Term
|
Definition
| > 4500g = increased risk for shoulder distocia and need for cesarean section |
|
|
Term
| order of fetal movements during labor |
|
Definition
descent
flexion
internal rotation
extension
external rotation
expulsion |
|
|
Term
| x-linked dominant affects who? |
|
Definition
son of male = not affected
offspring of female = 50% risk |
|
|
Term
| x-linked recessive who is affected? |
|
Definition
females = unaffected
males display the abnormal phenotype |
|
|
Term
| y-linked (always dominant), what is the affect? |
|
Definition
| associated with male infertility |
|
|
Term
| mitochondrial disorders are inherited from whom? |
|
Definition
|
|
Term
| abx to avoid in pregnancy |
|
Definition
SAFE Moms Take Really Good Care
Sulfonamides
Aminoglycosides
Flouroquinalones
Erythromycin
Metronidazole
Tetracycline
Ribavirin
Griseofulvin
Chloramphenicol |
|
|
Term
| use of chloramphenicol during pregnancy is associated with what? |
|
Definition
|
|
Term
| how is dilation assessed? |
|
Definition
| by placement of 1-2 fingers in the cervix and assessing the daimeter of the opening |
|
|
Term
|
Definition
| % thinning and shortening of the cervix |
|
|
Term
|
Definition
| distance in centimeters between the lowest bony portion of the fetus and the maternal ischial spines. |
|
|
Term
| what station is "engagement" |
|
Definition
|
|
Term
| what produces the greatest amount of fetal exposure to radiation |
|
Definition
|
|
Term
| how do we prevent GBS in the newborn? |
|
Definition
| GBS swab of the vagina and rectum at 36 weeks with antibiotic prophylaxis provided if positive (PCN or clindamycin) |
|
|
Term
|
Definition
| female partner has never been pregnant |
|
|
Term
|
Definition
| female partner had at least one conception followed by failure to concieve after 1 year of unprotected intercourse |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| high percentage of abnormal sperm forms |
|
Definition
|
|
Term
| intrauterine insemination (IUI) |
|
Definition
| useful when total sperm count > 10 million |
|
|
Term
| during female work up for infertility what labs are drawn on cycle day 3? why? |
|
Definition
| FSH and LH to determine ovarian reserve |
|
|
Term
| invitro fertilization (IVF) |
|
Definition
| useful when total motile sperm count is < 10 million or in cases of severe teratospermia |
|
|
Term
|
Definition
| invitro fertilization with intracytoplasmic sperm injection |
|
|
Term
|
Definition
invitro fertilization with embryo transfer.
egg and spem mixed in lab, mature for 2-6 days, embryo transferred to uterus via transcervical approach under U/S guidance |
|
|
Term
| difference between GIFT and ZIFT |
|
Definition
GIFT = gamete intra follopian transfer (transferred prior to fertilization) used by couples who wish to avoid extracorporeal fertilization
ZIFT = fertilized oocytes are transferred into the fallopian tube |
|
|
Term
| components of APGAR, when is it done, what is the scoring? |
|
Definition
Appearance
Pulse
Grimmace
Activity
Respirations
completed at 1 and 5 minutes
each component is scored 0, 1, 2
best total = 10 |
|
|
Term
trisomy 13
trisomy 18
trisomy 21 |
|
Definition
13 = Patau syndrome
18 = Edwards syndrome
21 = Down's syndrome |
|
|
Term
| small head, loose skin at nape of neck, single palmar (simean) crease, heart defects = common, GI malformation, chldhood leukemia, thyroid disease |
|
Definition
| Trisomy 21 - Down Syndrome |
|
|
Term
| 3-4x more common in females, profoundly retarded, less than 10% survive to age 1, prominent occiput, malformed ears, clenched hands with overlapping fingers, flexed big toe, prominent heels, prominent sternum |
|
Definition
|
|
Term
| cardiac defects in majority, most are missing portions of the brain, absent eyebrows, cleft lip/palate, polydactyly, undescended testes |
|
Definition
|
|
Term
| MC aneuploidy in miscarriage |
|
Definition
|
|
Term
