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23 Cards in this Set

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Pregnancy in a pt with prior tubal surgery for sterilization is assumed to be what until proven otherwise?
Ectopic
list risk factors for ectopic preg
PID
hx of tubal
IUD
in utero exposure to dithylstilbestrol
assisted reproduction techniques
previous ectopic
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
ECTOPIC
no missed menses are reported in what percent of ectopic cases
15%
When is a qualitative B-hCG test positive when in the urine and blood respectively?
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
what type of urine may cause a false negative urine preg test?
Dilute urine
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
virtually 100

if you suspect ectopic, and qualitative is negative, you can try quant
T/F

No single B-hCG levl can reliably distinguish btw a normal and pathologic prgenancy
True
primary goal of US in suspected ectopic preg?
to determine if an IUP is present
Give some of the ancillary findings on US that are suggestive of ectopic pregnancy in high-risk pts
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
define spontaneous abortion
loss of pregnancy before 20 weeks

or

loss of fetus weighing < 500 grams
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
Given the following definition, provide the type of abortion:

vagnial bleeding and dilatation of the cervic
inevitable ab
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
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
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
Given the following definition, provide the type of abortion:

evidence of infection during any stage of abortion
septic ab
how quickly should RhoGAM be administered after an Rh- woman who has a vaginal bleed?

dosage?
within 72 hours (hopefully before discharge)

150 micrograms
most common cause of septic abortion?
retained prodcuts of conception due to incomplete spontaneous or therapeutic ab and introduction of vaginal bacteria by instrumentation
woman in first or second trimester with hyperemesis should raise your suspicion for?
molar pregnancy
define hyperemesis gravidarum
intractable vomiting with weight loss
volume depeletion
lab values showing hypokalemia or ketonemia
Ketonuria is important to find in pregnant pts with vomiting because...?
it is a sign of starvation
the presence fo abdominal pain in nausea and vomiting of pregnancy or hyperemesis gravidarum is highly unusual and should...
suggest another diagnosis

think ruptured ectopic
gall bladder dz
pancreatitis
gastroenteritis
appendicitis
hepatitis