Exam 3 Flashcards

Question

secondary headaches

Answer 1

idiopathic intracranial hypertension: loss of vision complication, no issue to pregnancy central venous thrombosis: subarachnoid hemorhage reversible cerebral vasoconstriction syndrome

Answer 2

severe migraines <8 weeks: at risk for fetal-limb reduciton defects, MI, CV disease, venous thromboembolism, preeclampsia, gHTN

Answer 3

S: Systemic symptoms: illness or condition (fever) N: neurological symptoms or abnormal signs (altered mental status, change in vision, seizures) O: Onset is new or sudden or severe (worst headache of my life, subarachnoid hemorrhage?_ O: other associated conditions or features (trauma, illicit drug use, awakens from sleep) P: previous HA history with changes in symptoms

Answer 4

"milk coming in" 32 to 96 hours after birth rapid drop in maternal progesterone levels following the expulsion of the placenta combines with the secretion of prolactin and other permissive hormones such as cortisol and insulin to trigger lactogenesis II

Answer 5

at least 3 poops per day after day 4 | at least 6 wet/heavy diapers after day 4

Answer 6

vomiting, lethargy, breathing problems, refusing to feed press the forehead skin- is it yellow underneath? how many times in 24 hours are you nursing? (less than 8 is bad) how many poopy diapers in 24 hours (less than 3 or 4 by day 4) are poops yellow by day 4? how many wet of heavy diapers? (less than 4 is bad) can you hear the baby swallowing? is there red staining in the diaper? (less than day 3 is normal) can you tell if milk is in?

Answer 7

milk protein that inhibits milk secretion as milk accumulates in the alveoli. the longer milk remains in the breast, the higher concentrations of FIL, which downregulates milk production.

Answer 8

``` 5-7% of weight in hospital or by day 4 regain birthweight by 2 weeks 4-7oz a week during first month 1-2 lb/week for 1-6 months 1lb/month from 6-1year ```

Answer 9

no dietary restrictions can help with weight loss breastfed fine if mom only eats 1800 calories a day overweight women can restrict by 500 calories can have moderate excersize

Answer 10

less than 1% is transferred, some degree of transfer present much less than in utero more in colostrum

Answer 11

Water makes up majority of human milk (87.5%) Colostrum is present from 12-16wks EGA onward Thicker, yellowish (d/t beta carotene) 2-20ml/feeding, about 100ml avail during first 24h after birth higher in protein and minerals, and fat soluble vitamins than mature milk ++ sodium, chloride, potassium, carotenoids Note that the breast cannot synthesize water soluble vitamins (these must come from the mother’s diet - must supplement B12 if vegan) lower in sugars, fat, and lactose than mature milk Mild laxative effect

Answer 12

secretory IgA interferon fibronectin pancreatic trypsin inhibitor

Answer 13

risk factors: cracked or damaged nipples, plugged milk ducts, milk stasis by engorgement or ineffective milk removal, blocked nipple poore, nasal carrier of s. aureus, hyperlactation or high rate of milk synthesis, insulin dependent DM, nipple piercing

Answer 14

more than 2 sections classical incision previous uterine rupture other contraindications to vaginal delivery twins are okay not great candidates: uncontrolled diabetes, recurring issues (cephalo-pelvic disportion, failure to progress,) higher rates of VBAcing if you go into spontaneous labor contraindicated medications: miso and any cervical ripening (cervidil) can use pitocin- increases risk of rupture 2-3 times need to have a physician in the hospital (whole staff for c/section)

Answer 15

activation of HPA axis prematurely pathologic uterine distention inflamation (increased prostaglandin) decidua issues (abruption, ect...

Answer 16

fetal fibronectin (greater than 20 weeks, marker of PTL, hormone released) when its negative it is pretty sure not PTL, but positive does not mean much ferm, pool, dye speculum until proven placental location transvaginal US for cervical length cervical change can only be deduced if cervix is more than 2cm and 80% effaced (people walk around at that)

Answer 17

``` IV hydration mag sulfate bolus beta methazone terb (only for labor with tachysystole) niphedipine (calcium channel blockers NOT with mag) cerclage up to 24 weeks (put in 12-15) indomethicin (no more than 48) progesterone start 16-20 weeks (injeciton or vaginal) ```

Answer 18

less than 25mm 14-28 weeks

Answer 19

intrauterine environment is the first environment for a human. What happens there has an impact.