| short stature, low hairline, webbed neck, congential lymphedema, subtle intellectual impairments, cardiac anomalies, ovarian dysgenesis |
|
Definition
|
|
Term
|
Definition
| Klinefelter's - small testes, reduced fertility, increased risk for germ cell tumors and breast cancer. Normal intelligence, minority have breast development sufficient to warrant surgery. |
|
|
Term
|
Definition
any one of the following:
HTN present before pregnancy
HTN that develops up to 20 weeks gestation
new onset HTN after 20 weeks that persists > 12 weeks post partum |
|
|
Term
| what meds should be avoided in the tx of HTN during pregnancy? |
|
Definition
|
|
Term
| elevated BP + proteinuria > 300 mg/24 hrs |
|
Definition
|
|
Term
| classic triad of pre-eclampsia |
|
Definition
|
|
Term
|
Definition
pre-eclampsia + any 1 of the following:
BP > 160/110
Proteinuria > 5g/24 hrs or 3+ on dipstick
oliguria (<500mL/24hrs)
cerebral or visual disturbances
pulmonary edema
cyanosis
epigastric/RUQ pain
abnormal LFT's
thrombocytopenia
fetal growth restriction |
|
|
Term
|
Definition
| pre-eclampsia associated with tonic clonic seizure activity (most cases occur in 3rd trimester, during delivery, or in the first 48 hrs after delivery) |
|
|
Term
| seizure prophylaxis in severe pre-eclampsia |
|
Definition
|
|
Term
|
Definition
variation of severe pre-eclampsia associated with:
Hemolysis
Elevated Liver enzymes
Low Platelets |
|
|
Term
| who requires more aggressive screening for gestational diabetes? |
|
Definition
BMI > 34
personal hx of GDM |
|
|
Term
| when are women screened for GDM? how? |
|
Definition
|
|
Term
| what is the screening cut off for 1 hr OGTT? |
|
Definition
| some say 140 some say 130 |
|
|
Term
| if a woman fails the 1 hr OGTT what is done next? |
|
Definition
|
|
Term
| what are the classifications of GDM? |
|
Definition
A1 = glucose controlled diet alone
A2 = insulin required
B = < 10 yrs with DM
C = > 20 yrs with DM
F = concomitant nephropathy
R = malignant reitnopathy
H = heart impairment or disease |
|
|
Term
|
Definition
fasting BGL < 105
post prandial BGL < 130mg/dL |
|
|
Term
| GDM is associated with what? |
|
Definition
| increased risk fo childhood obesity and development of diabetes in offspring |
|
|
Term
| grading of perineal lacerations |
|
Definition
1 = break in skin and mucosa only
2 = laceration that extends to submucosa
3 = involves anal sphincter, partial or full thickness
4 = extends through anal sphincter into rectal mucosa |
|
|
Term
| midline episiotomy increases the risk of what? |
|
Definition
|
|
Term
| what type of episiotomy is less likely to increase the risk of tear? |
|
Definition
| mediolateral (more painful) |
|
|
Term
| review maternal physiology and changes during pregnancy |
|
Definition
|
|
Term
| universally mandated neonatal screening? |
|
Definition
|
|
Term
| babies at extremes of weights are often tested for what? (2) |
|
Definition
| hypoglycemia and polycythemia |
|
|
Term
| why is erythromycin ointment given to the baby in the first hour of life? |
|
Definition
| to prevent gonococcal ophthalmia neonatorum |
|
|
Term
| what vaccine is given prior to leaving the hospital? |
|
Definition
|
|
Term
|
Definition
| bluish discoloration of the cervix |
|
|
Term
|
Definition
| increase in vaginal discharge |
|
|
Term
|
Definition
| softening of the lower uterine segment |
|
|
Term
|
Definition
| cyanosis and softening of the cervix |
|
|
Term
|
Definition
| uterine softening in the anterior midlne along ureterocervical junction |
|
|
Term
|
Definition
| irregular softening of the fundus which develops over the site of implantation |
|
|
Term
|
Definition
| maternal sense of fetal movement |
|
|
Term
|
Definition
| darkening of the skin on the face from hormonal stimulaton of melanocytes |
|
|
Term
| tx of syphilis in pregnancy |
|
Definition
|
|
Term
| tx of chlamydia in pregnancy |
|
