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663 Cards in this Set
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- 3rd side (hint)
Where is the fundus at postpartum day one?
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Just below the umbilicus
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Uterus involution occurs as a result of:
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Autolysis of protein material within the uterine wall.
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What is a NST?
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The Non-Stress Test watches fluctuations in the baby's heart rate in response to it's own movements. Listen with fetoscope for 20 sec for FHR changes in response to activity. Moderate acceleration=good
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Increased number and activity of endocervical glands are responsible for:
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the formation of the mucus plug.
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Normal blood pressure is:
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90/60 - 140/90
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How many fetal kick counts are expected in an hour?
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8-10
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Blood volume increases by _________ during pregnancy.
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40-45%
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Placenta accreta is:
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placenta implantation is abnormally firm to uterine wall.
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Placenta increta is:
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placenta attached to the myometrium.
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Placenta percreta is:
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placenta attached through the uterus- may extend to nearby organs (like bladder) :(
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What is IgG?
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Immunoglobulin G- antibody moleculesIgG antibodies are involved in predominantly the secondary immune response. The presence of specific IgG, in general, corresponds to maturation of the antibody response.[2] Human IgG Subclasses: IgG is the only isotype that can pass through the human placenta, thereby providing protection to the fetus in utero. Along with IgA secreted in the breast milk, residual IgG absorbed through the placenta provides the neonate with humoral immunity before its own immune system develops. Colostrum contains a high percentage of IgG, especially in bovine colostrum.
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What is IgM?
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Immunoglobulin M: Immunoglobulin M, or IgM for short, is a basic antibody that is produced by B cells. It is the primary antibody against A and B antigens on red blood cells. IgM is by far the physically largest antibody in the human circulatory system. It is the first antibody to appear in response to initial exposure to antigen.IgM antibodies do not pass across the human placenta (only isotype IgG).
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Hemolytic disease of the newborn is produced by the union of:
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Rh-negative mother and
Rh-positive father |
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What is the difference between a direct and indirect coombs?
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The indirect Coombs test is used in prenatal testing of pregnant women. It detects antibodies against RBCs that are present unbound in the patient's serum.The direct Coombs test is used to detect antibodies or complement proteins that are bound to the surface of red blood cells in the fetus/newborn.
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What does a positive coombs from cord blood indicate?
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Antibodies coating the baby's RBCs.
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What is: Treponema Pallidum
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Is the bacteria that causes syphilis.
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Maternal malnutrition can lead to:
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1.) inadequate uteroplacental function
2.) IUGR & SGA 3.) hypertrophic & hyperplastic brain deterioration in the fetus |
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What is Turner Syndrome?
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A sex chromosome abnormality, where the second x is missing or incomplete. Affects girls only- often short and infertile.
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cystic fibrosis=
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genetic disease characterized by abnormal transport of chloride and sodium across epithelium, leading to thick, viscous secretions in the lungs, pancreas, liver, and intestine. affects caucasians, recessive gene
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sickle cell=
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is an autosomal recessive genetic blood disorder with overdominance, characterized by red blood cells that assume an abnormal, rigid, sickle shape. Affects Blacks, anemia, average life span 40y, 1/5000 chance in U.S. 1/500 Black children
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Down's syndrome=
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is a chromosomal condition caused by the presence of all or part of an extra 21st chromosome. Risk factor: maternal age
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Edward's syndrome=
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a genetic disorder caused by the presence of all or part of an extra 18th chromosome. 2nd most common after downs. kidney, heart and intestine problems, overlapping fingers, club foot, etc
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Patau syndrome=
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a chromosomal abnormality, a syndrome in which a patient has an additional chromosome 13 due to a nondisjunction of chromosomes during meiosis. often survive only days/weeks
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Tay Sachs=
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an autosomal recessive genetic disorder. In its most common variant, known as infantile Tay–Sachs disease, it causes a relentless deterioration of mental and physical abilities that commences around six months of age and usually results in death by the age of four.It is caused by a genetic defect in a single gene with one defective copy of that gene inherited from each parent. risk factors: ashkenazi descent, non-infantile, death by 41y
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What are the risks to the fetus if a non-sensitized mother acquires Rubella antepartum?
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for primary infection: deafness, heart defects, cataracts and mental retardation
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What is a circumvallate placenta?
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membranes double back for a short distance over the fetal surface when the chorionic plate is too small. There may be increased fetal loss with this condition and placental separation. fetal side of the placenta is smaller than the basal plate which is located on the maternal side.also called extrachorial placenta.
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What organism is thrush?
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candida albicans
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What is the main organism that causes a UTI?
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bacteria: Ecoli
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What organism is a mastitis infection typically caused by?
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bacteria: staphylococcus aureus
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What typically causes mastitis in breastfeeding women?
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caused by blocked milk ducts or milk excess. It is relatively common; estimates range depending on methodology between 5-33%. However only about 0.4-0.5% of breastfeeding mothers develop an abscess.
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What are three probable signs of pregnancy?
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enlargement of the abdomen
Hegar's signs: softening of uterus and cervix Chadwicks sign:bluish discoloration of the cervix, vagina, and labia caused by the hormone estrogen which results in venous congestion |
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What are five presumptive signs of pregnancy that the mother may feel/see?
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1.amenorrhea
2. nausea and vomiting 3. breast changes 4. frequent urination 5. quickening |
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Normal Hgb=
Normal Hgb at 2500 ft. elevation: |
11-13 gr.
higher than normal? |
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What are tubal/ectopic pregnancy signs/symptoms of rupture? At what weeks gestation do they often occur?
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6-10 weeks gestation.
lower abdominal pain (often prior to bleeding) vaginal bleeding shoulder pain |
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Rate of PPV?
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30/minute
Breath, 2, 3, Breath, 2, 3 |
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Rate of chest compressions?
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3:1 or 90/minute
1 and 2 and 3 and breath 1 and 2 and 3 and breath |
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Rubella Titer (german measles)
non immunity: immunity: has infection: |
non immunity:<1:10
immunity: >1:10 has infection: >1:40-64 the absence of IgG rubella antibodies means that the person likely has not been exposed to the rubella virus or been vaccinated and is not protected against it. The presence of IgG antibodies but not IgM antibodies indicates a history of past exposure to the virus or vaccination and indicates that the person tested should be immune to the rubella virus. |
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lochia rubra:
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red: day 2-3/5
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lochia serosa:
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pink/brown: day 3/5-10
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lochia alba:
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yellow/white: day 10-14
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Miscarriages are clinically diagnosed in __________ % of pregnancies?
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10
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Sperm survive and remain viable longer in a ______________ enviornment.
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alkaline.
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What secretes progesterone in the female reproductive system?
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corpus luteum (and placenta, later)
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What are white spots on the baby's tongue and gums that can easily be removed?
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milk residue
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What is polycythemia?
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increase in RBCs. measured through Hct. may be dehydration, heavy smoking, kidney disease
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Vitamin K is believed to prevent:
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newborn hemorrhagic disease, now called Vitamin K defiency in the newborn.
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What is a ELISA test? What does it typically test for during pregnancy?
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Enzyme-linked immunosorbent assay (ELISA). Typically tests for HIV.
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How many days can you expect newborn meconium following birth?
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3
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Implantation occurs about__________ days after fertilization.
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7-9 days.
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The heart of the embryo is a distinguishable organ by the________ week.
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8th.
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Fetal sex organs have differentiated and are developed by the end of the ________ lunar month.
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second.
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A fetus that weighs 300gr, measures 18cm, and can suck and swallow amniotic fluid is approximately _________ weeks.
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20 weeks.
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Through what weeks are the embryonic stage?
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2-8 weeks.
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Chadwicks sign=
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bluish discoloration of the cervix, vagina, and labia caused by the hormone estrogen which results in venous congestion.
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Hegar's sign=
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It pertains to the features of the cervix and the uterine isthmus. It is demonstrated as softening of the uterine consistency and the possibility to palpate or compress the connection between the cervix and the fundus. The sign is usually present from 4 to 6th week till 12 weeks of pregnancy. It is more difficult to recognize in multiparous women.
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Goodell's sign=
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is an indication of pregnancy. It is a significant softening of the vaginal portion of the cervix.
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When is the fetus most susceptable to teratogens?
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2-12 weeks
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The fetal heart begins beating at ______ week.
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4 weeks.
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The Brewer's diet recommends _______ gr. of protein/day
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80-100
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S.G.A.=
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Small for Gestational Age
poor fetal growth, potentially visual and hearing defects and mental retardation. suspect IUGR |
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Days of typical human gestation:
From LMP: From conception: |
280 from LMP
266 from conception Mittendorf's study says: 288 days from LMP for primips and 283 days from LMP for multips |
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Metrorrhagia=
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profuse bleeding from the uterus between periods
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position=
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relation of the presenting part to the 6 areas of the pelvic brim.
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attitude=
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the relationship of the fetal head to the trunk
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What is the L/S ratio?
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lecithin-sphingomyelin ratio. The lecithin-sphingomyelin ratio is a test of fetal amniotic fluid to assess for fetal lung immaturity. Lungs require surfactant, a soap-like substance, to lower the surface pressure of the alveoli in the lungs. This is especially important for premature babies trying to expand their lungs after birth. Surfactant is a mixture of lipids, proteins, and glycoproteins, lecithin and sphingomyelin being two of them.
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What L/S ratio indicates a low risk of RDS?
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An L/S ratio of 2 or more indicates a relatively low risk of infant respiratory distress syndrome
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What L/S ratio indicates a high risk of RDS?
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L/S ratio of less than 1.5 is associated with a high risk of infant respiratory distress syndrome. the concentration of lecithin in the amniotic fluid is <1.5 that of sphingomyelin
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During the first 10-12 weeks of pregnancy the corpus luteum:
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secretes progesterone to maintain the pregnancy until the placenta takes over.
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Constipation is usually the result of:
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prolonged stomach emptying time and decreased intestinal mobility
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Eutocia=
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normal labor
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1st degree laceration =
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perineal skin
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what is the curve of carus?
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sacrum, coccyx, pubic bones
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Irregular contractions with no dilation may be a sign of:
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latent labor
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What is the apgar score of 0, 1 & 2 for respirations?
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0=no breath
1=irregular breath/difficulty 2=crying |
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What is the apgar score of 0, 1 & 2 for grimace?
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0=no grimace
1=facial grimace 2=sneeze pull away |
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You can sterilize instruments by__________
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baking, boiling, pressure cooking, autoclave
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The placenta weighs approximately __________ the weight of the baby.
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1/5th
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Velamentous cord insertion=
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the umbilical cord inserts into the fetal membranes (choriamniotic membranes), then travels within the membranes to the placenta (between the amnion and the chorion). The exposed vessels are not protected by Wharton's jelly and hence are vulnerable to rupture.
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succenturiate placenta =
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an accessory (succenturiate) placental lobe to the main disk of the placenta.
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A battledore placenta=
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A battledore placenta is a placenta in which the umbilical cord is attached at the border/edge of the placenta and so resembles a battledore racket (raquet) which is a precursor to badminton.
When the umbilical cord placental end looks like it is connected to the edge of the placenta it is called a marginal or 'Battledore insertion'. |
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marginal insertion=
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insertion point occurs at the very edge of the placenta
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placenta triplex=
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Synonym for placenta tripartita ... A placenta consisting of three parts almost entirely separate, being joined together only by the blood vessels of the umbilical cord;
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What are the s/s of RDS?
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Insuction/retraction and grunting
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Vasa previa=
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fetal vessels crossing or running in close proximity to the inner cervical os. These vessels course within the membranes (unsupported by the umbilical cord or placental tissue) and are at risk of rupture when the supporting membranes rupture
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What are three clinical signs of maternal exhaustion:
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tachycardia/elevated pulse
tachypnea fever/elevated temperature |
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Hemorrhage is defined as blood loss that exceeds________cc/ml
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500
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Polyhydramnios is associated with____________.
