FM Case #14 (35 yo F w/ missed period Exam Questions and Answers (Solved Papers) signs of pregnancy - Correct Answers ✅-delayed menstrual period -symptoms of nausea -breast tenderness -malaise -bluish discoloration of the cervix (from venous congestion, Chadwick's sign, 8-10 wks) -palpably gravid uterus (10-12 wks) studies to diagnose pregnancy - Correct Answers ✅-home
pregnancy test: reliable, most tests detect concentration >25
mlU/mL
-blood tests of hCG: detect levels as low as 5mlU/mL, helpful
in determining viability of pregnancy since hCG levels rise predictably in early pregnancy
-transvaginal ultrasound: more sensitive than transabdominal
ultrasound in detecting early pregnancy , gestational sac can be visualized by 4-5 wks gestation & fetal pole seen by 5-6 wks, useful for dating pregnancy & evaluating ectopic pregnancy describe hCG levels in early pregnancy - Correct Answers ✅-levels double approximately every 2.2 days over the first few wks -then doubles more slowly ~every 3.5 days by 9 wks 1 / 3
FM Case #14 (35 yo F w/ missed period Exam Questions and Answers (Solved Papers) -levels peak at 10-12 wks & decline rapidly thereafter until 22 wks, when levels gradually rise until delivery Navel's Rule - Correct Answers ✅-determine due date 40 wks after beginning of LMP -subtract 3 months, add 7 days T/F--most deliveries occur within 2 wks of their due date - Correct Answers ✅True
gestational age determination - Correct Answers ✅-LMP:
time elapsed since 1st day of the last menstrual period (woman w/ regular periods)
-ultrasound: estimates gestational age of fetus, when used
for dating US is most accurate during early pregnancy & should be performed as early as possible (no later than 20 wks)
-fundal height: 3rd trimester, at 20 wks, top of uterus fundus
is usually at the level lot the umbilicus & after 20 wks, it elevates ~1cm above the umbilicus for each wk of pregnancy
-pregnancy dating:
embryonic age - Correct Answers ✅-calculated from the date of fertilization -2 wks after 1st date of LMP 2 / 3
FM Case #14 (35 yo F w/ missed period Exam Questions and Answers (Solved Papers) most clinicians use dates determined by US for any discrepancy of... - Correct Answers ✅-more than 1 wk btw the US & another method in the 1st trimester -more than 2 wks in the 2nd trimester -more than 3 wks in the 3rd trimester complete prenatal hx - Correct Answers ✅-medical hx -obstetric hx -hx of genetic risk factors -social hx initial pregnancy visit counseling - Correct Answers ✅- remember not all pts want to be pregnant >> always good to check to see how they are feeling about it -discuss early pregnancy counseling & perform recommended health maintenance exams -ask all pregnant pts about intimate partner violence (more common during pregnancy) Initial pregnancy visit studies - Correct Answers ✅-blood type/Rh status
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