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21 Cards in this Set
- Front
- Back
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Differential for bleeding before 20 weeks
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ectopic
molar abortion implantation cervicitis polyp carcinoma |
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most ectopics implant where?
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fallopian tube
yes that was an easy one don't get your ego all inflated |
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Risks for etopic
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anything causing damage to fallopain tube
PID tubal surgery IUD DES previous ectopic |
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False negative percentage for qualitative b-hcg in urine and serum respectively
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urine: <1%
urine: <0.5% |
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at what point can you see the following on transvaginal US
Gestational sac: Yolk sac: Fetal Pole: |
Gestational sac: 4.5 weeks
Yolk sac: 5.5 weeks Fetal Pole: 6.0 add about a week to the above for transabdominal |
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What finding on US has a 70% risk of ectopic?
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Adnexal mass
free fluid alone has 86% |
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Most common cause of abortion?
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chromosomal abnormalities
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pregnancy related blood vaginal discharge during the first half of pregnancy w/o cervical dilation =?
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threatened ab
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vaginal bleeding and dilation of the cervix =?
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inevitable abortion
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Tx for threatened ab?
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D/c home with close f/u
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tx for incomplete abortions?
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OB/Gyn consult for medical vs D&C to have uterus evacuated
PO misoprotol 600mg |
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Dose of RhoGAM for abortion?
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50mcg or 300mcg
must be within 72 hours |
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differential of bleeding after 20 weeks
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abruptio placentae
placenta previa vasa previa do not perform speculum or digital exam until you know the location of the placenta |
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premature separation of normally implanted placenta from uterine lining =
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abruptio placentae
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most common causes of abruptio placentae
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spontaneous
trauma cocaine olioghydraminos |
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Diagnosis of abruptio placentae
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Electronic fetal monitoring: very sensitive for fetal distress
transvaginal US: specific but not sensitive due to lack of detection of retroperitoneal clot |
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labs for abruptio placentae
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CBC, BMP
Coags FDP Fibrinogen Type and cross Fetal RBC |
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abruptio placentae treatment paln
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maternal stabilization
EFM OB consult For DIC: replace coagulation factors Immediate delivery for severe abruption |
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placenta that extends near, partially over, or beyond the internal cervial os due to implantation in the lower uterus = ?
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placenta previa
risk factors: c-section multiple gestation cocaine smoking |
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umbilical vessels course in the amniotic membrane at the lvl of cercial os tearing the blood vessels with membrane rupture during labor = ?
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vasa previa
risks: placenta previa in vitro fertilization |
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Code sepsis goals:
4 things to be done in 3 hours |
measure lactate (>4)(order vbg)
obtain BC prior to admin of abx Admin broad specturm abx administer 30cc/kg fluids |