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Urinary problems
IUGR Gestational Diabetes |
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Sock s/s and response:
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increased pulse, increased respirations, increased then decreased BP
02, IV, Blanket, nothing by mouth |
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An essential hormone responsible for reproduction is:
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estrogen
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At _______ weeks the fetus has a full set of fingerprints
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15
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In newborns, an early sign of sepsis is:
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hypothermia
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What is the name of the temporary opening between the atria in the fetal heart which allows blood to pass (air does not pass through lungs)
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foramen ovale
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Disease that passes from parent to offspring across the placenta is transmitted by a:
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vertical spread
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The uterine muscles ________ & ______ to dilate the cervix
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Retract and contract
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Trophoblast=
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the outer layer of the blastocyst that becomes the placenta
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Name the stages of development to the embryonic stage:
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ZiMBabwE
Zygote Morula Blastocyst Embryo |
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Tachycardia in the fetus may indicate:
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fetal infection
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What does GTPALM stand for?
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Gravida
Term Pre-term Abortions Live Multiples |
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Transmission of potential hereditary characteristics is the function of:
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genes
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How many chromosomes in the human cell?
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46 (23&23)
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The fetus receives oxygenated blood through the
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umbilical vein
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What are 3 positive signs of pregnancy?
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U/S, FHT, fetal movement felt by examiner
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Physiological jaundice is thought to be caused by:
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rapid destruction of RBCs
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A shrill, high pitched cry in a newborn may mean:
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increased intracranial pressure (hydrocephalus)
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Megaloblastic anemia=
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is an anemia (of macrocytic classification) that results from inhibition of DNA synthesis in red blood cell production.[1] When DNA synthesis is impaired, the cell cycle cannot progress from the G2 growth stage to the mitosis (M) stage. This leads to continuing cell growth without division, which presents as macrocytosis.
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What is megaloblastic anemia typically caused by? What condition is it associated with?
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Folic acid deficiency and/or vit. B-12 malabsorption.
Neural tube defects |
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Pica=
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cravings to eat non-food substances such as ice, clay, dirt, starch or plaster.
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The three phases of a uterine contraction are:
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increment
acme (peak) decrement |
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When is an ultrasound most accurate?
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8-10 weeks
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MsAFP3 or Triple Screen gives this information:
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Blood serum levels of MsAFP, hCG, estriol
It screens for neural tube defects, trisomies and other abnormalities |
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What is the risk of miscarriage with an amniocentesis:
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.5-1%
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When is an amnio typically done?
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15-20 weeks (but as early as 12)
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What does the BPP include?
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1. Non stress test
2. fetal movements 3. fetal breathing movements 4. fetal tones 5. AFI 6. Placental grading |
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Testing for Rh-negative antibodies determines:
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if sensitization has occurred. potential for increased risk to the fetus.
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Which blood type can receive any type of blood and why?
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AB is the universal recipient
O is the universal doner |
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What is HgB?
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is the iron-containing oxygen-transport metalloprotein in the red blood cellsHemoglobin in the blood carries oxygen from the respiratory organs (lungs) to the rest of the body (i.e., the tissues) where it releases the oxygen to burn nutrients to provide energy to power the functions of the organism, and collects the resultant carbon dioxide to bring it back to the respiratory organs to be dispensed from the organism.
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Hct is=
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packed cell volume (PCV) or erythrocyte volume fraction (EVF) is the percentage (%) of the concentration of red blood cells in blood. It is normally about 45% for men and 40% for women.
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What is a normal pulse, temperature and respirations in an adult?
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60-80bpm, 98.6F, 15-20pm
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What are s/s of hyperactive labor?
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contractions q 2m lasting 90s, rapid progressive cervical dilation, discomfort that seems out of proportion to ctx
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What labor pattern can you expect from a primip with a diagonal conjugate of 10cm?
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prolonged labor with failure of head to engage. a measurement of 10.5 is considered adequate
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What is a normal breathing pattern for a full term neonate?
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The abdomen is synchronous with the chest movements
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The average heartrate for a full term, quite and awake newborn is:
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120-140: davis says 110-150
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The neonate can contract syphilis from mom during:
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following 16 weeks of pregnancy
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sings of hypoglycemia in a newborn include:
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jitterniness Bluish-colored skin (cyanosis)
Breathing problems Decreased muscle tone (hypotonia) Grunting Irritability Listlessness Nausea, vomiting Pale skin Pauses in breathing (apnea) Poor feeding Rapid breathing Problems with maintaining body heat Shakiness Sweating Tremors Seizures |
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What are the 4 pelvic joints
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symphysis pubic join
sacrococcygeal joint 2 sacroiliac joints |
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What is erythroblastosis fetalis (hydrops fetalis)?
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Hemolytic disease of the newborn,
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Hemolysis leads to elevated --------------levels
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bilirubin
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A male child receives a _____chromosome from the mother and a ________ chromosome from the fater.
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x from mother and y from father
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Fertilization occurs normally in:
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the fallopian tubes
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What are s/s of hemolytic disease of the newborn?
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jaundice in the first 24 hours, enlarged liver
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lysis=
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breaking down of a cell
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Which STI affects the central nervous system?
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syphilis
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cervical cap=
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suctions to the cervix
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The chorion is a thick membrane that develops from__________
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tropholblasts
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at term the placenta is _____ of the baby's weight and has ______ cotyledons
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1/5-1/6
15-20 |
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Leopolds steps
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1.1 First maneuver: Fundal Grip
1.2 Second maneuver: Umbilical Grip 1.3 Third maneuver: Pawlick's Grip 1.4 Fourth maneuver: Pelvic Grip |
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marked tachycardia=
marked bradycardia= |
180
100 |
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s/s of pre-eclampsia and eclampsia
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elevated bp, proteinuria, edema, iligohydramnios, kidney function,
severe pre-eclampsia= risk of placental abruption eclampsia=seizures |
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At 37 weeks a fetus is:
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depositing layers of subcutaneous fat
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What is the primary cause of uterine enlargement during pregnancy?
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hypertrophy of pre-existing myometrial cells.
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anterior cervix=
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retroverted uterus
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which hormone controls the proliferative phase of the menstrual cycle?
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estrogen
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DES=
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Diethylstilbestrol From about 1940 to 1970, DES was given to pregnant women in the mistaken belief it would reduce the risk of pregnancy complications and losses. In 1971, DES was shown to cause a rare vaginal tumor in girls and women who had been exposed to this drug in utero.
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What are the risks to pregnant mothers exposed to DES in utero?
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vaginal clear cell adenocarcinoma; structural anomalies of the uterus; poor pregnancy outcomes
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Diagonal conjugate=
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a measurement of the distance from the inferior border of the symphysis pubis to the sacral promontory. The measurement, averages around 12.5 to 13.0 cm in adult women.
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Obstetrical conjugate=
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The line between the narrowest bony points formed by the sacral promontory and the inner pubic arch is termed obstetrical conjugate: It should be 10.5 cm or more. This anteroposterior line at the inlet is 1.5-2 cm less than the diagonal conjugate (distance from undersurface of pubic arch to sacral promontory).
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Interspinous measurement=
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The distance between the ischial tuberosities (normally > 10.5 cm)
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vitamin K is administered during the newborn neonatal period because:
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to help prevent vitamin K. deficiency syndrome. newborns lack intestinal bacteria with which to synthesize vitamin k.
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Why are the newborns hands and feet blue?
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acrocyanosis
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Suction the ________ then the ________
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mouth then nose
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Why may a postpartum woman's bowels be sluggish?
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progesterone, decreased abdominal muscle
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What is one presumptive sign of pregnancy?
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amenorrhea
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Naegele's Rule=
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The rule estimates the expected date of delivery (EDD) by adding one year, subtracting three months, and adding seven days to the first day of a woman's last menstrual period (LMP). The result is approximately 280 days (40 weeks) from the LMP.
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Nicole's Rule=
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Now called Wood's Method:
1. add 1 year to the first day of the LMP then: for primip= subtract 2 months, 2 weeks for multips=subtract 2 months, and 2.5 weeks (18 days) 2. add or subtract the number of days her cycle varies from 28 days |
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Another name for chronic hypertension=
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essential hypertension- preexisting condition
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anatomy=
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study of the structure and shape of the body and their relationship to one another
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physiology=
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study of how the body and its parts work and function
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Blood volume increases by:
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20-40%- frye says 50-60%; 30-50% in varneys
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Name two hormones that the placenta produces:
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estrogen and progesterone
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name one essential male hormone responsible for reproduction=
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testosterone
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After ovulation, menstruation takes place as the result of:
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degeneration of the corpus luteum
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vuvla=
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the external structures from the symphysis pubis to the perineum
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Which hormones stimulates and maintains milk production after childbirth?
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prolactin
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the primary function of hCG is:
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maintain the corpus luteum during the first trimester
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Development of the secondary sex characteristics in males is stimulated by:
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testosterone
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childbirth is also called:
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parturition
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menarche=
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first menstrual period
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After fertilization the produce of conception is_________ then_________.
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zygote, morula, blastocyst, implant (10-14 days) embryo
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embryonic stage=
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2-8 weeks from fertilization
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function of the placenta is to:
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provide nutrients/ remove waste, provide barrier to infection
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when is the embryo most suceptable to teratogens?
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2-12 weeks from conception, 4-12 weeks from lmp
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the heart begins beating in the embryo (from conception)
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21-22 days from conception, 35 days from LMP
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chorion
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s one of the membranes that exist during pregnancy between the developing fetus and mother. It is formed by extraembryonic mesoderm and the two layers of trophoblast and surrounds the embryo and other membranes. The chorionic villi emerge from the chorion, invade the endometrium, and allow transfer of nutrients from maternal blood to fetal blood. (outer membrane)
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amnion
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a membrane building the amniotic sac that surrounds and protects an embryo.
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how many arteries and veins in the umbilical cord?
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2 arteries=supply deoxygenated blood from the fetus to the placenta
1 vein=carries oxygenated blood from the placenta to the growing fetus A A V birdie |
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From LMP the average human gestation=
from conception= |
280 from lmp
266 from conception 288 days from lmp for primips 283 days from lmp for multip |
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fetus grows arm and leg buds at:
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4 weeks from lmp
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describe the fetal scull:
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anterior fontanel=diamond
posterior fontanel=triangle sagittal suture=ant-post, division b/wpartietal bones biparietal diameter=largest transverse diameter of the head bitemporal diameter=greatest distance between 2 temporal sutures |
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you can hear the fetal heart tones with a doppler at:
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10-12 weeks
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leukorrhea=
|
a profuse think or thick vaginal secretion begins in the first trimesterLeukorrhea may occur normally during pregnancy. This is caused by increased bloodflow to the vagina due to increased estrogen. Female infants may have leukorrhea for a short time after birth due to their in-uterine exposure to estrogen.
|
|
|
to relieve leg cramps=
|
-extend leg and dorsiflex foot
-elevate and support legs -increase ca, phosphorus/or mag |
|
|
chloasma
|
pigmentary changes from pregnancy
|
|
|
gravida=
|
times pregnant
|
|
|
parity=
|
any live births after 21-24 weeks
|
|
|
excessive use of antibiotics may result in vaginal infection with:
|
yeast (candida albicans)
|
|
|
1st trimester=
2nd trimester= 3rd trimester= |
1st trimester= 1-12 weeks
2nd trimester= 13-27 weeks 3rd trimester= 28-40+ weeks |
|
|
Innominate bone in the pelvis is comprised of the:
|
(hip bone) =ischium, illium and pubis
|
|
|
occiput=
military= brow= face= |
occiput
straight ahead sniffing position full extension of neck |
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|
Presentation=
|
refers to which anatomical part of the fetus is leading, that is, is closest to the pelvic inlet of the birth canal. According to the leading part, this is identified as a cephalic, breech, or shoulder presentation.
|
|
|
Cephalic presentations=
|
vertex (crown) — the commonest and associated with the fewest complications
sinciput (forehead) brow (eyebrows) face chin |
|
|
Breech presentations=
|
complete breech
footling breech frank breech kneeling |
|
|
Shoulder presentations=
|
arm
shoulder trunk |
|
|
Station=
|
some sources say -5 tp +5 others -4 to +4
At +3 and +4 the presenting part is at the perineum and can be seen. |
|
|
Lithotomy=
|
flat on back, legs in stirrups
|
|
|
FHT that stays the same with no variations is considered=
|
absent/silent variations, flat
|
|
|
episiotomy=
|
midline repairs easier, more comfortable, heals faster than medio-lateral
|
|
|
preterm labor starts prior to-
|
37 weeks
|
|
|
hemorrhage with blood loss exceeds=
|
500 cc (though frye says this is too little) approx 2 cups
|
|
|
types of shock midwives encounter=
|
hemorrhagic, hypovolemic, septic
|
|
|
If in shock=
|
911
do not give water (stomach shuts down? will be thirsty) legs up, head down on left side cover with blanket IV |
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|
Hegars sign=
|
softening of the lower uterine segment, isthmus uterus, junction of the cervix and uterus
|
|
|
chadwicks sign=
|
blue, red, purple cervix, vulva, rugae
|
|
|
goodell's sign=
|
softening of the cervix
|
|
|
delivering in a face presentation must come out________ and turn/rotate to a_________
|
posterior
mentum anterior position |
|
|
when delivering a breech you should:
|
-rotate anterior if turning posterior
-pull loop of cord (debated) -wrap a towel around baby and gentle support body (....) |
|
|
After a shoulder dystocia be prepared for:
|
hemorrhage, full resuscitation, maternal sepsis (hand inside- watch for fever)
|
|
|
Normal changes in pp recovery:
|
100 F in first 24 hours
uterus goes down 1fb a day diastasis recti is common in multips, may be perminent common to lose 9-15lbs immediately |
|
|
common pp discomforts:
|
constipation, mainly due to dehydration
excessive perspiration due to hormonal changes hemorrhoids (fiber, fluids, witchhazel, soaks, rest) |
|
|
dispareunia-
|
from Greek meaning "badly mated" painful sex
|
|
|
mature milk usually comes in at ____ days pp
|
2 days
|
|
|
In the pp period, if the mother presents with a fever, ask her:
|
Did her milk come in?
