnancy and lactation labeling rule (PLLR) says what, and when did it take effect?
Effective June 30, 2015. Replaced by 3 narrative subsections: 1. pregnancy 2. lactation 3. females and males of reproductive age. Each has to contain the following: registries, risk summary, clinical considerations, and data
53
Weight gain in pregnancy for underweight, normal, overweight and obese patients?
underweight (BMI < 18.5)- 28-40lbs normal weight (BMI 18.5- 24.9)- 25- 35lbs overweight- (BMI 25- 25.9)- 15- 25lbs obese (BMI 30+)- 11- 20lbs
54
Recommended initial therapy for gestational diabetes? (other than lifestyle modifications)
Sulfonylureas (glipizide, glimepiride). You can give a glucometer- if you do make sure to give instructions with it. If sulfonylureas not working add long acting insulin then lastly short acting with meals
55
How do Sulfonylureas work?
By stimulating beta cells in the pancreas
56
Why is A1c not reliable in pregnancy?
Changes in RBC production, anemias, etc.
57
Glucose tolerance test interpretations
``` need to fail 2/3 fasting >95 1 hour > 180 2 hours > 155 3 hours > 140 ```
58
What is pregnancy induced hypertension (PIH)?
elevated BP WITHOUT proteinuria: >30mmHg systolic or >15mmHg diastolic when compared to before 20 weeks gestation, or 140/90 if no baseline available. BP returns to normal usually 12 weeks post- partum
59
management of PIH includes what?
monitor BP, labs (CBC, LFTs, 24 hr urine, CrCL, Hgb/Hct) US to monitor fetal growth,* non- stress test after 32 weeks, rest (left lateral)
60
What should you always do when a pregnant patient comes to your office- no matter the complaint or what you are treating her for?
Urine dip. Check for proteinuria. Even if BP is normal always dip their urine.
61
HELLP syndrome***
``` Hemolysis Elevated Liver enzymes Low Platelets ```
62
pre- eclampsia s/s and treatment
sudden weight gain .2lbs/wk, digital/ facial edema (puffy face and hands), HTN (trace protein on UA), reflexes WNL progress to 3-4+ (hyper reflexia). Tx: bedrest, surveillance, steroids to help mature fetal lungs, hospitalization
63
what is eclampsia? s/s?
PIH + preeclampsia + seizure = eclampsia. Prodromal s/s (headaches, visual disturbances, RUQ or epigastric pain), BP over 160/100 consistently, tonic/ clonic seizures, oliguria, elevated creatinine, proteinuria of 5g or more in 24 hours, fetal distress in utero
64
What is placenta abruption? s/s
separation of placenta from uterine wall. 80% will have obvious bleeding, bright red, frank and 20% bleeding will be concealed- will have "rigid" abdomen, not always painful. Have about 10 mins to get to OR to save baby if this happen
65
Fetal well- being: kick counts- what does it do, how do we tell the patient to do it?
It monitors the fetal status, decreased activity= increased risk for fetal death. Tell mom to monitor kicks for 1 hour every day, should feel at least 10 movements, if not try again, if still not 10- call OB. They start 28- 32 weeks.
66
Fetal well being: NST- when should you do it? what should it show?
Not accurate before 28 weeks so don't do it before then. It should show 2 accelerations of the fetal heart rate 15bpm above and 15 seconds beyond baseline in 20 minutes of testing. Tells us that the placenta is delivering enough oxygen to baby.
67
Fetal well- being: biophysical profile- what are the 5 variables and how are they scored?
``` This evaluates fetus in real- time US 1. fetal breathing 2. gross body movements 3. fetal tone 4. amniotic fluid volume 5.NST If the variable is normal= 2 points; abnormal= 0 points Total of 10 possible points. 8-10 is normal, 6-8 repeat in 24 hours, <4 thinking about delivering baby ```
68
Hypothyroid considerations in pregnancy
20-40% increase in demand by week 4 gestation. Want to keep TSH less than 2.5, so need to increase dose of synthroid. test q4-6 weeks until 20 weeks gestation or med stable. Post partum- test 3 mos, 6 mos, keep in mind for differentials up until 1 year after pt gave birth
69
most common causative organism in mastitis? tx with?
Staph- tx with amoxil. Need to pump and dump after taking abx.
70
most common complication that we will treat in primary care post partum?
mastitis
71
PCP needs to screen for what in post partum patients?
depression! Use PHQ2-9. ensure proper psych referral if needed. If treating, Zoloft is good- monitor for suicide/ homicidal ideation

Primary Care 3 (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions