Kim teaches small group

Question 1

Molar pregnancy age distribution

Answer 1

the extremes

Old and young

Question 2

labs for DIC

Answer 2

fibrinogen
Increased D-dimer
Thrombocytopenia
PT-PTT INR

Question 3

Symptoms of prego mole

Answer 3

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

Question 4

HYDATDIFORM MOLE treatment

Answer 4

suction D/C to evacuate abnormal tissue

IV oxytocin will prevent hemorrhage and expel products

Put them on OCPs

Question 5

HYDATDIFORM MOLE HCG checks

Answer 5

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)

Question 6

HYDATDIFORM MOLE is asc. with what cancer

Answer 6

Choriocarcinoma

monitored via HCG

Question 7

Choriocarcinoma

Answer 7

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

Question 8

Endodermal sinus tumor

Answer 8

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

Serum AFP is often elevated.

Question 9

Risk of recurrent molar prego

Answer 9

1-2%

after 2 moles, recurrent 10%

Question 10

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

Answer 10

serous carcinoma

Question 11

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

Answer 11

SURFACE EPITHELIAL TUMORS are the most common

subtypes: serous and mucinous

Question 12

SURFACE EPITHELIAL TUMORS are made of what

Answer 12

Derived from coelomic epithelium that lines the ovary

Question 13

Symptoms of cervical cancer

Answer 13

post coidal bleeding

Question 14

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

Answer 14

You need to get a biopsy of cervix

BUT it could also be from endometrium or ovary

Question 15

Uterus polyp vs fibroid

Answer 15

Polyp is endometrial origin- soft

Fibroid is myometrium- hard

Question 16

Postmenopausal endometrium strip size

Answer 16

Normal 4 mm or less

4 mm or larger is not good

Question 17

What is a partial hysterectomy

Answer 17

partial will leave behind the cervix

Question 18

__________ intake can increase the pain associated with fibrocystic breast changes

Answer 18

Caffeine

Question 19

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

Answer 19

bloody discharge.

Question 20

Most postpartum mastitis is caused by

Answer 20

• 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.

Question 21

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

Answer 21

previous Cesarean section

Question 22

What prostaglandin is for prego

Answer 22

prostaglandin E2

Question 23

A biophysical profile is not of any value in ?

Answer 23

labor.

Question 24

___________ may be used for repetitive variable decelerations

Answer 24

Amnioinfusion

Question 25

Early decelerations are physiologic caused by ?

Answer 25

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

Question 26

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

Answer 26

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

Question 27

Late decelerations are associated with?

Answer 27

uteroplacental insufficiency.

Question 28

Variable decelerations show an ?

Answer 28

"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.

Question 29

Variable decelerations are typically associated with ?

Answer 29

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

Question 30

Fetal Bradycardia?

Answer 30

under 110

Question 31

Fetal Tachycardia?

Answer 31

Over 160

Question 32

Absent variability fetal HR

Answer 32

no changes in HR | hypoxia or other problems

Question 33

Mild variability fetal HR

Answer 33

less than 5 changes in HR | hypoxia or other problems

Question 34

Moderate variability fetal HR

Answer 34

2-25 changes in HR | Reassuring =)

Question 35

Marked variability fetal HR

Answer 35

over 26 changes in HR

Question 36

VEAL CHOP

Answer 36

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

Question 37

Variable decelerations…..

Answer 37

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

Question 38

Early decelerations………

Answer 38

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

Question 39

Accelerations…………….

Answer 39

OK, may need Oxygen reassuring (normal) sign; last for 15+ seconds and peaks 15+ beats/min

Question 40

Late decelerations……….

Answer 40

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

Question 41

Sinusoidal fetal HR

Answer 41

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

Question 42

Late decelerations when_____________ are an ominous sign

Answer 42

viewed as repetitive and/or with decreased variability

Question 43

Initial measures to evaluate and treat fetal hypoperfusion include

Answer 43

- 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.