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Primary care > OB > Flashcards

OB Flashcards

1
Q

Jewish

A

MD and Taysachs

Canavan gowshers

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2
Q

Jewish/french canadian

A

taysachs

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3
Q

AA

A

sickle

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4
Q

White

A

CF

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5
Q

Presumptive pregnancy

A

amenorrhea, tenderness, frequency, n/v, fatigue, chadwicks, linea nigra, chloasma, quickening (fetal movements)

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6
Q

Probable pregnancy

A

ballotment (boyency of baby), Braxton hicks, goodells (softening of cervix) and hegars (softening of lower uterine segment), uterine and abdominal enlargement, positive test (miscarriage, tubal, molar), palpation of fetal contour

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7
Q

Positive pregnancy signs

A
  • auscultation of fetal heart
  • palpation of fetal movements
  • ultrasound verification of gestation
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8
Q

nagels rule

A

-3 months + 7 days from first day of last period

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9
Q

Serum hcg doubles every

A

48 hours

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10
Q

1st trimester
2nd
3rd

A

1st- 1-3 months
2nd 3-6 months
3rd 6+

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11
Q 
PE measurements/description
Diagonal conj 
Transverse diameter 
Anterior posterior diameter 
Ischial tuberosity 
Cervical length
A 
Diagonal conj- 12.5 cm
Transverse diameter- sharp or blunt
Anterior posterior diameter - curved or flat
Ischial tuberosity- >8 cm 
Cervical length >4 cm (
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12
Q

Lab tests

A 
Blood type/Rh 
CBC 
HGB electro 
syphillis, hep b and c, HIV, G/C
varicella, rubella
BS 
HCG 
PAP 
UA 
TSHR 
other: CMV, parvo (day care), toxo (cats), gtt, hsv, toxic screen 
Genetic
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13
Q 
Nutrition pregnancy 
Folic acid 
calories 
Foods to avoid 
Protein
Dairy 
Whole grain 
Vitamin C 
Green leafy 
Other fruits/veg
A
  • 400 mcg a day
  • Increase 300 calories a day 1800-2400
  • avoid: soft cheese, shellfish, lobster, shrimp, clams, tuna swordfish such as LOWSWIMMING FISH NOT OKAY
  • protein: 75-100 g 4 serv
  • dairy: 4
  • whole grain: 6
  • vit C f/g: 2
  • green: 2
  • other f/v: 3
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14
Q

Routine schedule visits

A

^28 weeks: once a month
^36 weeks: twice a month
36+ every week until term
40+ twice a week, usually induced by 41

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15
Q

Postpartum visit schedule
Vaginal
C/S

A

Vaginal- 6 weeks
C/S- 2 weeks for incision, then 6 weeks later

if AMA or young- then more frequently

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16
Q

Prenatal visits and what we do/see at these visits

up to 20 weeks

A

each: BP wt urine
1st visit ASAP
12 weeks: FHR, fundus at symphisis pubis, FIRST SEQUENTIAL 10-12
16 weeks: Fundus between belly button and SP, recheck H+ H, second sequential (alpha fetal protein)
20 weeks: fundus at umbilicus, quickening, U/S** fetal survey

17
Q

Prenatal visits and what we do/see at these visits (20+ weeks)

A

24-28 weeks: fundus 1 cm a week, diabetic screen, RHOGAM, H+H, s/s PTL (cervix if at risk)
28 weeks: pediatrician, PCB, feeding, fetal kick count*
36: beta strep, cervix, s/s labor, lightening*
>36: cervix, fetal position, birth control, circumcision

18
Q

hegars

A

softening lower uterine segment

19
Q

goodell

A

softening of cervix

20
Q

chadwicks

A

bluish cervix

21
Q

1st trimester changes and tx

A

n/v/constipation/hemorrhoids/flatulence: emetrol, zofran, compazine, phenergan, metamucil

fatigue
urinary frequency/incontinence
varicosities 
headache 
Breast pain/menstrual cramps
22
Q

General physiologic changes of pregnancy

A

Smooth muscle relaxation (decreased peristalsis)
Increased blood volume
Increased CO - peaks 24 weeks
Increased GFR

