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Flashcards in Obstetrics Deck (109)
0

Why do pregnant women get anemia?

Dilutional effect, RBC rises 30% but volume rises 50%

1

What are the degrees of vaginal lacerations?

1st degree: Skin
2nd degree: Muscle
3rd degree: anus
4th degree: Rectum

2

What is Vernix?

Cheesy baby skin

3

What is Meconium?

Green baby poop

4

What is Lochia?

Endometrial slough

5

What is normal blood loss during a vaginal delivery?

500 mL

6

What is normal blood loss during a C- section?

1L

7

How do you treat A1 Gestational DM?

Diet

8

How do you treat A2 Gestational DM?

Insulin

9

What are identical twins?

Egg split into perfect halves "monochorionic"

10

What are fraternal twins?

Multiple eggs fertilized by different sperm

11

What is ovarian hyperstimulation syndrome?

Weight gain and enlarged ovaries after clomiphene use

12

Who makes the trophoblast?

Baby

13

Who makes the cytrophoblast?

Mom=> GnRH, CRH, TRH, Inhibin

14

Who makes the Syncitotrophoblast?

Mom and baby => HCG, HPL

15

When does implantation occur?

1 week after fertilization

16

When is B-HCG found in urine?

2 weeks after fertilization

17

What is the function of Estrogen?

Muscle relaxant, constipation , ^protein production, irritability, varicose veins

18

What is the function of Progesterone?

^ appetite, ^acne, dilutional anemia, quiescent uterus, pica, hypo TN, melasma

19

What makes progesterone <10wk old?

Corpus luteum

20

What makes progesterone > 10 wk old?

Placenta

21

What is the function of B-HCG?

Maintains corpus luteum, sensitizes TSHr => act hyperthyroid (to ^BMR)

22

What makes B -HCG?

Placenta

23

How fast should B-HCG rise?

Doubles every 2 days until 10 wks (when placenta is fully formed)

24

What is the function of AFP?

Regulates fetal intravascular volume

25

What is the function of HPL?

Blocks insulin receptors => sugar stays high (baby's stocking up on stuff needed for the journey)

26

What is the function of inhibin?

Inhibits FSH=> no menstruation

27

What is the function of. Oxytocin?

Milk ejection, baby ejection

28

What is the function of Cortisol in pregnancy?

Decreases immune rejection of baby, lung maturation

29

What are the thyroid hormone levels during pregnancy?

^TBG => ^bound t4, normal free t4 levels

30

When can you first detect fetal heartones?

Week 20

31

When can you tell the sex of a fetus by US?

Week 16

32

What does an AFI <5 indicate?

Oligohydramnios (cord compression)

33

What does an AFI >20 indicate?

Polyhydramnios (DM)

34

How fast should fundal height change?

Uterus grows 1cm/wk

35

What is the pool test?

Fluid in vagina

36

What is Ferning?

Estrogen crystallizes on slide

37

What is nitrazine?

Shows presence of amniotic fluid

38

What is the risk of chorionic villus sampling?

Fetal limb defects

39

What is the risk of amniocentesis?

Abortion (2% risk)

40

What is a normal biophysical profile?

>8

41

What is a biophysical profile?

"Test the Baby, MAN"

Tones of the heart
Breathing
Movement: BPD, HC, AC, FL
AFI
Non-stress test (normal = "reactive")

42

What pelvis types are better for vaginal delivery?

Gynecoid, anthropoid

43

Wht pelvis type will need C/S?

Platypelloid, android

44

How do you predict a due date with Nägele's Rule?

9 months from last menses -> add 1 wk

45

Why is Nägele's rule inaccurate?

B/c it does not start from ovulation date

46

How do you correct Nägele's Rule for cycles >28 days?

Add x days if cycle is x longer

47

How much weight should a pregnant woman again?

1 lb/wk

48

When should intercourse be avoided during pregnancy?

3rd trimester b/c PG-F in semen may cause uterine contractions

49

What are the Leopold maneuvers?

1) Feel fundus
2) Feel baby's back
3) Feel pelvic inlet
4) Feel baby's head

50

What is Stage I of labor?

Up to full dilation
1) Latent Phase ( 4cm cervical dilation
2) Active Phase (<12h): 4-10 cm cervical dilation (1cm/hr)

51

What is Stage II of labor?

Full dilation -> delivery
Station 0: baby above pelvic rim (most uteri are anteverted)
1. Engage
2. Descend
3. Flex head
4. Internal rotation
5. Extend head
6. Externally rotte
7. Expulsion: LDA most common presentation

52

What is Stage III of labor?