Answer 20

Jordan (p. 293): we could think of pregnancy as a crisis in that it is a “turning point or opportunity” that creates “disequilibrium” and prompts the pregnant person and the family to adapt to/make functional changes that are both physical and psychological. The successful, healthy adaptation to this “crisis” depends upon the pregnant person’s perspective on the crisis, the person’s access to resources, and the “resiliency” of both the person and the family

Answer 21

more likely to have relapse if pt. already on meds and we take them off SSRI (c) Venlafaxine (c) SNRI zoloft most safe prozac least most concentraion buproprion (c) paxil (D) ! (cardiac defects) NO PAROXITINE no valproic acid! (no) yes TCA (first line) benzos.. maybe ok? metabolize all meds faster the farther along in pregnancy you are

Answer 22

SSRI, CBT, first line no antidepressants for biopolar folks full trial of meds is 12 weeks at good dose, start feeling at 4-6 weeks

Answer 23

Highly protein bound, short-half life, a low M/P ratio, poor bioavailability ( poor oral absorption)

Answer 24

``` SSRI low risk with others monitor infant sedation/weight gain no pump and dump no routine milk or infant levels ```

Answer 25

gestational age 20-37 weeks documented regular UCs >6/hour ROM cervical change, greater than 2cm and 80% effaced

Answer 26

Late preterm: 34-36w Moderate preterm: 32-33w Very preterm: 28-31w Extremely preterm: <28 w

Answer 27

premature activation of HPA axis pathological uterine distension inflammation (increase prostaglandins) increase decidual hemmorhage

Answer 28

Fetal monitoring with Doppler and toco STERILE SPECULUM EXAM BEFORE DIGITAL EXAM Obtain fFN specimen with DACRON swab, THEN obtain cultures Lightly rotate swab across posterior fornix of the vagina for 10 seconds to absorb cervicovaginal secretions Transfer swab to buffer solution in transport tube and cap Specimen is stable at room temperature for 24 hours Obtain other cervicovaginal cultures and test for PROM as indicated Direct assessment of cervix for dilation Digital exam for effacement and dilation, if PROM has been ruled out Consider ENDOVAGINAL Cervical Length if available.

Answer 29

* Betamimetics - Ritodrine, Terbutaline * MgSO4•NSAID’s - Indomethacin, Clinoril * Calcium Channel Blockers - Nifedipine * Atosiban

Answer 30

``` POVERTY genetics weathering hypothesis prior PTB= highest predictor low weight, chronic stress, fertility treatment occupational physical activity peridontal disease BV UTI ```

Answer 31

singleton pregnnacy cervical length less than 25 prior PTB ** TVU gold standard for detection

Answer 32

can be asymptomatic, but still contagious symptoms: lymphadatomphy and rash. Also: nasal congestion, conjunctivitis, fever, malaise, person to person, airborne serological testing PCR choronic villus PCR after 22 weeks to be performed CRS unlikely after 20 weeks infection (worst in 1st trimester) US characteristics: microcephaly, cardiac, early growth retardation Congenital rubella syndrome: HEARING LOSS, cataracts, glaucoma, retinitis, patent ductus arteriosis, cardiac lesions

Answer 33

positive serology for IgM and IgG transmitted: respiratory droplets, close contacts, crosses placenta from infected mother to fetus, infection can ascend form lesions in birth canal

Exam 3 Flashcards

(57 cards)