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1. How do you measure fundal height: symphysis pubis to top of uterus
2. When can you start to hear fetal heart tones?: around 12 wks
3. What is quickening?: fetal movements felt by the mother
4. When is quickening felt: between 16-20 weeks
5. Abnormal Complaints in first trimester: 1st trimester: Vaginal bleeding
Book: spotting, bleeding, cramping, painful urination, severe vomiting and/or diarrhea, fever > 100.4,
symptoms of vaginal infection or STI; persistent or severe low abdominal pain, lightheadedness or
dizziness (particularly if accompanied by shoulder pain)
6. What vaccines should be avoided during pregnancy?: Live vaccines: MMR
,HPV, varicella, and live attenuated influenza vaccine
7. What labs are drawn at first visit?: CBC, RH (antibody screen) & TYPE, HIV,
RPR, MMR TITER, HEP B TITER, R/O STI's, FULL UA
8. What info is obtained at first OB visit?: PMH, Fx history, Genetic hx (mom & dad)
9. What is indicated when clu cells are seen?: BV
10. What is the treatment for BV: metronidazole (Flagyl) 500mg BID x 7 days
11. What are presumptive (subjective) signs of pregnancy?: Amenorrhea, N/V,
,FATIGUE, urine frequency, breast changes, quickening, pigment, striae
12. What are probable (objective) signs of pregnancy?: + HCG, enlarged Abdo, fetal outline,
Balloment, Braxton, Chadwick's, Goodall's, Hegar's signs 13. What are positive signs of
pregnancy?: Fetal HT, U/S, fetal movement
14. What does a bluish cervix indicate?: Chadwick's sign
15. How to use Nageles rule: +1 year + 7 days - 3 mos
16. What are signs of preeclampsia?: rapid weight gain, edema to hands and face,
HTN, H/A, visual changes, proteinuria, epigastric pain
17. What is the treatment of preeclampsia?: Bedrest, (nifedipine, hydralazine) if severe delivery of
the fetus
18. What does HELLP stand for?: hemolysis, elevated liver enzymes, low platelets
19. S/S of HELLP: EDEMA, N/V, RUQ pain
20. What should 'at home' plan be for preeclampsia?: high protein diet, daily kick counts, wkly non-
stress test & contraction monitor, monitor for hand and face edema, visual changes, B/P, epigastric
pain
21. When will you see a drop in the fundal height?: at 36 weeks as the head drops into canal
22. When is subinvolution suspected: when lochia turns bright red with clots 23. How would you
treat subinvolution?: Methergine 0.2mg PO TID for up to a week
24. what education should be given with a subinvolution?: if filling pad in an hour or lemon size clots
go to ED, if fever culture discharge
,25. Clinical presentation of mastitis?: unilateral breast red, painful, warm to touch usually clogged
milk duct
26. What education do you give with mastatitis: Continue to BF, Pump if breast are still hard after
feeding, warm compress
27. What B/C is used if still breastfeeding?: Progesterone only
28. When and how to screen for 1 hr GTT: between 24-28 wks, no need to fast, if over 140 then 3 hr
GTT is needed
29. How is gestational diabetes diagnosed?: if 3 hr gtt fasting is 95 >/= Or 2 of the following:
>180 @ 1hr
>155 @ 2 hr
>140 @ 3 hr
30. What is considered a good kick count?: 10 or more movements in 2 hrs
31. ACOG and USPSTF PAP guidelines: 1st at age 21 regardless of sexual activity 21-29 cytology
alone Q 3 yrs
30-65 cytology + HPV or HPV alone Q 5 yrs
30-65 cytology alone Q 3 yrs
32. ACS PAP guidelines: age 21-24 none
25-29 HPV alone or cytology + HPV Q5 yrs
25-29 cytology along Q3 yrs
30-65 cytology + HPV Q5 yrs
30-65 cytology alone Q3 yrs
, 33. What can be used to treat nausea in pregnancy: zofran 4 mg up to 3 times a day, can cause
Extrapyramidal symptoms (EPS) inform provider
34. What to educate on with N/V: keep a list of associated factors (food/activity), rest when nauseated,
avoid stress & triggers (smells/sights), avoid tight clothing, meditation/relaxation techniques
35. What is the treatment for trichomoniasis: metronidazole (Flagyl) 2g, single-dose, notify partner,
no sex for 7 days after treatment, educate on using condoms 36. How to treat vaginal candidiasis:
Miconazole (monostat) cream or vaginal suppository QHS x 7 days
37. 3 danger signs to report to provider: bleeding, severe cramping/abdo pain, painful urination
38. What to educate on intercourse during pregnancy: generally safe, but some contraindications are
threatened miscarriage (spotting/bleeding), avoid inserting anything into the vaginal for at least 2
weeks after bleeding stops
39. screening tests in the 2nd trimester: 1 hr gtt, fetal anatomy scan (U/S)
40. how to prevent neural tube defect in first trimester: folic acid (400 MCG) and vitamins 3 months
prior to pregnancy
41. What is the should average weight gain be for BMI of 18.5-24.9: 25-35 pounds
42. What OTC should be avoiding: Aspirin
Routine office visit times - (answer)every 4 weeks until 28 weeks
every 2 weeks until 36 weeks