Term
| What is chronic HTN in pregnancy?, |
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Definition
BP ≥ 140/90 before pregnancy or before 20 wks gestation.
new htn after 20 wks gestatin that persists for 12 wks postpartum it is dx chronic HTN retrospectively |
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Term
| What is Severe HTN for pregnancy? |
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Definition
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Term
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Definition
“transient htn of pregnancy”, new htn in pregnancy w/o proteinuria.
Who become normotensive 12 wks post partum |
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Term
| What is the "classic triad" of Pre-eclampsia? |
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Definition
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Term
| What is the required diagnostic criteria for Pre-eclampsia? |
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Definition
| ↑BP AND proteinuria of 300mg per 24 hrs (both are required for dx) |
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Term
| What is the treatment for pre-eclampsia? |
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Definition
| hospitalized for close observation and can try bed rest (although literature doesn’t support) |
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Term
| What is the treatment for pre-eclampsia? |
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Definition
| hospitalized for close observation and can try bed rest (although literature doesn’t support) |
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Term
| What are some predisposing factors for Pre-eclampsia? |
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Definition
AA
Maternal Age <20 or >35
Nulliparity
Multiple Gestation
Hydatidiform Mole
Polyhydramnios
Non-immune fetal hydrops
Twins
Obesity, DM, Chronic HTN (pre-pregnancy), Renal Dz |
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Term
| What is the BP in severe pre-eclampsia? |
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Definition
| BP >160/110 (two occasions 6 hrs apart while on bedrest) |
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Term
| What are the renal signs of SEVERE pre-eclampsia? |
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Definition
Proteinuria of 5 g or more in 24hrs ( or 3+ or more two dipsticks at least 4 hrs apart)
Oliguria (<500ml/24 hrs) |
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Term
| What are some abnormal labs that are seen in Severe Pre-eclampsia? |
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Definition
Abnl LFTs
Thrombocytopenia (<100,000 plt/mm3 from no other cause) |
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Term
| What are some pulmonary signs of severe pre-eclampsia? |
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Definition
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Term
| What are some neural signs of pre-eclampsia? |
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Definition
| Cerebral/visual disturbances |
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Term
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Definition
| tonic-clonic seizure activity (focal or gen) or unexplained coma |
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Term
| When do most cases of eclampsia present? |
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Definition
| Most cases present in 3rd trimester; 80% occur intrapartum or w/in first 48 hrs following delivery |
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Term
| What are the signs and symptoms of an ABNORMAL presentation of pre-eclampsia? |
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Definition
hypotension &/or proteinuria presenting before 20 wks gestation or more than 48 hrs postpartum
other S&S of severe pre-eclampsia w/o htn or proteinuria or both |
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Term
| What are some ways to prevent pre-eclampsia? |
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Definition
| calcium supplements, ASA (both these have a questionable benefit) |
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Term
| What are the risk factors for eclampsia? |
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Definition
chronic HTN,
↑ BMI,
gestational trophoblastic neoplasia,
mult gestation |
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Term
| What are the components of HELLP syndrome? |
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Definition
Hemolysis
Elevated Liver Enzymes
Low Platelets |
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Term
| How is severe pre-eclampsia treated? Why? |
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Definition
| delivery initiated upon dx;Maternal course is unpredictable and can worsen quickly |
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Term
| What med should be used as a seizure prophylaxis in severe eclampsia? What is the MOA of this med? |
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Definition
| magnesium sulfate; MOA: raises seizure threshold |
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Term
| When BP meds are needed for HTN during pregnancy, which meds should be AVOIDED? Why? |
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Definition
atenolol (growth restriction)
ACEI/ARB (fetal/neonate death & renal failure) |
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Term
| How is gestational DM classified? |
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Definition
A1: glucose can be controlled w/diet alone
A2: insulin needed for control |
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Term
| What are the risk factors for gestational DM? |
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Definition
Prior stillbirths
Prior fetus weighing > 9 lbs
Strong FMHx (1st deg)
Elevated BMI prior to preggers
Excessive wt gain during preggers |
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Term
| What are the complications of Gestational DM on the fetus? (Both Immediately and in the future) |
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Definition
Fetal Macrosomia
Inc risk of childhood obesity & development of DM in offspring |
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Term
| If a pt has gestational DM, what are the fasting BS goals, 1 hr postprandial and 2 hr postprandial? |
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Definition
| Fasting <105; 1 hr postprandial <155; 2 hr postprandial <130 |
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Term
| What are the normal values of Hgb in pregnant women during the 1st trimester, 2nd trimester and 3rd trimester? |
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Definition
1st trimester: hgb ≥ 11
2nd trimester: hgb ≥10.5
3rd trimester: hgb ≥11 |
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Term
| With twinning, how often should an NST and U/S be done? |
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Definition
Antepartum monitoring to include wkly NSTs beginning at 32wks, biwkly at 36 wks
U/S q 3-4 wks to assess fetal growth |
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Term
| What should be administered to the women who is having twins and you believe a premature delivery is likely? |
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Definition
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Term
| What birthweight is considered macrosomia? |
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Definition
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Term
