Course:
Doc:
Gynecology
Final Exam Review
Date:
Prof:
March 22, 2011
Dr. Amy Love
Final Exam Review
Dr. Love gave us these review questions. You have to know more than this covers to do well on the
final, but this will help you understand basic concepts. After taking the test I will suggest your at least
read through every slide from week 7 onward, since my final covered weeks 7-11.
Where does fertilization usu take place?
In the fallopian tube. Divides until goes to uterus and implants. Take 3-4 days to reach the uterus
and another 3-4 to implant.
How long is normal human gestation?
40 weeks. 37-42 weeks are also considered normal.
At what week of gestation does fertilization occur (approx)?
6 – 8 days…week 1?
Fertilization occurs about 2 weeks after 1st day of LMP. Weeks 1 and 2 are preconception
What are normal early SX of pregnancy?
 Nausea/vomiting esp in AM til about week 12-15
 Swollen/tender breasts
 Mood changes/irritability
 Fatigue
 Leucorrhea – white thicker vag discharge
 Lack of period
All because of hormonal changes
What are later changes of pregnancy?
 Softening/bluing of cervix (increased vascularity)
 Enlargement of uterus (growth of fetus - palpable after 15wks)
 Fetal heart tones (faster than moms, as early as 10 wks)
 Quickening: first fetal movement felt by the mother
o Primiparous: 18-20 weeks
o Multiparous: 16-19 weeks
 Braxton Hicks contractions: localized uterine contractions that may start at 20 weeks; very
irregular and variable
 At 20 weeks, ballotment: moveable baby
What causes these S/SX?
Hormone changes.
Increased: thyroid fnx, prolactin, cortisol, aldosterone, estrogen, progesterone.
Gynecology – Winter 2011
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Disclaimer: This is not an official AOMA document, is intended for reference only and is not a replacement for your own class notes. This document is
available for your use As Is and may contain errors and omissions. Cat Calhoun retains full copyright ownership, rights and protection in all material
contained herein. You may use this document for your own purposes and distribute it to other people provided you 1) do not charge for it and 2) attribute it
as having been generated by Cat Calhoun and disclose that it available free of charge on CatsTCMNotes.com. © 2010 Catherine (Cat) Calhoun
Prostaglandin, prolactin, oxytocin, bHCG
Mostly due to increased estrogen and progesterone.
What symptoms would need investigation?
Lack of fetal heart tones
What is Rh incompatibility? Who is at risk?
Mom Rh negative, baby Rh positive. Mother’s immune system develops antibodies to fetal blood
with 1st exposure, attacks fetal blood with 2nd exposure. Tx is Rh immune globulin injection in
7th month gestation and within 72 hours of delivery.
Which weeks of gestation are embryonic stage?
1st 8 weeks – 1st trimester.
At approx which week is fetus viable if born?
37? Lung development?
What is the role of the placenta?
Preserves/protects the fetus.
Gas exchange w/o mixing maternal/fetal circulation. Permeable to vitamins, glucose, fatty acids,
electrolytes, antibodies. Nourishment to baby, removes wastes, secretes hormones (chor
gonadotropin, progesterone, estrogens, etc.), blocks some harmful substances.
What role(s) do oxytocin play in birth? After birth? In breastfeeding?
Cervical dilation, contractions,
Lets milk down, human bonding, social memory, maternal behaviour.
Contentment, lowers anxiety, calmness/security around mate
What are the categories and types of contraceptive methods?
Categories: prevent ovulation, prevent sperm from meeting ovum, prevent implantation.
Types: OCP, sterilization, condoms, progestin injection, withdrawl, IUD, abstinence, patch,
diaphragm, emergency contraception,
Which are most effective? Cheapest?
Cheapest are barrier methods – condoms, diaphragms, cervical caps, sponges and spermicides.
Most effective: Copper T IUD, vasectomy, implants, injectables, OCP’s
What are ContraIndications to OCP use? SideEffects?
Side effects: nausea, breast tenderness, HA, fluid retention, reduction in vitamins b, c and
increased in A. Melasma, breakthrough bleeding, mod changes, thrombosis, increased
coag/angiotensin, HTN, neoplasias. Also wt gain, acne, mood changes, amenorrhea, increase in
insulin intol/increased chol.