Are her breasts sore? Is her uterus/abdomen tender? Does her lochia smell normal? Are there s/s of a UTI? |
|
|
PP blues last=
|
up to 2 weeks
|
|
|
A temperature rise may occur up to 24 hours pp due to:
|
dehydration or exertion associated with labor, infection
|
|
|
puerperal morbidity=
|
pp illness related to the pregnancy
|
|
|
a nosocomial infection is caused by:
|
the care provider or enviornment provided by the care provider
|
|
|
endometritis is caused by:
|
bacterial or viral contamination of the repro tract. Symptoms include lower abdominal pain, fever and abnormal vaginal bleeding or discharge. Caesarean section, prolonged rupture of membranes and long labor with multiple vaginal examinations are important risk factors. chronic caused by STI,tuberculous
|
|
|
List 7 cardinal movements:
|
descends, engages, flexes, internal rotation, extension, restitution, external rotation
|
|
|
head usually enters the inlet in ________ or _________ position because the pelvic inlet is widest from side to side.
|
occiput transverse or oblique
|
|
|
distinguish between stress and urge incontinence
|
stress= sneeze, running
urge= have to go all the time |
|
|
late pp hemorrhage can occur up to:
|
6 weeks
|
|
|
endometritis may present as=
|
tachycardia
uterine tenderness subinvolution increased wbc |
|
|
s/s of mastitis=
|
Breast tenderness or warmth to the touch
General malaise or feeling ill Swelling of the breast Pain or a burning sensation continuously or while breast-feeding Skin redness, often in a wedge-shaped pattern Fever of 101 F (38.3 C) or greater [4] The affected breast can then start to appear lumpy and red. Some women may also experience flu-like symptoms such as: Aches Shivering and chills Feeling anxious or stressed Fatigue Breast engorgement [5] |
|
|
peritonitis=
|
Peritonitis is an inflammation of the peritoneum, the serous membrane that lines part of the abdominal cavity and viscera.
|
|
|
s/s of peritonitis=
|
acute abdominal pain, abdominal tenderness, and abdominal guarding, which are exacerbated by moving the peritoneum, e.g., coughing (forced cough may be used as a test), flexing one's hips, or eliciting the Blumberg sign (a.k.a. rebound tenderness, meaning that pressing a hand on the abdomen elicits less pain than releasing the hand abruptly, which will aggravate the pain, as the peritoneum snaps back into place). Diffuse abdominal rigidity ("washboard abdomen") is often present, especially in generalized peritonitis
Fever Sinus tachycardia Development of ileus paralyticus (i.e., intestinal paralysis), which also causes nausea, vomiting and bloating. |
|
|
thrombophlebitis treatment includes:
|
bed rest, hot packs, compression stockings
|
|
|
What does RhoGam do to prevent sensitization?
|
The antibodies in the artificial anti-D will “fight off” any rhesus positive cells from the baby and prevent the woman from producing her own anti-D. The medicine is a solution of IgG anti-D (anti-RhD) antibodies that bind to, and lead to the destruction of, fetal Rh D positive red blood cells that have passed from the fetal circulation to the maternal circulation.
|
|
|
The normal weight gain of a newborn is _________/day or _______/week.
|
1/2-1 oz/day
6-12 oz/week |
|
|
another word for nosocomial is=
|
iatragenic
|
|
|
at six months the baby's weight is_____________
|
doubled
|
|
|
Your neonate has a pulse of 100+. What is the appropriate apgar score for him?
|
2
|
|
|
newborn respiration rate=
|
30-60
|
|
|
stump falls off between=
|
4-10days
|
|
|
1st period of reactivity is:
2nd stage= 3rd= |
1st stage: reactivity for first 30m after birth
2nd stage: 30-2hours, decreased period of responsiveness 3rd stage: 2-8 hours- second period of reactivity |
|
|
neuromuscular test refers to=
|
neurological maturity
|
|
|
ballard score=
|
Ballard Score, or Ballard Scale is a commonly used technique of gestational age assessment. It assigns a score to various criteria, the sum of all of which is then extrapolated to the gestational age of the baby. These criteria are divided into Physical and Neurological criteria. This scoring allows for the estimation of age in the range of 26 weeks-44 weeks. The New Ballard Score is an extension of the above to include extremely pre-term babies i.e. up to 20 weeks.
|
|
|
a cbc with differential=
|
CBC with white blood count and type
|
|
|
lie=
|
longitudinal, transverse, oblique
|
|
|
attitude=
|
relation of head to its trunk, flexed, military, brow, face
|
|
|
presentation=
|
part that lies at the pelvic brim= cephalic, breech
|
|
|
denominator (variety)=
|
mentum, occiput, sacrum, brow, acromian
|
|
|
denominator
|
the fetal part used to determine the position (occiput, sacrum, acromion process)
|
|
|
phimosis=
|
fully retracted foreskin
|
|
|
subinvolution
|
not going down (as in uterus) cause of retained placenta fragments
|
|
|
cervix of multip on the verge of true labor
|
little or no effacement with 1-2 cm or more of dilation
|
|
|
responsible fore closure of the ductus arteriosus is:
|
increase in oxygen levels in the blood
|
|
|
hypoxemia=
|
decreased oxygen levels in the blood
|
|
|
emia=
|
blood cells
|
|
|
malnourishment leads to irreversible damage for child, especially during
|
the last few months of pregnancy and first few months of life- brain cells grow rapidly
|
|
|
every midwife should have and provide to her clients:
|
1. code of ethics
2. definition of midwifery practice 3. standards for the practice of midwifery 4. a philosophy of care |
|
|
chest compression rate/minute
|
90/minute
|
|
|
PPV rate=
|
breath, 2 and 3, breath, 2 and 3
|
|
|
an normal infant should void ______ x in a 24 hour period
|
6
|
|
|
impending fetal demise is seen with:
|
a flat baselin, a wandering baseline, a sinusoidal baseline
|
|
|
macrocytic anemia:
|
large red blood cells, b-12/folic acid defeciency
|
|
|
microcytic anemia:
|
small blood cell, iron deficiency
|
|
|
normocytic anemia=
|
caused from blood loss?
|
|
|
HSV s/s
|
painful itchy bumps "vesicles", fever, malaise, inguinal lymph swelling
|
|
|
What rubella titer indicates immunity? non immunity?
|
immunity= >1:8
non-immune=<1:8 primary infection: 4-fold increase in antibody levels |
|
|
syphilis s/s
|
depends on if it is a primary, secondary, latent or tertiary outbreak, but skin lesion, called a chancre,sometimes painful, sometimes not, rash, may include fever, sore throat, malaise, weight loss, hair loss, and headache, lymph node enlargment
|
|
|
fetal iron stores in the breastfed baby last _____ months following birth
|
4-6
|
|
|
piskacek's sign=
|
asymmetric enlargement of the body of the pregnant uterus as a result of its enlargement in the cornual region, usually over the site of implantation.
|
|
|
newborn's regain their birth weight at:
|
10 days
|
|
|
endometrium after birth is regenerated at:
|
6 weeks
|
|
|
hemorrhoids caused by: ______ and ______
|
progesterone (relaxes veins) and enlarging uterus
|
|
|
hypertension see a risk in blood pressure of:
|
30/15
140/90 mild |
|
|
the placenta secretes the following hormones:
|
progesterone, estrogen, HCG, HPL (human placenta lactogen)
|
|
|
Human placental lactogen (HPL)=
|
also called human chorionic somatomammotropin, is a polypeptide placental hormone. Its structure and function is similar to that of human growth hormone. It modifies the metabolic state of the mother during pregnancy to facilitate the energy supply of the fetus. HPL has anti-insulin properties.
|
|
|
maternal vital that remains elevated in the immediate pp
|
temperature
|
|
|
what are the most ominous heart tones besides (flat)
|
late decelerations with loss of short term fetal variability
|
|
|
AFP=
|
increased in open neural tube defects and omphalocele & decreased in Down syndrome. Typically, MSAFP is measured in the beginning of the second trimester (14–16 weeks)
|
|
|
the smallest pelvic diameter to which the fetus has to accomodate itself is:
|
interspinous diameter
|
|
|
largest diameter of the fetal head=
|
occipitomental
|
|
|
widest point when head enters pelvic inlet=
|
biparietal
|
|
|
to detect abnormal or periodic fetal heart rate changes or patterns when using a fetascope:
|
5 second increments and a 5 second break between the period of counting during a ctx
|
|
|
anterior fontannel closes at:
|
12-18 months (about when baby starts talking)
|
|
|
posterior fontannel closes at:
|
3-6 months pp
|
|
|
what triggers milk ejection?
|
sucking
|
|
|
normal glucose levels for mom=
for baby= |
80-120, 80-100 fasting
40+ |
|
|
military presentation is also called
|
sinciput (latin for forehead)
|
|
|
pain with movements of the cervix think.....
|
ectopic pregnancy
|
|
|
chest circumference=
|
30-36 cm (11-14 inches)
|
|
|
most likely to suffer from mastitis:
|
breastfeeding moms at more than a week pp
|
|
|
1st degree tear involves=
|
involving only the skin around the vaginal opening.
|
|
|
2nd degree tear involves=
|
involve vaginal tissue (vaginal mucosa) and the perineal muscles
|
|
|
3rd degree tear involves=
|
involve vaginal mucosa, posterior fourchette, perineal skin and muscles, and external anal sphincter
|
|
|
4th degree tear involves=
|
involve the perineal muscles and anal sphincter as well as the tissue lining the rectum.
