NR 602 MIDTERM STUDY QUESTIONS AND ANSWERS

Presumptive Signs of Pregnancy: Amenorrhea, N&V, breast tenderness or changes, deepening pigmentation, urinary frequency, fatigue, increased basal bodytemperature, and quickening (at 16 weeks). 2. Probable Signs of Pregnancy: Goodell'ssign (cervicalsoftening at 4wk), Chad-wick's sign (blue color of vagina & cervix at 6-8 wk), enlarged uterus, (+) urine or blood pregnancy test. 3. Positive Signs of Pregnancy: Palpation of fetus, ultrasound visualization offetus, and fetal heart tones. 4. 12 week FundalHeight: The fundusshould be at the level ofthe symphysis pubis 5. 16 week FundalHeight: The fundusshould be between the symphysis pubis andumbilicus 6. 20 week Fundal Height: The fundus should be at the level of the umbillicus 7. 25-35 week Fundal Height: The fundus should measure from the symphysispubis and correlate with with gestational week (+/- 2 cm) 8. Naegele's Rule: Add 7 days to LMP, subtract 3 months, add 1 year; Used tocalculate due date 9. Tier 1 Birth Control: Fail rate 1%; IUD, DMPA (Depo), Progestin implant,sterilization 10. Tier 2 Birth Control: Fail rate 2-3%; OCP, COC's, transdermals, cervical ring. 11. Tier 3Birth Control: Failrate roughly 20%;Barrier methods, can protect againstSTIs 12. Caldwell-Moloy Classification: Four basic pelvic types: gynecoid, android,anthropoid, and platypelloid 13. FSH: Gonadotrophin: targets the ovaries, where it stimulates the growth and development of the primary follicles and results in the production of estrogen andprogesterone. 14. LH: Gonadotrophin: targets the developing follicle within the ovary; it is respon-sible for ovulation, corpusluteum formation, and hormone production in the ovaries. 15. Hypothalamus: Releases gonadotropin-releasing hormone (GnRH) in apulsatile manner to initiate negative feedback system. Stimulates gonadotrophins-FSH&LH release-Estrogen/Progesterone release- Pituitary glandnotes Estrogen/Progesterone levels and regulates the cycle by altering further FSH/LH release. 16. Ovarian Cycle: The 28 days of the menstrual cycle as they apply to events inthe ovary. The ovarian cycle has three subphases: the follicular phase, ovulation,and the luteal phase. 17. Follicular Phase: The first phase of the ovarian cycle, during which a follicle (an oocyte and its surroudning cells) enlarges and matures.This phase is under the 3 / 8 control of FSH from the anterior pituitary, and typically lasts from day 1 to day 14 ofthe menstrual cycle.The follicle secretes estrogen during this time period. 18. Ovulatory Phase: The second stage of the general menstrual cycle, when themature ovum is released. Approximately 10 to 12 hours after the LH peak 19. Luteal Phase: The third phase of the ovarian cycle, during which a corpus luteum is formed from the remnants of the follicle that has ovulated its oocyte. Thecorpus luteum secretes progestrone and estrogen during this time period, which typically lasts from day 15 to day 28 of the menstrual cycle. Formation of the corpulluteum is triggered by the same LH surge that triggers ovulation, however in the absence of LH (levels quickly decline after the surge) the corpus luteum begins to degenerate. 20. Endometrial Cycle: The 28 days of the menstrual cycle as they apply to the events in the uterus.The endometrial cycle is also known as the uterine cycle, andhas the three subphases: menstruation, the proliferative phase, and the secretory phase. 21. Menstruation phase: Decline in progesterone levels causes functional layer ofendometrium to discharge resulting in vaginal bleeding called menstruation. This marks the end of one cycle and the beginning of the next cycle. Begins with the initiation of menses and lasts 4 to 6 days 22. Proliferative phase: The second phase of the uterine (endometrial) cycle, duringwhich the endometriumis "rebuilt". This phase ofthe cycle is underthe controlof estrogen,secreted from the follicle developing in the ovary during thistime period.Typically lasts from day 6 to day 14 of the menstrual cycle. 23. Secretory phase: The third phase of the endometrial cycle, during which the "rebuilt" endometrium is enhanced with glycogen and lipid stores. Primarily under the control of progestone and estrogen (secreted from the corpusluteum during thistime period);typically lasts from day 15 to day 28 of the menstrual cycle. 24. Gravida: The total number of pregnancies the woman has had (this numbershould total the TPAL numbers) 25. Term: Those occurring from 37 to 42 weeks' gestation 26. Preterm: Those occurring after the point of viability, which is usually interpreted as gestational age greater than 20 weeks and lessthan 37 weeks and/or fetal weightgreater than 500 gm 27. Abortions: Abortions:spontaneous and induced prior to 20 weeks' gestation 28. A Rating: Recommendation to screening all women aged 21 to cervicalcancer w/ PAP test every 3 years For women aged 30 to 65 who would like to lengthen the screening interval recom-mendation to co-testing with a combination of Pap test and human papillomavirus (HPV) testing every 5 years. 4 / 8 29. D Rating: Harms or potential harms outweigh the benefits and therefore recom-mends against Screening women younger than age 21 Screening women older than 65 years who have been screened adequately andwho are not at increased risk for cervical cancer Screening women who have had a hysterectomywith removal ofthe cervix and haveno history of high-grade precancerous lesions or cervical cancer Screening women younger than age 30 with HPV testing either with Pap test oralone ( 30. B Rating: Recommendation to screening all sexually active women age 24 years and younger, and women older than 24 who are at an increased risk for a sexually transmitted infection (STI), for chlamydia and gonorrhea. The most signifi-cant risk factor for infection is age.Adolescents and women through 24 years of ageare at highest risk for developing these STIs. USPSTF recommends using nucleic acid amplification tests (NAATs) to diagnose chlamydia and gonorrhea infections, both of which can be tested using the same specimen. 31. B Rating: Screeningmammography every 2 yearsfor women age 50 to 74 years 32. B Rating: Screening for BRCA-related cancer, but only for women with a familyhistory associated with an increased risk for BRCA gene mutations. Risk factors include a family history of any of the following: Breast cancer diagnosed before age 50Bilateral breast cancer Breast and ovarian cancer Breast cancer in one or more male family membersMultiple cases of breast cancer in the family One or more family members with two types of BRCA-related cancerAshkenazi Jewish ethnicity 33. Emergency Contraceptive Pill: Yuzpe, levonorgestrel, and ulipristal acetate.The copper IUD can be inserted as long as 5 days after unprotected intercourse.Levonorgestrel (only ECP OTC) 34. Fibroadenoma: a round, firm, rubbery mass that arises from excess growth of glandular and connective tissue in the breast Discrete, smooth, round or oval, nontender, mobile 35. Cyst: Discrete, tender, mobile;size may fluctuate with the menstrual cycle 36. Lipoma: Discrete, soft, nontender; may or may not be mobile 37. Fat Necrosis: Ill defined, firm, nontender, nonmobile 38. Phyllodes tumor: Low grade malignant tumor of the stroma Discrete, firm, round, mobile, findingssimilar to a fibroadenoma, but massis usuallylarger; may observe stretching of skin due to rapid tumor growth