Test #1 OBGYN

Preterm labor is defined as labor that begins before — weeks of gestation

38

The normal duration of pregnancy is

40 weeks, 280 days or 9 calendar months

Blood volume increases by — % during pregnancy

45%

Treatment for vaginal bleeding includes — blood flow, — , and initiating — therapy and — access based on the patients condition

Absorbing, transport, oxygen and IV

The paramedic accurately describes the difference between endometritis and endometriosis when she states

"Endometritis is an infection of the uterine lining, while endometriosis occurs when endometrial tissue is found outside the uterus."

How long are trimesters

13 weeks

After the delivery of the infant, where do you place the cord clamps

1st 10cm from the baby 2nd 5cm above the first clamp

How many arteries does the umbilical cord have

2

Transport all trauma patients at — weeks or more gestation

20

What week of gestation can fetal heart tones be detected by stethoscope

20th

Guidelines of neonatal resuscitation include: A) initiating chest compressions if the infants heart rate is below 100, and it does not respond to ventilations B) assisting ventilations if the infants respiratory rate is below 30 and tactile stimulation does not increase the rate C) intubating the infant and initiating ACLS procedures if the heart rate fall below 80 D) administering 25% dextrose IV if the infants respiratory rate is less than 15

Assisting ventilations if the infants respiratory rate is below 30 and tactile stimulation does not increase the rate

What fibers contract to help maximize the sloughing of the endometrium and to help with post partum bleeding

Myometrial fibers

Women who has not been pregnant

Nulligravida

The term for a women who has yer to deliver her first child

Nullipara

Women who has NOT yet delivered her first child

Nullipara

How many veins does the umbilical cord have

One

What are the primary female gonads, or sex organs

Ovaries

The release of an egg from the ovary is called

Ovulation

The release of an egg from the ovary is called: A) the preembryonic stage B) ovulation C) menstruation D) gestation

Ovulation

What is one of the leading causes of female infertility and ectopic pregnancy

PID

If you note crowning before transporting the patient to the hospital: A) have the mother cross her legs, and transport immediately. B) place the mother in a knee - chest position, and transport C) prepared to deliver the baby, as the birth is imminent. D place the mother in the Trendelenburg position, and transport

Prepared to deliver, the baby, as the birth is eminent

The patient is a 43 y/o female who is 36 weeks pregnant and alert complaining of ABD pain. She states the she slipped on the wet floor earlier today. She did not have any acute onset of pain but over the next few hours developed lower ABD cramping similar to menstrual pain that comes and goes, as well as lower back ache, she is G4P3, has a history of cardiovascular disease, renal disease, and has ABD surgery for a hernia 4 months ago. Based on this history the patient is most likely experiencing

Preterm labor

Women who is pregnant for the first time

Primigradiva

A women who has given birth to her FIRST child is called

Primipara

Women who has delivered her first child

Primipara

Which of the following statements about changes in maternal physiology during pregnancy is true

Progesterone causes decrease in airway resistance

What is the term for when the umbilical cord precedes the fetal presenting part

Prolapsed cord

When the umbilical cord is the presenting part and is compressed in the birth canal

Prolapsed cord

What phase may fertilization of a egg take place during the menstrual cycle

Proliferative

What phase of the menstrual cycle, the uterine lining thickens ad becomes engorged with blood

Proliferative

Ovulation takes place at the end of the: A) proliferative phase B) secretory phase C) ischemic phase D) menstrual phase

Proliferative phase

The proper position for the expectant mother in the event of a limb presentations is

Prone knee-to-chest fashion

The term "tocolysis" refers to: A) the acceleration of labor by administrations of Pitocin B) an infection acquired by the mother and passes on to the fetus C) the process of stopping labor D) the disruption of blood flow from the placenta to the fetus

The process of stopping labor

Hemodynamic changes of pregnancy include: A) the stroke volume progressively declining to term following a rise early in the pregnancy B) cardiac output increasing 2.5-3 L per min during the first trimester C) blood volume decreasing slightly, by 1-5% D) heart rate remaining abut the same

The stroke volume progressively declining to term following a rise early in the pregnancy

Which process occurs during the proliferative phase of the menstrual cycle

Thickening of the endometrium

Labor consists of uterine contractions that cause the dilation and effacement of the cervix. The term "effacement" means that the uterus is: A) thinning and shortening B) thinning and lengthening C) releasing the placenta D) returning to its normal, pre pregnancy size

Thinning and shortening

The process of stopping labor is called

Tocolysis

Which of the following statements regarding meconium staining is NOT true

The presence of meconium staining is often difficult to determine

The premature separation of a normally impacted placenta from the uterine wall is called

