Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

EC Physical Examination > Random Pregnancy > Flashcards

Random Pregnancy Flashcards

1
Q

How is BP affected in pregnancy?

A

BP decreases beginning at 8 weeks gestation until a low point is reached mid pregnancy. The diastolic pressure gradually rises to prepregnany levels by term

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Back pain may be related to what psychologic processes during pregnancy?

A

lax ligaments
weight gain
hyperlordosis
anterior tilt of the pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the cause of epigastric pain in pregnancy?

A

pressure from the gravid uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the cause of round ligament pain during pregnancy?

A

stretching of the ligaments caused by the enlarging uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How is the HR affected in pregnancy?

A

HR gradually increases throughout pregnancy until it is 10-30% higher at term

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How can the onset of htn be measured during pregnancy?

A

measure BP consistently in the right arm in the sitting position or left lateral recumbent position AFTER 10 minutes rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is gestational htn?

A

BP reading greater than or equal to 140/90

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What percentage of pts develop gestational htn?

A

5-10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is a sign of preeclampsia?

A

BP of 160/110 or greater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What percentage of patients with depression during pregnancy will have postpartum depression?

A

39%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the percentage of postpartum psychosis?

A

0.1%-0.2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the RF of postpartum depression?

A

h/o depression
prior postpartum depression
poor social support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When should pregnant pts be screened for depression?

A

during pregnancy
postpartum
routine well child visits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What screening can be used for depression in pregnancy?

A

PHQ-2

Edinburgh Postnatal Depression scale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

The growing fetus is responsible for how much weight gained in pregnancy?

A

6-8lbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How much does the increase in fluid volume account for weight gain in pregnancy?

A

2-3 lbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How much does the increase in blood volume?

A

3-4lbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How much does the increase in breast enlargement?

A

1-2lbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How much does the increase in uterine enlargement?

A

2 lbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How much does the increase in amniotic fluid?

A

2 lbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How much does the increase in maternal fat and protein stores?

A

4-6lbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What accounts for the majority of weight gain during first and second trimesters?

A

maternal tissue growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What accounts for the majority of weight gain during the third trimester?

A

fetal growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When does postpartum weight loss occur?

A

the first 6 months after both, with most occurring 3 months after delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How much should patients with a prepregnancy BMI of 19.8 to 26 gain over the entire pregnancy?

A

25-35 lbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Underweight patients with a BMI less than 19.8 should gain how much over the entire pregnancy?

A

28-40lbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Overweight pts with a BMI of 26.1-29 should gain how much weight?

A

15-25 lbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Obese patients with a BMI of >29 should gain no more than how much weight?

A

11-20lbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Obese patients are at risk of developing what complications?

A 
gestational htn
preeclampsia 
gestational DM
cesarean devilery
failure to initiate breast feeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What processes assist in dissipating the excess heat caused by increased metabolism during pregnancy?

A

peripheral dilation and increased number of capillaries in the hands and feet
acceleration of sweat and sebaceous gland activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What happens to the skin in pregnancy?

A

skin thickens and fat is deposited in the sib dermal layers.
some degree of increased pigmentation
new nevi may appear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are striae agravidarum and when do they appear?

A

stretch marks- second trimester

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

When do telangiectasias appear?

A

2-5th month of pregnancy and resolve after delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is pigmentation of the linea alba called?

A

linea nigra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is melasma?

A

“mask of pregnancy”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is a diffuse redness covering the entire palmar surface or the thenar and hypothenar eminences likely related to estrogen.

A

palamar erythema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is telogen effluvium?

A

2-6 months after delivery when increased hair shedding occurs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

When will regrowth of hair occur?

A

6-12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How are autoimmune illnesses affected in pregnancy?

A

can lead to temporary remission of the pregnant individuals autoimmune/inflammatory diseases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Before the second trimester the pregnant pt is the source of thyroid hormone for the fetus, therefore what is important to maintain?

A

adequate iodine intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

The diagnosis of hyperthyroidism in pregnancy is difficult but what is highly suggestive?

A

weight loss
tachycardia
bruit over the thyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

How can you confirm hyperthyroidism in a pregnant patient?

A

measure TSH and free T4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the result of the eyes undergoing physiologic and hormonal adaptation in pregnancy?

