Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
51 Cards in this Set
- Front
- Back
|
What are the indications for ultrasound in pregnancy?
|
Non-mandatory in routine low-risk prenatal care
1. Uncertain gestational age. 2. size/date discrepancies 3. vaginal bleeding 4. multiple gestations 5. High-Risk situations: - problems with previous pregnancies - fetal distress - Suspected abortion - fetal death. |
|
|
What laboratory studies are recommended at initial prenatal visit?
|
- CBC
- HepB surface Antigen - HIV testing - Syphilis screen with Rapid plasma reagin (RPR) - Urinalysis & culture - Rubella Antibody (ensure immunity) - Blood type - Rh status with antibody screen - Pap Smear - Cervical swab for Gonnorrhea & Chlamydia |
|
|
When is ultrasound the most accurate in estimating the fetal age?
|
16-20 weeks
|
|
|
What level of radiation exposure is associated with increased fetal risk?
|
>5 rads
Dental x-rays = .00017 rads |
|
|
Timing of trisomy screening
|
Optimal = 16-18 weeks.
May be performed 15-20 wks |
|
|
Down syndrome
- Characteristics |
trisomy 21
short stature, mental retardation. short neck, typical facial appearance, endocardial cushion defects, duodenal atresia |
|
|
Edward syndrome
|
trisomy 18
profound mental retardation rocker-bottom feet clenched fists 1 year survival is 40% |
|
|
Patau syndrome
|
trisomy 13
profound mental retardation holoprosencephaly cleft lip with palate 1 year survival is 40% |
|
|
triple marker screen
|
window is 15-20 weeks
MS-AFP, hCG and estriol trisomy 21 --> low MS-AFP and estriol with high hCG; perform amniocentesis for karyotype trisomy 18 --> all markers are decreased; perform amniocentesis for karyotype |
|
|
Advanced Maternal Age
|
Pregnancy with estimated date of delivery at age 35 or more.
|
|
|
Isoimmunization
|
Development of specific antibodies
due to antigenic stimulation by exposure to another individual's RBCs or associated material. |
|
|
Rh isoimmunization
|
Rh negative woman develops anti-D (Rh factor) antibodies
|
|
|
Asymptomatic Bacteriuria
|
≥100,000 cfu/mL of pure pathogen (bacteria) in mid-stream voided specimen
|
|
|
Vertical Transmission
|
Infectious passage from mother to fetus
- in utero - during labor - postpartum |
|
|
Quadruple Marker Screen
|
Week 15-20
Inhibin A, AFP, hCG, estriol ↑ sensitivity for Down's (80%) |
|
|
How many pregnancies are unplanned or unintentional?
|
~ 50%
|
|
|
When is a fetus most susceptible to radiation?
|
Early development.
Week 2-15. |
|
|
What imaging procedures have not been proven to be harmful to fetus?
|
Ultrasound.
MRI - not recommended though. |
|
|
How much folic acid recommended for general female population (of child-bearing age)?
|
400 micrograms of Folic Acid daily for low-risk females of child-bearing age/population for at least 1 month prior to conception
|
|
|
What is lack of folic acid most associated with?
|
Neural tube defects.
|
|
|
How much folic acid recommended for female of child-bearing age with Diabetes Mellitus?
|
1 mg of folic acid daily
at least 1 month prior to conception |
|
|
How much folic acid recommended for female of child-bearing age with epilepsy?
|
1 mg of folic acid daily
at least 1 month prior to conception |
|
|
How much folic acid recommended for female with previous pregnancy complicated by neural tube defect?
|
4 mg of folic acid daily
at least 1 month prior to conception |
|
|
Can chorionic villous sampling detect neural tube defects?
|
Nope, only genetic or chromosomal defects
|
|
|
Pregestational DM & Pregnancy-
Fetal Complications |
1. Macrosomia
2. Microsomia (long-standing DM) 3. Neural tube defects 4&5. Cleft-lip &/or palate 6. Cardiovascular malformations 7. Renal defects 8. hypocalcemia 9. polycythemia 10. hyperbilirubinemia 11. IUGR 12. Hyperinsulinemia leading to Hypoglycemia 13. RDS 14. birth injury 15. perinatal mortality 16. Left colon hypoplasia/immaturity |
|
|
What specific genetic screens should be offered to African & African-American women?