Abruptio placentae

Sharp, tearing pain and a stiff, board like abdomen without vaginal bleeding in a pregnant patient include: A) a central abruption of the placenta B) placenta previa C) an ectopic pregnancy D) spontaneous abortion

A central abruption of the placenta

The two most common emergency gyno complaints are

ABD pain and vaginal bleeding

One of the two MOST common emergency gynecologic complaints is: A) vomiting B) fever C) abdominal pain D) back pain

Abdominal pain

Termination of pregnancy before the 20th week of gestation is called

Abortion

Separation of the placenta from the uterine wall

Abruptio placentae

The patent is a 41 y/o female who is alert and is in obvious distress complaining of ABD ain. The pt states that she is 32 weeks pregnant and has experienced an acute onset of tearing ABD pain this evening. She admits to smoking cocaine this afternoon. She is G%P@ with two spontaneous abortions. Her skin sis cool, moist and pale and you note abt 50ml of dark red vaginal bleeding. Her ABD is rigid to palpation in all quadrants. HR=128 BP 90/52 RR 22 SPO2 99% which of the following is most likely

Abruptio placentae

Early separation of the placenta A. Is accompanied by the tearing and rupture of ligaments and blood vessels associated with the uterus, producing profound life-threatening maternal shock B. Can be caused by pulling on the umbilical cord C. Can be caused by aggressive attempts to express the placenta when the uterus is relaxed D. All of the above

All of the above

When caring for a pregnant patient who is experiencing vaginal bleeding, you should: A) gain information about the color, amount, and duration of B) assess the amount of bleeding by counting the number of sanitary pads used C) save any passed clots or tissue for evaluation D) all of the above

All of the above

When maternal blood volume increases, pregnant women receive supplemental iron to prevent anemia. This is because: A) the mothers red blood cells do not carry as much oxygen as they did before the pregnancy B) there is a decrease in the number of the mothers red blood cells because they are now shared with the fetus C) although both red blood cells and plasma increase, there is slightly more plasma D) there is only an increase in plasma, not in red blood cells

Although both red blood cells and plasma increase, there is slightly more plasma

The clear, watery fluid that surrounds and protects the developing fetus is called

Amniotic fluid

The membranes that surround and protect the developing fetus throughout the period of intrauterine development are the

Amniotic sacs

The most significant pregnancy related changes occur in the uterus. These changes include: A) an increase in weight of the uterus to approximately 2 pounds B) an increase in the vascular system of the uterus to about 1/4 of the mother's total blood volume C) the development of a layer of mucus on the lining of the uterus D) an increase in the capacity of the unit to nearly a liter of fluid

An increase in weight of the uterus to approximately 2 pounds

Treatment for gynecologic abdominal pain includes making the patient

Comfortable and providing transport

Which of the following statements regarding uterine rupture is false

Because of todays advancements medial procedures, uterine rupture rarely results in maternal or fetal death

Cystitis is a — infection, which often occurs secondary to a urinary tract infection

Bladder

Which of the following statements is TRUE regarding fetal development? A) fetal heat tones may be detected with a stethoscope by the 16th week B) the baby may be able to survive if born before the 20th week C) by the 38th week, the baby is considered fully developed D) the sex of the infant can usually be determined by 8 weeks gestations

By the 38th week, the baby is considered fully developed

When the baby's head is too large for the birth canal

Cephalopelvic disproportion

What is the difference between Braxton Hicks and true labor

Cervical changes

Because cardiac output increases up to 30% during pregnancy, patients who have serious preexisting heart disease may develop: A) pulmonary embolism B) congestive heart failure C) palpitations D) angina pectoris

Congestive heart failure

When caring for a victim of sexual assault, consider the patient a

Crime scene

The bulging of the fetal head past the opening of the vagina during a contraction is called

Crowing

Which of the following is the most reliable sign of impending delivery

Crowning

An infection of the urinary bladder

Cystitis

What structures function is to conduct the egg from the space around the ovaries into the uterine cavity

Fallopian tubes

The preparation for multiple births, such as twins the paramedic should expect all of the following except

Delivery is never in the same manner as individual delivery

An ectopic pregnancy is a pregnancy on which the: A) baby is delivered prematurely B) developing fetus implants outside the uterus C) fetus develops in an abnormal position, such as buttocks superior D) fetus is spontaneously expelled during the first trimester

Developing fetus implants outside the uterus

When caring for the female patient with vaginal bleeding, do NOT pack

Dressings in the vagina

Severe discomfort during a woman's menstrual period is known as: A) PID B) dysmenorrhea C) dyspareunia D) LMP

Dysmenorrhea

Painful urination often associated with cystitis is called

Dysuria

Pregnancy toxemia resulting in seizures

Eclampsia

Assume that any female of childbearing age with lower abdominal pain is experiencing

