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AANP Study Cards > Pregnancy > Flashcards

Pregnancy Flashcards

1
Q

What is the presentation of placenta abruption

A
  • sudden onset of vaginal bleeding

- uterine contractions

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2
Q

What are risk factors for placenta abruption

A
  • Previous abruption is the strongest risk factor
  • hypertension
  • preeclampsia
  • smoking
  • trauma
  • cocaine use
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3
Q

What is placenta previa

A

-placenta impants too low on either the top of the cervix or the cervical isthmus

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4
Q

What are sx suggestive of a placenta previa

A
  • bright red vaginal bleeding

- painless bleeding

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5
Q

What is the presentation of the severe pre-eclampsia

A

-sudden onset of severe recurrent headache
-visual abnormalities
-pitting edema (edema on face, eyes and fingers)
-rapid weight gain
-right upper quadrant pain
-BP >140/90
-Proteinuria
-Oliguria
-

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6
Q

What is HELLP

A
  • hemolysis
  • elevated liver enzymes
  • low platelets
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7
Q

What are the findings in HELLP syndrome?

A
  • RUQ pain
  • N/V
  • Malaise

Lab abnormalities:

  • Elevates in AST, ALT, LD
  • Decrease in Platelets
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8
Q

WBC count is ____ throughout pregnancy especially in the 3rd trimester, can be as high has _____

A

elevated; 10,500

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9
Q

What lab values are elevated in pregnancy

A

ALP, lipid profile, Total T3, WBC, GFR, ESR, TSH

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10
Q

How are hemoglobin and hematocrit values different in pregnancy

A

Both are reduced in pregnancy

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11
Q

What is the use of serum alpha-fetoprotein

A

-biochemical marker used to estimate a pregnant woman’s risk fo having a fetus/infant with down syndrome

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12
Q

If you have an abnormal alpha-fetoprotien what do you then order

A

triple or quad screen to evaluate for trisomy 21

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13
Q

If you have a high alpha-fetoprotein what are concerns

A
  • neural tube defects
  • omphalocele
  • gastroschisis
  • multiple gestation
  • pregnancy dating error
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14
Q

What is the triple marker screen test composed of

A
  • AFP
  • beta HCG
  • estriol serum level values
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15
Q

What is the quad marker screen test composed of

A

-combination of the triple screen (AFP, beta HCG, estriol) and inhibin-Aq

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16
Q

Tay-Sachs is common in

A

Jewish descents

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17
Q

Cystic Fibrosis is common in

A

whites

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18
Q

Sickle cell anemia is common in

A

African American

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19
Q

______ is an important indicator of the viability of pregnancy and useful in the _____ trimester

A

Doubling time; 1st

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20
Q

What is a normal HCG patter in a viable pregnancy

A

HCG doubles every 48 hours for the 1st 12 weeks

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21
Q

Screen for _____ in pregnancy

A

HBsAg, HIV, gonorrhea, chlamydia, syphilis, HSV, check rubella/varicella titres

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22
Q

What antibiotic is okay in 1st and 2nd trimester but contraindicated in 3rd trimester and why

A

Macrobid

-b/c of increased risk of hemolytic anemia

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23
Q

What macrolide is category C and should be avoided

A

Clarithromycin

24
Q

What is the risk of pseudoephedrine in pregnancy

A

-increased risk of gastrochisis

25
Q

What is the risk of sulfa drugs in pregnancy

A
  • cause hemolytic anemia

- hyperbiliruminemia

26
Q

What health education should you provide in pregnancy

A
  • take 400mcg of folic acid prenatally
  • avoid soft cheeses, undercooked meats, raw milk
  • avoid cat litter
  • do not eat raw shellfish or oysters
  • no cold cuts, hot dogs, deli meat
  • no ETOH or smoking
  • regular coffee 8oz/d is okay
  • no excessive heat
27
Q