A

hypersensitive and change the refractory power of the eye
blurred vision for contact wears
diabetic retinopathy may worsen
mild corneal edema and thickening
intraocular pressure falls by latter half of pregnancy

44
Q

What are the symptoms indicative of pregnancy induced hypertension (PIH)?

A

diplopia
scotomata
blurred vision
amaurosis fagax

45
Q

What is seen on retinal examination with PIH?

A

segmental arteriolar narrowing with a wet, glistening appearance indicative of edema. (different compared to long stand htn with vascular tortuosity, angiosclerosis, hemorrhage and exudates)

46
Q

Why should cycloplegia and mydratic agents be avoided unless there is a need to evaluate for retinal disease?

A

bc of systemic absroption

47
Q

What is the result of increased estrogen levels and increased vascularity in the upper respiratory tract?

A 
nasal stuffiness
decreased sense of smell
epistaxis
fullness in the ears
impaired hearing
48
Q

What is the result of increased estrogen levels and increased vascularity in the connective tissue of the gums?

A

hormone induced laryngeal changes may lead to hoarseness, deepening or cracking of voice, vocal changes or persistent cough

49
Q

How does pregnancy affect anatomic changes in the chest?

A

as the lower ribs flare- an increase in the lateral diameter of about 2cm and an increase in the circumference of 5-7cm

50
Q

How does the costal angle change in later pregnancy?

A

increases from about 68.5 degrees to 103.5 degrees

51
Q

How is the diaphragm affected during pregnancy?

A

the diaphragm is 4cm above its usual position but its movement increases so that most breathing is done by the diaphragm

52
Q

How are minute ventilation and respiratory rate affected during pregnancy?

A

minute ventilation increases due to increased tidal volume

respiratory rate is unchanged

53
Q

How is asthma affected in pregnancy?

A

varied course-may get worse better or unaffected

54
Q

In pregnant pts, what % increase is there in blood volume?

A

40-50% increase over prepregnancy level

55
Q

Why does blood volume increase in pregnant pts?

A

As a result of the increase in plasma volume which begins in first trimester and reaches a max in the 30th week

56
Q

How much does plasma volume increase in pregnancy ?

A

increases 50% with single and as much as 70% with twin pregnancy

57
Q

The heart works harder to accommodate the increased ____ ____ and ___ ____ required for the expanded blood volume.

A

heart rate and stroke volume

58
Q

How is the left ventricle affected in pregnancy?

A

increases in both wall thickness and mass

59
Q

When does blood volume return to pre pregnancy state?

A

within 3-4 weeks after delivery

60
Q

How is the apical pulse shifted during pregnancy?

A

upward and more lateral by 1-1.5cm

61
Q

How might the heart sounds change after 20 weeks gestation?

A

more audible splitting of S1 and S2 and S3 may be readily heard. However a fourth heart sound is abnormal

62
Q

Where will systolic ejection murmurs be heard in pregnant pts?

A

over the pulmonic area in 90% of pregnant pts.

intensified during inspiration or expiration but not not louder than grade 2

63
Q

How is the EKG affected in pregnancy?

A

its NOT!

64
Q

What might suggest an abnormality in the cardiac exam?

A

cyanosis
clubbing
persistent neck vein distended
development of a diastolic murmur

65
Q

Should JVP change in pregnancy?

A

NO

66
Q

During pregnancy how was the systemic vascular resistance change?

A

systemic vascular resistance decreases and peripheral vasodilation occurs resulting in palmar erythema and spider telaniectasias

67
Q

How was systolic and diastolic pressure change?

A

systolic BP decreases slightly but there is a greater decrease in diastolic BP

68
Q

Lower BP can be noted when pt is supine in third trimester, why?

A

secondary to venous compression of the vena cava and impaired venous return

69
Q

What may cause an increase in dependent edema, variscosities of legs and vulva and hemorrhoids?

A

compression of the pelvic veins and interior vena cava from the enlarged uterus. Blood pools in the lower extremities

70
Q

What position does the blood not pool in the lateral extremities?

A

when in the lateral recumbent position

71
Q

What happens in the abdomen to the muscles in pregnancy?

A

as the uterus enlarges the abdominal wall stretches and loses tone

72
Q

What happens during the third trimester in the abdomen?

A

the rectus abdominis muscle may separate, allowing abdominal contents to protrude at the midline

73
Q

How is the umbilicus affected during pregnancy?

A

it flattens or protrudes

74
Q

When does the abdominal counter change in pregnancy?

