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Flashcards in Midterm Deck (31)
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1

how hcg meausured and time frame

- urine (around missed period)
- serum (9d after ovulation)
- do quantitative
- if miscarriage, ectopic.. do serial
- US will tell you if viable ... at 6 weeks... TVUS
heartbeat

2

1st tri US - for what?

- accurate due date
- know if premature, if baby is growing properly, for other testing
- if you know due date but ssx don't make sense
if pelvic pain, abd pain, spotting/bleeding

3

What are the reasons to know an accurate due date?

Pre-post maturity, out of hospital birth, testing

4

Pt experienced vaginal bleeding.
what do you ask her?

○ how long, pad?, streak of blood when wiping, how much?
○ color?
cramping?

5

Vaginal Bleeding during pregnancy DDX? - What kind of bleeding is common?

Cervicitis, vaginal lesions, polyps, threatened miscarriage, ectopic pregnancy, physiologic bleeding, intercourse, etc.

- What kind of bleeding is common?

6

Suppose she has cramping at 7 weeks
- would US r/o or r/i spontaneous abortion?

- yes bc heart beat
- can't find w a doppler (only at 10 wks)

7

Common Eti for spontaneous abortion

- abN cell divison, MC is chromosomal abN, progesterone xu
- congenital abN, trauma, exposure to teratogens, uterine abN/infx, etc. (know 1)

8

Low R Quadrant pain DDx

- ectopic pregnancy, ovarian cyst, appendicitis, round ligament pain, diverticulitis

9

Where do most Ectopic Pregn implant?

fallopian tubes

10

When should a pt establish prenatal care?

1st trimester

11

What are some labwork on the first visit? (know 2)

HIV, TSH, urine culture, PAP, GC, blood type

12

What increases the risk of ectopic pregnancy?

Tubal surgery, other tubal issues, DES exposure, infertility, previous PID, having IUD, previous STI infection (GC/US)

13

What advice regarding weight gain?

- 25-35 pounds
- 1 lb/wk
- don't diet

14

ECTOPIC PREGNANCY RUPTURE when? findings?

@ 6-12 weeks
Internal bleeding, shock, death.. medical emergency

15

How can you Dx and r/o ectopic pregnancy?

Repeated US and serum HCG.

16

TX OPTIONS for ectopic pregnancy

Methotrexate and surgery.

17

Prenatal panel

avorh, CBC, hepatitis, antibody screen, syphilis, HIV, urine culture, pap, gonorrhea, chlamydia, blood type testing (Rh- needs RHOGAM)

18

Nutritional Guidelines

Increase protein to 60mg
increase calories
Avoid raw fish
Take vitamin
Heated deli meat
Eat quality food
Incorporate veggies

19

When does an implantation occur in pregn (about teratogens)?

- 4-5th wk of preg or 1 wk after fertilization

20

Why is smoking dangerous? (know 2)

- premature, still birth, decrease O2 supply, increased resp dz to child, etc.

21

Why are ppl nauseous in pregnancy?

- increased peristalsis, gastric secretions, etc.

22

2 vits/herbs for nausea (know 2)

b6, k c, cardamom, mint

23

How does nausea resolve in pregnancy on its own?

resolved bc placenta takes over making hormones

24

HYPEREMISIS GRAVEDERIM
- what is it?
- DDX's?

- uncontrollable nausea vomiting, weak, dehydrated
- DDX: St flu, appendicitis, gb dz, kd infx

25

SOB w bad lab work indicating anemia... 2 herbs?

rhumex, nettles, teraxicum

26

2 risk dt anemia?

post partum hemorrhage, etc.

27

Teratogens... when else in life is a person vulnerable to teratogens?

wks 5-10 in fetal life during organogenesis, at newborn, adolescence, and during luteal cycle in women (breastfeeding)...

28

best way to faciliated oxytocin release during pregnancy

relaxed, dim lights, no talking

29

sleepy 1st trimester pt? hormone?

progesterone

30

Herbal Tx for insomnia (know 1)

scutilaria, chamomile, valerian

31

Fetal alc syndrome

- pre or post natal size of head cirumference delay, flattened face, upturned nose, etc.