Weight gain in pregnancy

A
  • Normal: 25-35 lbs
  • Underweight patients: 28-40 lbs
  • Obese patients: 11-20 lbs
28
Q

Women >35 years have higher risk of

A
  • chromosomal abnormalities
  • pre-eclampsia
  • low birth weight infants
  • miscarriage
  • premature birth
  • complications during delivery
29
Q

What are positive signs of pregnancy

A
  • palpation of the fetus
  • ultrasound and visualization of the fetus
  • fetal heart tones
30
Q

What are probable signs of pregnancy

A
  • goodell’s sign (cervical softening @ 4 weeks)
  • Chadwicks (blue coloration at 6-8 weeks)
  • Hegars (softening of hte uterin isthum at 6-8 weeks)
  • enlarged uterus
  • ballottement
  • urine or blood pregnancy test
31
Q

What are presumptive signs of pregnancy

A
  • amenorrhea
  • N/V
  • Breast changes
  • fatigue
  • urinary frequency
  • slight increase in body temperature
  • quickening (at 16 weeks)
32
Q

At 12 weeks the uterine fundus rises above the

A

symphysis pubis

33
Q

At 16 weeks the uterine fundus is

A

between symphysis pubis and umbilicus

34
Q

At 20 weeks the uterine fundus is

A

At the umbilicus

35
Q

Fundal height between 20-35 weeks should

A

equal the number of weeks in cm +/- 2 cm

36
Q

What are physiologic changes of pregnancy

A
  • HR increases by 15-20 bpm
  • S3 is common, wide split of S1 or S2 split
  • May hear systolic ejection murmur
  • Cardiac output increases by 50%
  • physiologic anemia of pregnancy
  • preload increases
  • hypercoagulable state
  • mild edema
  • total lung capacity drops to 4L
  • degreased peristalsis
  • kidney size increases
37
Q

Cholasma/melasma is related to

A

high estrogen

38
Q

What is naegele’s rule

A

Used to estimate EDD
LMP - 3 months + 7 days or
LMP + 9 months + 7 days

39
Q

If you use methydopa in pregnancy what should you check or monitor

A

baseline LFTs contraindicated in active liver disease

40
Q

Uterine involution takes

A

6 weeks

41
Q

What is oligohydramnios

A

-AFI <5cm

42
Q

What is a normal AFI

A

5-25cm

43
Q

What are risk with oligohydramnios

A
  • fetal malformation
  • pulmonary hypoplasia
  • umbilical cord compression
  • fetal or neonatal death
44
Q

What is rhogam

A

immunoglobin that helps prevent maternal isoimmunization

45
Q

If rhoGAM is not givne to an RH-negative women this will result in

A

fetal hemolysis and fetal anemia in future pregnancies

46
Q

What is the dose of rhogam

A

300mcg IM at 28 weeks and 72 hours post delivery

47
Q

What test detects the presence of Rh antibodies

A

Coombs test

48
Q

What are risk factors for GDM

A
  • previous GDM
  • Obesity
  • Ethnicity (asia, american indian, pacific islander, african american, hispanic_
  • macrosomic infant
  • age >35
49
Q

What is the preferred test for GDM

A

75g OGTT

50
Q

What is the diagnostic criteria for 75g OGTT in GDM

A
  • Fasting 92mg/dL +
  • 1 hour 180mg/dL +
  • 2 hour 153mg/dL +
51
Q

First line treatment for GDM is

A

Lifestyle modifications

52
Q

75g OGTT is the ____ however if a 50g OGTT is performed and positive what is required

A

screening and diagnostic test;

a 100g follow up

53
Q

In individuals with GDM check for diabetes at

A

4-12 weeks postpartum

54
Q

In a pregnant adult a count of ____ is considered a UTI

A

10^3

55
Q

A threated abortion

A

vaginal bleeding but os remains closed

56
Q

inevitable abortion

A

cervix is dilated

AANP Study Cards (20 decks)

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