|
|
|
most common cause of uterine rupture=
|
separation of previous cesarean scar with pitocin hyperstimulation
|
|
|
90 min after birth normal to see_________ in a newborn
|
sleep, murmur, bowel sounds, heart rate of 108
|
|
|
marked bradycardia cutoff
|
bellow 100
|
|
|
fertile cervical mucus is ________ and the peak day is________
|
clear, slippery, stretchy
peak day=last day of this kind of mucus |
|
|
maternal cardiac output is highest_________
|
immediately pp
|
|
|
polyhydramnios causes and s/s
|
causes= multiple gestation, diabetes, urinary probs
s/s=difficulty palpating and heart fht, edema, confirm with u/s |
|
|
chloasma occus with___________ and most often in_________
|
pregnancy, oral contraception
brunettes and dark skin |
|
|
bartholins cysts=
|
formed when a Bartholin's gland is blocked, causing a fluid-filled cyst to develop; glands = two glands located slightly posterior and to the left and right of the opening of the vagina. They secrete mucus to lubricate the vagina
|
formed when a Bartholin's gland is blocked, causing a fluid-filled cyst to develop
|
|
HIV most likely transmitted:
|
during labor and delivery
|
|
|
ecchymosis=
|
bruising
|
|
|
complications of HPV (warts) in pregnancy=
|
increase in the number and size of warts
excessive bleeding during delivery if tearing or cutting extends to affected area intrapartum laryngeal infection of the baby |
|
|
gastroschisis=
at risk for= |
defect in the anterior abdominal wall through which the abdominal contents freely protrude (organs on outside)
dehydration, hypothermia |
|
|
at 12 weeks the uterus is:
at 16: at 20: |
12=just above pubic bone
16=halfway btw pubic bone and umbillicus 20=umbilicus |
|
|
bishop pelvic score
highest score= induce at= |
The Bishop score grades patients who would be most likely to achieve a successful induction. The duration of labor is inversely correlated with the Bishop score; a score that exceeds 8 describes the patient most likely to achieve a successful vaginal birth. components of vaginal exam= cervical position, consistency, effacement, dilation, fetal station
highest score=13 5 or less- labor unlikely to start without induction |
|
|
sex of fetus seen at=
|
14 weeks
|
|
|
cold stress effects on newborn:
|
hypoglycemia, pulmonary vasoconstriction, metabolic acidosis
|
|
|
varicella infection can be passed to the newborn :
|
day 6 BEFORE birth-day 2 following birth, if preg. then baby can get passive immunity before day 6
|
|
|
abruptio placenta s/s
|
tender, rigid uterus (from blood buildup), elevated maternal pulse, shock, abnormal fht
|
|
|
DIC=
Possible complication of= s/s of DIC= |
Disseminated intravascular coagulation=DIC leads to the formation of small blood clots inside the blood vessels throughout the body.[1] As the small clots consume coagulation proteins and platelets, normal coagulation is disrupted and abnormal bleeding occurs from the skin
causes=abruptio placentae, pre-eclampsia, amniotic fluid embolism s/s=The affected person is often acutely ill and shocked with widespread haemorrhage (common bleeding sites are mouth, nose and venepuncture sites), extensive bruising, renal failure |
|
|
this procedure_______ examines amniotic fluid through intact membranes
|
amnioscopy
|
|
|
vital non expected to change in pregnancy=
|
blood pressure (this is so not true)
changes include: displaced heart to left, hrate increase 10 beats, increased cardiac volume |
|
|
combined oral contraceptives prevent pregnancy by inhibiting the production of:
|
FSH & LH
|
|
|
oral contraceptives can cause bloating/sodium retention from:
|
increased estrogen
|
|
|
genotype=
|
the genetic makeup of a cell, an organism, or an individual (i.e. the specific allele makeup of the individual) usually with reference to a specific character under consideration.[1] For instance, the human CFTR gene, which encodes a protein that transports chloride ions across cell membranes, can be dominant (A) as the normal version of the gene, or recessive (a) as a mutated version of the gene. Individuals receiving two recessive alleles will be diagnosed with Cystic fibrosis.
|
|
|
phenotype=
|
is an organism's observable characteristics or traits. Phenotypes result from the expression of an organism's genes as well as the influence of environmental factors and the interactions between the two.
|
|
|
cystic fibrosis, sickle cell anemia, and tay-sachs, which can be diagnosed by prenatal genetic studies are examples of:
|
autosomal recessive disorders
|
|
|
autosome=
|
a chromosome that is not a sex chromosome, or allosome; that is to say, there is an equal number of copies of the chromosome in males and females.[1] For example, in humans, there are 22 pairs of autosomes. In addition to autosomes, there are sex chromosomes, to be specific: X and Y. So, humans have 23 pairs of chromosomes.
|
|
|
besides restoration of the diploid number of chromosomes what else occurs at fertilization?
|
start of mitotic cell division and fetal sex determination
|
|
|
ponstel (Mefenamic acid) to relieve primary dysmenorrhea=
|
a non-steroidal anti-inflammatory drug used to treat pain, including menstrual pain.Mefenamic acid decreases inflammation (swelling) and uterine contractions by a still unknown mechanism. However it is thought to be related to the inhibition of prostaglandin synthesis. (antiprostaglandin)
|
|
|
the primary function of hCG is to:
|
maintain the corpus luteum during the first trimester
|
|
|
an __________ pH increases:
|
vaginal infections
|
|
|
which hormone is responsible for the production of clear, elastic cervical mucus associated with spinnbarkeit and ferning?
|
estrogen
|
|
|
oocyte=
|
immature egg
|
|
|
oogenesis=
|
The formation of an oocyte is called oocytogenesis, which is a part of oogenesis.[1] Oogenesis results in the formation of both primary oocytes before birth, and of secondary oocytes after it as part of ovulation.
|
|
|
oogonia=
|
a primordial oocyte in a female fetus Oogonia are formed in large numbers by mitosis early in fetal development from primordial germ cells. In humans they start to develop between weeks 4 and 8 and are present in the fetus between weeks 5 and 30. Once the primordial germ cells have arrived in the ovary, they develop into oogonia. Oogonia migrate from the yolk sac to the genital ridge (site of the future ovaries) located on the posterior abdominal wall. Oogonia develop by mitosis. However, some of them become primary oocytes, which begin meiosis which is halted in prophase I. When they have entered Prophase I of meiosis they become primary oocytes; it is important to note that this process is complete before birth, in contrast to spermatogenesis.
|
|
|
the physiologic effects of estrogen include:
|
increased basal metabolism
placental growth smooth muscle tissue relaxant development of acini (mammary) cells in the breasts |
|
|
If conception fails to occur, menstration takes place about 2 weeks after ovulation as a result of:
|
degeneration of the corpus luteum (drop in progesterone)
|
|
|
the physiologic effects of estrogen include:
|
development of secondary sex characteristics, myometrial thickening, maturation of ovarian follicles
|
|
|
testosterone production is stimulated by:
|
luteinizing hormone
|
|
|
In response to anterior pituitary stimulation, the graafian follicle secretes:
|
An antral follicle (or Graafian follicle) is an ovarian follicle during a certain latter stage of folliculogenesis. estrogen
|
|
|
developing follicles and the graafian follicle are found in the
|
cortex of the ovaries
|
|
|
the non-pregnant uterus is lined by the:
|
endometrium
|
|
|
which principle factor causes vaginal pH to become acidic:
|
the action of doderlein's bacillus (lactobacillus)
|
|
|
the frenulum and prepuce of the clitoris are formed by the:
|
labia minora
|
|
|
Frenulum of labia minora=
|
the fourchette or the posterior commissure of the labia minora) is a frenulum where the labia minora meet posteriorly.The fourchette may be torn during delivery due to the sudden stretching of the vulval orifice, or during intercourse.
|
|
|
the labia minora taper, extending posteriorly to form the:
|
fourchette
|
|
|
the increased activity of the endometrial glands during the luteal phase of the female reproductive cycle is stimulated by:
|
(secretatory phase) named from corpus luteum- progesterone
|
|
|
increased levels of Gn-RH stimulate the anterior pituitary to secrete:
|
Gonadotropin-releasing hormone (GnRH), also known as Luteinizing-hormone-releasing hormone (LHRH) and luliberin. responsible for the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the anterior pituitary.
|
|
|
the external visible structures of the female reproductive system extending from the symphysis pubis to the perineum
|
vulva
|
|
|
the almond shaped area enclosed laterally by the labia minora and extending from the clitoris to the fourchette is called
|
vestibule
|
|
|
when obtaining a pap smear, the midwife removes cells from the squamocolumnar junction called the:
|
inside of the external os
|
|
|
in which portion of the fallopian tube the site of sterilization?
|
isthmus
|
|
|
in which portion of the fallopian tubes does fertilization normally occur?
|
ampulla
|
|
|
the largest portion of the uterus is the:
|
myometrium
|
|
|
endometrium is called__________ in pregnancy
|
decidua basalis
|
|
|
which term refers to the upper first portion of the uterus?
|
corpus uteri (incudes cavity and fundus)
|
|
|
the uterine isthmus is essential during pregnancy in the formation of:
|
lower uterine segment
|
|
|
the vaginal portion of the cervix that dilates during labor is called the:
|
eternal os
|
|
|
the vas deferens is a:
|
also called ductus deferens, part of the male anatomy of many vertebrates; they transport sperm from the epididymis in anticipation of ejaculation.conduit for spermatozoa
|
|
|
the male hormone testosterone which maintains spermatogenesis is synthesized and released by:
|
The mesonephric duct (also known as Wolffian duct, archinephric duct, Leydig's duct and nephric duct) is a paired organ found in mammals including humans during embryogenesis.In a male, it develops into a system of connected organs between the efferent ducts of the testis and the prostate, namely the epididymis, the vas deferens, and the seminal vesicle. The prostate forms from the urogenital sinus and the efferent ducts form from the mesonephric tubules.
For this it is critical that the ducts are exposed to testosterone during embryogenesis. Testosterone binds to and activates androgen receptor, affecting intracellular signals and modifying the expression of numerous genes..[1] In the mature male, the function of this system is to store and mature sperm, and provide accessory semen fluid. |
|
|
CVS can detect which genetic disorders:
|
tay-sachs, cystic fibrosis, trisomy 21, not neural tube defects
|
|
|
after CVS, no:
|
sex for two days, spotting normal, no bed rest needed
|
|
|
Most common indication for performing CVS:
|
maternal age
|
|
|
to diagnose endometriosis do:
|
laparoscopy and biopsy results
|
|
|
cervical cap=
|
inserted prior to arousal, leave in up to 48 hours,
|
|
|
contraindications for cervical cap=
|
abnormal papgiven birth may have scar tissue or irregularly shaped cervixes that interfere with the cap forming a good seal.[26] For some women, available sizes of cervical caps do not provide a correct fit. Also, cavity rim caps are not recommended for women with an anteflexed uterus.
|
|
|
LAM (lactation amennorhea method)
|
For women who meet the criteria (listed below), LAM is 98% - 99.5% effective during the first six months postpartum.[1]
Breastfeeding must be the infant’s only (or almost only) source of nutrition. Feeding formula, pumping instead of nursing,[2] and feeding solids all reduce the effectiveness of LAM. The infant must breastfeed at least every four hours during the day and at least every six hours at night. The infant must be less than six months old. The mother must not have had a period after 56 days post-partum (when determining fertility, bleeding prior to 56 days post-partum can be ignored). |
|
|
oral contraceptives- wait ______ months before attempting pregnancy
|
3
|
|
|
discontinue the pill and call if you have:
|
severe headaches
|
|
|
contraindications of a diaphragm:
|
frequent UTIs
|
|
|
proper diaphragm use:
|
use water soluable jelly, store cool, dry place, check for tears before each use, fefit if gain/lose 15 lbs
|
|
|
contraceptive film dissolves in the vagina and acts as a _______
Insert it ______ minutes before sex effective up to: |
spermacide (chemical barrier)
15-20 2 hours |
|
|
IUD contraindications:
reexamine after insertion at: |
PID, ectopic, AIDS
fist menses |
|
|
the lower uterine segment forms at about ________ weeks of pregnancy.
|
28-30
|
|
|
placenta forms from the:
|
chorionic vili and decidua basalis
|
|
|
partner with pregnancy symptoms=
|
couvade syndrome
|
|
|
milk supplies to mother:
|
calcium, riboflavin (B2), and vitamin a
|
|
|
vitamin c foods=
|
oranges, grapefruit, cabbage, bananas, parsley, brocoli, brussel sprouts, liver, oysters, goat milk
|
|
|
iron foods=
|
spinach, beef, organs, dried fruit, red meat, lentils, beans, poultry, fish, leaf vegetables, tofu, chickpeas, black-eyed peas, blackstrap molasses,
|
|
|
nosebleeds intermittently caused by:
|
hyperemia (increase of blood flow) of the nasal mucous membranes
|
|
|
typical feelings about pregnancy:
1st trimester: 2nd: 3rd: |
ambivalent
identify baby as separate human prepare for labor |
|
|
folic acid
helps to prevent: |
vitamin B9,[3] vitamin Bc, The human body needs folate to synthesize DNA, repair DNA, and methylate DNA as well as to act as a cofactor in biological reactions involving folate.[7] It is especially important in aiding rapid cell division and growth, such as in infancy and pregnancy. Children and adults both require folic acid to produce healthy red blood cells and prevent anemia.
