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AANP Study Cards > Pregnancy > Flashcards

Pregnancy Flashcards

1
Q

What is the presentation of placenta abruption

A
  • sudden onset of vaginal bleeding

- uterine contractions

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2
Q

What are risk factors for placenta abruption

A
  • Previous abruption is the strongest risk factor
  • hypertension
  • preeclampsia
  • smoking
  • trauma
  • cocaine use
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3
Q

What is placenta previa

A

-placenta impants too low on either the top of the cervix or the cervical isthmus

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4
Q

What are sx suggestive of a placenta previa

A
  • bright red vaginal bleeding

- painless bleeding

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5
Q

What is the presentation of the severe pre-eclampsia

A

-sudden onset of severe recurrent headache
-visual abnormalities
-pitting edema (edema on face, eyes and fingers)
-rapid weight gain
-right upper quadrant pain
-BP >140/90
-Proteinuria
-Oliguria
-

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6
Q

What is HELLP

A
  • hemolysis
  • elevated liver enzymes
  • low platelets
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7
Q

What are the findings in HELLP syndrome?

A
  • RUQ pain
  • N/V
  • Malaise

Lab abnormalities:

  • Elevates in AST, ALT, LD
  • Decrease in Platelets
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8
Q

WBC count is ____ throughout pregnancy especially in the 3rd trimester, can be as high has _____

A

elevated; 10,500

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9
Q

What lab values are elevated in pregnancy

A

ALP, lipid profile, Total T3, WBC, GFR, ESR, TSH

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10
Q

How are hemoglobin and hematocrit values different in pregnancy

A

Both are reduced in pregnancy

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11
Q

What is the use of serum alpha-fetoprotein

A

-biochemical marker used to estimate a pregnant woman’s risk fo having a fetus/infant with down syndrome

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12
Q

If you have an abnormal alpha-fetoprotien what do you then order

A

triple or quad screen to evaluate for trisomy 21

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13
Q

If you have a high alpha-fetoprotein what are concerns

A
  • neural tube defects
  • omphalocele
  • gastroschisis
  • multiple gestation
  • pregnancy dating error
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14
Q

What is the triple marker screen test composed of

A
  • AFP
  • beta HCG
  • estriol serum level values
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15
Q

What is the quad marker screen test composed of

A

-combination of the triple screen (AFP, beta HCG, estriol) and inhibin-Aq

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16
Q

Tay-Sachs is common in

A

Jewish descents

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17
Q

Cystic Fibrosis is common in

A

whites

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18
Q

Sickle cell anemia is common in

A

African American

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19
Q

______ is an important indicator of the viability of pregnancy and useful in the _____ trimester

A

Doubling time; 1st

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20
Q

What is a normal HCG patter in a viable pregnancy

A

HCG doubles every 48 hours for the 1st 12 weeks

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21
Q

Screen for _____ in pregnancy

A

HBsAg, HIV, gonorrhea, chlamydia, syphilis, HSV, check rubella/varicella titres

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22
Q

What antibiotic is okay in 1st and 2nd trimester but contraindicated in 3rd trimester and why

A

Macrobid

-b/c of increased risk of hemolytic anemia

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23
Q

What macrolide is category C and should be avoided

A

Clarithromycin

24
Q

What is the risk of pseudoephedrine in pregnancy

A

-increased risk of gastrochisis

25
What is the risk of sulfa drugs in pregnancy
- cause hemolytic anemia | - hyperbiliruminemia
26
What health education should you provide in pregnancy
- take 400mcg of folic acid prenatally - avoid soft cheeses, undercooked meats, raw milk - avoid cat litter - do not eat raw shellfish or oysters - no cold cuts, hot dogs, deli meat - no ETOH or smoking - regular coffee 8oz/d is okay - no excessive heat
27
Weight gain in pregnancy
- Normal: 25-35 lbs - Underweight patients: 28-40 lbs - Obese patients: 11-20 lbs
28
Women >35 years have higher risk of
- chromosomal abnormalities - pre-eclampsia - low birth weight infants - miscarriage - premature birth - complications during delivery
29
What are positive signs of pregnancy
- palpation of the fetus - ultrasound and visualization of the fetus - fetal heart tones
30
What are probable signs of pregnancy
- goodell's sign (cervical softening @ 4 weeks) - Chadwicks (blue coloration at 6-8 weeks) - Hegars (softening of hte uterin isthum at 6-8 weeks) - enlarged uterus - ballottement - urine or blood pregnancy test
31
What are presumptive signs of pregnancy
- amenorrhea - N/V - Breast changes - fatigue - urinary frequency - slight increase in body temperature - quickening (at 16 weeks)
32
At 12 weeks the uterine fundus rises above the
symphysis pubis
33
At 16 weeks the uterine fundus is
between symphysis pubis and umbilicus
34
At 20 weeks the uterine fundus is
At the umbilicus
35
Fundal height between 20-35 weeks should
equal the number of weeks in cm +/- 2 cm
36
What are physiologic changes of pregnancy
- HR increases by 15-20 bpm - S3 is common, wide split of S1 or S2 split - May hear systolic ejection murmur - Cardiac output increases by 50% - physiologic anemia of pregnancy - preload increases - hypercoagulable state - mild edema - total lung capacity drops to 4L - degreased peristalsis - kidney size increases
37
Cholasma/melasma is related to
high estrogen
38
What is naegele's rule
Used to estimate EDD LMP - 3 months + 7 days or LMP + 9 months + 7 days
39
If you use methydopa in pregnancy what should you check or monitor
baseline LFTs contraindicated in active liver disease
40
Uterine involution takes
6 weeks
41
What is oligohydramnios
-AFI <5cm
42
What is a normal AFI
5-25cm
43
What are risk with oligohydramnios
- fetal malformation - pulmonary hypoplasia - umbilical cord compression - fetal or neonatal death
44
What is rhogam
immunoglobin that helps prevent maternal isoimmunization
45
If rhoGAM is not givne to an RH-negative women this will result in
fetal hemolysis and fetal anemia in future pregnancies
46
What is the dose of rhogam
300mcg IM at 28 weeks and 72 hours post delivery
47
What test detects the presence of Rh antibodies
Coombs test
48
What are risk factors for GDM
- previous GDM - Obesity - Ethnicity (asia, american indian, pacific islander, african american, hispanic_ - macrosomic infant - age >35
49
What is the preferred test for GDM
75g OGTT
50
What is the diagnostic criteria for 75g OGTT in GDM
- Fasting 92mg/dL + - 1 hour 180mg/dL + - 2 hour 153mg/dL +
51
First line treatment for GDM is
Lifestyle modifications
52
75g OGTT is the ____ however if a 50g OGTT is performed and positive what is required
screening and diagnostic test; a 100g follow up
53
In individuals with GDM check for diabetes at
4-12 weeks postpartum
54
In a pregnant adult a count of ____ is considered a UTI
10^3
55
A threated abortion
vaginal bleeding but os remains closed
56
inevitable abortion
cervix is dilated

AANP Study Cards (20 decks)

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