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Flashcards in OG Deck (119):
1

embryo

fertilization to 8 weeks

2

fetus

8 weeks to birth

3

developmental age

number of days since fertilization

4

gestational age

number of days/weeks since LMP

5

naegle rule

subtract 3 months, add 7 days

6

first trimester dates

12 weeks DA
14 weeks GA

7

second trimester dates

24 weeks DA
26 weeks GA

8

pre-viable

born before 24 weeks

9

post term

greater than 42 weeks

10

F-PAL

full term
preterm
abortions
living children

11

goodell sign

FIRST sign of pregnancy,
4 weeks
= softening of the cervix

12

ladin sign

softening of the midline of the uterus,
6 weeks

13

chadwick sign

blue discolouration of vagina and cervix
6-8 weeks

14

when does palmar erythema present

first trimester

15

when does chloasma present

16 weeks

16

when does linea nigra present

second trimester

17

US in pregnancy

CONFIRMS INTRAUTERINE

18

PREGNANCY=

beta hCG greater than 1500 OR
5 weeks= gestational sac on ultrasound

19

morning sickness caused by

increase in estrogen, progesterone, hCG

20

other GI complication of pregnancy

constipation

21

renal in pregnancy

INCREASE GFR--> decrease BUN/cr

22

haem in pregnancy

- anaemia
- hypercoagulable

23

most accurate way of establishing gestational age at 11-14 weeks

ULTRASOUND

24

triple screen

MSAFP, estriol, beta hCG

25

quad screen

+ INHIBIN A

26

triple and quad screening done when

15-20 weeks

27

after 36 weeks how often does the mum come to see the doctor

every week

28

braxton hicks that are continued

CHECK THE CERVIX
since real contractions will have a dilated cervix, vs. BH contractions= closed cervix

29

CBC done when

27 weeks,
if Hb less than 11 replace iron orally

30

glucose load

24-28 weeks, fasting or non fasting ingestion of 50g glucose and serum glucose checked 1 hr later

31

glucose tolerance test

FBG, 100g glucose and serum glucose check 1,2,3hrs

32

GDM if....

either glucose load or GTT is positive

33

postive glucose load

glucose greater than 140 send for OGTT

34

if gave them pregnant woman iron--->

give stool softener

35

CVS done during

10-13wks

36

Amniocentesis done during

11-14wks

37

strongest risk factor for ectopic pregnancy

PREVIOUS HISTORY of ectopic

38

contraindications to MTX

1. immmunosuppressed
2. liver disease
3. non compliant
4. greater than or equal to 3.5cm
5. fetal heart

39

MCC spontaneous abortions

chromosomal abnormalities

40

work up for spontaneous miscarriage

- CBC
- blood type-- RH
- US*********

41

what must be done for a miscarriage

ULTRASOUND-- to determine what type of misacarriage

42

missed miscarriage

death of fetus, but all products of conception present in uterus

43

tx of threatened abrtion

bed rest,
pelvic rest

44

septic abortion

infection of uterus and surrounding areas

45

medical tx of misacarriages

PGE1 to dilate cervix for expulsion of products

46

when to stop delivery if....

24-33 EGA
600-2500g

47

when to deliver

34-37 EGA
greater than 2500g

48

list of conditions where you should NOT NOT NOT NOT NOT stop with tocolytics

- PET/ eclampsia
- maternal cardiac disease
- greater than 4 cm cervical dilation
- maternal haemorrhage
- fetal death
- chorioamnionitis

49

most commonly used tocolytic

magnesium sulfate

50

side effects of magnesium sulfate

- RESPIRATORY DEPRESSION
and cardiac arrest--- thus nb to check DTRs often

51

commonly used tocolytics

- magnesium sulfate
- CCBs
- terbutaline
- NOT NOT NOT NOT NOT NOT NOT indomethacin

52

preterm fetuses WITHOUT chorioamnionitis

tx= betamethasone

53

what type of US for placenta previa

TRANSABDOMINAL

54

complete previa

completely covers the internal cervical os

55

partial previa

partially covers the internal cervical os

56

marginal previa

on the MARGIN, adjacent to internal os, touching the edge of os

57

low lying placenta

NOT covering the internal os-- more than 0cm, but less than 2cm away; implanted in the lower uterine segment

58

tx for placenta previa

STRICT PELVIC REST-- NOTHING INTO VAGINA

59

risk factors for abruption

- HTN
- previous hx
- cocaine
- external trauma
- smoking

60

MCC DIC in pregnancy

placenta abruption

61

complications of concealed placental abruption

- DIC
- uterine tetany
- fetal hypoxia
- fetal death
- sheehan syndrome

62

tx of uterine rupture

LAPAROTOMY ASAP-- since baby could be outside of the uterus floating around in the abdomen

