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23 Cards in this Set
- Front
- Back
Pregnancy in a pt with prior tubal surgery for sterilization is assumed to be what until proven otherwise?
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Ectopic
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list risk factors for ectopic preg
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PID
hx of tubal IUD in utero exposure to dithylstilbestrol assisted reproduction techniques previous ectopic |
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what must be considered in all women of childbearing age who present with abdominal or pelvic complaints or with unexplained signs or sx of hypovolemia
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ECTOPIC
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no missed menses are reported in what percent of ectopic cases
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15%
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When is a qualitative B-hCG test positive when in the urine and blood respectively?
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urine: >20 mIU/mL
blood: >10 mIU/mL therefore a positive test implies that B-hCG is present in at least this concentration. At this level of detection, the false negative rate for detection of pregnancy will not be >1% for urine, and <0.5% for serum |
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what type of urine may cause a false negative urine preg test?
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Dilute urine
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The sensitivity of a quant serum testing for the diagnosis of pregnancy is ____% when an assay capable of detecting >5 mIU/mL of B-hCG is used
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virtually 100
if you suspect ectopic, and qualitative is negative, you can try quant |
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T/F
No single B-hCG levl can reliably distinguish btw a normal and pathologic prgenancy |
True
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primary goal of US in suspected ectopic preg?
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to determine if an IUP is present
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Give some of the ancillary findings on US that are suggestive of ectopic pregnancy in high-risk pts
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Finding/risk % of ectopic:
Small amount of free pelvic fluid / 52 Echogenic adnexal mass / 70 moderate to large amount of free pelvic fluid / 86 any mass plus echogenic fluid / 97 |
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define spontaneous abortion
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loss of pregnancy before 20 weeks
or loss of fetus weighing < 500 grams |
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Given the following definition, provide the type of abortion:
Pregnancy related bloody vaginal discharge or frank bleeding during the first half of pregnancy without cervical dilation |
Threatened abortion
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Given the following definition, provide the type of abortion:
vagnial bleeding and dilatation of the cervic |
inevitable ab
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Given the following definition, provide the type of abortion:
passage of only parts of the products of conception...morel likely to occur btw wk 6-14 of pregnancy |
incomplete ab
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Given the following definition, provide the type of abortion:
passage of all fetal tissue including trophoblast and all products of conception before week 20 of conception |
complete ab
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Given the following definition, provide the type of abortion:
fetal death at <20 weeks without passage of any fetal tissue for 4 week after fetal death |
missed ab
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Given the following definition, provide the type of abortion:
evidence of infection during any stage of abortion |
septic ab
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how quickly should RhoGAM be administered after an Rh- woman who has a vaginal bleed?
dosage? |
within 72 hours (hopefully before discharge)
150 micrograms |
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most common cause of septic abortion?
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retained prodcuts of conception due to incomplete spontaneous or therapeutic ab and introduction of vaginal bacteria by instrumentation
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woman in first or second trimester with hyperemesis should raise your suspicion for?
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molar pregnancy
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define hyperemesis gravidarum
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intractable vomiting with weight loss
volume depeletion lab values showing hypokalemia or ketonemia |
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Ketonuria is important to find in pregnant pts with vomiting because...?
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it is a sign of starvation
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the presence fo abdominal pain in nausea and vomiting of pregnancy or hyperemesis gravidarum is highly unusual and should...
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suggest another diagnosis
think ruptured ectopic gall bladder dz pancreatitis gastroenteritis appendicitis hepatitis |