Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

REPRO II Exam 2 > Dunn OB/GYN IV > Flashcards

Dunn OB/GYN IV Flashcards

1
Q

38yo F G3P2002

  • labor and delivery 31 weeks
  • significant vaginal bleeding
  • abdomen - mobile mass
  • no pain
  • US - placental over cervical os
A

placenta previa

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

placenta tissue over cervical os

A

placenta previa

painless antepartum bleeding after 20 weeks

US before digital exam - don’t want hemorrhage

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

severity of placenta previa

A

total - os totally covered
partial
marginal - edge of placenta at margin of os
low-lying - implanted lower uterus close to os

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

fetal vessels at cervical os

A

vasa previa

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

risk fx placenta previa

A 
previous PP
previous C section
multi gestation
multiparity
advanced age
infertility tx
previous abortion
smoking
cocaine**
male fetus 
non white
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

tx of placenta previa

A

asymptomatic - plan C section

bleeding - emergeny C section possible

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

vaginal delivery

A

attempted if placental edge >10mm from internal os

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

four Ts of post partum hemorrhage

A

tone - no contraction - bleeding
trauma
tissue
thrombus

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

tx of uterine atony bleeding

A

massage
pitocin/cytotec
methergine - no with HTN
hemabate - no with asthma

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

halogenated anesthetics

A

cause of uterine atony

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

second most common cause of PPH

A

trauma

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

most common cause of PPH

A

PPH = post partum hemorrhage

atony

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

ITP

A

idiopathic thrombocytopenic purpura

abnormal platelet function

cause of thrombus PPH

also amniotic fluid embolus and vWD

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

17yo G1P0 at 38 weeks

  • feeling dizzy
  • edema
  • HTN
  • HA
  • obese
  • elevated uric acid
A

tx - induce labor

preeclampsia

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

leading cause of maternal and prenatal morbidity and mortality worldwide

A

preeclampsia

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

risk fx for preeclampsia

A 
HTN
renal disease
age >40 or <18
fam hx
antiphospholipid antibody syndrome
DM
multifetal gestation
high BMI
AA
17
Q

diagnosis of preeclampsia

A

systolic >140
diastolic >90
-two occasions at least 4 hours apart after 20 weeks of gestation

proteinuria >0.3g in 24 hr urine

protein/Cr ratio >0.3

dipstick +1

18
Q

pt with new onset HTN w/out proteinuria

A 
diagnosis of preeclampsia
-platelet 1.1
liver transaminases 2x normal
pulmonary edema
cerebral or visual sx
19
Q

severe preeclampsia

A

CNS dysfunction
hepatic abnormality
severe BP elevation >160/110

20
Q

mild preeclampsia

A

no end organ damage

BP >140/90

21
Q

early onset preeclampsia

A

<34 weeks

high risk of fetal death

22
Q

late onset preeclampsia

A

> 34 weeks

23
Q

preeclampsia indications for delivery

A 
nonreassuring fetal heart sounds
rupture membrane
uncontrollable BP
oliguria
Cr >1.5
pulmonary edema
SOB or chest pain and pulse ox <94%
HA
RUQ pain
HELLP syndrome
24
Q

severe HA, visual abnormality, RUQ tenderness, epigastric pain

A

severe preeclampsia

need urgent delivery

25
Q

HELLP

A

hemolysis
elevated liver enzymes
low platelets

with preeclampsia

pathology - aberrant placentation

26
Q

diagnosis of HELLP

A

RUQ tender, edema, HTN

platelet <100,000
abnormal liver function
periphera smear w/ schistocytes/bilirubin

27
Q

tx of preeclampsia

A

delivery

28
Q

preeclampsia antepartum management

A

antiHTN
-labetalol, hydralazine, nifedipine

mag sulfate

bed rest

corticosteroids

delivery at 37 weeks

29
Q

postpartum preeclampsia management

A

no NSAIDs

antiHTN

monitor BP 72 hours after delivery

30
Q

prevention of preeclampsia

A

low dose ASA starting late 1st trimester

weight loss

exercise

31
Q

prognosis of preeclampsia

A

early detection - decreased risk serious complications

32
Q

fetal complications of preeclampsia

A

complications related to prematurity

uteroplacental insufficiency

oligohydramnios

33
Q

eclampsia

A

preeclampsia - leads to coma

if gets severe

34
Q

tx of eclampsia

A

ABCs

seizure tx - IV MgSO4**

stabilize mother
control BP
deliver fetus
postpartum HTN and seizure control

35
Q

PRES

A

posteror reversible encephalopathy syndrome

cerebral edema, ischemia, hemorrhage to posterior hemispheres

MRI/CT changes

due to HTN

HA, AMS, visual disturbances, seizures

tx - control HTN, seizures

prognosis - most recover 2 weeks

can cause death

REPRO II Exam 2 (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions