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51 Cards in this Set
- Front
- Back
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Q550. what causes increased Thyroid Binding Globulin?; how does this affect T3 and T4?
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A550. Inc estrogen; T3 and T4 inc binding to TBG leading to low serum levels of free T3 and T4
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Q551. what is the cause of gestational diabetes?; how?
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A551. hPL; it is an insulin antagoinist (inc diabetic effect and leading to inc insulin and protein synthesis)
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Q552. what is the adequate amount of nutrition needed in pregnancy?; breast feeding?
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A552. Pregnancy: 300 kcal/day; Breast feeding: 500 kcal/day
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Q553. how often should prenatal visits be?
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A553. every 4 weeks until week 28; week 28 - 36: every 2 weeks,; 36 to term: every week
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Q554. when is genetic screening done?; what are the (3) main tests?
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A554. during second trimester (usu 15 - 20 weeks); MSAFP,; b-hCG,; Estriol
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Q555. which germ cell ovarian tumor has a different treatment method then the others?; what is the Tx?
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A555. Dysgerminoma; Tx: Radiation
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Q556. what is tested in pregnancy b/t 27 and 29 weeks?; (3)
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A556. Glucose Loading Test (for gestational diabetes),; Hematocrit (for iron levels),; Glucose Tolerance Test if GLT is positive
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Q557. how is the Glucose Loading Test performed?; (2)
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A557. give 50g oral glucose and check in one hour if > 140 mg/dL, then do GTT
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Q558. How is a Glucose Tolerance Test performed?; What are the blood glucose values for fasting, one, two and three hour intervals?
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A558. Fasting glucose: give 100 g oral glucose and test at 1, 2 and 3 hours; Gestational Diabetes = Fasting glucose > 105 mg/dL; or any two values over 180, 155 or 140 respectively
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Q559. what can dehydration lead to later in pregnancy?
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A559. Braxton-Hicks contractions
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Q560. what causes edema of lower extremities, feet and ankles, and hemorrhoids in pregnancy?; Tx?
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A560. Compression of IVC and pelvic veins; Tx: elevating feet
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Q561. what is the best test for fetal lung maturity?; normal levels?
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A561. Lecithin/Sphingomyelin ratio; normal > 2
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Q562. describe a positive Non-Stress Test
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A562. 2 increases in FHR in 20 min that are >15 beats above nml and for >15 seconds
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Q563. describe a positive Oxytocin Challenge Test
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A563. 3 contractions in 10 minutes
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Q564. (5)* categories of the Biophysical Profiles
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A564. Test the Baby MAN!:; Fetal Tone,; Fetal Breathing,; Fetal Movement,; Amniotic Fluid volume,; NST (zero or 2 points each; nml is 8 - 10)
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Q565. Definition:; multiple gestation with at least one IUP and at least one ectopic
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A565. Heterotrophic Pregnancy
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Q566. at what b-hCG levels should you detect an IUP on vaginal US?
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A566. IUP should be seen on US with b-hCG of 1500 – 2000 mIU/mL
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Q567. at what b-hCG levels should you detect a fetal heartbeat with trans-abdominal US?
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A567. Fetal heartbeat should be seen with b-hCG > 5000 mIU/mL
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Q568. Tx for Ruptured Ectopic
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A568. Exploratory Lap (and maintain fluid levels)
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Q569. what hormone best resembles b-hCG?; how?
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A569. LH; they also have similar beta units (in addition to similar alpha)
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Q570. what is the criteria to use Methotrexate for an ectopic?; (2)
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A570. ectopic must be < 3.5 cm,; without heartbeat
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Q571. what is the progesterone level in a nonviable intra- or extra- uterine pregnency?
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A571. < 5 ng/mL
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Q572. what is the progesterone level in 98% of intrauterine pregnancies?
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A572. > 25 ng/mL
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Q573. what does G5P2124 indicate?