A

when listening occurs about 2 weeks before term in nullipara and the fetal presenting part descends into the true pelvis

75
Q

What forms on the abdomen as the skin is stretched?

A

striae

76
Q

Why is heartburn a common concern in pregnancy?

A

during the second trimester the lower esophageal sphincter pressure decreases and peristaltic wave velocity also decreases.

77
Q

What causes constipation in pregnancy?

A

gastric emptying is normal but GI transit time is prolonged in the 2nd and 3rd trimesters

78
Q

When are gallstones more common in pregnancy and why?

A

2nd and 3rd trimester as a result of the gallbladder becoming more distended with decreased emptying time and change in tone. the status and The secretion of lithogenic bile increases the formation of cholesterol crystals and the development of gall stones.

79
Q

How are the kidneys affected in pregnancy?

A

they enlarge by about 1cm in length and the renal pelvis and ureters dilate from effects of hormones and pressure from the enlarging uterus

80
Q

Dilation of the ureter is greater on the _____ side because it is affected by displacement of the uterus due to the ovarian vein.

A

right

81
Q

The ureters also ____ and form single and double curves or varying sizes and angulation.

A

elongate

82
Q

How can the changes in ureters and kidneys affect a pregnant pt?

A

can lead to urinary statuses and pyelonephritis in gravid women with asymptomatic bacteriuria

83
Q

What position can renal function be most efficient?

A

if women lays in lateral recumbent position to help prevent compression the vena cava and aorta

84
Q

How long will the renal changes last after delivery?

A

3-4 months

85
Q

What causes the elevated of the bladder trigone and causes thickening of the posterior margin of the bladder after the 4th month of pregnancy?

A

increase in uterine size
hyperemia of all pelvic organs
hyperplasia or muscle and connective tissue

86
Q

What is the result of the deepening and widening of the trigone by the end of pregnancy?

A

may result in micrthematuria

87
Q

How is the colon affected during pregnancy?

A

it is displaces laterally upward and posteriorly
peristaltic activity may decrease
water absorption is increased

88
Q

What is the result of the colon changes in pregnancy?

A

bowel sounds are diminished

constipation of flatus are more common

89
Q

How is the appendix affected in pregnancy?

A

It is displaced upward and laterally, away from McBurney’s point.

90
Q

How much time post party does the pelvic floor regain tone?

A

6-7 weeks postpartum

91
Q

IF a woman is taking iron during pregnancy how does that affect her stool?

A

stool may be dark green or black. iron may also contribute to constipation or cause diarrhea

92
Q

How do increased hormone levels in pregnancy affect MSK?

A

elasticity of ligaments and softening of the cartilage in pelvis at 12-20 weeks.
Increased mobility of the sacroiliac, sacrococcygeal and symphysis pubis

93
Q

How is the spine affected in pregnancy?

A

lordosis occurs in an effort to shift the center of gravity back over the lower extremities.

94
Q

What contributes to the “waddling” gait of late pregnancy?

A

increased mobility and instability of the sacroiliac joints and symphysis pubis as the ligaments become less tense

95
Q

How can you asses for lumbosacral hyperextension?

A

bend forward at the waist to touch toes. palpate the distance between L4 and S1. If it becomes flixed before the spine is fully extended, the women will be hyperextended when walking

96
Q

When does most back pain resolve after delivery?

A

within 6 months after

97
Q

What causes carpal tunnel syndrome during the last trimester?

A

the associated fluid retention during pregnancy.

98
Q

When using a doppler, what is heard as a pulsatile pumping sound?

A

arterial flow

99
Q

When suing a doppler was is heard as a sound of rushing wind?

A

venous flow

100
Q

What instruments are used for fetal heart rate?

A

fetoscope, Left scope, stethoscope or Doppler

101
Q

What has a band that fits against the head of the listener and also has a metal band that aids in bone conduction so that heart tones are heard more easily

A

fetoscope

102
Q

What has a weighted end that when places on the abdomen does not need stabilization?

A

Left scope

103
Q

When can a fetoscope and Left scope detect fetal heart rate?

A

17-19 weeks gestation

104
Q

What is an ultrasound that picks up suffering frequencies from the beating fetal heart?

A

doppler method

105
Q

When can the doppler method detect a fetal heart?

A

10-12 weeks

EC Physical Examination (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions