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Flashcards in OB Shelf Deck (361)
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1

What are the screening recommendations for chlamydia?

1. All sexually active non-pregnant women aged 24 and younger, or >25 if high risk
2. All pregnant women aged 24 and younger, and >25 if high risk

2

What are the risk factors for chlamydial infection?

- Hx of chlamydial or other STIs
- New or multiple sex partners
- Inconsistent condom use
- Exchanging sex for money or drugs

3

What is Goodells sign?

Softening of the cervix during pregnancy

4

What is Hegars sign?

Softening of the uterus during pregnancy

5

What is Chadwicks sign?

bluish purple hue in the cervix and vaginal walls during pregnancy
- caused by hyperemia

6

How do you date pregnancies?

Naegle's Rule:
minus 3 months, plus 7 days!
so if LMP was Sept 25th, 9-3 = 6, June 25th, Add 7 days = July 2nd

7

Triad of interstitial cystitis??

1. Urinary urgency
2. Urinary frequency
3. Chronic pelvic pain

8

In interstitial cystitis, what exacerbates the pelvic pain?
relieves it?

1. Sexual intercourse
2. Filling of the bladder
3. Exercise
4. Spicy foods
5. Certain beverages
Relieved via voiding of bladder

9

What does cystoscopy classically demonstrate in interstitial cystitis?

submucosal petechiae or ulcerations

10

What is the triad of pelvic inflammatory disease?

1. Pelvic pain
2. Cervical motion tenderness
3. fever

11

What is the single most useful parameter for predicting fetal weight by ultrasonogram in suspected FGR?

Abdominal circumference

12

What is fetal growth restriction? Describe the 2 types

2 types: symmetrical and asymmetrical
1. Symmetrical: insult to fetus <28wks gestation and growth of head and body is deficient
- usually the result of genetic anomalies or TORCH infections

2. Asymmetric: insult to fetus after 28wks, normal head size and reduced abdominal circumference

13

When is FGR suspected?

when fundal height is at least 3cm less than the actual gestation age in weeks

14

What measurement can be used to differentiate between symmetric and asymmetric FGR?

head to abdomen circumference

15

When are serum progesterone measurement taken to detect ovulation?

Mid-luteal phease

16

What are the symptoms of severe preeclampsia?

1. HTN (160/110)
2. Proteinuria (>5g on 24hr urine)
3. Oliguria
4. Pulmonary edema
5. Thrombocytopenia
6. Elevated liver enzymes

17

What is HELLP syndrome?

Hemolysis
Elevated liver enzymes
low platelets

18

What causes RUQ pain in preeclampsia?

hematoma formation and formation of thrombi in the portal capillary system can cause swelling of the liver with distention of he hepatic (Glissons) capsule

19

Pt with eclampsia is given what to prevent further seizures?

magnesium sulfate

20

what screening test is performed in all pregnant women, regardless of risk factors?

RPR!

21

What is the difference between mild and severe eclampsia?

Mild: HTN >140/90, proteinuria >0.3g/24hr after the 20th week gestation
Severe: HTN >160/110, proteinuria >5g/24hrs, oliguria, elevated liver enzymes, thrombocytopenia, and possibly Pulmonary edema

22

when is transient HTN seen in pregnancy?

second half of pregnancy or during labor and delivery

23

What is the tx for the HTN seen in preeclampsia and eclampsia?

Methyldopa: centrally acting alpha agonist

24

What is the ideal range of maternal fasting glucose?

75-90mg/dL

25

What is the tx for gestational diabetes?

subcutaneous insulin (doesnt cross the palcenta)

26

What are the risks to the fetus associated with gestational diabetes?

1. Macrosomia
2. Hypocalcemia (from PTH suppression)
3. Hypoglycemia
4. Hyperviscosity due to polycythemia
5. Respiratory difficulties
6. Cardiomyopathy
7. CHF

27

What is the mechanism behind the polycythemia in infants of a diabetic mother?

- fetal hypoxia due to increased BMR incuded by hyperglycemia
- this causes increased EPO production by the fetus -> increased red blood cell mass and O2 capacity of the blood

28

What causes early decelerations?

Fetal head compression leading to a vagal response

29

What causes variable decelerations?

Umbilical cord compression

30

What causes late decelerations?

Uteroplacental insufficiency -> fetal hypoxia -> fetal acidosis