| What are the most contributing risk factors to a macrosomia infant? |
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Definition
| elevated preconception BMI & excessive maternal wt gain |
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Term
| What are the MC neonatal effects of Rh isoimmunization reaction? |
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Definition
| MC newborn effects are neonatal anemia & jaundice |
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Term
| What is the treatment (prevention) for Rh Isoimmunization? |
|
Definition
| rhogam given at 28w and w/in 72 hrs of delivery or given if 1st trimester abortion or miscarriage |
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Term
| What is the MC trisomy with increased maternal age? |
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Definition
| Down's syndrome - Trisomy 21 |
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Term
| What trisomy has characteristic including Short limbs, Wide pelvis, Sandal gap (foot), Clinodactyly, Loose skin @ nape of neck and Small head? |
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Definition
| Trisomy 21 - Down Syndrome |
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Term
| Which trisomy has characteristics described as Small mouth/jaw/neck, Shield chest/short sternum, Wide set nipples, Flexed big toe/prominent heels, Prominent occiput, Clenched hands/fingers overlap? |
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Definition
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Term
| Which trisomy is described as Missing parts of brain, Cleft lip &/or palate, Clenched hands/polydactyly, and Undescended/abnl testes? |
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Definition
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Term
| What is the MC aneuploidy in miscarriages? |
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Definition
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Term
| Which genetic condition causes hygroma/hydrops on U/S, Webbed neck, Wide set nipples, Spots on skin, Lymphedema (hands/feet), Short stature, and Low hairline? |
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Definition
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Term
| Which chromosomal abnormality causes male w/ feminization, Tall, Emo/learning probs, Poor beard growth, Breasts develop, and Under-developed testes? |
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Definition
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Term
| Which pregnancy category should be used with caution and if benefit outweighs the risk? |
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Definition
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Term
| Which pregnancy category does the risk clearly outweigh the benefits and should be avoided during pregnancy? |
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Definition
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Term
| What can maternal heavy metal exposure lead to in a fetus? |
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Definition
|
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Term
| What are some known teratogens? |
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Definition
Alcohol
ACEI
Aminopterin (folate antag.)
Lithium
Accutan(isotretinoin)
DES
Cyclophosphamides
MTX
Warfarin/Coumadin
Tetracycline
Thalidomide
Valproic acid
Phenytoin(dilantin)
Carbamezapine(tegretol)
Live vaccines (rubella) |
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Term
| What is a low mobile sperm count? |
|
Definition
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Term
| What are the two MC female etiologies behind infertiiization? |
|
Definition
| Ovarian dysfunction and Tubal/pelvic dysfunction |
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Term
| What is the MC tubal/pelvic cause of dysfunction? |
|
Definition
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Term
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Definition
| checks uterus and tubal patency |
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Term
| What hormones levels are checked in a female for infertility screening? |
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Definition
| FSH/LH, Progesterone, TSH/PRL |
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Term
| At what progesterone level is ovulation confirmed? (approximately occurs on what day of the cycle?) |
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Definition
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Term
| What is the treatment for PCOS anovulation? |
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Definition
| clomiphene citrate, gonadotropins, metformin, ovarian drilling, aromatase inhibitors |
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Term
| What is the treatment for hypogonadism anovulation? |
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Definition
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Term
| What is the treatment for high PRL anovulation? |
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Definition
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Term
| MC way to 'treat' infertility due to tubal dz? |
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Definition
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Term
| Treatment for infertility due to endometriosis? |
|
Definition
| Surgery or if too severe IVF |
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Term
|
Definition
| IntraUterine Insemination |
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Term
| What is the effect of Letrozole? |
|
Definition
|
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Term
|
Definition
| Gamete intrafallopian transfer |
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Term
|
Definition
| Gamete intrafallopian transfer |
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|
Term
| abortion b/c of med reasons |
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Definition
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|
Term
| Abortion offered to high order multips |
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Definition
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Term
| Done up to 7 wks with RU486-mifiprex-mifipristone-abortion pil |
|
Definition
| Early Non-Surgical Abortion |
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Term
|
Definition
| Mifeprex - progesterone antagonist (ends early prego) & Misoprotol-prostaglandin analogue (causes contraction) |
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|
Term
| Abortion from Conception to 4 wks using surgery |
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Definition
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|
Term
| abortion by vacuum aspiration from Conception to 12 wks |
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Definition
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|
Term
| abortions by dilatation & evac from 15.5 - 22 weeks |
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Definition
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|
Term
| abortions by induction method from 15wks and beyon |
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Definition
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|
Term
| With induction method abortion, how is fetus killed? |
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Definition
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Term
| During induced abortion, how are contractions induced? |
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Definition
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