Delivery of placenta (due to PG-F)

Blood gush-> cord lengthens -> fundus firms

53

How do you monitor baby's HR?

Doppler, scalp electrode

54

How do you monitor uterus?

Tocodynamics, uterine pressure catheter.

55

What Bishop's score predicts delivery will be soon?

>8

56

What are braxton-hicks contractions?

Irregular contractions w/closed cervix

57

What is a Vertex presentation?

Posterior fontanel (triangle shape) presents firts, normal

58

What is a sinciput presentation?

Anterior fontanel (diamond shape) presents first

59

What is a face presentation?

Mentum anterior -> forceps delivery

60

What is compound presentation?

Arm or hand on head -> vaginal delivery

61

What is a complete breech?

Butt down, thighs and legs flexed

62

What is a Frank breech?

Butt down, thigh flexed, legs extended (~pancake)

63

What is a footling breech?

Butt down, thigh flexed, one toe is sticking out of cervical os

64

What is a Double Footling breech?

Two feet sticking out of cervical os

65

What is a Double footling breech?

Two feet sticking out of cervical os

66

What is a transverse lie?

Head is on one side, butt on the other

67

What is a Shoulder dystocia?

Head out, shoulder stuck

68

Can you try vaginal delivery on a woman who has had a Classic horizontal C/Spreviously?

No, must have C/S for all future pregnancies

69

Can you try vaginal delivery on a woman who has had a low transverse C/S previously?

Yes

70

What is early deceleration?

Normal, due to head compression

71

What is late deceleration?

Uteroplacental insufficiency b/c placenta can't provide O2 /nutrients

72

What is a variable deceleration?

Cord compression

73

What is increased beat-to-beat variability?

Fetal hypoxemia

74

What is decreased beat-to-beat variability?

Acidemia

75

What is Pre-eclampsia?

Delivery

76

What is HELLP syndrome?

Hepatic injury causing:

Hemolysis
Elevated Liver enzymes
Low Platelets

77

What is Eclampsia?

HTN + seizures

78

What are the symptoms of eclampsia?

H/A, changes in vision , epigastric pain

79

What is the treatment for eclampsia?

4mg Mg sulfate as seizure prophylaxis

80

What is a chorioamnionitis?

Fever, uterine tenderness, lower fetal HR

81

What are the symptoms of amniotic fluid emboli?

Mom just delivered baby and has SOB -> PE, death (amniotic fluid-> lungs)

82

What is endometritis?

Post partum uterine tenderness

83

What is an incomplete molar pregnancy?

2 sperm + 1 egg (69, XXY) has embryo parts

84

What is a complete molar pregnancy?

2 sperm + no egg (46, XX-both paternal) , no embryo

85

What is Pseudocyesis?

Fake pregnancy w/ al the signs and symptoms

86

What is the most common cause of 1st trimester maternal death?

Ectopic pregnancy

87

Whatis the most common cause of 1st trimester espontaneous abortions?

Chromosomal abnormalities

88

Whatis the most common cause of 3rd trimester espontaneous abortions?

Anti-cardiolipin Ab, placenta problems, infection, incompetent cervix

89

What is threatened abortion?

Cervix closed, baby intact (Tx bed rest)

90

What is an inevitable abortion?

Cervix open, baby intact (Tx cerclage = sew cervix shut until term)

91

What is an incomplete abortion?

Cervix open, fetal remnants (Tx: D&C to prevent placenta infection)

92

What is a missed abortion?

Cervix closed, no fetal remnants (Tx: D&C)

93

What is a complete abortion?

Cervix open, no fetal remnants (test B-HCG)

94

What is a septic abortion?

Fever >100 degress F, malodorous discharge

95

What is Placenta Previa?

Post-coital bleeding, placenta covers cervical os; ruptures placenta arteries

96

What is vasa previa?

Placenta aa. Hang out of cervix

97

What is Placenta Accreta?

Placenta attached to superficial lining

98

What is placenta increta?

Placenta invades into myometrium

99

What is Placenta percreta?

Placenta perforates through myometrium

100

What is Placenta abruptio?

Severe pain, premature separation of placenta

101

What is velamentous cord insertion?

Fetal vessels insert between chorion and amnion

102

What is a uterus rupture?

Tearing sensation, halt of delivery

103

What is an Apt test?

Detects HbF in vagina

104

What is Wrights stain?

Detects nucleated fetal RBC in Mom's vagina

105

What is Kleihauer-Betke test?

Detects pecentage of fetal blood in maternal circulation (dilution test)

106

What is maternity blues?

Post-partum crying, irritability

107

What is post partum depression?

Depression > 2 weeks

108

What is post partum psychosis?

Hallucinations, suicidal, infanticidal