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A573. Twins
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Q574. Definition:; Spontaneous abortion time
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A574. pregnancy ending < 20 weeks
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Q575. Type of Abortion:; any IU bleeding < 20 weeks without dilation or expulsion of POC
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A575. Threatened abortion
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Q576. Type of Abortion:; death of embryo of fetus < 20 weeks with complete retention of POC (usu leads to complete SAB)
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A576. Missed abortion
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Q577. Type of Abortion:; no expulsion of POC, but bleeding and dilation of cervix such that viability is unlikely
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A577. Inevitable abortion
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Q578. (2) ways an incomplete abortion can be taken to completion in first trimester
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A578. D&C; Prostaglandins (Misoprotol)
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Q579. causes of abortion in second trimester; (4)
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A579. Congenital abnormalities; cervical / uterine abnormalities,; trauma,; systemic Disease or infection
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Q580. (3) ways an incomplete abortion can be taken to completion in second trimester
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A580. D&E,; Prostaglandins (Misoprostol),; Oxytocin at high doses
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Q581. Definition:; Painless dilation leading to infection, Preterm Premature Rupture of Membranes (PPROM) or PTL
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A581. Incomplete cervix
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Q582. what should be done if patient is in first trimester and has a history of incomplete cervix?; when?
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A582. Cerclage; 12 - 14 weeks
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Q583. (3) tests to verify if patient has ruptured membranes
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A583. Pool - collection of fluid in vagina; Nitrazine - turns blue (alkaline); Ferning
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Q584. Definition:; Rupture of membranes > 1 hour before onset of labor
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A584. Premature Rupture of Membranes; (PROM)
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Q585. (5) parts of a Bishop score
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A585. Dilation,; Effacement,; Station,; Cervical consistency,; Cervical position
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Q586. Bishop score points zero - 3 for:; Dilation
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A586. zero: Closed; 1 point: 1 - 2; 2 points: 3 - 4; 3 points: > 5
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Q587. Bishop score points zero - 3 for:; Effacement
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A587. zero: 0 - 30%; 1 point: 40 - 50%; 2 points: 60 - 70%; 3 points: > 80%
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Q588. Bishop score points zero - 3 for:; Station
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A588. zero: -3; 1 point: -2; 2 points: -1 to zero; 3 points: +1 - +3
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Q589. Bishop score points zero - 3 for:; Cervical consistency
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A589. zero: Firm; 1 point: Medium; 2 points: Soft; 3 points: (none)
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Q590. Bishop score points zero - 3 for:; Cervical position
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A590. zero: Posterior; 1 point: Mid; 2 points: Anterior; 3 points: (none)
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Q591. Definition:; Lengthening (thinning) of the cervix
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A591. Effacement
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Q592. Definition:; relationship of fetal occiput to maternal pelvis
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A592. Fetal Position
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Q593. (4) ways to Induce labor
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A593. Pitocin,; Prostaglandins (Cervadil or Misoprostol),; Mechanical dilation of cervix,; Rupture of membranes (Amniotomy)
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Q594. MC 4 steps to Augment and monitor labor progress
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A594. water broke? if not -> Amniotomy; change? if not -> IUPC; change? if not -> Pitocin; change? if not -> C-section
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Q595. what does an IUPC measure with respect to contractions?; (2)
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A595. 1. Time of contraction; 2. Strength of contractions
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Q596. Name the (6)* movements of labor in order and what each means
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A596. Engagement - biparietal diameter (largest) part of head enters pelvis,; Flexion - smallest diameter of head enters,; Descent - head completely into pelvis,; Internal rotation - from OT to OA or OP,; Extension - vertex passes beyond pubic synthesis; crowning occurs; External rotation - after delivery of the head as the head rotates to face forward
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Q597. (3) P's of the Active Phase that may cause problems in delivery
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A597. Power (strength of contractions),; Passenger (size and position of infant),; Pelvis (shape)
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Q598. (5) steps of Tx in patient with Non-reassuring fetal status
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A598. 1. Give mother oxygen mask; 2. turn her to Left side to decrease IVC compression; 3. D/C Pitocin; 4. if due to Hypertonus (long contraction) or Tachysystole (>5 contractions in 10 min), give Terbutaline to relax uterus; 5. If 1 – 4 does not work, C-section patient
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Q599. Dx:; Painless vaginal bleeding in the third trimester; Tx for perterm patient (<36 weeks)?; (3); Tx for term patient?
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A599. Placenta previa; Tx for Preterm:; 1. Monitor in hospital; 2. Transfusion PRN; 3. Tocolytic to prolong until 36 weeks; Tx for Term: C-section
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Q600. Dx:; Vaginal bleeding, painful contractions, firm and tender uterus; Tx?
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A600. Placental Abruption; Tx – Delivery (by C-section if mother or baby is unstable)
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