Definition
|
|
Term
| tx of gonorrhea in pregnancy |
|
Definition
|
|
Term
| tx of herpes simplex in pregnancy |
|
Definition
| oral or topical suppression at 35 weeks, c-section if active lesions at time of delivery |
|
|
Term
| tx of trichomoniasis during pregnancy |
|
Definition
|
|
Term
| tx of candidiasis during pregnancy |
|
Definition
|
|
Term
| what is the integrated screen? |
|
Definition
| NT if first trimester, and 2 blood draws (2 first trimester, 1 second) |
|
|
Term
| what does the integrated screen test for? |
|
Definition
| Down syndrome, Open Spina Bifida, Trisomy 18 |
|
|
Term
| what vaccines should be avoided in pregnancy |
|
Definition
| live attenuated - MMR, yellow fever, BCG, varicella, and oral polio |
|
|
Term
| what must be done if Mom is positive for cystic fibrosis? |
|
Definition
|
|
Term
| delivery before the 20th completed week of gestation of all or any part of POC with or without the fetus weighing < 500g |
|
Definition
|
|
Term
| bleeding of intrauterine origin occuring before the 20th week w/ or w/o urtine contraction, w/o dilation of the cervix and w/o expulsion of POC. may resolve with bedrest |
|
Definition
|
|
Term
| expulsion of all POC before the 20th week, observe pt, ensure all POC are removed. if after 1st trimester, consider hospitalization |
|
Definition
|
|
Term
| expulsion of some but not all POC before 20th week. Tx = D&C |
|
Definition
|
|
Term
| bleeding of intrauterine origin before the 20th week with dilation of the cervix |
|
Definition
|
|
Term
| embryo or fetus dies in utero but the POC are retained |
|
Definition
|
|
Term
| infection of the uterus and sometimes surrounding structures associated with abortion |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| disappearance of the S&S of pregnancy, negative B-hCG, abnormal U/S findings |
|
|
Term
| tx of occult cord prolapse |
|
Definition
| place pt in lateral sims or trendelenburg, if recurs or continues --> C-section |
|
|
Term
| presentation and tx of overt cord prolapse |
|
Definition
cord is below the presenting part of the fetus.
place pt in knee-chest position with continuous upward pressure against presenting part to lift it off the cord, immediate c-section.
NEVER replace the cord back into the uterine cavity |
|
|
Term
| 2 types of abruptio placentae |
|
Definition
concealed - hemorrhage contained within the uterine cavity - complications often severe.
external - blood drains through the cervix, complications usually less severe. |
|
|
Term
| 3 types of placenta previa |
|
Definition
complete = completely covers internal os
partial = partially covers internal os
marginal = implanted at margin of os |
|
|
Term
| cardinal sign of placenta previa |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| try to flatten out pelvic area, legs hyperflexed onto maternal abdomen, suprapubic pressure applied while gentle downward pressure on head is applied |
|
|
Term
|
Definition
| rotate fetal shoulders to oblique position |
|
|
Term
|
Definition
| pushing posterior shoulder around toward fetal back in a corkscrew fashion |
|
|
Term
| twins average how many weeks gestation? triplets? |
|
Definition
twins = 35 weeks
triplets = 32 weeks |
|
|
Term
| demise of one twin during first trimester |
|
Definition
|
|
Term
| gravida/para interpretation |
|
Definition
GFPAL
gravida = # of pregnancies
Full term
Premature
Aborted
Living Children |
|
|
Term
|
Definition
| first day of LMP - 3m + 7d + 1yr |
|
|
Term
| what is measured on ultrasound by gestational dates |
|
Definition
5-12 wks = fetal crown-rump length
20-30 wks = biparietal diameter, femur length, abdominal circumference
after 30 weeks accuracy decreases. estimated weight and measure of amniotic fluid |
|
|
Term
| MC site of ectopic pregnancy |
|
Definition
|
|
Term
| largest risk associated with ectopic pregnancy based on location |
|
Definition
