Final Flashcards

1
Q

Ectopic pregnancy lab values (2)

A

QhCG should rise at least 53% over 48H

progesterone less than 5

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2
Q

ectopic pregnancy medical over surgical tx? (4)

A

if less than 3.5 cm
QhCG less than 5000
no cardiac activity
unruptured

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3
Q

normal pregnancy TVUS findings (2)

A

gestational sac “double ring” at 5 wks.

fetal pole w/ heart activity at 5.5-6 weeks

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4
Q

Hydatidiform Mole imaging findings (2)

A

chorionic villi are a mass of clear vesicles

snowstorm on U/S

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5
Q

abn bleeding, enlarged uterus, absent heart tones, elevated QhCG, pre-eclampsia before 20 weeks

and these plus pulm/CNS findings?

A

hydatidiform mole

choriocarcinoma

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6
Q

parts of hyperemesis gravidarum (3)

and when do you see it

A

dehydration, ketonuria, wt loss

begins 1st trimester, usu. resolves before 20 weeks

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7
Q

when to screen for Rh

A

first visit & 26-28 weeks

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8
Q

who gets RhoGAM

A

Rh- mom

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9
Q

HELLP?

A

Hemolysis
Elevated Liver enzymes
Low Platelets

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10
Q

mild preeclampsia? severe preeclampsia?

A

> 140/90 & >300 mg/24h urine

> 160/100, >5 g/24h urine

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11
Q

most accurate IUGR screening

A

MCA doppler flow on US

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12
Q

components of BPP w/ UA doppler (5)

A
fetal tone
movement
breathing
NST
amniotic vol.
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13
Q

test w/ negative predictive value for acidosis in IUGR

A

nonstress test

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14
Q

1 hr OGTT result indicating a 3h OGTT?

A

> 130-140

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15
Q

high values on 3h OGTT (4)

A

1 hr: 180
2 hr: 155
3h: 140
any over 200

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16
Q

when to screen for gestational diabetes (2)

A

24-28 weeks w/ 1h OGTT

6 weeks postpartum w/ 2h OGTT

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17
Q

most common site of ectopic pregnancy

A

ampullary portion of fallopian tube

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18
Q

hallmark of gestational diabetes

A

insulin resistance

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19
Q

when does preterm labor occur

A

after 20 weeks but before 37 weeks

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20
Q

preterm labor lab?

A

fetal fibronectin: present at term but not at 22-35 weeks
if present: risk of preterm L&D
if not present: no labor for 2 weeks

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21
Q

preterm labor prevention (2)

A

smoking cessation

progesterone IM for pts w/ hx preterm labor. Start at 16-20 weeks and continue until 36 weeks

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22
Q

leading cause of 3rd trimester bleeding

A

placenta previa

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23
Q

acute painless bleeding in 2nd/3rd trimester

A

placenta previa

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24
Q

placenta previa diagnostics

A

abd US followed by confirmation w/ TVUS

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25
Q

bleeding and internal/external hemorrhage

A

abruptio placentae

26
Q

vaginal bleeding on ROM w/ changes in fetal HR

A

vasa previa

27
Q

vasa previa diagnostics (2)

A
U/S using color doppler
Apt test (after the fact)
28
Q

vasa previa treatment

A

corticosteroids
possible 3rd trimester hospitalization
Cesarian delivery at 35 weeks

29
Q

risks assoc. w/ PPROM before 26 weeks (2)

A

fetal pulm. hypoplasia

limb positioning defects

30
Q

PROM diagnostics (2)p

A

Nitrazine paper

Fern test

31
Q

when does the quickening occur

A

18-20 weeks

16-18 weeks in multiple births

32
Q

methods of dating the pregnancy (4)

A

uterus size
quickening- when does it occur
uterine fundus position at 20 weeks
first trimester US- most accurate

33
Q

protraction disorder (3)

A

cervical dilation rate at less than 1 cm/hr or less than 1.2-1.5 cm/hr (nulli/multi)
latent phase longer than 20 or 14h (nulli/multiparous)
second stage longer than 3h w/ anesthesia or 2h w/o anesthesia

34
Q

arrest disorder (2)

A

no cervical dilation in the active phase of labor for > 2 h

no descent after 1 hour pushing

35
Q

breech treatment

A

external cephalic version at 36 weeks w/ tocolytics to relax the uterus

36
Q

most common cause of cephalopelvic disproportion

A

contraction of the mid-pelvis

37
Q

diagnosis of funic cord prolapse

A

palpitation of pulsatile mass

38
Q

diagnosis of occult prolapse

A

fetal HR changes

39
Q

how to relieve shoulder dystocia

A

McRobert’s manuever

40
Q

early decelerations indicate

A

head compression

41
Q

variable decelerations indicate

A

cord compression

42
Q

late decelerations indicate

A

uteroplacental insufficiency

43
Q

sign of fetal intolerance to labor

A

decelerations in fetal HR

44
Q

risk factors that incr. risk of uterine rupture in VBAC (4)

A

vertical incision in uterus
> 2 prior cesarian deliveries
induction of labor (don’t use ptocin)
previous uterine rupture

45
Q

definition of postpartum hemorrhage (2)

A

> 500 mL blood loss, vaginal birth

> 1000 mL blood loss, cesarian

46
Q

most common cause of postpartum hemorrhage

A

uterine atony

47
Q

how to diagnose postpartum hemorrhage (3)

A

10% decr. in HCT
need for transfusion
S&S of blood loss

48
Q

diagnosing ovulatory function (2)

A

serum progesterone: > 3 ng/mL is evidence of recent ovulation. Measure 1 week prior to menses (day 21)

ultrasound: follows dominant follicle, most accurate

49
Q

ovarian reserve diagnostics (2)

A

Anti-mullerian hormone: how many eggs are left. measured any time. less than 1 ng/mL indicates poor embryo quality, poor response to ovarian stimulation
FSH: measure on day 3 of cycle. greater than 20 indicates poor response

50
Q

hysteroscopy use (2)

A

evaluate uterine cavity

diagnostic & therapeutic- can remove polyp

51
Q

semen analysis values (3)

A

volume: below 1.5 mL is low
concentration: should be above 15 million
motility: at least 40% should be motile

52
Q

low volume of sperm sample w/ few sperm indicates (2)

A

androgen deficiency

GU obstruction/absence of vas deferens

53
Q

vaginal bleeding with a closed cervix

A

Threatened abortion

54
Q

incomplete abortion is signified by?

A

persistent bleeding & cramping following passage

55
Q

vaginal bleeding with an open cervix before 20 weeks

A

inevitable abortion

56
Q

recurrent SAB is?

A

> 3 consecutive pregnancy losses

57
Q

mifepristone use? (3)

A

not given after 9 weeks
PO, then buccal admin. 24-48h later
follow up US in 7 days

58
Q

absent fetal heart tones, no cardiac activity on US, retained pregnancy

A

missed abortion

59
Q

tx postabortive syndrome (2)

A

Methergine

D&C

60
Q

lambda sign on US

A

dichorionic twins

61
Q

T sign on US

A

monochorionic twins