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OB/Peds
Test 1 material PCC Stachenotes
68
Anatomy
Graduate
03/29/2012

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Cards

Term
Operculum
Definition
Mucus plug in the cervical os
Term
Quickening
Definition
Mother feels the fetus move (16-20 weeks)
Term
Lightening
Definition
Fetus decends into the pelvis (39-40 weeks)
Term
Gravidity
Definition
The state of a woman being pregnant
Term
Parity
Definition
The state of a woman haven given birth to a viable fetus.
Term
A)Gravida 1, Para 0
B)Gravida 1, Para 1
C)Gradida 2, Para 0
D)Gravida 2, Para 1
C)Gravida 2, Para 2
Definition
A)currently pregnant for 1st time or was pregnant once and lost the pregnancy
B) Delivered a viable fetus from her 1st pregnancy or delivered viable twins (or more) from her 1st pregnancy
C) Currently pregnant for the 2nd time after losing 1st pregnancy or lost 2 pregnancies
D) Pregnant for the 2nd time, 1st pregnancy was viable
E) Pregnant twice, both delivered
Term
Alpha-fetoprotein (AFP)
Definition
blood test screening for birth defects (15-18 weeks)
Term
Women who are overweight are __% less likely to conceive.
Definition
40% less likely to conceive.
Term
"A lone factor, be it insult, irritant, hormone, gene, with whatever the potential it may possess for altering the body, must still rely on the response of that body to dertermine its impact."
Definition
?...a system that is properly functioning to its potential, may resist destructive forces more successfully with less damage.
Term
When should you make healthy changes before conception?
Definition
at least 3 months to a year.
Term
According to research, the most effective care is given by: midwive, family physicians, or obstetricians?
Definition
All equally effective, women were slightly more satisfied with care from midwives and family physicians.
Term
Why are the first 12 weeks of pregnancy important?
Definition
Time of organogenesis and heightened fetal vulnerability to teratogens.
Term
Air travel for pregnant women is safe until ___.
Definition
4 weeks before the EDD.
Lenghy trips increase the risk of venous thrombosis.
Term
What are some contraindications for breastfeeding?
Definition
maternal HIV, chemical dependency, certain medications.
Term
Caloric requirements for pregnant women increase by
Definition
340-450 kcal/day in 2nd and 3rd tri's.
Term
Pregnant women should gain approxiamtely
Definition
25-35 lb. during pregnancy.
Term
Of aspartame, sucralose, saccharin, and acesulfame-k, which would you most want to limit or avoid?
Definition
saccharin: it can cross the placenta and may remain in fetal tissue.
Term
Chamomile
Definition
May act as a uterine stimilant or lead to abortion
Term
Licorice
Definition
May alter hormone levels, and lead to possible premature labor.
May result in high prolactin/estrogen levels.
May elevate blood pressure
Term
Peppermint
Definition
May worsen heartburn and GURD
May promote flow of bile from gall bladder and aggravate gallstone symptoms.
Term
Pregnant patients history should include:
Definition
Current pregnancy
Past pregnancies
Medical Hx
Contraceptive Hx
Family Hx
Psychological Hx
Plans for childbirth
Risk factors
Term
Pregnant patients "cheif complaint" should include:
Definition
Patient's age
Marital status
Gravidity and parity
Last Menstrual period
Previous usual menstrual period
Expected date of delivery
Occupation
Father of baby and his occupation
Term
Pregnant patients "present Problem" should include
Definition
Description of current pregnancy
previous medical/health care
Attention given to specific problems:
nausea, vomiting, fatigue, edema
Term
Review of symptoms
special attention is given to:
Definition
Reproductive system
Cardiovascular system
Endocrine system
Urinary tract
Respiratory function
Term
The growing fetus accounts for __lbs. of the total weight gain.
Definition
5-10
Term
Most of the weight gain associated with pregnancy is due to
Definition
Placenta
Amniotic fluid
Uterus
Blood and fluid volumes
Breasts
Fat reserves
Term
What is accountable for most of the weight gain during:
2nd tri
3rd tri
Definition
2nd: Maternal tissue growth
3rd: Baby growht
Term
Striae Gravidarum
Definition
"stretch marks"
2nd tri
May be influenced by cortisol levels (stress). Hydration and nutrition are the best prevention.
Term
Telangiectasias
Definition
"vascular spiders"
May be found on face, neck, chest, and arms
usually resolve after delivery.
Term
Hemangiomas
Definition
old ones may increase in size, new ones may develop.
Term
Cutaneous tags
Definition
result from epithelial hyperplasia
Term
Increased Pigmentation
Definition
Found to some extent in all pregnant women.
Term
Linea nigra
Definition
pigmentation of linea alba
Term
Chloasma
Definition
"mask of pregnancy"
70% of pregnant women
Hyperpigmentation
Usually fades, sun exposure worsens, makes it more likely to be permanent.
Term
Palmar Erythema
Definition
Diffuse redness covers the entire palmar surface or the thenar and hypothenar eminences.
Term
Itching in pregnancy.
Definition
Fine: breasts and abdomen due to stretching
Ru Roh: Generalized itching, begins in palms and soles starting in 3rd tri. Sign of more serious condition. (liver being strained, skin taking some of detox role)
Term
Thyroid during pregnancy
Definition
Some degree of goiter may develop if iodine defficient.