prevent= neural tube defects |
|
|
foods high in folate:
|
Leafy vegetables such as spinach, asparagus, turnip greens
Legumes such as dried or fresh beans, peas and lentils Egg yolks.[70] Baker's yeast Fortified grain products (pasta, cereal, bread); some breakfast cereals (ready-to-eat and others) are fortified with 25% to 100% of the recommended dietary allowance (RDA) for folic acid Sunflower seeds Liver and liver products contain high amounts of folate Kidney[70] Moderate amounts: Certain fruits (orange juice, canned pineapple juice, cantaloupe, honeydew melon, grapefruit juice, banana, raspberry, grapefruit and strawberry) and vegetables (beets, corn, tomato juice, vegetable juice, broccoli, brussels sprouts, romaine lettuce and bok choy),[71] beer.[72] |
|
|
ibuprofin=
|
non-steroidal anti-inflammatory drug, decreases prostaglandins (which are mediators of pain, inflammation, and fever), thins blood. (stop labor=ibuprofin?)
available under a variety of popular trademarks, including Motrin, Nurofen, Advil, and Nuprin.[7] |
|
|
preeclamptic s/s in 1st trimester think:
|
hydatidiform mole
|
|
|
frequent leg cramps: what should you ask mom?
|
assess intake of diary products (sodium, calcium, magnesium and potassium help prevent cramps)
ask of varicose veins |
|
|
GTPAL
|
Gravida=number of total pregnancies
Term= term deliveries Preterm OR Para= Abortions= abortions (both surgical abortions and miscarriages) Living= living children (para) |
|
|
direct coombs=
indirect coombs= negative/positive= |
direct=cord blood, used to detect these antibodies or complement proteins that are bound to the surface of red blood cells;
indirect=detects antibodies against RBCs positive = bad, negative indirect = good, rhogam |
|
|
waddling=which hormone
|
relaxin
|
|
|
women can feel a quickening around=
|
18-20 weeks (first)
14-18 weeks (2nd) |
|
|
funic souffle=
uterine souffle= |
funic=is a blowing sound heard in synch with fetal heart sounds, and may originate from the umbilical cord. (FHT)
uterine= a sound made by the blood within the arteries of the gravid uterus. |
|
|
the bag of waters.....
|
maintains temperature, cushions, prevents cord entanglement, provides even muscle growth
|
|
|
kegels=which muscle
|
puboCoccygeus muscle (PC muscle)
|
|
|
MsAFP timeframe
|
Typically, MSAFP is measured in the beginning of the second trimester (14–16 weeks)
|
|
|
MSAFP above normal can indicate
|
above normal is seen in multiple gestation, when there is placental abruption, as well as in a number of fetal abnormalities, such as neural tube defects including spina bifida and anencephaly, and abdominal wall defects
|
|
|
PIH and Diabetes may need magnesium sulfate to prevent: by:
|
to prevent seizures, by decreasing neuromuscular irritability
|
|
|
magnesium sulfate toxity s/s and side effects
|
respiratory depression, los of deep tendon reflexes (clonus),
flushing/sweating occur |
|
|
main s/s of PIH indicating eclamptic seizures
|
epigastric pain, elevated liver enzymes, blurry vision,
|
|
|
when a seizure occurs first:
|
maintain a patent airway, turn a woman on Lside incase of vomit
|
|
|
what is the chance of developing diabetes later in life with a positive GTT test?
|
25%-50%
|
|
|
the biophysical profile includes:
|
The biophysical profile (BPP) has 5 components: 4 ultrasound (US) assessments and a nonstress test (NST). The nonstress test (NST)(CTG) evaluates fetal heart rate and response to fetal movement. The five discrete biophysical variables:
Fetal movement Fetal tone Fetal breathing Amniotic fluid volume Fetal Heart Rate |
|
|
NST=
|
presence of two or more fetal heart rate accelerations within a 20-minute period, with or without fetal movement discernible by the woman.
|
|
|
kickcounts=
|
10 movements/1 hour
20 movement/2 hours |
|
|
this hormone is responsible for the increase in cells which produce milk within the breast and stimulate the initial production of milk:
|
prolactin
|
|
|
this hormone produced by the placenta ensures proper fetal development and stimulates the milk glands in the breast in anticipation of breastfeeding
|
HpL Human placental lactogen
It modifies the metabolic state of the mother during pregnancy to facilitate the energy supply of the fetus. HPL has anti-insulin properties. HPL is a hormone secreted by the syncytiotrophoblast during pregnancy. |
|
|
this hormone is found in early pregnancy and is responsible for helping limit the activity of the uterus and soften the cervix in preparation for delivery:
|
relaxin
|
|
|
this hormone is the only pregnancy hormone released by the posterior pituitary:
|
oxytocin
|
|
|
birth defects are most likely to occur during this time of fetal development:
|
2-12 weeks of gestation
|
|
|
at the end of pregnancy, the progesterone levels from the placenta drop off, thereby stimulating the begining of:
|
labor/uc
|
|
|
production of this hormone diminishes once the placenta is mature enough to take over estrogen and progesterone production:
|
HcG
|
|
|
this organ continues to produce both progesterone and estrogen for the duration of the pregnancy
|
placenta
|
|
|
supplements of this hormone are sometimes prescribed as a fertility treatment or to assist in reducing the risk of miscarriage
|
progesterone
|
|
|
during the pregnancy, these two hormones working in conjunction stimulates the growth of breast tissue and prevents lactation until after the birth
|
progesterone and estrogen
|
|
|
this hormone plays a very important role in the development of the fetus. W/out it, the lungs, kidneys, liver, adrenal glands and other organs would never be triggered into maturation
|
estrogen
|
|
|
the levels of this hormone get higher and higher right up to just before the birth, then fall to allow contractions leading to labor
|
progesterone
|
|
|
this refers to the day the woman becomes pregnant
|
conception
|
|
|
this hormone is only produced during pregnancy. first by the ovaries, and later by the placenta
|
HcG
|
|
|
this hormone induces smooth muscle contractions in the uterus and mammary glands
|
oxytocin
|
|
|
these tissue hormones seem to play a role in getting labor started and may be used in their synthetic form to induce labor in a pregnancy which has gone past 40weeks
|
prostaglandins
|
|
|
this hormone stops the uterus from making spontaneous movements and stops the uterus from contracting
|
progesterone
|
|
|
this hormone found in maternal plasma and urine increase dramatically during the first trimester and may contribute to causing nausea and vomiting often associated with pregnancy
|
hCG
|
|
|
this hormone prevents the release of eggs from the ovaries and stimulates the production of the hormones estrogen and progesterone
|
hCG
|
|
|
this hormone protects the female fetuses from the effects of androgens in the mother's systems
|
estrogen
(androgens= substances that have a masculinizing effect) |
|
|
one role of this hormone during pregnancy is to regulate the production of progesterone over the full term. as this hormone is produced by the placenta, progesterone production is stimulated and regulated
|
estrogen
|
|
|
predisposed to uti's after birth from:
|
trauma to the trigone of the bladder
|
|
|
to determine if the mother has femoral thrombophlebitis: (with s/s of pain/edema of R leg)
|
Homans' sign is a sign of deep vein thrombosis (DVT). A positive sign is present when there is pain in the calf or popliteal region with examiner's abrupt dorsiflexion of the patient's foot at the ankle while the knee is flexed to 90 degrees.[1][2] This sign is frequently elicited in clinical practice because of the ease of use, although it is falling into disfavor because of poor reliability and because it is frequently positive in individuals without DVT.
|
|
|
kernig's sign
|
Kernig's sign (after Waldemar Kernig (1840–1917), a Baltic German neurologist) is positive when the leg is bent at the hip and knee at 90 degree angles, and subsequent extension in the knee is painful (leading to resistance).[3] This may indicate subarachnoid haemorrhage or meningitis.[4]
|
|
|
babinski sign:
|
The lateral side of the sole of the foot is rubbed with a blunt instrument or device so as not to cause pain, discomfort or injury to the skin; the instrument is run from the heel along a curve to the toes, Extensor: the hallux dorsiflexes, and the other toes fan out; this is Babinski's sign- found in healthy infants
|
|
|
heparin for (hx of femoral throbophlebitis)
|
prevents addtional thrombus formation
|
|
|
thrombophlebitis therapy includes:
|
maintain bedrest (keep leg still)
monitor pedal pulses moist heat to area |
|
|
Brandt Andrew's Maneuver
|
Placental delivery can be achieved by use of the Brandt-Andrews maneuver, which involves applying firm traction on the umbilical cord with one hand while the other applies suprapubic counterpressure
|
|
|
warfarin:
|
(also known under the brand names Coumadin, Jantoven, Marevan, Lawarin, Waran, and Warfant) is an anticoagulant. It is most likely to be the drug popularly referred to as a "blood thinner," yet this is a misnomer, since it does not affect the thickness or viscosity of blood. Instead, it acts on the liver to decrease the quantity of a few key proteins in blood that allow blood to clot. most widely used anticoagulant
|
|
|
HIV receives retrovir which:
|
prevention of viral replication delayed development of AIDS production of increased numbers of CD4 T cells
|
|
|
organism responsible for mastitis:
|
S. aureus is the most common etiological organism responsible, but S. epidermidis and streptococci are occasionally isolated as well.
|
|
|
thrombophlebitis therapy includes:
|
maintain bedrest (keep leg still)
monitor pedal pulses moist heat to area |
|
|
Brandt Andrew's Maneuver
|
Placental delivery can be achieved by use of the Brandt-Andrews maneuver, which involves applying firm traction on the umbilical cord with one hand while the other applies suprapubic counterpressure
|
|
|
warfarin:
|
(also known under the brand names Coumadin, Jantoven, Marevan, Lawarin, Waran, and Warfant) is an anticoagulant. It is most likely to be the drug popularly referred to as a "blood thinner," yet this is a misnomer, since it does not affect the thickness or viscosity of blood. Instead, it acts on the liver to decrease the quantity of a few key proteins in blood that allow blood to clot. most widely used anticoagulant
|
|
|
HIV receives retrovir which:
|
prevention of viral replication delayed development of AIDS production of increased numbers of CD4 T cells
|
|
|
organism responsible for mastitis:
|
S. aureus is the most common etiological organism responsible, but S. epidermidis and streptococci are occasionally isolated as well.
|
|
|
to assess baby's spinal nerves elicit the ________ reflex
|
crossed extension reflex (touch one foot, other knee flexes) stepping on nail, one retracts, other supports weight and goes rigid
|
|
|
chest pain with pink frothy sputum and diaphoresis (sweating) are early signs of:
|
AFE (amniotic fluid embolism)
|
|
|
magnet reflex:
|
baby pushes back if you push feet
|
|
|
galant reflex
|
stroke side of abdomen, turns
|
|
|
a neonate with respiratory distress syndrome- signs typically show up in ______ hours
|
4
|
|
|
hypoglycemia in neonate s/s
|
tremor
|
|
|
what results from deposits of bilirubin in the neonates brain, especially in the brain stem and basal ganglia
|
Kernicterus is damage to the brain centers of infants caused by increased levels of unconjugated bilirubin.The word originates from the German kern, nucleus, kernel, and the Greek ikterus, jaundice
|
|
|
unequal bilateral femoral pulses in a neonate typically indicates:
|
Coarctation (narrowing) of the aorta
|
|
|
most reliable indicator of neonatal infection:
|
a change in feeding pattern
|
|
|
when caring for a circumcised neonate:
|
cover with sterile gauze and petroleum jelly for 24 hours
|
|
|
a neonate with erythroblastosis fetalis. This disease results from:
|
destruction of red blood cells (Hemolytic disease of the newborn)
|
|
|
ABO incompatibility:
Mom is: Baby is: |
Mom is O
Baby is A or B For Caucasian populations about one fifth of all pregnancies have ABO incompatibility between the fetus and the mother, but only a tiny minority develop symptomatic ABO HDN[1]. The latter only occurs in mothers of blood group O because they can produce enough IgG antibodies to cause hemolysis. |
|
|
epstein's pearl's=
|
Epstein's pearls are small white or yellow cystic vesicles (1 to 3 mm in size) often seen in the median palatal raphe of the mouth of newborn infants (occur in 65-85% of newborns). They are typically seen on the roof of the mouth (palate) and are filled with fluid. They are caused during the development of the palate by entrapped epithelium (fissural cyst).
|
|
|
hemorrhagic areas in the inner aspects of the sclera are:
|
normal
This is a conjunctival hemorrhage. These may occur at birth and represent broken blood vessels on the surface of the sclera (the white part of the eyeball). These are resorbed and disappear in a few weeks without consequence. |
|
|
cyanosis of the hands and feet in a newborn is:
|
normal
|
|
|
hypospadias:
|
a birth defect of the urethra in the male that involves an abnormally placed urinary meatus (the opening, or male external urethral orifice). Instead of opening at the tip of the glans of the penis, a hypospadic urethra opens anywhere along a line (the urethral groove) running from the tip along the underside (ventral aspect) of the shaft to the junction of the penis and scrotum or perineum
|
|
|
DTP vaccine:
first given at____ months of age. |
diphtheria, pertussis (whooping cough) and tetanus. DTaP and Tdap refer to similar combination vaccines in which the pertussis component is acellular.
