Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Women's health Exam 3 > OB/GYN review > Flashcards

OB/GYN review Flashcards

1
Q

Which vaccines are contraindicated in pregnancy?

A

Varicella, MMR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Prepregnancy plans should include?

A
  • Prenatal vitamins (folic acid >400mg)
  • healthy lifestyle counseling
  • transitional birth control- condoms; let system bounce back from OCP
  • vaccinations- get Varicella or MMR at least 3 months before
  • referral

also cessation of smoking, alcohol, caffeine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is associated with increased risk for ectopic pregnancy?

A
  • history of chlamydia
  • smoking
  • history of PID
  • prior ectopic pregnancy
  • assisted reproduction- (hetertrophic pregnancy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what level of HCG should you see tissue in the uterus?

A
  • > 1500 HCG
  • by 2000 you should see
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Patient comes in with cramping, bleeding and on examination cervix is closed

A

threatened abortion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

patient comes in cramping and bleeding and cervix is dilated

A

inevitable abortion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Patient comes in with moderate bleeding and cramping- cervix is obscured by dark blood and some tissue from the os

A

incomplete abortion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

possible all tissue would be excreted from the fundus, pt may recall passing tissue

A

complete abortion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is naegele’s rule?

A
  • a ways of dating the pregnancy
    • 9months and a week
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are ways to date a pregnancy?

A
  • LMP
  • Naegele’s rule
  • fundal height
  • fetal heart tones
  • ultrasound
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the most common reason for an abnormal fetal screen?

A

The dates are inaccurate, so the expectations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are first trimester screenings for mom and baby?

A
  • mom: entry panel
  • fetal: 1st trimester screen (NT/ PAPP-A, b-hcg)
  • these screening cover trisomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are second trimester screenings for mom and baby?

A
  • mom: 1-hr glucola(roughly at 24-28 weeks), CBC, antibody screen
  • fetal: Triple/Quad screen (AFP, b-hcg , estriol/inhibin A)
  • If the first trimester screening was done, only check AFP in 2nd trimester

AFP- indicator for open neural tube defects (spina bifida)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are third trimester screenings for mom and baby?

A
  • mom: CBC (anemia) , Group B strep
  • PRN: depression, STI
  • Fetal: NST, BPP (keep an eye on fetal status, if the NST is not reactive—> complete BPP)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is another screening test that can be perfomed on mom and baby? Considered “advanced”

A

“Advanced screening test (NIPT, cell-free fetal DNA)

  • Maternal serum test
  • 10-20 weeks (optimal 11-13)
  • T21, 18, 13, and some sex chromosomes aneuploidies (limitations- T21 easier to detect than 13)
  • “near-diagnostic” DNA test
  • if multiples, can’t tell which twin is affected

If NIPT abnormal–> direct fetal tissue test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What fetal diagnostic test can be completed at 10-15 weeks?

A
  • fetal: Chorionic Villi Sampling- can be done 1st trimester- sampling placenta
17
Q

what fetal diagnostic test can be completed at 15-20 weeks?

A
  • Fetal: Amniocentesis- abdominal or vaginally getting amniotic fluid (looking for sloughed cells w/in fluid)
  • can’t do too early, so you can get enough fluid
18
Q

in terms of fundus height, where do you expect the fundus to be at 12 weeks, 20 weeks, 36-38 weeks, 40 weeks?

A
  • 12 weeks: fundal height just above pubic bone; fundus meets pelvic brim
  • 20 weeks: fundal height is approximately at the level of her umbilicus
  • 36-38: fundus usually right up under sternum
  • 40 weeks: Fundus drops below 38 week level as presenting part drops down into pelvis
19
Q

what heatlth maintence is recommended for pregnant patients?

A
  • Influenza, COVID vacc
  • Tdap, vaccine (recommended every third trimester of every pregnancy)
  • PRN: RhoGAM, HSV prophylaxis
20
Q

when is RhoGam given? What is it for?

A
  • given at 28 weeks
  • RhoGAM is given when there is an RH- mom and RH + baby
  • can also be used for threatened abortions, trauma or potential for bleeding to help to stop body from making antibodies against RH+ blood
21
Q

What is a postive kick count?

A
  • At least 10 times in an hour = positive kick count
22
Q

what is considered a positive non-stress test?

A
  • Fetal HR response to fetal activity
  • Seeing at least 2 heart rate responses is positive, non reactive can usually goes onto biophysical profile
23
Q

what is the biophysical profile? How is it scored?

A
  • BPP: NST + ultrasound to look for fetal movement, overall tone and amniotic fluid index
  • scored 0-2 for each category: 8-10 =reassuring, 6= equivacal, 0,2,4= not reassuring, move toward delivery
24
Q
  • Preexisting
  • mild: 140-159/ 90-109
  • severe: 160/110
A

Chronic Hypertension

25
Q
  • After 20 weeks - no preexisting
  • 5-10% weeks
  • no proteinuria
A

Gestational Hypertension

26
Q
  • hypertension with proteinuria
  • multisystem involvement possible (implicates problems w/placenta, can include heart and other systems
A

Pre-eclampsia (Toxemia)

27
Q

elevated BP + proteinuria + seizures

A

Eclampsia

28
Q
  • Hemolysis (anemic), elevated LFT, lower platelets(bleeding, DIC, abnormal blood counts)
  • can happen to patients with pre/eclampsia
A

HELLP syndrome

29
Q

How do you workup patients with hypertensive disorders?

A

PE: BP, edema, heart, lungs, eyes (papilledema), abdomen(RUQ tenderness), Neuro (CNS instability), fetal status

labs: CBC, BUN/CR, LFTs, ua, 24-hr urine, coags

30
Q

what are acceptable medications to treat hypertensive conditions in pregnancy?

A
  • methyldopa, a/b-blockers (labetolol), hydralazine, CCB (nifedipine)
31
Q

what are acceptable medications to treat hypertensive conditions in pregnancy?

A
  • methyldopa, a/b-blockers (labetolol), hydralazine, CCB (nifedipine)
32
Q

what are not acceptable medications to treat hypertensive conditions in pregnancy?

A
  • ACE-I, ARBS
  • Diuretics

can cause pregnancy loss

32
Q

ex. of gestational diabetes complications

A

congenital anomalies
SAB and stillbirth
macrosomia
polyhydraminos (excess amniotic fluid)
placental abruption(big baby, big placenta)
neonatal hypoglycemia

33
Q

what is associated with postpartum hemorrhage?

A
  • prolonged labor
  • precipitous labor (too fast and furious)
  • pre-eclampsia
  • multiple gestation
  • retained placenta
  • operative delivery
  • uterine atony (uterine muscle doesn’t contract )

can treat uterine atony with massage or medication

34
Q

what factors are associated with preterm labor?

A
  • smoking (Causes vascular inflammation)
  • short interpregnancy interval (uterus is not healed enough < 12-18 months)
  • UTI/ genital tract infection (inflammatory response)
  • periodontal disease (systemic inflammation)
35
Q

what is associated with placental abruption?

A
  • Gestation hypertension
  • prior placental abruption
  • multiparity
  • smoking
  • cocaine use
  • trauma
  • PT will present with: Bleeding, pain, “hard, board-like abdomen and tenderness”
35
Q

What are primary factors to be considered to evaluate progression of labor?

A
  • Cervical effacement & dilation
  • contraction frequency & intensity
  • fetal present part at the inlet

Women's health Exam 3 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions