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Obstetrics > Misc Prenatal Visits > Flashcards

Misc Prenatal Visits Flashcards

(61 cards)

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1
Q

Group Prenatal Visits’ Impacts

A

lower PTB rates

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2
Q

Early DMII Screening in Pregnancy: Risk Factors
(along with BMI >25)

done @ first PNC

name HLD and TG #s, A1c as risk factors

A

-HLD <35
-TG >250
-A1c >5.7
-PCOS
-physical inactivity
-first deg relative w/ DM
-most non-White pts
-hx >4000g deliv
-hx GDM
-HTN
-insulin resistance
-hx cardiovascular d/z

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3
Q

When to give Flu Vx to pregnant pt in hospital setting, not outpatient

A

-hx severe allergy to flu vx

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4
Q

Nasal spray flu vx: safe in pregnancy?

A

No (live, attenuated)
can give postpartum

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5
Q

When to give flu vx to pregnant pt in ANY setting

i.e. pharmacy, mobile clinic, church

A

Hives or lesser allergy to eggs

angioedema, resp distress, nausea/vomiting -> clinical setting (outpt)

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6
Q

Reason for leukorrhea in pregnancy (white discharge)

MoA

A

Estrogen!

cervical gland hypertrophy

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7
Q

Exercise Recs in Pregnancy

A

30 mins / day
5d/w
150min/w

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8
Q

Thimerosal-containing vaccines: safe?

what is it

A

yes. does not cause autism.

acts as preservative

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9
Q

CDC priority groups for flu vx

A

pregnant / postpartum
kids 6mo - 4yrs
>50yo
chronic d/z
immunosuppressed
health care / long-term care
household contacts of above^
BMI >40

for during vx shortages

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10
Q

TDaP Vx ideal timing in pregnancy

Why?

A

27-36w

max placental transfer of maternal Abs

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11
Q

Do you give tDaP vx in pregnancy if previous pregnancy / tday vx was <10yrs ago?

A

yes (give every pregnancy)

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12
Q

GERD MoA in Pregnancy

A

lower esophageal sphincter resting tone is lower in pregnancy

more ability to relux

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13
Q

GERD tx in Pregnancy

A
  1. lifestyle
  2. antacides (calcium carbonate)
  3. H2 receptors (famotidine)
  4. PPI (omeprazole)
    1. EGD
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14
Q

Ideal weight gain in Pregnancy (by BMI)

A

Underweight (BMI<20): 28-40 lbs
Ideal weight (BMI 20-25): 25-35lbs
Overweight (BMI 25-30): 15-20lbs
Obese (BMI >30): 11-20lbs

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15
Q

MCC severe poly

A

fetal anomaly (90%)

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16
Q

MCC mild-mod poly

A

idiopathic (40%), diabetes, multiple gestation

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17
Q

Prognosis of fetal atrial flutter

A

-rare
-FHR >300
-can cause heart block
-can cause fetal hydrops

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18
Q

Prognosis of fetal ventricular tachy

A

-FHR often <200
-can cause fetal hydrops
-improved prognosis compared to atrial flutter

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19
Q

fetal SVT tx

where to administer

A

digoxin

hospital setting (admit / monitor)

NOTE: adenosine is used in adult SVT, not fetal SV

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20
Q

Hrs of monitoring if Abd. Trauma

A

4hrs minimum from event
if ctx -> 24hrs

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21
Q

Gastrochisis:
1. laterality
2. sac
3. assoc.

A
  1. right (paraumbilical)
  2. no sac!
  3. not assoc w/ aneuploidy; somtimes GI issues
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22
Q

Omphalocele
1. laterality
2. sac
3. assoc.

A
  1. midline
    • sac!
  3. aneuploidies (T13, 18, 21), cardiac defects, Beckwith-Wiedemann, males, extremes of maternal age
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23
Q

Oligo Etiol

A

HTN/PEC
NSAIDS
maternal thrombosis
PPROM
urinary obstruction
renal agenesis (production issue)
demise
infxn
postterm
TTTS
abruption

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24
Q

Poly Etiol

A

anencephaly
esophageal atresia
Bartter S/d (defective reabsorption -> polyuria)

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25
fetal PAC mgmt
expectant | most common fetal arrythmia
26
IVF risk of twinning
28%
27
IVF increases risk for:
1. multiple gestations 2. VTE 3. HTN / PEC 4. ovarian hyperstimulation s/d 5. GDM 6. PTD
28
GA Early Term pregnancy
37w0d-38w6d
29
GA Full Term Pregnancy
39w0d-40w6d
30
GA Late-Term Pregnancy
41w0d-41w6d
31
GA Postterm
>/=42w0d
32
TTTS occurs in what kind of pregnancy
monochorionic (share a placenta) | rarely di/di
33
Physiologic Cardiac Changes in pregnancy
1. decreased SVR -> dec kidney perfusion -> inc fluid -> expanded plasma volume -> inc cardiac output
34
Describe physiologic changes impacted by stenotic valvular lesions in pregnancy
stenosis = fixed obstruction -inc HR > less atrial emptying time > inc preload, less cardiac output
35
Describe physiologic changes impacted by regurge valvular lesions in pregnancy
-inc in plasma volume -> cardiac chambers dilate and accomodate
36
SLE pt: how many months quiescent prior to conception?
6mo preconception -> improved outcomes
37
38
gum swelling in pregnancy: name MoA
epulis of pregnancy (vascular swelling of gums)
39
safety threshhold for radiation exposure to fetus
20-40mGy
40
NT defect risk if one affected sibling?
3%
41
NT defect risk if 2 affected siblings?
10%
42
MCC adnexal mass in pregnancy
simple, benign, <5cm
43
MCC >6cm complex adnexal mass in pregnancy
dermoid (mature teratoma)
44
MoA theca lutein cysts | presentation ## Footnote scenarios
overestimulation hcg | b/l, complex, septated ## Footnote multiple gestation, GTN, hydrops
45
Most common complication of fibroids in pregnancy
pain | no inc risk of congenital issues, labor dystocia (if fundal), PPROM
46
MCC peptic ulcer d/z repro age feale
H Pylori
47
H pylori tx
PPI + amoxicillin, clarithromycin x2wk
48
common weight loss % for dx of hyperemesis of pregnancy
5% loss of pre-pregnancy weight
49
U.S. women obesity prevalence
~40%
50
GA at which twin growth rate slows down
28-32w
51
obese women in pregnancy have a lower risk of _____
gastrochisis
52
TST+ in HIV+ pt if ___mm?
>5mm induration
53
TST+ in person with no risk factors if ___mm?
>15mm
54
TST+ in pt w/ recent TB contact if ___mm?
>5mm
55
TST+ in recent immigrant from high-prevalent country if ___mm?
>10mm
56
TST+ in IVDU pt if ___mm?
>10mm
57
TST+ in resident / employee pt of high-risk setting if ___mm?
>10mm | prison, hospital (v. similar...)
58
TST+ in 5yr old pt if ___mm?
>15mm | (<4yr old is >10mm)
59
TST+ in 2yo pt if ___mm?
>10mm
60
TST+ in immunocomp. pt if ___mm?
>5mm
61
TST+ in organ transplant pt if ___mm?
>5mm

Obstetrics (16 decks)

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