2 months |
|
|
milia=
|
white papules on nose/forehead
|
|
|
LGA=
|
over 4000gr, 8.8 lbs
|
|
|
SGA=
|
under 2500 gr, 5.5lbs
|
|
|
ortalani's sign=
|
is a physical examination for developmental dysplasia of the hip. (hip click) if positive, refer to pediatrician
|
|
|
calcium=
|
leg cramp prevention, bones, prevents bp increases, blood clotting, nerve transmission,
dairy (milk cheese), spinach,seaweeds such as kelp, wakame and hijiki; nuts and seeds (like almonds and sesame); blackstrap molasses; beans; figs; quinoa; amaranth; collard greens; okra; rutabaga; broccoli; dandelion leaves; kale; and fortified products such as orange juice and soy milk. An overlooked source of calcium is eggshell, which can be ground into a powder and mixed into food or a glass of water |
|
|
the chest circumference is typically _____ inches smaller than the head
|
1 inch or 2.5 cm
|
|
|
folic acid=
|
prevents neural tube defects, heart health
Leafy vegetables such as spinach, asparagus, turnip greens Legumes such as dried or fresh beans, peas and lentils Egg yolks.[70] Baker's yeast Fortified grain products (pasta, cereal, bread); some breakfast cereals (ready-to-eat and others) are fortified with 25% to 100% of the recommended dietary allowance (RDA) for folic acid Sunflower seeds Liver and liver products contain high amounts of folate Kidney[70] |
|
|
Iron=
|
red meat, lentils, beans, poultry, fish, leaf vegetables, tofu, chickpeas, black-eyed peas, blackstrap molasses, fortified bread, and fortified breakfast cereals
|
|
|
Potassium=
|
controls bp, decreases kidney stones
include parsley, dried apricots, dried milk, chocolate, various nuts (especially almonds and pistachios), potatoes, bamboo shoots, bananas, avocados, soybeans, and bran, although it is also present in sufficient quantities in most fruits, vegetables, meat and fish.[72] |
|
|
Vitamin A:
|
good for reproduction, immune function, eyes, fat soluble
found in: liver (beef, pork, chicken, turkey, fish) (6500 μg 722%), including cod liver oil dandelion greens (5588 IU 112%)[11] carrot (835 μg 93%) broccoli leaf (800 μg 89%) – According to USDA database broccoli florets have much less.[12] sweet potato (709 μg 79%) butter (684 μg 76%) kale (681 μg 76%) spinach (469 μg 52%) pumpkin (400 μg 41%) collard greens (333 μg 37%) Cheddar cheese (265 μg 29%) cantaloupe melon (169 μg 19%) egg (140 μg 16%) |
|
|
phototherapy:
|
cover baby's eyes (genitals?), turn baby frequently, will poop green stools, urinate green pee
|
|
|
priapsim:
|
a potentially painful medical condition, in which the erect penis or clitoris[1] does not return to its flaccid state, despite the absence of both physical and psychological stimulation, within four hours
|
|
|
vitamin C:
|
water soluble, protect cells, increase immune system, antioxidant, prevent bleeding from capillaries: found in:
guava, red pepper, oranges, mangos, strawberry, kale,brocoli |
|
|
Vitamin D:
|
(D-deficeincy= rickets)
fat soluble, low d levels can contribute to cancer, and increased depression, provides repro support and PIH, dark skin harder to absorb, can overdose, found in: sun, Fatty fish species, such as: Catfish, 85 g (3 oz) provides 425 IU (5 IU/g) Salmon, cooked, 100 g (3.5 oz) provides 360 IU (3.6 IU/g) Mackerel, cooked, 100 g (3.5 oz), 345 IU (3.45 IU/g) Sardines, canned in oil, drained, 50 g (1.75 oz), 250 IU (5 IU/g) Tuna, canned in oil, 100 g (3.5 oz), 235 IU (2.35 IU/g) Eel, cooked, 100 g (3.5 oz), 200 IU (2.00 IU/g) A whole egg provides 20 IU if egg weighs 60 g (0.333 IU/g) Beef liver, cooked, 100 g (3.5 oz), provides 15 IU (0.15 IU/g) Fish liver oils, such as cod liver oil, 1 Tbs. (15 ml) provides 1360 IU (90.6 IU/ml) UV-irradiated mushrooms and yeast are the only known vegan significant sources of vitamin D from food sources.[109][110] Exposure of portabella mushrooms to UV provides an increase of vitamin D content in an 100-g portion (grilled) from about 14 IU (0.14 IU/g non-exposed) to about 500 IU (5 IU/g exposed to UV light, milk fortified, cereals fortified |
|
|
Fat soluble vitamins:
|
A, D, E, K
|
|
|
Water soluble vitamins:
|
B, C
|
|
|
Vitamin E:
|
fat soluble, protects cells, assists in wound healing (cell membranes), found in: vegetable oils, nut and nut oils, avocados
can overdose |
|
|
Zinc
|
trace element, Most zinc is in the brain, muscle, bones, kidney, and liver, with the highest concentrations in the prostate and parts of the eye. Semen is particularly rich in zinc, which is a key factor in prostate gland function and reproductive organ growth., increase immune system, nerves, *watch in vegetarians* found in: Oysters, lobster and red meats, especially beef, lamb and liver have some of the highest concentrations of zinc in food, also found in wheat germ, various seeds, sesame, poppy, alfalfa, celery, mustard, beans, nuts, almonds, whole grains, pumpkin seeds, sunflower seeds and blackcurrant.
|
|
|
Vitamin K
|
fat soluble, blood clotting, bone health, *don't supplement with clotting disorders hx DVT* found in: kale, spinach, collards, chard, mustard greens, brocoli, brussel sprouts, parsley, alfalfa, nettles
|
|
|
platypelloid pelvis:
|
transverse oval, sacrum flat, sidewalls sl. covergent (\ /), iscial spines wide prominent, pubic arch >90 wide; *tight at inlet, baby doesn't usually engage, 3%rare
|
|
|
Gynecoid pelvis:
|
round, sacrum- not flat, like a dish, sidewalls straight, ischial spines blunt, pubic arch 2fb w/ space or 90degrees, common
|
|
|
Android pelvis:
|
heart shaped "heart breakers", sacrum flat, sidewalls covergent (\ /), ischial spines pointy and close, pubic arch <90 very narrow *male pelvis, baby gets down and you can see head but it cannot come out*
|
|
|
Anthropoid pelvis:
|
anterior posterior oval, sacrum flat, side walls covergent (\ /), ischial spines prominent, pubic arch <90 degrees slightly narrow
*posterior babies, common in women of color* |
|
|
non breastfeeding women typically resume menstruating in about
|
8-12 weeks
|
|
|
the pp physical assessment most indicative of a pp infection
|
foul smelling lochia
|
|
|
Mom has a negative rubella titer: 1:10, mom is vaccinated in the pp period. Is breastfeeding okay? How long should she wait to get pregnant following the vaccination?
|
yes to bf
3 months following vaccine |
|
|
breastmilk from a mother 2 weeks pp looks like:
|
bluish white and thin
|
|
|
ambulation after birth may cause
|
hypotensive episodes, faint, decreased blood pressure
|
|
|
If the NARM exam says:
always all never the answer is/is not correct |
is NOT
|
|
|
B-1:
|
Thiamin; whole grains; pr0cesses protein/carbs
|
|
|
B-2:
|
riboflavin, milk grains, metabolism, new RBC
|
|
|
B-3
|
Niacin, meat fish, chicken, grains, metabolism, good cholesterol
|
|
|
b-5:
|
Pantothetic acid: chicken beef, tomatoes, oats, organs, fortafied soy produces, fort. grains, nervous system, morning sickness, and carpal tunnel
|
|
|
B-6:
|
pyridoxal phosphate (PLP), organs, fort. soy products and grains, nervous system, morning sickness, carpul tunel
|
|
|
B-7:
|
Biotin, liver meats, fruits, amino acids/fat synthesizers
|
|
|
B-12:
|
Cobalanin, meat fish, poultry, fort. cereal, produces RBC (anemia!)
|
|
|
esophageal atresia
|
causes the esophagus to end in a blind-ended pouch rather than connecting normally to the stomach; presence of EA is suspected in an infant with excessive salivation (drooling) and in a newborn with drooling that is frequently accompanied by choking, coughing and sneezing. When fed, these infants swallow normally but begin to cough and struggle as the fluid returns through the nose and mouth.
|
|
|
Bilirubin above the level of ______ is a concern. ______ is dangerous.
|
12
20 |
|
|
cramp in leg during labor a result of:
to relieve it: |
pressure on the lumbosacral nerve plexus
extend leg, dorsiflex foot |
|
|
colostrum contains _______ than mature breast milk.
|
less fat and more protein
|
|
|
for cardiac pts. do not breastfeed if on:
|
warfarin therapy like coumadin
|
|
|
breastmilk is produced in the:
|
alveoli
|
|
|
which hormones stimulates the let-down reflex:
|
oxytocin
|
|
|
possible amount of blood with placenta seperation:
|
1 cup 244cc
|
|
|
with high bp, get in this position:
|
left lateral
|
|
|
supine:
trundelenberg: lithotomy: prone: semi-fowlers: |
supine:flat on back
trundelenberg: on back with legs and butt raised lithotomy: on back with stirrups prone: face down, straign semi-fowlers: leaning back, semi bent |
|
|
tocolytic agent is:
|
anything used to stop labor
|
|
|
ritodrine for premature labor adverse effects:
|
maternal palpitations, fetal hypoglycemia, fetal hypoxia
|
|
|
contraindications for using tocolytic agent to manage preterm labor:
|
active vaginal bleeding, fetal distress, cervical dilation of 4-5 cm
|
|
|
baseline FHR for a normally developing fetus is typically:
|
120-160 bpm with variability
|
|
|
decel that begins 30 seconds after UC begins and returns to baseline after contraction ends:
|
late decelerations: placental insuffieniency
|
|
|
early decelerations:
variable decelerations: |
mirrors UC, head compression
random: cord compression |
|
|
diaphoretic:
|
sweating
|
|
|
to determine if there was a SROM:
|
ferm test
nitrazine paper kegels, lying, then rising with ctx *if leak during UT then asynclitic?* |
|
|
SROM for several hours:
|
take temp every 2-4 hours, vitamin c, increase fluids,
|
|
|
place fetascope or doppler over:
|
the shoulder of the fetus
|
|
|
-3 station is at the level of:
|
the pelvic inlet
|
|
|
-3 station, LOA, RHR most audible in which quadrant of the abdomen
|
LLQ
|
|
|
head compression causes:
|
fetal vagal nerve stimulation (decreased fhr)
|
|
|
what is the most helpful in assessing the adequacy of the Mother's placental perfusion:
|
the duration of the rest phases between contractions
|
|
|
tingling and numbness in her hands and feet as she is breathing and 8 cms:
these s/s indicate: |
hyperventilating, exhale into cupped hands, then re-inhale
respiratory alkalosis: ncreased respiration (hyperventilation) elevates the blood pH (a condition generally called alkalosis) (carbon dioxide makes more acidic) |
|
|
Mother's nervous, UC start to slow down, MW should:
|
suggest to mom that she may need more privacy
|
|
|
episiotomy is performed for:
|
reducing the time the baby is in distress after reaching the perinuem, or shoulder dystocia for more room
|
|
|
HELLP syndrome s/s
|
Hemolysis
Ellevated liver enzymes Low platlete counts preeclampsia but worse |
|
|
DIC s/s
|
bleeding out of unlikely orifices
|
|
|
Old mec looks like:
fresh mec looks like: peanut butter looking mec: |
brown/yellow
term mec: black, green/pea soup dead baby..... |
|
|
magnesium:
|
good for heart, muscles, nerve and bones: dark greens, nuts, soy beans, quinoa, halibut
|
|
|
recemmended pharma treatment for yeast infection during pregnancy?
