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Clin Med Final Material 5 > Preconception Counseling, Infertility, Abortion- Paulson > Flashcards

Preconception Counseling, Infertility, Abortion- Paulson Flashcards

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1
Q

What is the purpose of prenatal care and why is it important?

A

Purpose is to have a successful pregnancy and mothers receiving prenatal care have lower risk of complications

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2
Q

Is marajuana safe to use in pregancy?

A

No

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3
Q

What is an important question to consider in preconception counseling?

A

Discuss a patient’s desire to become pregnant and when

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4
Q

All patients thinking about becoming pregnant should take what?

A

Folic acid supplements because it may be beneficial in reducing neural tube defects and cardiac anomalies

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5
Q

Are pregnant women able to get live vaccines?

A

No so it is good to get them done during preconception counseling

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6
Q

Organ development occurs at approx what part of gestational age?

A

3-10 weeks so in the first trimester

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7
Q

________ is defined as no pregnancy after trying for 12 months with normal sexual activity without contraception

A

Infertility

Can try IVF in this case

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8
Q

Due date is calculated how?

A

40 weeks from the first day of the last LMP

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9
Q

What are some common things to expect when pregnant?

A
  • Thyroid issues
  • Gerd, constipation, gallstones
  • N/V throughout the day
  • Decreased BP and inc HR which is why women shouldn’t lay flat on back at night
  • Anemia
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10
Q

Supplemental _____ is encouraged during pregnancy because of anemia during pregnancy

A

iron

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11
Q

What are some cardiac manifestations of being pregnant?

A

increased CO, lower BP, inc HR, increased venous pressure in lower extremities from compression of IVC by uterus

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12
Q

What are some hematologic manifestations of pregnancy?

A

-Anemia and hypercoag state (DVT, PE)

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13
Q

Renal manifestations of pregnancy?

A

-Increased size and increased GFR

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14
Q

Respiratory manifestations of pregnancy?

A

Increase in tidal volume, inc in inspiratory capacity

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15
Q

Derm manifestations of pregnancy?

A

Spider angiomas and hyperpigmentation (melasma)

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16
Q

_______ refers to termination of pregnancy before 20 wks

A

Abortion (spontaneous or therapeutic)

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17
Q

A patient comes in complaining of bright red vaginal bleeding, low back pain and a bHCG level that is falling or not adequately rising. WHat should we be concerned about?

A

Abortion

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18
Q

This is when all products of conception are expelled before 20 weeks, cervical os is closed.

A

Complete abortion

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19
Q

This is whsen a pregnancy can not be saved and the treatment is D&C

A

inevitable abortion

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20
Q

What is the tx for threatened abortion?

A

Recommended pelvic rest

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21
Q

What is a threatened abortion? And what constitutes a good prognosis?

A

Possible pregnancy loss

*less cramping/pain have better outcomes typically

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22
Q

This is when only some products of conception are passed before 20 weeks

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A

Incomplete abortion

23
Q

What is the tx for incomplete abortion?

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A

D& C, methotrexate, expectant management

24
Q

This is when the embryo is not viable prior to 20 weeks and products of conception are retained in the uterus

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A

Missed abortion

25
Tx for missed abortion?
D& C, methotrexate, expectant management
26
A patient presents with uterine bleeding, fever, increased leukocytosis, abdominal pain and foul smelling d/c. She is pregnant. What might this be and what is the best way to dx it?
septic abortion: where the fetus hasn't survived and there's also an infection Abdominal X-ray, U/S and labs
27
Treatment for septic abortion?
Hospitalization and broad spectrum IV abx. May need D& C for retained POCs (products of conception).
28
What are three drugs used in elective first trimester abortions?
The three M's (mmm.... abortion) -Mifepristone, misoprostol, methotrexate
29
How to do an elective abortion in the 2nd trimester?
Dilation and evacuation
30
What is the safest and most effective method for terminating pregnancy of 12 weeks gestation or less?
Suction cutterage
31
This is when there are 3 or more consecutive spontaneous abortions before 20 weeks
recurrent pregnancy loss
32
Previously called a "blighted ovum" and when an embryo fails to develop or is resorbed after loss of viability?
Anembryonic pregnancy
33
How is an Anembryonic pregnancy diagnosed?
U/S will show empty gestational sac w/o a fetal pole
34
This is the leading cause of pregnancy related death in the first trimester?
Ectopic pregnancy
35
Where is the mc site of ectopic pregnancy?
Fallopian tubes
36
These are symptoms of what? Pain, bleeding, amenorrhea, syncope
Ectopic pregnancy
37
What imaging should you do for an ectopic pregnancy and what should the bHCG level be at?
Transabdominal U/S and bHCG <1500
38
What is the tx of choice for ending early ectopic pregnancy?
Methotrexate 500 mg IM
39
What is the second line tx for ending early ectopic pregnancy?
Surgical-Labroscopy
40
Snowstorm pattern
Gestational Throphoblastic disease
41
This is an umbrella term for a group of pregnancy related tumors
Gestational trophoblastic tumors
42
Preeclampsia in the first or early second trimester may be pathognomonic for what?
Molar pregnancy
43
A patient presents with uterine bleeding in the first trimester, rapid enlargement of the uterus and HCG titers greater than expected for gestational age. What condition should we think about?
Gestational Throphoblastic disease
44
This is a benign neoplasm derived almost entirely from abnormal placental proliferation?
Hydatidiform mole (AKA molar pregnancy)
45
What is a complete Hydatidiform mole?
Contains no fetal tissue and bHCG >50,000
46
What is a partial Hydatidiform mole?
Contains some fetal tissue and bHCG <50,000
47
What is the dx of choice for Hydatidiform mole?
U/S
48
"snowstorm pattern" is described for _____ mole
complete hydatidiform mole
49
Cystic changes in the placenta are a hallmark finding of _______ mole
partial hydatidiform mole
50
This is characterized by multiple grapelike vesicles filling and distending the uterus
hydatidiform mole
51
What is the treatment for a molar pregnancy?
suction and cutterage under GA - submit path - prophylactic chemotherapy
52
What could be indicative of a malignancy after a molar pregnancy?
bHCG rise | -So we want to watch this closely to see if levels rise
53
This is a malignant tumor usually of the placenta? What is the prognosis?
Choriocarcinoma - high cure rate **Look for rise in bHCG
54
What is the tx for choriocarcinoma?
Chemotherapy

Clin Med Final Material 5 (18 decks)

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