| interstitial because it allows for the most growth and usually ruptures latest --> increased risk of death |
|
|
Term
|
Definition
| ectopic in combination with intrauterine |
|
|
Term
| what should be avoided in PROM |
|
Definition
|
|
Term
| 3 hallmark findings of PROM |
|
Definition
| pooling of fluid, nitrazine test, ferning (leafy) pattern |
|
|
Term
| tx of PROM in conjunction with amniotitis |
|
Definition
| delivery + broad spectrum abx |
|
|
Term
|
Definition
|
|
Term
| 3 typical progrssive phases of DV |
|
Definition
tension building phase
battering phase
honeymoon phase |
|
|
Term
|
Definition
|
|
Term
|
Definition
| hips flexed with knees extended bilaterally |
|
|
Term
|
Definition
| hips and knees flexed bilaterally |
|
|
Term
|
Definition
| one or both legs are extended below the level of the buttocks |
|
|
Term
| how is fetal positioning assessed? |
|
Definition
| palpation, ballotment, leopold maneuvers |
|
|
Term
| size date discrepancy, 1st trimester bleeding, B-hCG > expected, hyperemesis |
|
Definition
| gestational trophoblastic disease |
|
|
Term
|
Definition
|
|
Term
|
Definition
toxoplasmosis
other = hep B, syphilis, VZV, HIV, parvo virus B19
rubella
cytelomegalovirus
herpex simplex virus |
|
|
Term
| baseline fetal heart rate |
|
Definition
|
|
Term
|
Definition
| presence of periodic accelerations (2 within 20 minutes) of > 15 bpm for 15 seconds |
|
|
Term
|
Definition
1 = true contraction and effacement -> complete dilation
2 = complete dilation -> delivery of baby
3 = delivery of baby -> delivery of placenta |
|
|
Term
| induction of labor and Bishop score |
|
Definition
Bishop score < 5 induction not likely to be successful
> 9 = labor likely to occur spontaneously |
|
|
Term
| total loss of sensory perception, may include loss of consciousness |
|
Definition
|
|
Term
| absence/dullness of sensibility of pain without loss of consicousness |
|
Definition
|
|
Term
| pt looses sensation in the legs and lower abdomen, anesthetic is injected into the space outside the spinal canal |
|
Definition
|
|
Term
| local anesthetic injected into the spinal fluid (subarachnoid space) and causes loss of sensation to the lower body |
|
Definition
|
|
Term
| quick pain relief to the perineum, vulva, and vagina. No relief of labor pains |
|
Definition
|
|
Term
| bolus or continous infusion of local anesthetic via catheter |
|
Definition
lumbar epidural block.
target = T10-L1 for first stage
T10-S5 for second stage |
|
|
Term
| review materal and fetal indications for cesarean section |
|
Definition
|
|
Term
| prevention of Rh isoimmunization |
|
Definition
| administration of RhoGAM to all Rh negative Mom's at 28 weeks and a second dose within 72 hrs of delivery |
|
|
Term
| iron deficiency anemia is more common in what pregnancies? |
|
Definition
| adolescent due to poor nutrition |
|
|
Term
| durtion of labor is estimated on what curve? |
|
Definition
|
|
Term
| ACOG designates a prolonged second stage of labor as what? |
|
Definition
| > 2 hrs (3hrs with epidural) for first delivery. > 1 hr in subsequent deliveries |
|
|
Term
| AFI > 24 cm or a single pocket of fluid at least 8cm that results in amniotic fluid volume of more than 2000mL |
|
Definition
|
|
Term
| AFI less than 7cm or the absence of a fluid pocket 2-3cm in depth |
|
Definition
| oligohydramnios = increased risk of fetal death |
|
|
Term
| oligohydramnios associated with renal agenesis or dysgenesis, sxs = marked deformation of the fetus due to intrauterine constraint |
|
Definition
|
|
Term
| localized warmth, tenderness, and erythema in one breast |
|
Definition
|
|
Term
| uterine level during pregnancy |
|
Definition
8 wks = pubic symphysis
12 wks = abdominal organ
16 wks = half way between pubic symphysis and umbilicus
20 wks = at the umbilicus
26-34 wks = correlates with gestational age
36-40 wks = decrease in fundal height |
|
|
Term
