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Flashcards in Kim teaches small group Deck (43):
1

Molar pregnancy age distribution

the extremes
Old and young

2

labs for DIC

fibrinogen
Increased D-dimer
Thrombocytopenia
PT-PTT INR

3

Symptoms of prego mole

-Hyperemesis
-Irregular heavy bleeding
-Toxemia
-thyroid storm
-large uterus
-absent fetal heart
-tone/movement
-passage of tissue

4

HYDATDIFORM MOLE treatment

suction D/C to evacuate abnormal tissue

IV oxytocin will prevent hemorrhage and expel products

Put them on OCPs

5

HYDATDIFORM MOLE HCG checks

weekly until under 2 for three measurements
Then once a month for 6 months

need to be on birth control (differentiate why there is Hcg)

6

HYDATDIFORM MOLE is asc. with what cancer

Choriocarcinoma
monitored via HCG

7

Choriocarcinoma

Malignant tumor composed of trophoblasts and syncytlotrophoblasts; mimics
placental tissue, but villi are absent

8

Endodermal sinus tumor

Malignant tumor that mimics the yolk sac; most common germ cell tumor in
children

Serum AFP is often elevated.

9

Risk of recurrent molar prego

1-2%

after 2 moles, recurrent 10%

10

BRCAl mutation carriers have an increased risk for ____________ of the
ovary and fallopian tube

serous carcinoma

11

two most common subtypes of the most common ovarian tumor _________ are _________

SURFACE EPITHELIAL TUMORS are the most common

subtypes: serous and mucinous

12

SURFACE EPITHELIAL TUMORS are made of what

Derived from coelomic epithelium that lines the ovary

13

Symptoms of cervical cancer

post coidal bleeding

14

What happens when you get a pap + for adenocarcinoma of cervix

You need to get a biopsy of cervix

BUT it could also be from endometrium or ovary

15

Uterus polyp vs fibroid

Polyp is endometrial origin- soft
Fibroid is myometrium- hard

16

Postmenopausal endometrium strip size

Normal 4 mm or less

4 mm or larger is not good

17

What is a partial hysterectomy

partial will leave behind the cervix

18

__________ intake can increase the pain associated with fibrocystic breast changes

Caffeine

19

A normal mammogram does not rule out breast cancer, especially in the presence of ?

bloody discharge.

20

Most postpartum mastitis is caused by

-staphylococcus aureus, so a penicillin-type drug is the first line of treatment

-Dicloxacillin (penicillin resistant staphylococci)

-Erythromycin may be used in penicillin allergic patients.

21

Prostaglandins are used for cervical ripening and are contraindicated in patients with history of _________

previous Cesarean section

22

What prostaglandin is for prego

prostaglandin E2

23

A biophysical profile is not of any value in ?

labor.

24

___________ may be used for repetitive variable decelerations

Amnioinfusion

25

Early decelerations are physiologic caused by ?

fetal head compression during uterine contractions, resulting in vagal stimulation and slowing of the heart rate

characteristic mirror image of the contraction

26

A late deceleration is a symmetric fall in the fetal heart rate, beginning at ?

start at/ after the peak of the uterine contraction and returning to baseline only after the contraction has ended.

27

Late decelerations are associated with?

uteroplacental insufficiency.

28

Variable decelerations show an ?

"V-Shape"

acute fall in the FHR, with a rapid down slope and a variable recovery phase.
may not bear a constant relationship to uterine contractions.

29

Variable decelerations are typically associated with ?

cord compression, especially in the setting of low amniotic fluid volume.

30

Fetal Bradycardia?

under 110

31

Fetal Tachycardia?

Over 160

32

Absent variability fetal HR

no changes in HR
hypoxia or other problems

33

Mild variability fetal HR

less than 5 changes in HR
hypoxia or other problems

34

Moderate variability fetal HR

2-25 changes in HR
Reassuring =)

35

Marked variability fetal HR

over 26 changes in HR

36

VEAL CHOP

Variable decelerations…..Cord compression
Early decelerations………Head compression
Accelerations…………….OK, may need Oxygen
Late decelerations……….Placental Insufficiency

37

Variable decelerations…..

Cord compression

Variable decels → reposition mother to knee-chest position to get baby’s head off the cord OR use two fingers to lift the baby’s head off the cord until further interventions required

amnioinfusion may be used to treat patients with variable decelerations

38


Early decelerations………

Head compression

sign that baby is descending into the pelvis, monitor as needed

39


Accelerations…………….

OK, may need Oxygen

reassuring (normal) sign; last for 15+ seconds and peaks 15+ beats/min

40


Late decelerations……….

Placental Insufficiency

worrisome sign; reposition mother, administer IV fluids and anticipate discontinuing/decreasing Oxytocin or administering a tocolytic to decrease

41

Sinusoidal fetal HR

last 20 minutes--> immediate delivery
Looks like a sign wave

42

Late decelerations when_____________ are an ominous sign

viewed as repetitive and/or with decreased variability

43

Initial measures to evaluate and treat fetal hypoperfusion include

-maternal position to left lateral position--> ↑ perfusion to the uterus
-maternal O2
-treatment of maternal hypotension
-discontinue oxytocin
-consider intrauterine resuscitation with tocolytics
-intravenous fluids
-fetal acid-base assessment with fetal scalp capillary blood gas or pH measurement.