Exam 3 Abn Preggo 1 Flashcards Preview

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Flashcards in Exam 3 Abn Preggo 1 Deck (20):
1

Ectopic Pregnancy is?

Predisposing factors?

Implantation other than in endometrial cavity

Any that impairs tube's ability to transport gametes or embryos

2

Ectopic Pregnancy presentation? (3)

Pelvic/abd pain, bleeding
Hemoperitoneum sxs: shoulder pain, subdiaph pain
Orthostatic sxs: dizzy, syncope, weak from blood loss

3

Ectopic Pregnancy physical exam should include? (3)

Vitals for ortho ∆s, signs of shock
Abd tenderness
Pelvic: unilat mass, tender, cervical tender

4

Ectopic Pregnancy labs? (3)

CBC: for anemia
Quant hCG: ↑ >53% over 48hrs in N preggo, less in ectopic
Serum progest: 20 is N, ectopic is lower

5

Ectopic Pregnancy: Trans Vag US?

If "preg of unknown location", next step?

Visualize IUP or ectopic
IUP = Gestational sac as double ring at 5 wks, cardiac activity @ 5-6 wks

If can't confirm either = preg of unknown location

If unknown loc -> follow w/ serial QhCG and TVUS until confirmation

6

Ectopic Pregnancy tx? (4)

Methotrexate for fetal reabsorb
Serial QhCGs
Laparoscopy
Salpingectomy/ostomy

7

Ectopic Pregnancy: When use meds instead of surgery? (5)

< 3.5 cm
QhCG < 5k
Cardiac activity
Ruptured vs unrup
Reliable to f/u

8

Gestational Trophoblastic Dz (GTD) is?

Unique marker?

Tumors from abnormal trophoblast cells ->
grow inside the uterus after conception

hCG

9

Hydatidiform mole is? (5)

Most C GTD
35yo
Chorionic villi become mass of clear "grapes"
Partial: Fetus U present (fertilized by 2 sperm), missed abortion
Complete: fetus absent (fertilization of empty egg), theca lutein cysts

10

Hydatidiform mole presentation? (6)

Abn bleeding
Enlarged uterus
Snow storm on US
QhCG high
Preeclampsia before 20 wks
Thyroid storm

11

Hydatidiform mole tx? (3)

Evacuation of uterus
Monitor QhCG x 6-12 mo
Avoid preggo for 1 yr

12

Choriocarcinoma is?

Malignant tumor from any trophoblastic tissue (mole, ectopic, normal preg)
Mets everywhere

13

Choriocarcinoma presentation? (6)

U not sen until already mets
Irreg vag bleeding
Dyspnea/Cough/Hemoptysis
CNS
Rectal bleed
Enlarged uterus

14

Choriocarcinoma dx? (2)

High QhCG and snowstorm on US
CT abd, pelvis, head

15

Choriocarcinoma tx? (3)

Chemo
Methotrexate
Monitor QhCG

16

Hyperemesis Gravidarum is?

Causes what?

Tx?

Unexplained, intractable N/V in 1st tri
Causes dehyd, ketonuria, wgt loss
U resolves by 20 wks
Antiemetics, hydration

17

Rh D Alloimmunization pathophys?

Rh - mom w/ Rh + fetus
Mom makes IgG Ab's against baby RBCs

18

Rh D Allo presentation?

None in mom
Affected baby = mild anemia/↑bilirubin -> ↓tone, poor feed, apnea, seizures death

19

Rh D Allo dx studies? (2)

Draw titers 26-28 wks
↑titers = sensitization
Doppler -> measure middle cerebral artery flow (high velocity = anemia)

20

Rh D Allo tx?

Prevention?

Fetal transfusion

Anti-D IG at 28 wks and w/i 72hrs of delivery
Binds fetal Rh -> prevents anti-Rh Ab development