| breast feeding is dependent on what hormones? (6) |
|
Definition
estrogen
progesterone
prolactin
hyman placental lactogen
cortisol
insulin |
|
|
Term
| benefits of breast feeding to baby? mom? |
|
Definition
baby = antibodies, less obesity, bonding
mom = partial contraceptive benefits, faster uterine involution, reduced blood loss, decresed risk of breast/ovarian cancer, reduce risk of OA and obesity, decreased cost |
|
|
Term
| when should breast feeding be avoided? |
|
Definition
| maternal infection with HIV, CMV, areolar herpes, acute hepatitis B or C |
|
|
Term
| early warning signs associated with birth control |
|
Definition
ACHES
abdominal pain
chest pain
headache
eye problems
severe leg pain |
|
|
Term
| OCP and abx reaction exists for what abx? |
|
Definition
| rifampin and griseofulvin |
|
|
Term
| inidcations for the progestin only mini-pill |
|
Definition
those who can't take estrogen
those who are breast feeding |
|
|
Term
| why is lybrel not really used? |
|
Definition
| 365 day birth control - not used because of increased bleeding profile |
|
|
Term
|
Definition
vaginal birth after cesarean
not often attempted because of incresed risk of uterine rupture during labor |
|
|
Term
| menstrual cycle is composed of what? |
|
Definition
| ovarian and uterine cycles |
|
|
Term
| what ovarian phase corresponds to uterine proliferative phase? |
|
Definition
|
|
Term
| what ovarian phase does the secretory cycle correspond to? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| uterine tissue found elsewhere in the body |
|
Definition
|
|
Term
| risk factors for endometriosis |
|
Definition
short menstrual cycles
long menstrual flow
uninteruprted menstruation x 15-20yrs
nulliparity |
|
|
Term
| bilateral pain at onset or cessation of menses, cervical motion tenderness |
|
Definition
|
|
Term
| abnormal anovulatory cycles, hyperandrogensism, polycystic ovaries |
|
Definition
|
|
Term
|
Definition
|
|
Term
| absence of menses for 12 months |
|
Definition
|
|
Term
| condyloma accuminata = genital warts, usually caused by what? |
|
Definition
|
|
Term
| HPV strains at higher risk for cervical dysplasia |
|
Definition
|
|
Term
| MC type of cervical cancer |
|
Definition
|
|
Term
| guardasil vaccinates against what strains of HPV? |
|
Definition
|
|
Term
| rhink, bubbly, pale green or gray copious discharge |
|
Definition
|
|
Term
|
Definition
|
|
Term
| classification system for breast cancer findings |
|
Definition
BI-RADS
1 = normal
2 = benign appearing
3 = probably benign/possibly malignant
4 = suspicious for malignancy
5 = malignant until proven otherwise |
|
|
Term
| MC neoepithelial neoplasm of the breast? |
|
Definition
|
|
Term
|
Definition
baseline at 35-39 yo
every 1-2 yrs > 40 yo |
|
|
Term
| eczemoid lesion of the mipple caused by large malignant cells which arise from ducts and invade the surrounding nipple epithelium |
|
Definition
|
|
Term
| MC area to find breast cancer |
|
Definition
| upper outer quadrant (Tail of Spence) |
|
|
Term
| what is the thought behind sentinel node biopsy? |
|
Definition
| biopsy the first node recieving draining from tumor site, if it is negative the remainder of the nodes are negative. If it's positive there may be additional nodes involved |
|
|
Term
| modified radical vs radical mastectomy |
|
Definition
modified radial = leaves muscle
radial = takes everything including muscle |
|
|
Term
| tx of HER2 positive breast cancer |
|
Definition
|
|
Term
| ER positive breast cancer |
|
Definition
| slower course and responsive to hormonal therapy |
|
|
Term
|
Definition
| infiltrating ductal carcinoma |
|
|
Term
| type of brast cancer that is often positive for estrogen or progesterone receptors |
|
Definition
| infiltrating lobar carcinoma |
|
|
Term
| type of ectopic to rupture earliest |
|
Definition
|
|
Term
|
Definition
| pregnancies that continue 14 days past EDC |
|
|