A thyroid bruit may be heard due to increased vascularity
Term
Corneal changes associated with pregnancy
Definition
Corneal edema and thickening (3rd tri)
Causes hypersensitivity
Term
Krukenberg spindles
Definition
increase in corneal epithelial pigmentation.
Term
Why might contact lense wearers have a greasy sensation associated with their eyes during pregnancy?
Definition
Tears contain an increased level of lysosome.
Term
Costal angle change during pregnancy
Definition
68 degrees pre pregnancy
103 degrees post pregnancy
Term
Blood volume during pregnancy
Definition
40% increase, mainly due to increase in plasma volume.
Term
Cardiac output during pregnancy
Definition
Increases 40-50%
Term
Heart position during pregnancyq
Definition
shifted to a horizontal position with slight axis rotation.
Term
Blood pressure ___ during the 2nd trimester and ____ during the 3rd
Definition
decreases
returns to pre pregnancy levels
Term
Naegele rule
Definition
add 7 days to the first day of the last normal mestrual period and count back 3 months.
Term
Measure the Fundal Height
Definition
Have the patient empty bladder
Patient supine
Measure from upper pubic symphysis to superior fundus
Recorded in cm.
Most accurate between 20-30 weeks
fundal height=gestational age.
Term
Hormonal influences on muskuloskeletal system during pregnancy
Definition
Progesterone: alterss the vascular supply to the motor unit (decreases smooth muscle tone) as well as the surrounding structures
Estrogen: relaxes the joint capsule, allows more "play" in the joints
Relaxin: Contributes to the relaxation effect allowing pelvis to open.
Term
Women with uncomplicated "morning sickness" have been noted to have better/worse pregnancy outcomes?
Definition
Better
Term
When should morning sickness begin?
Definition
before 9th week
Term
Hydatiform Mole
Definition
Complete:no identifiable fetal tissue
Partial: Some recognizable fetal tissue
Signs: vaginal bleeding, Hyperemesis
Absense of fetal heart tones
Treatment:Evacuation and curettage or hysterectomy
Term
Ectopic Pregnancy
Definition
Any pregnancy outside the uterine cavity.
97% Tubal
Abdominal pain, vaginal bleeding, normal/slightly enlarged uterus, palpable adnexal mass, pelvic pain with manipulation of the cervix.
Diagnosis: Ultrasound
Term
Spontaneous Abortion
Definition
Pregnancy loss at less than 20 weeks
50% of pregnancies complicated by bleeding.
20% of pregnancies (30% may be more accurate)
Diagnose: ultrasound, dilated cervix?
Term
Threatened abortion
Definition
pregnancy complicated by bleeding before 20 weeks
Term
Inevitable abortion
Definition
The cervix has dilated, but the products of conception have not been expelled.
Term
Placenta Previa
Definition
Implantation of the placento over or near the internal os of the cervix.
Vaginal bleeding in the 2nd or 3rd trimester.
Diagnose:ultrasound
Term
Abruptio Placentae
Definition
Separation of the normally located placenta after the 20th week of gestation (prior to birth)
Compromises blood supply to the fetus
1% of all pregnancies
Can be caused by maternal hypertension
Presentation: vaginal bleeding, abdominal, back, or uterine tenderness, fetal distress, abnormal uterine contractions, 15% Fetal death
Difficult to identify on ultra sound
Term
Polyhydramnios
Definition
Abnormally high levels of amniotic fluid (>2000mL)
Exam: rapidly enlarging uterus, difficulty palpating fetus
Manage diabetes, steroid therapy
Term
Oligohydramnios
Definition
Inadequate levels of amniotic fluid
Causes: fetal uninary tract anomalies, placental insufficiency, premature rupture of membrane, leakage of amniotic fluid
Complications: infection, fetal distress
Term
Preeclampsia
Definition
Pregnancy-specific multisystem disorder of unkown etiology.
New onset of elevated blood pressure and proteinuria after 20 weeks' gestation.
3rd leading cause of pregnancy related deaths
Term
Preeclampsia
history and examination
Definition
visual disturbance, persistant headache, epigastric or R upper quadrant pain, increased edema.
Term
Preeclampsia
Diagnosis
Definition
Elevated blood pressure
>140 systolic or >90 diastolic
Proteinuria
>.3g in 24 hour urine collection
Term
Preeclampsia management
Definition
Magnesium sulfate (during labor to prevent seizures)
Antihuertensive drug therapy.
exercise, lifestyle, chiropractic
Term
Preeclampsia-HELLP Syndrome
Definition
Hemolysis,
Elevated Liver enzymes
Low Platelet count
4-14% preeclamptic women
25% mortality or serious morbidity
Term
Eclampsia
Definition
severe complication of preeclampsia
new onset of seizures in a woman with preeclampsia
Deliver baby ASAP
Term
Preterm labor
Definition
8-10% of US births
Management:
Tocolytic Therapy- slow down contractions, can buy up to 3 days
Corticosteriods- stimulate lung developement
Term
Post Term Pregnancy
Definition
Pregnancy 42+ weeks
mortality rate doubles at 42 weeks, 4-6x greater 44 weeks
Term
Gestational diabetes
Definition
Glucose intolerance that begins or is first recognized, during pregnancy.
Increases preeclampsia, c section, future diabetes.
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