23
Q

2nd trimester changes

A

Backache
Syncope (pooling of blood, pressure vena cava, increase BV)
Leukorrhea (increased E2, thin white yellow)
Epitaxis/epulsis (E2, r.o sinusitis, HTN, anemia)
Muscle cramps (pressure on nerves- adequate calcium)
Round ligament pain (avoid long standing or sitting- ectopic, cyst, appendix, hernia)
Increased saliva/bad taste (avoid starch)
PICA (assess constipation, intestinal obstruction, lead intoxification, anemia, hypercalcemia)

24
Q

3rd trimester changes

A

Braxton hicks- after 6 months- painless tightening, no dilation (left lateral position)
Dyspnea
Edema (increased capillary permeability, decreased return)
Dyspepsia(progesterone decreased peristalsis- tums mylanta maalox r/o gall bladder hernia ulcer)

25
Q

Proper weight gain
^ 20 weeks
20+

Normal weight:
Underweight:
Overweight:

A

^20 weeks: 10 lbs
20+= 1 lb/week

Normal weight: 24-32 lbs
underweight: 28-36 lbs
Overweight >30 BMI: 11-20 lbs

26
Q

U/S in pregnancy when to do it (indications and intervals) and what does it assess for

A
  • early if dont know date
  • bleeding or decreased movement
  • > 35
  • hx PID tubal surgery
  • Genetic anomaly hx
  • infertility
  • post date
  • gestational diabetes PIH
  • 10-12 weeks (1 sequential screen)
  • 20 weeks (fetal survey)
  • assess growth or amniotic fluid (SD)
  • fetal position
27
Q

Nonstress test indications

A

1-2 weeks when post date

  • decreased movement
  • START at 32 weeks if PID or diabetes
  • r/o contrx preterm delivery
  • anemia
  • SD
  • fetal anomalies
  • history of stillborn
  • abnormal AFP, US
28
Q

Biophysical profile scoring

A
  • Fetal breathing (2) 30 sec
  • Fetal movements (2) 3 sep limb/trunk
  • Fetal tone (2) extend/flex 1 x 1
  • Amniotic fluid volume (2) 1 cm diameter pocket
  • NST (if done) (2)
29
Q

Amniocentesis indications

what does it test for

risks

A
  • U/S: 1tbsp: needle into sac
  • women >35
  • men >50
  • abnormal AFP

test for: DNA, chromosomes, karyotype, viral study, biochemical linkage assay, AFP, inborn errors

risk: SAB, infx, leakage, hemorrhage, injury

30
Q

Labor s/s

A 
regular, consistent, painful q 5 months 
pressure 
fluid- leak or gush 
pink/red mucus- increases 
mucus plug- thick white dislodges (doesn't indicate imminent labor)
31
Q

Labor stages
1
2
3

A

1- beginning to 10 cm (efface 100% and descends to station level)
2- delivery
3- placenta

32
Q

Postpartum assessment 9 Bs

A

Birth baby breasts belly bowel bladder bleeding bonding birth control

33
Q 
Breasts postpartum 
if nursing? 
leaking? 
day 1-2 
day 3-5
A

if nursing defer
should not be leaking anymore
1-2 soft
3-5 engorged

34
Q

Bleeding postpartum
stages

when does menses return?

A

1-3 rubra
5-7 serosa
1-3 weeks alba

menses return 6-8 weeks non nursing
8-14 weeks nursing

35
Q

Belly

A

should be back to normal

36
Q

Breast feeding advantages

A

better dentition
less ear infections and speech defets
immune system
bonding

fat, CHO, vit A, calories

moves meconium quicker, establish flora

37
Q 
Nutrition for breast feeding 
Calories 
Protein 
Dairy 
Weaning
Storage
A

Initial postpartum use 650 calories ^ 500
then later use 950 calories ^ 750 calories
MINIMUM 1800 15-20 g protein

weaning: drop 1 feed every other day
storage: 72 hours in fridge, 1 month in freezer, 6 months deep freeze (good for 23 hours after thawing, no glass)

Primary care (16 decks)

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