Gynecology – Winter 2011
www.CatsTCMNotes.com
Page 2 of 4
Disclaimer: This is not an official AOMA document, is intended for reference only and is not a replacement for your own class notes. This document is
available for your use As Is and may contain errors and omissions. Cat Calhoun retains full copyright ownership, rights and protection in all material
contained herein. You may use this document for your own purposes and distribute it to other people provided you 1) do not charge for it and 2) attribute it
as having been generated by Cat Calhoun and disclose that it available free of charge on CatsTCMNotes.com. © 2010 Catherine (Cat) Calhoun
Contraindications - absolute:
Vascular or heart disease hx, SLE/DM w/nephro or retinopathy, cigarettes over age 35, HTN,
cancers (breast/endo), preggers, liver disease.
CI’s – relative:
Smoking, migraines, amenorrhea (undx), macroadenoma secreting prolactin
What are some ways to increase fertility and chance of conception?
 Improve your timing – do basal temp charts, have sex/induce conception based on this.
Best chance is day prior to ovulation
 Stop smoking
 Avoid coffee, alcohol, pot, pesticide exposure, stress, douching, lubes/saliva lube,
 Make sure dudes don’t carry cell phone in pocket, pelvic junk is right temp. Get his
sperm checked.
 Lose weight if BMI is 25+
 Check the lady equipment
What are S/SX of SAB? Ectopic PG?
SAB (spontaneous abortion)
Heavy bleeding, dilated cervix, gush of amniotic fluid if over 20 weeks, passage of tissue
Ectopic preggers
Spotting, cramping pain, amenorrhea, rupture (sudden excruciating pain), other sx of preggers
such as fatigue, breast tenderness, changes in appetite, etc.
What is Preeclampsia? Eclampsia?
Preeclampsia: Pregnancy induced hypertension or PIH, edema, protein in the urine.
Eclampsia: Coma and convulsions before, during, or shortly after childbirth, characterized by
edema, hypertension, and proteinuria.
What is PROM? What risks are associated?
Premature Rupture of Membranes. Can be PROM if rupture more than 1 hour before the onset of
labor (any gestational age).
Risks: perinatal morbidity (distress, sepsis, cord prolapse, placental abruption, fetal death), fetal
malnutrition, infection. For mother = sepsis, inflammation
How many cms is full cervical dilation?
10?
What are some methods of labor induction?
Herbs/acupuncture/homeopathy (Gelsemium)
Gynecology – Winter 2011
www.CatsTCMNotes.com
Page 3 of 4
Disclaimer: This is not an official AOMA document, is intended for reference only and is not a replacement for your own class notes. This document is
available for your use As Is and may contain errors and omissions. Cat Calhoun retains full copyright ownership, rights and protection in all material
contained herein. You may use this document for your own purposes and distribute it to other people provided you 1) do not charge for it and 2) attribute it
as having been generated by Cat Calhoun and disclose that it available free of charge on CatsTCMNotes.com. © 2010 Catherine (Cat) Calhoun
Breast stim, foley catheter, prostaglandin gel on cervix, stripping of membranes, amniotomy
(artificial break water)
IV with pitocin
What does VBAC stand for?
Vaginal Birth After Cesearean
What is meconium?
Meconium is the earliest stools of an infant. Unlike later feces, meconium is composed of materials
ingested during the time the infant spends in the uterus: intestinal epithelial cells, lanugo, mucus,
amniotic fluid, bile, and water. Dark green or black and tarry. Lines fetal intestines. Usually not released
until after birth, but if during or pre birth can mix with the amniotic fluid.
Gynecology – Winter 2011
www.CatsTCMNotes.com
Page 4 of 4
Disclaimer: This is not an official AOMA document, is intended for reference only and is not a replacement for your own class notes. This document is
available for your use As Is and may contain errors and omissions. Cat Calhoun retains full copyright ownership, rights and protection in all material
contained herein. You may use this document for your own purposes and distribute it to other people provided you 1) do not charge for it and 2) attribute it
as having been generated by Cat Calhoun and disclose that it available free of charge on CatsTCMNotes.com. © 2010 Catherine (Cat) Calhoun