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NM702 > Putting it all together...Module 3 > Flashcards

Putting it all together...Module 3 Flashcards

1
Q

When is Naegele’s rule appropriate

A

Has known LMP
Has regular cycles
Did not conceive on hormonal contraception or while breastfeeding
Has a clinical picture that fits

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2
Q

Food to avoid to prevent Listeriosis

A

Listeriosis
- avoid food that could contain listeriosis
* raw sprouts
* soft cheeses
* dell meats and hot dogs (cold, not heated)
* smoked seafood
* Raw milk (unpasteurized)

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3
Q

Food to avoid to prevent Toxoplasmosis

A

Toxoplasmosis:
- Avoid undercooked meat..
- avoid contact with cat feces
- avoid drinking water contaminated with toxoplasma gondii

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4
Q

Fish to avoid to prevent mercury in fish

A

Avoid:
Tuna, bigeye
King mackerel
Marlin
Shark
Swordfish
Orange roughy
Tilefish (Gulf of Mexico)

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5
Q

U/S vs menstrual cycle dating in first trimester
when to change from menstrual cycle date to u/s date

A

< 9 weeks = more than 5 days

9 0/7-13 6/7 weeks = more than 7 days

14 0/7 - 15 6/7 weeks = more than 7 days

16 0/7 - 21 6/7 weeks = more than 10 days

22 0/7 - 27 6/7 weeks = more than 14 days

28 0/7 weeks and beyond = more than 21 days

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6
Q

OB labs:

A

Anemia:
H/H or CBC

Blood type and antibiotics:
Blood type compromised of the blood group and the presence or absence of the RH factor
Antibody screen

Infections:
RPR or VDRL
Rubella immunity
Hepatitis B and C
HIV
Urine Culture..

For individual patients: Chlamydia, gonorrhea, PPD, HSV, varicella

Other conditions:
Hgb electrophoresis
diabetes screen
Pap
Thyroid

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7
Q

why is an antibody screen needed

A

it evaluates for antibodies in the mother’s blood that might cross the placenta and attack fetal red blood cells, causing hemolytic disease of the new born.

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8
Q

Pan-ethnic nondirective

A

Screens for 100+ conditions simultaneously, without regard to ethnic group or ancestry

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9
Q

Expanded

A

Screens all patiets for specific conditions, regardless of identified ethnic group or ancestry

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10
Q

Ethnic-specified; targeted

A

screens for conditions considered to be common in ethnic group with which the patient identifies and conditions identified through family history

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11
Q

Example of ethnic-specified, targeted

A

Tay-Sachs: individuals of Ashkenazi Jewish, Cajun, or French-Canadian descent

Canavan disease and familial dysautonomia: individuals of Ashkenazi Jewish descent

Fragile X syndrome: Individuals with a family history of intellectual disability suggestive of fragile X syndrome

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12
Q

Example of pan-ethnic nondirective

A

Cystic fibrosis
Spinal muscular atrophy
Hemoglobinopathies

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13
Q

What is the First trimester screen

A

Ultrasound to measure nuchal translucency (NT) + blood draw for maternal serum markers ….NT/serum screen

Is the first portion of sequential and integrated screens

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14
Q

Time fame First trimester screen

A

10 (or 11) - 14 weeks

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15
Q

What conditions is tested for First trimester screen

A

Aneuploidies (Trisomies 13, 18, 21)

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16
Q

Time frame for Chorionic villus sampling (CVS)

A

10-13 (or 14 ) weeks

17
Q

What conditions are tested for Chorionic villus sampling

A

Aneuploidies and other chromosomal conditions

18
Q

Time frame for cell-free DNA (cfDNA)
Noninvasive prenatal testing (NIPT)
Noninvasive prenatal screening (NIPS)

A

Anytime between 10 weeks and term

19
Q

What conditions tested for cfDNA

A

Aneuploidies (Trisomies 13, 18, 21)

20
Q

What tests test for only Aneuplooidy test

A

First trimester screen
Triple, quad and penta screens
Integrated and sequential screen
Noninvasive prenatal testing (cell-free DNA)

21
Q

What tests test for structural anomaly (neural tube defect) tests

A

Alpha-fetoprotein (AFP) component of triple, quad, penta, integrated and sequential screens

22
Q

What to tell patient about NT/Serum screen

A

Nuchal translucency u/s + markers

  • Noninvasive; does not risk fetal harm
  • Does not determine fetal sex
  • Positive results (abnormally thick nuchal fold or abnormal serum markers) require confirmatory testing
  • In some settings, after the NT/serum screen, patients can choose to proceed to diagnostic testing OR have additional serum markers drawn in the second trimester OR do no additional testing
23
Q

What to tell patient about chorionic villus sampling

A

Results available in less then one week

Determines fetal sex

Invasive; risk of pregnancy loss, harm to fetus, infection and amniotic fluid leakage. Specific stats for these risks vary with the provider performing the procedure

As a diagnostic test, it can be tremendously reassuring when the results are negative/normal

24
Q

What to tell patients about cfDNA

A

Noninvasive; does not risk fetal harm

Can determine fetal sex

Positive results require confirmatory testing

Very high negative predictive value (a negative test is quite reassuring that the fetus does NOT have an aneuploidy)

Higher positive predictive value (A positive test is likely to be a true positive) compared with traditional genetic screening tests

Flexible timeframe of test (anytime between 10 weeks and term) allows for information early in pregnancy (which can be beneficial for people who might not continue the pregnancy) AND allows for information later in pregnancy for those who are late to care.

25
Q

What genetic tests can determine fetal sex

A

Chorionic villus sampling

cfDNA

26
Q

Non serious cause for 1st trimester bleed

A

Implantation bleeding
Cervical irritation from infection or intercourse
Subchorionic hemorrhage
Fibroids or endometrial polyps

27
Q

Most relevant history for implantation bleed

A

Timing usually limited to around 2 weeks after ovulation
Usually small amount of bleeding for short duration

28
Q

Most relevant history for cervical irritation from infection or intercourse

A

Timing in relation to intercourse or exam

STI sx

29
Q

Most relevant history for subchorionic hemorrhage

A

Timing in relation to gestational age

Usual to have subchorionic hemorrhage prior to 8-10 weeks

Usually painless bleeding

Identified by U/S

30
Q

Most relevant history for Fibroids or endometrial polyps

A

Pt may report history of fibroids or endometrial polyps\

Uterus may be enlarged and irregular if fibroids

Identified by ultrasound

31
Q

What is listeriosis

A

Bacteria

32
Q

Food concerning for Listeriosis

A

Raw sprouts
soft cheeses
smoked seafood
raw milk (unpasteurized)
deli meats and hot dogs (cold, not heated)

33
Q

What is Toxoplasmosis

A

Parasites

34
Q

Food concerning for Toxoplasmosis

A

Undercook/contaminated meat
Pork/lamb/venison/
shell fish
oysters/clams/mussels
Drinking water contaminated with toxoplasma gondii
Cat feces….cats that eat infected small animals

Indoor cats who are fed commercial, cooked food virtually no risk of passing Toxoplasma gondii

NM702 (32 decks)

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