Lecture 12 Flashcards Preview

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Flashcards in Lecture 12 Deck (77):
1

What type vaccines do you not give pregnant women?

Live virus vaccines

2

What is the goal of preconception counseling

Optimize a woman's health pre-pregnancy

3

What is one of the first things that change with pregnancy?

Breast tenderness

4

When does softening and enlargement of the uterus happen?

6 weeks into pregnancy

5

What is when the vagina seems congested and is blueish?

Chadwick sign

6

WHat is the sign associated with softening of the cervix?

Hegar sign

7

What test is used to confirm pregnancy?

Urine or serum hCG (human chorionic gonadotropin)

8

The hCG beta quant should do what in early pregnancy?

Double about every day

9

Which is more sensitive, urine or serum hCG?

Serum

10

TVUS can detect pregnancy at how many weeks?

3-4 weeks gestation Beta HCG 1000-2000)

11

When can you visualize the fetus via abdominal US?

5-6 weeks (can see a gestational sac)

12

B/w what weeks is there doppler detection fo fetal haert tones?

10-12 weeks

13

What is EGA?

Estimated gestation age

14

What is EDD?

Estimated date of delivery

15

When is CVS performed?

>10 weeks

16

When is amniocentesis usually performed?

15-20 weeks

17

When is cordocentesis performed?

>20 weeks GA

18

What 3 tests are performed in the first timester (10-13 weeks)?

HcG (quantitative)
PAPP-A
CVS

19

What does a decrease in PAPP-A indicate?

Aneuploidy (abnormal chromosome number)

20

What makes up the triple test (what do you add for quad)?

AFP (alpha fetal protein)
Estriol
Hcg
(inhibin A- only quad)

21

Do values in the triple/ quad screen vary by race?

Yes

22

How often do you see women under 28 weeks?

Every 4 weeks

23

What is the normal range for fetal heart tones?

120-160 bpm

24

What maneuvers are used to determine fetal presentation?

Leopold maneuvers

25

What do you look for on urine in a normal ob exam?

Glucose
Protein (albumin)

26

What is external cephalic version (ECV)?

Where you turn the baby so they don't present breech. Done at 36-38 weeks

27

If the fundal height is at the umbilicus, what week are they probably at?

20 weeks

28

What are some routine labs?

CBC
RPR?FTA
glucose
blood type/ rH
urinalysis
Group B strep
BMP
STD: gc, chlamydia, hep B

29

What is associated with genetic defects and you need to get a profile on?

Rubella

30

At what week does the 3rd trimester start?

28 weeks

31

What is an indirect way to measure fetal activity?

Fetal kick counts

32

How many fetal kick count should there be in an hour?

4-10 kicks an hour

33

What is the biophysical profile

Get an NST, look at breathing movement, look for gross body movements (GSM) on US, look at fetal tone, amniotic fluid index

34

What is the normal range for biophysical profile

8-10

35

What is a concerning number for biophysical profile?

Under 6

36

What happens in breast in the first 8 weeks?

Nipple/ areola enlarge
Prominence montgomery tubercles
Ductal growth
Increased blood flow

37

When is colostrum produced?

Later in pregnancy
leakage is common

38

What happens to total serum calcium for the mom?

Decrease total serum calcium

39

What is the hormone that leads to ligament laxity and joints loosen?

Relaxin

40

What happens with the eyes to pregnant women?

Can have blurred vision due to cornea thickness.
Increased intraocular pressure due to fluid retention

41

What happens to the thyroid hormone in pregnancy?

Gets larger

42

What hormone becomes more prevalent in early pregnant?

free T4 (should level down after 14 weeks)

43

Does Mom's TSH cross the placenta?

No

44

Does aldosterone synthesis increase or decrease?

Increase

45

Does DHEA increase or decrease?

Decrease (favor estrogen)

46

What is Ptyalism?

Feeling of excess saliva

47

Why do pregnant women have heart burn?

Decreased esophageal sphincter, increased gastric pressure and delayed gastric emptying

48

Why are women more constipated when pregnant?

Takes longer for food to go from stomach to cecum

49

What happens with a lipid profile in pregnant women?

All levels go up

50

What may happen with total albumin?

Serum decreases (not really decreases, just over a larger volume)

51

What GI conditions are pregnant women more at risk for?

Cholecystitis and gallstone

52

What happens with glucose levels in pregnant women?

blunted response to glucose load  postprandial hyperglycemia

53

What increases in the CV in the first part of pregnancy?

Increased stroke volume

54

After increased stroke volume, what happens to the heart?

Heart rate increases (more circulating blood volume and less PVR)

55

How much does cardiac output increase by?

30-50%

56

Where does the heart shift with pregnancy?

Up and left

57

Women who are pregnant are in what type state hematologically?

Hyper-coagulable state w/ increased risk of DVT

58

in pregnancy, the dilutional affect on the RBCs leads to a decreased H and H known as what?

Physiologic anemia

59

What do the kidneys increase the excretion of to compensate for decreased PCO2?

Serum bicarb

60

Do the kidneys enlarge?

yes

61

What levels will decreased with renal values?

BUN
creatinine
Uric acid

62

GFR increases by how much in pregnancy?

50%

63

What 2 things will be excreted more in pregnant women?

Vitamin B12
Folic Acid

64

What is the only antibody going across the placenta?

IgG

65

What hormone does the placenta produce?

human placental lactogen (HPL)

66

when does fetal bone marrow begin production?

Weeks 21-22

67

Where does surfactant secretion begin?

Week 26

68

What is the name for fetal waste?

meconium

69

How is bilirubin eliminated in womb?

Placenta

70

Birth defect where infants intestines are born outside the abdominal cavity.

gastroschisis

71

What makes a male, male?

Gene trigger

72

When does the thyroid develop?

End of 1st trimester

73

What weeks does the 4 chamber heart form?

5-8 weeks

74

When are lungs able to breathe without assistance?

28 weeks

75

When does meconium begin to accumulate?

18 weeks

76

When are gonads differentiated?

6-8 weeks

77

When do the fetal kidneys produce urine? And how much urine do they produce

11-12 weeks; 400-1200 ml urine/day