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Emergency Medicine > Vaginal bleeding in Pregnancy > Flashcards

Vaginal bleeding in Pregnancy Flashcards

(49 cards)

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1
Q

Abortion: termination at

A

20 wks; 500 g

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2
Q

Bloody vaginal discharge/bleeding + closed cervical os

A

Threatened abortion

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3
Q

Partial/complete placental separation & dilation of cervical os

A

Incomplete abortion

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4
Q

Complete expulsion of entire pregnancy

A

Complete abortion

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5
Q

Dead products retained in uterus with closed cervical os

A

Missed abortion

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6
Q

Preterm premature rupture of membranes (PPROM) at a previable gestational age

A

Inevitable abortion

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7
Q

Mgt of threatened abortion

A

Bed rest, paracetamol for suprapubic discomfort, mild cramps, pelvic pressure, or persistent low backache

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8
Q

TVS finding in threatened abortion

A

gestational sac ± subchorionic hemorrhage

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9
Q

B-Hcg levels in threatened abortion

A

1500-2000 by 4.5 weeks

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10
Q

TVS finding in complete abortion

A

minimally thickened endometrium without gestational sac

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11
Q

Mgt of missed abortion

A

dilatation & curettage

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12
Q

Mgt of incomplete abortion

A

completion curettage, misoprostol, expectant

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13
Q

Most frequent site of ectopic pregnancy

A

Ampulla (70%)

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14
Q

Common UTZ findings in ectopic pregnancy (early)

A

Hematosalpinx

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15
Q

Classic triad of ectopic pregnancy

A

Missed menses, pain, vaginal bleeding/ spotting

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16
Q

PE findings in tubal rupture

A

cervical motion tenderness; boggy mass beside uterus

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17
Q

Symptoms in hemoperitoneum

A

Diaphragmatic irritation (neck/ shoulder pain), esp on inspiration

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18
Q

Entire sloughed endometrium taking form of endometrial cavity passed from tubal pregnancy

A

Decidual cast

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19
Q

Serum B-hCG discriminatory level (DL)

A

> 1500 mIU/mL

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20
Q

Above DL but (-) IUP

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A

ectopic pregnancy vs complete abortion

21
Q

Below DL

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A

Declining pattern: failing IUP (serially checked 48h later)

22
Q

TVS endometrial finding b/w 4.5-5 wks AOG

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A

Gestational sac

23
Q

TVS endometrial finding b/w 5-6 wks AOG

24
Q

TVS endometrial finding b/w 5.5-6 wks AOG

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A

Fetal pole with cardiac activity

25
Endometrial pattern in ectopic pregnancy
Trilaminal patter with anechoic fluid collections
26
Medical mgt for ectopic pregnancy
Methotrexate (single dose: 50 mg/m2 BSA; multi: 1 mg/kg at days 1,3,5,7) and leucovorin (multidose: 0.1 mg/kg days 2,4,6,8)
27
CI to methotrexate use
``` Tubal rupture Breast feeding IUP PUD Active pulmonary dse Immunodeficiency Hepatic, renal or hematologic dysfx ```
28
Preferred surgical mgt for ectopic pregnancy
Laparoscopy
29
Sx mgt to remove small unruptured ectopic pregnancy
SalpingoStomy
30
Sx mgt that inimizes recurrence of ectopic pregnancy
Tubal resection
31
Group of tumors typified by abnormal trophoblast proliferation
Gestational trophoblastic disease (GTD)
32
GTD with villi
Hydatidiform mole
33
Is a complete Hmole benign or malignant?
Benign
34
Is an invasive Hmole benign or malignant?
Malignant
35
Nonmolar trophoblastic malignant neoplasms lack villi. Name 3.
Choriocarcinoma Placental site trophoblastic tumor Epithelioid trophoblastic tumor
36
A mass of clear vesicles with abN chorionic villi
Complete Hmole
37
Mass with focal and less advanced hydatidiform changes; may contain some fetal tissue
Partial molar pregnancy
38
TVS finding in complete mole
Snowstorm appearance (numerous anechoic cystic spaces
39
Ddx in b-hCG increased above AOG
Hmole; ectopic pregnancy
40
Mgt of Hmole
Termination by suction curretage
41
Hallmark sx of placenta previa
Painless sentinel bleeding (begins w/o warning/ pain/ contractions)
42
Clinical examination for placenta previa suspects should be done using the ___ technique
Double set-up
43
Most accurate method of assessment of placenta previa
TVS
44
Mgt for placental abruption
Emergency CS
45
S/Sx of placental abruption
Sudden abdominal pain, vaginal bleeding and uterine tenderness
46
Bleeding starts at the ___ in abruptio placenta
decidua basalis
47
Evidence seen in placenta for abruption
Circumcised depression on the maternal surface
48
DX of placenta accreta
TVS with doppler color flow (myometrial invasion)
49
3 classifications of morbidly adherent placenta (accrete syndromes)
1. Placenta accrete: attached to myometrium 2. Placenta increta: invade myometrium 3. Placenta percreta invade serosa

Emergency Medicine (7 decks)

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