|
7-day topical azole therapy, no PO,
|
|
|
recommended pharma treatment for bv infection during pregnancy?
|
metronidazole PO, no clindamycin vaginal cream
|
|
|
recommended pharma treatment for trich infection during pregnancy?
|
metronidazole PO
|
|
|
recommended pharma treatment for chlamydia infection during pregnancy?
|
enrythromycin PO, if not tollerated amoxicillin NO doxyclcline or erythromycin estolate, retest 3 weeks after
|
|
|
recommended pharma treatment for gonorrhea infection during pregnancy?
|
cephalosporin PO, or spectinomycin. ciprofloxacin, ofloxacin, and levofloxacin contraindicated
|
|
|
recommended pharma treatment for PID infection during pregnancy?
|
hospitalize for parenternal antibiotics, contraindicated ofloxacin, levofloxacin, doxyclcline
|
|
|
recommended pharma treatment for HSV infection during pregnancy?
|
aciyclovir, famciclovir for suppressive crosses placenta
|
|
|
recommended pharma treatment for HPV infection during pregnancy?
|
cryotherapy with liquid nitrogen, or trichloroacetic acid. podofilox, imiquimod, and podphyllin contraindicated
|
|
|
recommended pharma treatment for syphilis infection during pregnancy?
|
benzathine penicillin IM + second IM dose one week later. doxyclcline and tetracylcine contraindicated. penicillin allergic hospitilized and desensitized
|
|
|
hormonal contraceptive suppress the production of:
|
FSH and LH
|
|
|
Suzie misses one day of COC pills. Instruct her to:
|
she probably wont' become prego, but use a backup method for the next 7 days. take the forgotten pill as soon as you remember, then the next one at the regular time
|
|
|
Suzie missed two days of COC pills. Instruct her to:
|
take 2 pills the day you remember, and 2 pills the next day. use back up method for the next 7 days. don't be surprised if you have midcycle spotting
|
|
|
Suzie missed three days of COC pills. Instruct her to:
|
She is at risk for pregnancy and will likely start bleeding. Use back up for next 7 days. throw away remainder of pill package, start a new package. if you have a sunday start pill type, continue taking an active pill every day in your old package until sunday, then start a new one
|
|
|
Suze missed two pills during the third week of her pill-taking cycle. Instruct her to:
|
She is at risk for pregnancy and will likely start bleeding. Use back up for next 7 days. throw away remainder of pill package, start a new package. if you have a sunday start pill type, continue taking an active pill every day in your old package until sunday, then start a new one
|
|
|
primary follicles:
|
At the start of the menstrual cycle, some 12-20 primary follicles begin to develop under the influence of elevated FSH to form secondary follicles. primary follicles developed from primordial follicles in early fetal life
|
|
|
primordial follicles
|
developed in the ovary at around 10–30 weeks after conception.
primary follicles form from primordial follicles |
|
|
secondary follicle
|
also called the dominant follicle By around day 9 of the cycle, only one healthy secondary follicle remains, with the rest having undergone cellular atresia. The remaining follicle is responsible for producing large amounts of oestradiol during the late follicular phase.
|
|
|
tertiary follicle
|
also called a mature follicle On day 14 of the cycle, an LH surge occurs, which itself is triggered by the positive feedback of oestradiol. This causes the secondary follicle to develop into a tertiary follicle, which then ovulates some 24–36 hours later. An important event in the development of the tertiary follicle occurs when the primary oocyte completes the first meiotic division, resulting in the formation of a polar body and a secondary oocyte. The empty follicle then forms a corpus luteum which later releases progesterone hormone
|
|
|
Oogenesis
|
Oogonium --(Oocytogenesis)--> Primary Oocyte --(Meiosis I)-->First Polar Body (Discarded afterward) + Secondary oocyte --(Meiosis II)--> Secondary Polar Body (Discarded afterward) + Ovum
the creation of an ovum (egg cell). It is the female form of gametogenesis. The male equivalent is spermatogenesis. It involves the development of the various stages of the immature ovum.Folliculogenesis is a separate sub-process that accompanies and supports all three oogenetic sub-processes.Synchronously with ootidogenesis, the ovarian follicle surrounding the ootid has developed from a primordial follicle to a preovulatory one. |
|
|
the cervical cap reduces the risk of STIs but does/does not protect against HIV.
|
does not
|
|
|
primary instructions/characteristics of cervical cap:
|
insert 30-3 hours before intercourse
insert spermicide in cap, not on rim no additional spermicide with more sex check position after each sex leave cap in for 6-8 hours after se leave cap in for up to 48 hours |
|
|
cervical cap associations/complaints/failure rate
|
cap odor, fewer UTI, no cap with menstruation, failure rate in nulliparous: 9-20%; mulliparous 20-40%
|
|
|
developing and the graafian (antral) follicle are found in the:
|
cortex of the ovaries
|
|
|
describe the femcap
|
nonallergenic silicone rubber cervical cap. wide brim that creates a groove between the dome and the brim. brim seals against the vaginal walls and directs semen into grove. fewer UTIs that diaphragm, greater difficulty of inserting and removing
|
|
|
describe Lea's shield:
|
one size made of silicone rubber, no need to fit, compares well with other barrier methods
|
|
|
the rim of the diaphragm fits:
|
behind the cervix into the posterior vaginal fornix; anteriorly, against the soft tissues posterior to the pubic bone
|
|
|
a woman should be rechecked for fit with the diaphragm after:
|
a few weeks after her first sexual experiences; after each pregnancy (regardless of gestational age or abortion); as part of her anual health care exam; if she has lost or gained more than 10lbs (though one study found that this was unnecessary)
|
|
|
describe the characteristics for diaphragm use:
|
insert prior to arousal, leave in at least 6-8 hours after sex, up to 24 hours, no bowel movement with in, if more than 2 hours between sex or with each sex, more spermicide, can be used while menstruating
|
|
|
by the _____ week LMP the fetal intestines are back inside the abdomen.
|
12th (called omphalocele when they are out) move out at the 9th week LMP)
|
|
|
flat spring diaphragm:
|
normal size vagina, strong vaginal support, shallow pubic arch
|
|
|
coil spring diaphragm:
|
strong vaginal support, average or deep arch pubic, normal or unusul vaginal size
|
|
|
arching spring:
|
unsual vaginal size, poor vaginal support, women who have at least one vaginal delivery
|
|
|
vaginal foam tablets:
|
irratation, burning sensation and foaming practice, 6-26% failure rate
|
|
|
vaginal contraceptive film:
|
cover cervical os at least 15 minutes prior, remains effective 1 hour 6-26%
|
|
|
contraceptive sponge
|
polyurethane foam that contains 1000mg spermicide for continuous release into vagina. wet with tap water. may be inserted for 24 hours prior to intercourse, left in place at least 6, no more than 30, never reused 6-26% (newer versions boast 99% perfect use)
|
|
|
contraceptive suppositories:
|
insert at least 15 minute before sex, messy, least effective
|
|
|
in which portion of the fallopian tube does the site of sterilization occur?
|
ampulla
|
|
|
in which portion of the fallopian tube does sterilization occur?
|
isthmus
|
|
|
the largest portion of the uterus is the:
|
myometrium
|
|
|
the vas diferens is a :
|
condiuit for spermatozoa
|
|
|
the male hormone testosterone, which maintains spermatogenesis, is shythesized and released by:
|
Leydig's cells
|
|
|
progesterone is the " " hormone
|
calming
|
|
|
lie=
|
longitudinal, oblique, transverse
|
|
|
position versus presentation:
|
position: ROA, RSA, etc presentation: cephalic, breech, ect
|
|
|
the physiologic effects of estrogen do include:
|
development of secondary sex characteristics, mymetrial thickening, maturation of the ovarian follicles
|
|
|
the physiologic effects of progesterone include:
|
increased basal metabolism, placental growth, development of acini cells in the breasts
|
|
|
Oogonium
|
(plural oogonia) may refer to either a primordial oocyte in a female fetus some of them become primary oocytes, which begin meiosis which is halted in prophase I. diploid
|
|
|
primary Oocyte
|
When they have entered Prophase I of meiosis they become primary oocytes;Primary oocytes are present from week 10 until menopause at ~53 years in human females. diploid
|
|
|
secondary Oocyte
|
Immediately after meiosis I, the haploid secondary oocyte initiates meiosis II. However, this process is also halted at the metaphase II stage until fertilization, if such should ever occur. When meiosis II has completed, an ootid and another polar body have now been created.
|
|
|
ovum
|
An ovum (plural ova, from the Latin word ovum meaning egg or egg cell) is a haploid female reproductive cell or gamete.
|
|
|
edometriosis
|
a gynecological medical condition in which cells from the lining of the uterus (endometrium) appear and flourish outside the uterine cavity, most commonly on the ovaries.Complications of endometriosis include:
Internal scarring Adhesions[14] Pelvic cysts Chocolate cyst of ovaries Ruptured cyst Bowel obstruction |
|
|
which is the most important factor affecting amniocentesis:
|
needle insertion site
|
|
|
which criteria are used for confirming a diagnosis of endometriosis:
|
laparoscopy and biopsy
|
|
|
tobacco smokers have _______ estrogens and a ________ luteal phase
|
Smoking causes decreased estrogens with increased breakthrough bleeding and shortened luteal phases.
|
|
|
effect of smoking on menopause and follicles:
|
Smokers have an earlier than normal (by about 1.5–3 years) menopause which suggests that there is some toxic effect of smoking on the follicles directly. Chemically, nicotine has been shown to concentrate in cervical mucous and metabolites have been found in follicular fluid and been associated with delayed follicular growth and maturation. Finally, there is some effect on tubal motility because smoking is associated with an increased incidence of ectopic pregnancy as well as an increased spontaneous abortion rate.
|
|
|
amnio performed:
|
14-16 weeks
|
|
|
CVS performed:
|
10-12 weeks
|
|
|
edema in some COC women's hands and feet is probably caused by sodium retention resulting from:
|
an increased estrogen level
|
|
|
calcium foods
|
milk, cheese, yogurt, corn, tortillas, calcium-set tofu, kale, broccoli
|
|
|
Iron foods
|
fortified dairy products and cereals, fish liver, oils, egg yolks
|
|
|
Vitamin A foods
|
liver, dairy products, egg yolks, fish, carrots, carrots, green leafy vegetables, pumpkins, sweat potatoes
|
|
|
Vita D foods:
|
Fortified diary products, fish liver, oils, egg yolks
|
|
|
Vit. E foods
|
vegetable oils, unprocessed cereals grains, nuts, fruits, vegetables, meats, wheat germ
|
|
|
Vitamin K foods:
|
green leafy vegetables, brussel spouts, cabbage, spinach
|
|
|
Vit C foods:
|
citrus fruits, tomatoes, potatoes, broccoli, brussel sproats, spinach
|
|
|
B6 foods
|
fortified cereals, whole grain breads, organ meats, meat poultry legumes
|
|
|
B12 foods:
|
fortified cereals, meat, fish, shellfish, poultry, dairy products
|
|
|
Folic acid foods:
|
enriche cereals, green leafy vegentables, enriched whole grain bread
|
|
|
Zinc foods
|
fortified cereals, red meats, certain seafoods
|
|
|
uterine souffle=
|
maternal heart
|
|
|
funic souffle=
|
cord tones
|
|
|
AFP increases/decreases in fetal demise?
|
increases
|
|
|
magnesium sulfate primary:
|
decreases neuromuscular irritability
|
|
|
respiratory alkaosis
|
increased respiration (hyperventilation) elevates the blood pH (a condition generally called alkalosis)
|
|
|
Potter's Syndrome
|
(also known as Potter's syndrome, Potter's sequence or Oligohydramnios sequence) is the atypical physical appearance of a fetus or neonate due to oligohydramnios experienced in the womb.clubbed feet, pulmonary hypoplasia and cranial anomalies related to the oligohydramnios.
