Term
| What is "Quickening" and when does it appear? |
|
Definition
| small flutters felt in the abdomen, which is signs of the fetus kicking around 18 weeks |
|
|
Term
| What is Chadwick's sign and when does it appear? |
|
Definition
| Violet discoloration of the vagina. Appears around 5-6 weeks gestation |
|
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Term
| What is Goodell's sign and when does it appear? |
|
Definition
| Violet discoloration of the cervix. Appears around 5-6 wks gestation. |
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Term
| When does the uterus rise up into the abdomen and become palpable above the pubic symphysis? |
|
Definition
|
|
Term
| When is the uterus palpable at the umbilicus? |
|
Definition
|
|
Term
| Why do pregnant women experience hyperpigmentation of the nipples/areolae? |
|
Definition
| Pregnancy induces melanocyte-stimulating hormone |
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|
Term
| Components of fetal US and when they appear? |
|
Definition
Gestational sac: 4-5wks
Echogenic ring: 6 wks
Yolk sac: 6-7 wks |
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|
Term
| When does the fetal heartbeat first appear on US? |
|
Definition
|
|
Term
| What is the definition of "Para"? |
|
Definition
| Number of births after 20 wks |
|
|
Term
|
Definition
T: full-term deliveries (>37wks)
P: preterm deliveries (20-36wks)
A: abortions and miscarriages (<20 wks)
L: Live children |
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|
Term
| Typical duration of pregnancy? |
|
Definition
| 280 days/40weeks/10lunar months from LMP |
|
|
Term
|
Definition
| Add 7 days to LMP then add 9 months. |
|
|
Term
| What is the gestational age cutoff for chronic HTN? |
|
Definition
|
|
Term
| How many fetal kicks is considered normal movement? |
|
Definition
|
|
Term
| What is the recommended prenatal visit timing/frequency? |
|
Definition
Intake at 6-8wks
Follow-up at 10-12 weeks
Then every 4-6 weeks until 34 weeks
Then every 2 weeks until 37 weeks
Then weekly until delivery |
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|
Term
| When to perform initial gestational diabetes screening test with 50g and results? |
|
Definition
24-28wks
Positive if >135 after 1hr |
|
|
Term
| When should Tdap immunization be given? |
|
Definition
| Between 27-36 wks. 32 wks optimal |
|
|
Term
| When should the quad screen be done? |
|
Definition
|
|
Term
| When should Rh- women get Rhogam? |
|
Definition
|
|
Term
| When does nonstress testing begin? |
|
Definition
|
|
Term
| Treatment of patients with prior preterm birth? |
|
Definition
| Progesterone, starting at 16-20 weeks and up until 36 weeks |
|
|
Term
| How do we tx pts w/ high risk of preeclampsia? |
|
Definition
| Low dose aspirin (81mg/day) starting @ 12wks |
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|
Term
| Symptoms of severe preeclampsia? |
|
Definition
BP > 160/110
RUQ pain
Edema
Visual changes
Renal failure
Thrombocytopenia |
|
|
Term
| Cutoffs for mild, moderate and severe thrombocytopenia? |
|
Definition
Platelet count:
100-149=mild
50-99=moderate
<50=severe |
|
|
Term
| What does the First Trimester Screen for aneuploidy measure and when is it performed? |
|
Definition
Serum beta-hCG and PAPP-A (pregnant-associated plasma protein- A)
9-14wks |
|
|
Term
| What is measured by quad screen and when is it performed? |
|
Definition
AFP, estriol, inhibin-A, and beta-hCG
15-21wks |
|
|
Term
| How do we screen pts w/ gestational diabetes for overt postpartum diabetes? |
|
Definition
| 6 weeks postpartum, deliver 75g 2-hr GTT |
|
|
Term
| What are weight gain guidelines based on BMI? |
|
Definition
BMI < 19.8 = 28-40lbs
BMI 19.8-26 = 25-35lbs
BMI 26-29 = 15-25lbs
BMI >29 = 11-20lbs |
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|
Term
|
Definition
Phone call 10-14 days PP
Office visit 4 weeks PP |
|
|
Term
| What is secondary prevention? |
|
Definition
Screening for existing disease in asymptomatic individuals to develop treatment plan
E.g. pap smear, colonoscopy, hyperlipidemia screening |
|
|
Term
| Pap/HPV testing guidelines? |
|
Definition
Ages 21-30: q3yrs *JUST PAP
Ages 30-65: q5yrs PAP + HPV |
|
|
Term
| DXA scan frequency based on T-score? |
|
Definition
Initial screening @65 or in postmenopausal younger than 65 with high risk
If -1 to -1.5: DXA again in 10-15yrs
If -1.5 to -2.0: DXA again in 3-5yrs
If -2.0 to -2.5: DXA again in 2yrs
If <-2.5: dx w/ osteoporosis |
|
|
Term
| What is Fitz-Hugh Curtis syndrome? |
|
Definition
Perihepatitis resulting from PID
-RUQ pain |
|
|
Term
| What causes peau d'orange of the breast? |
