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ob/gyn > OB 1 > Flashcards

OB 1 Flashcards

1
Q

Common symptoms of pregnancy (initially)

A

Amenorrhea, breast tenderness, nausea and vomiting

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2
Q

What is morning sickness caused by?

A

increasing beta-HCG, esetrogen and progesterone

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3
Q

embryo

A

fertilization to 8 weeks

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4
Q

fetus

A

8 weeks to birth

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5
Q

infant

A

birth to one year old

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6
Q

developmental age

A

number of days since fertilization

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7
Q

gestational age

A

number of days/weeks since last menstrual period (usually 2 wks longer than DA)

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8
Q

Nagele rule

A

LMP - 3 months + 7 days = EDD

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9
Q

first trimester

A

fertilization until 12 weeks (DA) or 14 weeks GA

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10
Q

second trimester

A

DA: 12 - 24 weeks or GA 14 - 26 weeks

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11
Q

third trimester

A

DA: 24 weeks to birth or GA 26 weeks to birth

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12
Q

pre-viable

A

fetus born before 24 weeks

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13
Q

preterm

A

fetus born between 25 - 37 weeks

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14
Q

term

A

fetus born between 38 - 42 weeks

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15
Q

postterm

A

fetus born after 42 weeks

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16
Q

gravidity

A

number of times a patient has been pregnant

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17
Q

parity

A

what happens to pregnancy, 4 parts: term births, preterm births, abortions, living children

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18
Q

goodell sign

A

softening of the cervix, felt first at 4 weeks DA

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19
Q

quickening

A

first time the mother feels fetal movement, often 16-20 weeks, earlier for multiparous women

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20
Q

ladin sign

A

softening of the midline of the uterus, felt at 6 weeks

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21
Q

Chadwick sign

A

blue discoloration of vagina and cervix, 6-8 weeks

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22
Q

telangiectasias/palmar erythema

A

small blood vessels/reddening of the palms, first trimester

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23
Q

chloasma

A

“mask of pregnancy” - hyperpigmentation of face, forehead, nose and cheeks; @ 16 weeks

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24
Q

linea nigra

A

line of hyperpigmentation that can extend from xiphoid to pubic symphysis, second trimester

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25
Q

when can a gestational sac be seen on US?

A

beta-HCG of >1500 IU/mL or 5 weeks

26
Q

physiologic changes of pregnancy - CARDIAC

A

increased cardiac outout and HR, decreased BP

27
Q

physiologic changes of pregnancy - GI

A

morning sickness, GERD 2/2 decreased LES tone, constipation 2/2 decreased motility

28
Q

physiologic changes of pregnancy - RENAL

A

increased kidney and ureter size, increased GFR, decrease in BUN/Cr

29
Q

physiologic changes of pregnancy - HEMATOLOGY

A

anemia, hypercoagulable state (increase fibrinogen, venous stasis)

30
Q

How much does the plasma volume increase by?

A

50%

31
Q

When can you US to confirm GA? What else can you do then?

A

Between 11 and 14 weeks; can also check for nuchal translucency

32
Q

Thickened or elnarged nuchal translucency is an indication of what?

A

Down syndrome

33
Q

What is first trimester screening?

A

noninvasive evaluation to identify risks of chromosomal abnormalities; combo of blood tests and US

34
Q

when do you perform the triple or quad screens?

A

at 15 to 20 weeks

35
Q

triple screen

A

maternal serum alpha fetoprotein, beta-HCG, estriol

36
Q

quad screen

A

maternal serum alpha fetoprotein, beta-HCG, estriol, inhibin A

37
Q

increased MSAFP may indicate

A

dating error, neural tube defects, or abdominal wall defects

38
Q

third trimester testing

A

CBC (Hgb 140 - glucose tolerance test), cervical clx for chlam and gon (tx if pos), GBS (ppx if pos)

39
Q

chorionic villus sampling

A

at 10 to 13 weeks inadvanced maternal age or known genetic dz, obtains fetal karyotype; transabdominally or transvaginally

40
Q

amniocentesis

A

at 11 to 14 weeks inadvanced maternal age or known genetic dz, obtains fetal karyotype; transabdominally

41
Q

fetal blood sampling: method and indication

A

transabdominal percutaneous umbilical blood sample, done for patients with Rh isoimmunization or fetal CBC needed

42
Q

most common location for an ectopic pregnancy

A

ampulla of the fallopian tube

43
Q

risk factors for ectopic pregnancy

A

previous ectopic pregnancy, PID, IUD

44
Q

presentation of an ectopic pregnancy

A

unilateral lower abdominal or pelvic pain, vaginal bleeding

45
Q

abortion

A

pregnancy that ends before 20 weeks or fetus is <500 grams

46
Q

maternal factors that increase risk of abortion

A

anatomic abnormalities, infxns (STDs), immunological factors, endocrinological factors, malnutrition, trauma, Rh isoimmunization

47
Q

complete abortion: US findings & treatment

A

US: no products of conception found; Tx: f/u in office

48
Q

incomplete abortion: US findings & treatment

A

US: some products of conception found; Tx: D&C/medical

49
Q

inevitable abortion: US findings & treatment

A

US: products of conception intact, intrauterine bleeding, dilation of cervix; Tx: D&C/medical

50
Q

threatened abortion: US findings & treatment

A

US: products of conception intact, intrauterine bleeding, no dilation of cervix; Tx: bed rest, pelvic rest

51
Q

missed abortion: US findings & treatment

A

US: death of fetus but all parts of conception present in the uterus; Tx: D&C/medical

52
Q

septic abortion: US findings & treatment

A

US: infxn of the uterus and the surrounding areas; Tx: D&C and IV abx (levo, metronidazole)

53
Q

medical treatment for abortions

A

medications that induce labor such as misoprostol

54
Q

presentation of multiple gestations

A

exponential growth of uterus, rapid weight gain by mother, elevated beta-HCG and MSAFP

55
Q

preterm labor

A

combination of contractions (abd pain, LBP, pelvic pain) with cervical dilation; occurs between 20 and 37 weeks

56
Q

premature rupture of membranes

A

patient has h/o a “gush of fluid” from vagina

57
Q

cervical incompetence

A

no h/o contractions, painless dilation of the cervix

58
Q

risk factors for preterm labor

A

premature rupture of membranes, multiple gestation, h/o preterm labor, placental abruption, maternal factors

59
Q

maternal factors that increase risk of preterm labor

A

uterine anatomical abnormalities, infxn (chorioamnionitis), preeclampsia, intraabdominal surgery

60
Q

allow preterm delivery to occur under these circumstances

A

maternal severe HTN, maternal cardiac dz, cervical dilation >4cm, maternal hemorrhage, fetal death, chorioamnionitis

61
Q

tocolytics

A

used in preterm labor to slow the progression of cervical dilation by decreasing uterine contractions; Mag sulfate, CCB, turbutaline

62
Q

what steroid is used to “mature the fetuses lung’

A

beclomethasone

ob/gyn (4 decks)

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