|
|
|
Colostrum vs. mature breast milk
|
colostrum has higher levels of protein and lower levels of fat and carbs than mature
|
|
|
Lack of Moro reflex may indicate:
|
brachial plexus injuries, fractured clavical, disorders of the motor system
|
|
|
cephalhematoma:
|
a hemorrhage of blood between the skull and the periosteum of a newborn baby secondary to rupture of blood vessels crossing the periosteum. Because the swelling is subperiosteal its boundaries are limited by the individual bones, in contrast to a chignon.
|
|
|
caput succedaneum
|
Caput succedaneum presents as a scalp swelling that extends across the midline and over suture lines and is associated with head moulding. Caput succedaneum does not usually cause complications and usually resolves over the first few days.
|
|
|
organism typically responsible for mastitis
|
S. aureus
|
|
|
mastitis symptoms:
|
Breast tenderness or warmth to the touch
General malaise or feeling ill Swelling of the breast Pain or a burning sensation continuously or while breast-feeding Skin redness, often in a wedge-shaped pattern Fever of 101 F (38.3 C) or greater [4] The affected breast can then start to appear lumpy and red. Some women may also experience flu-like symptoms such as: Aches Shivering and chills Feeling anxious or stressed Fatigue [5] |
|
|
Ortolani's sign:
|
physical examination for developmental dysplasia of the hipA positive sign is a distinctive 'clunk' which can be heard and felt as the femoral head relocates anteriorly into the acetabulum:
|
|
|
Kernicterus:
|
chronic bilirubin encephalopathy is damage to the brain centers of infants caused by increased levels of unconjugated bilirubin.
|
|
|
Hydrops fetalis
|
condition in the fetus characterized by an accumulation of fluid, or edema, in at least two fetal compartments.
|
|
|
likely cause of hyrdrops fetalis
|
Hydrops fetalis usually stems from fetal anemia, when the heart needs to pump a much greater volume of blood to deliver the same amount of oxygen. This anemia can have either an immune or non-immune cause. Non-immune hydrops can also be unrelated to anemia, for example if a tumor or congenital cystic adenomatoid malformation increases the demand for blood flow. The increased demand for cardiac output leads to heart failure, and corresponding edema.
|
|
|
Athetosis
|
symptom characterized by involuntary convoluted, writhing movements of the fingers, arms, legs, and neck.This symptom does not occur alone and is often accompanied by the symptoms of cerebral palsy, as it is often a result of this disease.
|
|
|
Esophageal atresia
|
It causes the esophagus to end in a blind-ended pouch rather than connecting normally to the stomach
|
|
|
VACTERL syndrome
|
Vertebral column, Anorectal, Cardiac, Tracheal, Esophageal, Renal, and Limbs. It is associated with polyhydramnios in the third trimester.
|
|
|
symptoms of esophageal atresia
|
drool excessively. Although the infant may swallow normally, a rattling sound may be heard in the chest along with coughing and choking , especially when the infant tries to nurse. Some infants, depending on the severity of the defect, may appear blue (cyanosis), a sign of insufficient oxygen in the circulatory system. The infant' s abdomen may be swollen and firm (distended) because the abnormal trachea allows air to build up in the stomach, filling the abdominal space that holds the surrounding organs.
|
|
|
Homans' sign
|
sign of deep vein thrombosis (DVT). A positive sign is present when there is pain in the calf or popliteal region with examiner's abrupt dorsiflexion of the patient's foot at the ankle while the knee is flexed to 90 degrees
|
|
|
Avoid ______ consumption when taking Iron supplements
|
calcium
|
|
|
Take _________ with Iron supplementation.
|
vitamin c
|
|
|
Folic acid foods
|
enriched cereals, green leafy vegetables, enriched whole grain bread, fortified foods, liver, meat, orange juice, asparagus, navy beans, brewer's yeast
|
|
|
calcium foods
|
cheese, sardines, yogurt, collard greens, milk, blackstrap molasses, spincach, tofu (with calcium)
|
|
|
Bishop's Score
|
Dilation (Dilate)
Effacement (Every) Station (Single) Cervix (Cervix) Postion (Please) |
|
|
BPP
|
HR (Hot)
Breathing (Babies) AVF (Act) Movement (Move) Extention & Flexion (Ex & Flex) |
|
|
chlamydia s/s closely resemble what other STI:
|
gonorrhea
|
|
|
normal weight gain in a newborn
|
one ounce per day/ 4-6 ounces per week
|
|
|
SIMS position
|
lie on their left side, left hip and lower extremity straight, and right hip and knee bent.
|
|
|
a presumptive sign of pregnancy:
|
Signs that the mother experiences (nausea, vomiting, amenorhea, frequent urination, breast tenderness)
|
|
|
a probable sign of pregnancy:
|
any sign that the practitioner can identify (goodalls, hegars, chadwicks, pikaskis, enlarged abdomen)
|
|
|
a positive sign of pregnancy
|
any sign that can be directly related to the fetus (doppler FHT, ultrasound, or movement of the fetus felt by midwife)
|
|
|
the vegan mother should be sure to get adequate intake of:
|
B-12 (found in fortified soy products, fresh juice) sublingual vitamins (cyanocobalamin or hydroxocobalamin)
|
|
|
aproximate risk of down's syndrome at 35, 40 and 45 years
|
35=1/250 or .4%
40= 1/75 1.3% 45= 1/20 5% |
|
|
Which women are most likely to suffer from mastitis?
|
a breast feeding woman more than a week pp (as opposed to less than a week or a non bf woman)
|
|
|
Normocytic anemia
|
anemia caused by blood loss
|
|
|
Normal MCV in pregnancy
|
>90 um (fL)
|
|
|
Normal MCH
|
>32 pg
|
|
|
Microcytic-hypochromic anemia:
|
Low MCV and MCHC= Iron deficiency, thalassemias, sideroblastic
|
|
|
What is thalassemia and who is at risk for it?
|
reduced rate of synthesis or no synthesis of one of the globin chains that make up hemoglobin. This can cause the formation of abnormal hemoglobin molecules, thus causing anemia, the characteristic presenting symptom of the thalassemias.
Mediterranean peoples,West Asia and North Africa, South Asians |
|
|
Macrocytic-megaloblastic anemia:
|
large-abnormal RBCs, B12 deficiency, folate deficiency, chemotherapy; Increased MCV
|
|
|
Oral contraception can be started __________ after a first or second trimester abortion.
|
immediately
|
|
|
COC can be started in the ________ week for women who are not breastfeeding.
|
third
|
|
|
marked bradycardia=
bradycardia tachycardia marked tachycardia |
100
120 160 180 |
|
|
At which point in pregnancy/postpartum is cardiac output the highest
|
immediately pp (biggest dose of oxytocin)
|
|
|
If engagement occurs in the LOP position and birth occurs in the OP postion, external rotation will bring the fetal head into which of the pelvic positions
|
LOT
|
|
|
absence of moro or grasping reflex during newborn exam (that was present at birth). what do you do?
|
have newborn see pediatrician immediately
|
|
|
The uterine fundus normally palpated in the immediate pp is:
|
approximately 2/3 the way between the symphysis pubis and umbilicus
|
|
|
Gastroschisis
|
congenital defect characterized by a defect in the anterior abdominal wall through which the abdominal contents freely protrude.
|
|
|
According to the Bishops Scoring System, what number is favorable and likely to result in a sucessful labor induction
|
a score of at least 6
|
|
|
Your pregnant client in rubella non-immune and has been exposed recently. What do you do?
|
Obtain IgG and IgM antibodies; no vaccine during pregnancy because the vaccine is an attenuated live virus that could theoretically cause malformations. Immunize her immediately pp. breastfeeding is not an contraindication.
|
|
|
If not pp, women should be asked if they are pregnant, informed of potential risk, and advised to avoid pregnancy for _______ after receiving the vaccine.
|
1 month
|
|
|
What are the four leopold's maneuver's:
|
start at the funds and end at the pelvic brim:
1. What's in the fundus 2. Where's the back 3. What's in the pelvis (Pawlik's grip) 4. Where's the cephalic prominence 4. |
|
|
According to Freidman's curve: what is the average length of normal active labor for nulliparas and the upper limit.
|
average: 4.9, upper limit 11.7
|
|
|
According to Friedman's curve what is the average and upper limit length of normal active labor for multiparas
|
average=2.2 upper=5.5
|
|
|
According to Friedman, the average and minimum rate of dilation in nulliparas women is:
|
3 cm per hour/no less than 1.2cm/hour
|
|
|
According to Friedman, the minimum rate of dilation and maximum slope in multiparas women is:
|
5.7 cm/hour and no less than 1.5 cm/hour
|
|
|
According to Friedman, the average and minimum rate of descent in nulliparas women is:
|
1.6cm/hour and no less than 1.0 cm/hour
|
|
|
According to Friedman, the average and minimum rate of descent in multipars women is:
|
5.4cm/hour and no less than 2.1 cm/hour
|
|
|
In which days surrounding childbirth is it most likely that maternal varicella infection will be passed on to the newborn?
|
Day 6 before birth and day 2 following birth
|
|
|
What are the effects of cold stress on the newborn?
|
metabolic acidosis
pulmonary vasocontriction hypoglycemia |
|
|
Name the three fetal shunts:
|
ductus arteriosus
foramen ovale ductus venosus |
|
|
what is the ductus arteriosus?
|
also called the ductus Botalli, is a blood vessel connecting the pulmonary artery to the aortic arch. It allows most of the blood from the right ventricle to bypass the fetus's fluid-filled non-functioning lungs.
|
|
|
what is the most directly responsible for closure of the ductus arteriosus?
|
increased oxygen levels in the blood
|
|
|
What causes the foramen ovale to shut?
|
pressure from increased blood flow in the left side of the fetal heart (pressure from right atrium decreased in comparison to the left)
|
|
|
what is the largest diameter of the fetal scull?
|
occipitomental
|
|
|
What is the most frequent reason for seizures in the neonatal period?
|
hypoxic-ischemic encephalopathy
|
|
|
how long after birth does complete regeneration of the endometrium at the placental site take?
|
4 weeks
|
|
|
what does the placenta of a woman with severe chronic hypertension typically look like?
|
extensive infarction of entire cotyledons
|
|
|
Describe the platypoid pelvis:
|
transverse oval, short hollow flat sacrum,posteriorly inclined slightly convergent side walls, ischial spines may be prominent, not encroaching, pubic arch greater than 90
|
|
|
Describe the anthropoid pelvis:
|
anterior-posterior pelvis, flat anteriorly inclined sacrum, convergent side walls, prominent but not encroaching ischial spines, pubic arch just slightly less than 90
|
|
|
Describe the gynecoid pelvis
|
Round, dished sacrum, straight sidewalls, blunt ischial spines, pubic arch of 90
|
|
|
Describe the android:
|
heart shape, flat, slightly anteriorly inclined, convergent sidewalls, sharp prominent encroaching ischial spines, pubic arch <90
|
|
|
another name for uterine fibroid:
|
myoma, plural myomata
|
|
|
ecchymosis
|
bruise
|
|
|
According to Friedman, what is the average length of 2nd stage for multiparas?
|
15 minutes (whatever)
|
|
|
COC should be stopped 3-6 months prior to conception in order to:
|
replenish the body's stores of copper, zinc and other microminerals
|
|
|
How high can a mother's temperature rise to when her milk comes in and still be considered normal?
|
101
|
|
|
At what age is fhr reactivity typically reached
|
28-32 weeks
|
|
|
The blood flow through the placenta is:
|
500-800ml/minute
|
|
|
What is the first sign of a newborn cord infection?
|
newborn stopped feeding
|
|
|
What are the lactiferous ducts?
|
tree branched system connecting the lobules of the mammary gland to the tip of the nipple. They are also referred to as galactophores, galactophorous ducts, mammary ducts, mamillary ducts and milk ducts. They are structures which carry milk toward the nipple in a lactating female.
|
|
|
ectopic pregnancy has slow ________ HcG because of:
|
rising, the implantation site
|
|
|
Describe the fetal circulatory system:
|
Right atrium
foramen ovale left atrium left ventricle aorta systemic circulation umbillical arteries placenta umbillical vein ductus venosus inferior venal cava right atrium |
|