|
Sickle Cell trait screening
|
|
|
What specific genetic screens should be offered to French-Canadian women?
|
Tay-Sachs (& Cystic Fibrosis)
|
|
|
What specific genetic screens should be offered to Ashkenazi Jewish women?
|
Tay-Sachs & Cystic Fibrosis
|
|
|
What specific genetic screens should be offered to Southeast Asian women?
|
Thalassemia
|
|
|
What specific genetic screens should be offered to Middle Eastern women?
|
Thalassemia
|
|
|
What specific genetic screens should be offered to Caucasian women?
|
Cystic Fibrosis
|
|
|
Name 7 medical conditions that are associated with High-risk pregnancies.
|
1. Diabetes mellitus
2. Asthma 3. Thyroid disease 4. Hypertension 5. Lupus 6. Thromboembolism 7. Seizures (psychiatry & counseling) |
|
|
How to estimate delivery date?
|
Naegele's rule=
1st day of LMP - 3 months + 7 days |
|
|
When are heart tones heard by doppler fetoscope?
|
10 weeks of gestation
|
|
|
Visit timing protocol for normal pregnancy
|
q 4wks from initial - 28 wks
q 2wks from 28-36 wks q 1wk >36 wks gestation. |
|
|
What criteria must be met for reported LMP to be reliable?
|
1. date is certain
2. LMP was normal 3. No contraceptive use in past 1 yr 4. no bleeding since LMP 5. Regular menses prior to LMP (if not met then ultrasound) |
|
|
Human chorionic gonadotropin
- source |
Hormone secreted by syncytiotrophoblast of the placenta.
|
|
|
Human chorionic gonadotropin
- function |
Preserving corpus luteum during early pregnancy in order to maintain progesterone secretion until the placenta is able to produce progesterone itself.
- stimulation of maternal thyroid - potentiation of male sexual differentiation. |
|
|
Human chorionic gonadotropin
- levels & timing |
Production starts 8 days post fertilization.
Level doubles every 48 hrs. Peak level 6-8 weeks gestation |
|
|
Human chorionic gonadotropin structure
|
alpha & beta subunits
beta is specific to hCG (& pregnancy) and is the basis of all pregnancy tests. |
|
|
What hormones contain the alpha-hCG subunit?
|
hCG
TSH LH FSH |
|
|
What hormone is responsible for preparing endometrium for implantation of ovum?
|
Progesterone
|
|
|
What homone is responsible for prolactin induction during pregnancy?
|
Estrogen.
|
|
|
Signs & Sx of Trichomonas vaginitis
|
STD.
Malodorous, gray-green, thin, frothy discharge. Vaginal & vulvar pruritus, edema & erythema. Dysuria. Dyspareunia (painful sex). pH increases to 5-6 (basic) (no eosinophils) |
|
|
Trichomonas vaginalis
|
Highly motile pear shaped organism with 3-5 flagella.
Larger than WBC, smaller than vaginal epithelial cell. |
|
|
Signs and sx of candida vaginitis
|
non-malodorous discharge, white & thickened consistency.
pH = 4-4.5 |
|
|
Clue cells are associated with __.
|
Bacterial vaginosis - Gardnerella vaginalis.
- elevated pH often seen as well |
|
|
Multinucleated giant cells in vaginal discharge are most associated with __.
|
Genital herpes.
a vesicular rash also. |
|
|
Uterine Fibroids
- signs & sx - pathology - aggravating & relieving factors |
Dysmenorrhea, heavy menses, enlarged uterus.
+/- infertility. most common benign uterine tumor; Estrogen-dependent tumor. Increase in size with OCPs or pregnancy. Regress after menopause. Most common indication for hysterectomy. |
|
|
Signs & Sx of Endometriosis
|
Dysmenorrhea
Dyspareunia Tender pelvic nodes Fixed retroverted uterus Infertility (Not enlarged uterus) |
|
|
Signs and symptoms of Pelvic congestion syndrome
|
Dull, ill-defined pelvic ache
-usually worse pre-menstruation -relieved by menses often associated with hx of sexual problems. (Not enlarged uterus) |
