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Flashcards in Obstetrics Deck (65):
1

progesterone is used for

decreasing risk of preterm delivery

2

2 most common causes of anemia in pregnancy

iron deficiency, blood loss

3

which med should you give for a patient with a boggy uterus and bleeding?

IM prostaglandin F2-alpha

4

oxytocin for bleeding

short time, rapid infusion (not as IV bolus or push)

5

misoprostol for bleeding

give per rectum or mouth

6

breech presentation associations

Prematurity, multiple gestation, genetic disorders, polyhydramnios, hydrocephaly, anencephaly, placenta previa, uterine anomalies and uterine fibroids

7

ACE inhibitors

oligohydramnios, fetal growth retardation and neonatal renal failure, hypotension, pulmonary hypoplasia, joint contractures and death

8

late decels: significance

uteroplacental insufficiency

9

early decels: significance

head compression, vagal response

10

variable decels: significance

cord compression

11

frank breech

buttocks first, legs up

12

complete breech

buttocks first, legs crossed

13

footling breech

foot first

14

labor induction

cytotec for cervical ripening FIRST, then rupture of membranes

15

Mg therapeutic level

4-7 mEq/L

16

Mg therapy side effects

pulm edema, resp depression, cardiac arrest

17

most common abnormal karyotype in spontaneous abortion

autosomal trisomy (mostly trisomy 16)

18

MgSO4 mechanism of action

competing with calcium entry into cells

19

Indomethacin - type of drug

PGE synthetase inhibitor

20

Indomethacin - action

blocking conversion of free arachidonic acid to prostaglandin

21

Beta-adrenergic agents - mechanism of action

increase cAMP in cell = decrease free Ca++

22

Calcium channel blockers

inhibiting calcium transport into cells

23

when to give RhoGAM

28 weeks, after any episode of antenatal bleeding or after an invasive procedure, such as amniocentesis or chorionic villus sampling

24

fetal tachycardia - associations

maternal fever, chorioamnionitis

25

infant death rate in twins

five times that in singletons

26

cerebral palsy in twins - rate

5-6 times that in singletons

27

what % of twins deliver early

58%

28

postpartum hemorrhage - vaginal

>500cc

29

postpartum hemorrhage - cesarean

>1000cc

30

premature rupture of membranes - how to manage?

after 36 weeks = induce labor

31

risks of smoking in pregnancy

placental abruption, placenta previa, fetal growth restriction, preeclampsia and infection

32

postterm delivery associations

macrosomia, oligohydramnios, meconium aspiration, uteroplacental insufficiency and dysmaturity

33

metabolic disturbance in pregnancy?

compensated respiratory alkalosis

34

Septic pelvic thrombophlebitis

rare, characterized by high fever unresponsive to antibiotics, diagnosis of exclusion

35

Amnioinfusion indications

treatment of repetitive variable decelerations, regardless of amniotic fluid meconium status

36

Cervicitis - causes

chlamydia, gonorrhea, trichomonas, other infections

37

normal hematocrit in women

38% to 46%

38

normal hematocrit in men

42% to 54%

39

prolonged labor, long time with ROM, abdominal cramping, pain, tender uterus fundus, heavy foul-smelling lochia

Endomyometritis

40

treat endomyometritis

ampicillin + gentamicin (gram-negative organisms) (polymicrobial infection)

41

vancomycin covers

S. aureus and penicillin-resistant gram-positive bacteria

42

Ciprofloxacin

gram-negative pathogens, including Pseudomonas

43

most common cause postpartum hemorrhage

uterine atony

44

increase in systolic:diastolic umbilical flow ratio indicates...

increased vascular resistance

45

IUGR monitoring

twice weekly NST with AFI and weekly umbilical artery Doppler studies

46

macrosomia

estimated fetal weight >4000g in diabetic mom, >4500g in normal mom

47

Valproic acid use during pregnancy - most common defect

1 to 2% incidence of neural tube defects - specifically lumbar meningomyelocele

48

valproic acid syndrome

spina bifida, cardiac defects, facial clefts, hypospadius, craniosynostosis, and limb defects, particularly radial aplasia

49

Caudal regression syndrome - cause

poorly controlled diabetes

50

Azkanazi Jewish associated syndromes

Fanconi anemia, Tay-Sachs disease, Cystic Fibrosis, and Niemann-Pick disease

51

B-thalassemia population

Mediterranean

52

3 uterotonics

Methergine, prostaglandins and oxytocin

53

uterotonic contraindicated in hypertension

methergine

54

Contraindications to estrogen

history of thromboembolic disease, women who are lactating, women over age 35 who smoke or women who develop severe nausea with combined oral contraceptive pills

55

combined OCPs decrease risk for which types of gyne cancers?

ovarian and endometrial (slightly higher risk of cervical CIN)

56

tubal ligation associated with slight reduction in risk for which cancer?

ovarian cancer

57

antiphospholipid syndrome workup

anticardiolipin and beta-2 glycoprotein antibody status, PTT, and Russell viper venom time

58

recurrent pregnancy loss association

antiphospholipid antibody

59

factor V Leiden associated with recurrent pregnancy loss?

no

60

cervical insufficiency - when/how diagnosed?

second trimester by history, physical exam and other diagnostic tests, such as ultrasound

61

treatment for antiphospholipid syndrome

aspirin + heparin

62

drug for prevention of preterm delivery

progesterone

63

medical and surgical abortion can be offered up to

49 days

64

medical abortion drugs

Mifepristone (an antiprogestin) followed by misoprostol (a prostaglandin) to induce uterine contractions

65

manual vacuum aspiration abortion effective until

8 weeks