63

gestational HTN

bp greater than 140/90mmHg without proteinuria or edema

64

mild preclampsia

greater than 140/90
dipstick 1+-2+
24hr urine greater than 300mg

65

edema in mild PET

hands, feet, face

66

edema in severe PET

GENERALIZED

67

32-36 weeks test needed

NST: fetal well being
US: fetal size

68

greater than 36 weeks test needed

twice weekly testing
1 NST
1 BPP: AF and fetal well being

69

37 weeks test needed

L/S ratio

70

38-39 weeks if patient refuses L/S ratio

NO TEST-- INDUCE LABOUR

71

tx for GDM

diet and exercise
do NOT NOT NOT NOT tell them to lose weight

72

macrosomia, when should US be done

if fundal height is greater than 3cm

73

earl deceleration

decrease in HR that occurs with contractions
HEAD COMPRESSION

74

variable decelerations

decrease in HR and return to baseline with no relationship to contractions
UMBILICAL CORD COMPRESSION

75

late decelerations

decrease in HR after contraction started. no return to baseline until contractions ends
FETAL HYPOXIA

76

lightening

fetal descent into pelvic brim

77

stage 1

labor--> cervical dilation
primi: 6-18hrs
multi: 2-10hrs

78

latent phase

labor--> 4cm
primi: 6-7hrs
multi: 4-5hrs

79

active phase

4cm--> full
primi: 1cm/hr
multi: 1.2cm/hr

80

stage 2

cervical dilation--> delivery neonate
primi: 30-3hrs
multi: 5-30 minutes

81

stage 3

delivery neonate--> delivery placenta
30 minutes

82

what not to give asthmatic pregnant women

PROSTAGLANDINS--> bronchospasm

83

protracted cervical dilation causes

3P's
- power: strength and frequency of uterine contractions
- passenger: size and position of fetus
- passage: passenger larger than pelvis= cpd

84

TX OF cpd

CS

85

arrest disorders

- cervical dilation
- fetal descent

86

cervical dilation arrest

no cervical dilation for past 2 hrs

87

fetal descent arrest

no fetal descent for 1 hour

88

frank breech

hips F
knees E

89

complete breech

hips F
knees F

90

footling breech

feet first
- complete= both feet
- incomplete= 1 foot

91

up until what point is it okay for baby to be breech

36 weeks

92

PPH extra side note

assure there is no rupture of the uterus

93

premenstural dysphoric disorder

PSYCHIATRIC DISORDER

94

vaginal diaphragm...

USELESS without the jelly
6hrs before
6hrs after

95

labial fusion

21 beta hydroxylase deficiency
- excess androgens
- reconstructive surgery

96

chronic irritation of vulva with hyperkeratosis (Raised white lesion)

squamous cell hyperplasia

97

tx squamous cell hyperplasia of vulva

sitz baths or lubricants

98

PC bartholins

- PAIN PAIN PAIN
- dyspareunia

99

tx bartholins

incision and drainage
--> MARSUPIALIZATION= allow the space to remain open

100

bilateral pagets of vulva

radical vulvectomy

101

unilteral pagets of vulva

modified vulvectomy

102

PC SCC of vulva

PRURITUS

103

stage 0 SCC vulva

CIS

104

stage 1 SCC vulva

vaginal wall, less than 2 cm

105

stage 2 SCC vulva

vulva or perineum more than 2 cm

106

stage 3 SCC vulva

tumor spreading to lower urethra or anus, unilateral lymph nodes present

107

stage 4 SCC vulva

tumor invasion into bladder, rectum, or bilateral lymph nodes

108

stage 4a SCC vulva

distant mets

109

unilateral LNs SCC vulva tx

modified radical vulvectomy

110

bilateral LNs SCC vulva tx

radical vulvectomy

111

PC adenomyosis

- dysmenorrhea
- menorrhagia

112

dx of adenomyosis

CLINICAL
- large, globular, boggy uterus

113

most accurate dx of adenomyosis

MRI

114

definitive dx of adenomyosis

hyterectomy

115

tx of adenomyosis

HYSTERECTOMY

116

rf for endometriosis

FDR with endometriosis

117

pain in endometriosis

cyclical-- 1-2 weeks before menses

118

exam for endometriosis

nodular uterus and adnexal mass

119

SE's danazol

- acene
- oily skin
- weight gain
- hirsuitism