Pregnancy

Question 1

First trimester: Sx

Answer 1

Morning sickness
Constipation
Frequent urination
Decreased BP
Full/tender/sensitive breasts
Ligament and joint capsule laxity

Question 2

Second trimester: Sx (normal)

Answer 2

Edema
Shortness of breath 
Back pain
Abdominal pain
Pubic symphysis pain
Varicose veins
Hemorrhoids

Question 3

Second trimester: complications

Answer 3

Preeclampsia
Supine hypotension syndrome
Diastasis recti

Question 4

Third trimester: Sx (normal)

Answer 4

Edema
Compression syndrome 
Backache
SI pain
Leg cramps 
Pelvic discomfort
Costal margin pain
Frequent urination/incontinence

Question 5

Third trimester: complications

Answer 5

Gestational diabetes

Ketoacidosis

Question 6

Supine hypotension syndrome:

Answer 6

Fetus compresses vena cava

If supine, pillow under right hip

Side lying (especially on left)

Question 7

Cause of pregnant edema

Answer 7

Mechanical blockage (weight of uterus in inguinal region)

Question 8

Causes of shortness of breath during pregnancy

Answer 8

Mechanical: uterus shoves guts into diaphragm

Physiological: 20% increase in O2 needed

Question 9

Inguinal compression can cause

Answer 9

Varicosities

Edema

Question 10

Diastasis recti

Answer 10

Separation of rectus abdominus at linea alba

Test supine, knees bent – more than three finger width

Remex: TVA (plank, leg drop, glute bridge). No crunches.

Question 11

Gestational Diabetes

Answer 11

Pregnancy acquired diabetes mellitus (insulin resistance)

Usually 3rd trimester

Increased chance of: (pre)eclampsia, infection, hydramnios, macrosomia, regular Type II later in life

Ketoacidosis

Question 12

Macrosomia

Answer 12

Big honkin’ baby

Question 13

Ketoacidosis

Answer 13

Medical emergency
2° to diabetes

Excessive ketosis –> decreasing pH of blood.

Question 14

Ketoacidosis: Sx

Answer 14

Warm dry skin
Tachycardia 
Hypotension
Lethargy
Vomiting
Coma

Distinctive breath

Question 15

Hydramnios

Answer 15

Excessive amniotic fluid

Increased chance of early labour

Maternal respiratory discomfort

Question 16

Pre-eclampsia

Answer 16

Pregnancy induced hypertension (PIH)

Change in values more significant than absolute numbers

Usually 2nd trimester

7% pregnant women; 2nd most common cause of maternal mortality.

Question 17

Preeclampsia: Sx

Answer 17

Headaches
Blurred/altered vision 
Abdominal or shoulder pain NOE
Nausea and vomiting
Confusion 
SOB
Generalized Edema

Question 18

Preeclampsia: Dx

Answer 18

Sudden increase in BP
Proteinuria
Generalized Edema

Question 19

Eclampsia

Answer 19

AKA toxemia

Preeclampsia + seizures

Question 20

Risk factors for (pre)eclampsia

Answer 20

Multiples
Pre existing hypertension
Chronic kidney disease
Diabetes 
Over 30 years old

Question 21

Effects of progesterone during pregnancy

Answer 21

Relaxes smooth muscle
> constipation
> frequent urination
> decreased BP

Question 22

Placenta previa

Answer 22

Implantation of cervix over uterus

Placenta can shear off and cause antepartum hemorrhage

Question 23

Abruptio placenta

Answer 23

Premature detachment of placenta

Hemorrhage
Fetal distress

Question 24

Possible causes of pitting edema

Answer 24

Increased blood hydrostatic pressure 
Decreased colloid osmotic pressure
Increased permeability of blood vessels
Increased ECF volume 
Lymphatic blockage
Local histamine release.

Question 25

Possible causes of pitting Edema

Answer 25

Systemic conditions (congestive heart failure, liver or kidney disease, pre-eclampsia)

Question 26

Broad ligaments

Answer 26

Lateral uterus to lateral sacral bowl Refer pain to low back, buttock, sciatic pattern, especially 6th month

Question 27

Round ligaments

Answer 27

Anterior uterus to public symphysis Diagonal pain from top of uterus to groin. Usually unilateral. Second trimester.

Question 28

Sacrouterine ligament

Answer 28

Posterior uterus to anterior sacrum Achiness around sacrum

Question 29

Most common location of clot formation for DVTs

Answer 29

Iliac Femoral Saphenous veins

Question 30

Obturator internus TrP

Answer 30

Coccyx area - circular pattern May refer down posterior thighr

Question 31

Obturator internus

Answer 31

Medial greater trochanter --> ischiopubic ramus and obturator membrane. Lateral rotation with hip extension Abduction with hip flexion Travels through lesser sciatic foramen

Question 32

Pelvic floor muscle TrP

Answer 32

Oblong pattern coccyx to crack

Question 33

Generalized edema can be a sign of

Answer 33

Pre-eclampsia High blood pressure Kidney dysfunction Heart failure.

Question 34

During pregnancy blood volume can increase by how much?

Answer 34

40-50%

Question 35

In pregnancy to avoid pubic symphysis pain

Answer 35

Avoid forward and lateral lunges

Question 36

According to WTFK no supine exercise

Answer 36

After first trimester

Question 37

When positioning no supine massage

Answer 37

After 22 weeks

Question 38

Most common locations for clot formation

Answer 38

Iliac femoral saphenous veins

Question 39

Prone position is not recommended after first trimester because

Answer 39

Increased intrauterine pressure Stresses sacrouterine ligament Increased lumbar lordosis Increased mucus

Question 40

Supine position is not recommended after first trimester because

Answer 40

Supine hypotensive syndrome