|
Definition
| Subcutaneous lymphatic obstruction & tumor growth pull on connective tissue ligaments in the breast |
|
|
Term
| What is cancer en cuirasse? |
|
Definition
| Hard, woody texture of the breast skin (rare manifestation of breast cancer due to subcutaneous spread) |
|
|
Term
| What 2 muscles comprise the pelvic floor? |
|
Definition
| Coccygeus and levator ani |
|
|
Term
| What structure is cut during an episiotomy? |
|
Definition
|
|
Term
| What is the location and function of Skene's glands? |
|
Definition
| Lower end of urethra- drains mucous onto lateral margin of external urethral orifice |
|
|
Term
| What is Pfannenstiel's incision? |
|
Definition
| Transverse suprapubic incision used for hysterectomy |
|
|
Term
| What are the most important ligaments stabilizing the uterus to the pelvic wall? |
|
Definition
| Transverse cervical (cardinal) ligaments |
|
|
Term
| What is a normal baseline fetal heart rate (FHR)? |
|
Definition
|
|
Term
| What is considered normal variability in the fetal heart tracing? |
|
Definition
| 5-25bpm in a 10 minute window |
|
|
Term
| What are normal accelerations from 24-32 weeks? |
|
Definition
| Should last >10s and peak >10bpm above baseline |
|
|
Term
| What are normal accelerations after 32 weeks? |
|
Definition
| Should last >15s and peak >15bpm above baseline |
|
|
Term
|
Definition
| Gradual decrease leading up to contraction and hits lowest point at peak of contraction (due to changes in head pressure during contraction) |
|
|
Term
| What are variable decels? |
|
Definition
| Caused by umbilical cord compression. Rapid decrease in FHR, lasts less than 30s, w/ rapid return to baseline |
|
|
Term
|
Definition
Indicate severe deoxygenation (to mom and/or placenta)
Start after peak of contraction, gradual decrease in FHR (Prolonged >2 mins) |
|
|
Term
| What are the criteria for a "reactive" non stress test (NST)? |
|
Definition
| 2 or more normal accelerations (lasting 15s, more than 15bpm above baseline) in a 20 min window |
|
|
Term
| What does a positive contraction stress test (CST) look like? |
|
Definition
| Late decels in FHR on >/= 50% of contractions (This is harmful to baby) |
|
|
Term
| What is measured in biophysical profile (BPP) and how is it scored? |
|
Definition
Fetal breathing movements
Fetal body movements
Amniotic volume
Fetal tone
Fetal heart rate
All scored 0 or 2- total of 10/10 |
|
|
Term
| What is fetal fibronectin (fFP) and why is it measured? |
|
Definition
| "Glue" that attaches amniotic sac to uterine lining, gets shed in the vagina- used to test for preterm delivery from 22-34 weeks. Very high negative predictive value |
|
|
Term
| What is considered "early perimenopause" |
|
Definition
| Woman's periods differ up to 7 days from their normal cycle |
|
|
Term
| What is the average age of onset of perimenopause? |
|
Definition
|
|
Term
| How long does perimenopause last on average? |
|
Definition
|
|
Term
| What is considered "late perimenopause"? |
|
Definition
| >2 missed cycles or >60 days of amenorrhea |
|
|
Term
| Structural causes of abnormal uterine bleeding (AUB)? |
|
Definition
PALM:
Polyp
Adenomyosis (growth of endometrial tissue into uterine muscle)
Leiomyoma (fibroid)
Malignancy/Hyperplasia |
|
|
Term
| Non-structural causes of AUB? |
|
Definition
COEIN:
Coagulopathy
Ovulatory Dysfunction
Endometrial
Iatrogenic
Not yet classified |
|
|
Term
| What is the "pearl sign" on ultrasound? |
|
Definition
| Ring of large follicles (>25) on the ovaries- pathognomonic for PCOS |
|
|
Term
| What is considered a normal menstrual frequency? |
|
Definition
|
|
Term
| What is considered normal menstrual volume? |
|
Definition
|
|
Term
| How long does AUB have to last to be considered chronic? |
|
Definition
|
|
Term
|
Definition
| Breast tenderness, ovulatory pain, bloating (associated w/ menstruation) |
|
|
Term
| Recommended folic acid supplementation for pregnancy? |
|
Definition
| 0.4mg starting at least 1 month prior to conception and continuing throughout pregnancy |
|
|
Term
| How do you calculate Total Motile Sperm Count? |
|
Definition
TMSC = Million sperm/mL x motility (% moving)
want it greater than 6 |
|
|
Term
| How do you tx chlamydia in pregnancy? |
|
Definition
| Erythromycins and penicillins |
|
|
Term
| What organism causes chancroid? |
|
Definition
|
|
Term
| Name of topical ointment for lichen sclerosis? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Clinical presentation of molar pregnancy? |
|
Definition
| Very high HcG, hyperthyroidism, vaginal bleeding, hyperemesis gravidarum |
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