Ectopic pregnancy

If a female patient presents with severe unilateral abdominal pain that radiates to the shoulder on one side, a missed menstrual period and vaginal bleeding, you should suspect

Ectopic pregnancy

Implantation of an egg other than in the uterus

Ectopic pregnancy

The implantation of a developing fetus outside of the uterus is called

Ectopic pregnancy

The thinning and shortening of the cervix during labor is called

Effacement

The inner layer of the uterine wall where the fertilized egg implants is called

Endometrium

Which of the following would be considered routine prehospital care of the patient exhibiting indication of imminent delivery

Establish IV of normal saline

The approximate date the infant will be born is called

Estimated date of confinement

What female sex hormones control the ovarian menstrual cycle, pregnancy and lactation

Estrogen and progesterone

Fertilization of the egg takes place in the: A) uterus B) vagina C) fallopian tube D) cervix

Fallopian tube

Fertilization of the ovum usually occurs in the

Fallopian tubes

Which structure allows for mixing of blood between the right and left atria

Foramen ovals

Which of the following is part of the mothers routine postpartum care

Fundal massage

What is the uppermost part of the uterus

Fundus

It is your pts due date and she is in labor, she has two 3 y/o twins and has had one miscarriage. You should describe her as being

G3, P1, Ab1

A pregnant women may develop diabetes during the pregnancy. This is called: A) gravid diabetes B) obstetric diabetes C) gestational diabetes D) uterine diabetes

Gestational diabetes

The distance from the symphysis pubis to the fungus can be used to calculate

Gestational length in weeks

Supine hypotensive syndrome occurs when the: A) heart is compressed by the gravity uterus when the mother lies supine B) gravid uterus compresses the inferior vena cava when the mother lies in the supine position C) body reacts to the mother lying in the supine position by dilation of the major blood vessels D) fetus lying at the same level as the mother when she is lying in the supine position, now requires more blood

Gravid uterus compresses the inferior vena cava when the mother lies in the supine positions

Which of the following is appropriate in the care of the patient in the first stage of labor

History, physical exam, transport

Management consideration for a pt with pre-eclampsia included all of the following EXCEPT

IV administration of diazepam

If the amniotic fluid appears to have the color and consistency of "pea soup"

If baby is vigorous no action is needed

If a delivery involving a limb presentation is encountered

Immediately transport the patient to the hospital

The patient is a 32y/o female who complains of the onset of contractions 45 min ago. She is 39 weeks pregnant G3P2. She states that the contractions are 2 min apart but her membrane has not ruptured. She is anxious and responds affirmatively when you ask if she feels the urge to move her bowels. Which of the following is most likely?

Imminent delivery

What is crowing an indication of

Imminent delivery

Women who has been pregnant more than once

Multigravida

Which of the following maternal changes is expected during pregnancy

Increased cardiac output, increased blood volume

Do NOT preform an — vaginal exam in the field

Internal

Which of the following statements is true regarding the umbilical cord? A) if it is found to be around the babies neck at the time of delivery, it must immediately be clamped and cut. B) it is a flexible, black structure, usually several feet in length. C) it circulates amniotic fluid through the uterus. D) it contains two arteries and one vein

It contains two arteries in one vein

Which of the following statements about the delivery of the placenta is TRUE

It should be placed in a biohazard bag and brought to the ED with the patient

A women who has delivered more then one baby is called

Multipara

Women who has delivered more than one baby

Multipara

With limb presentation, place the mother in the

Knee-chest position

What structure protects the vaginal and the urethra

Labia

When obtaining the history of any female patient of childbearing age, the paramedics should always document the patients

Last menstrual period

Which of the following medications is considered a tocolytic for preterm labor

Magnesium sulfate

What is called when the fetus passes feces into the amniotic fluid

Meconium staining

What term refers to the onset of menses, usually occurring between ages 10 and 14 years

Menarche

The cessation of menses and ovarian function due to decreased secretion of estrogen is

Menopause

What phase does the ischemic endometrium shed, along with a discharge of blood, mucus and cellular debris

Menstral phase

Mid cycle abdominal pain associated with ovulation is known as

Mittelschmerz

Which structure protects the pubic symphysis

Mons pubis

During the second stage of labor: A) contractions are usually mild, occur every 10-20 minutes. B) the patient feels the urge to push "bear down" C) The placenta (after birth) is delivered D) the cervix dilates to 10 cm

Patient feels the urge to push "bear down "

The MOST important female reproductive organs are internal and are located within the

Pelvic cavity

An acute infection of the reproductive organs is called

Pelvic inflammatory disease

Your pt is complaining of abdominal pain, which increases when she walks. To avoid this she walks with a shuffling gait. She also complains of fever, chills, nausea and vomiting. She is MOST likely experiencing: A) an ectopic pregnancy B) a ruptured ovarian cyst C) pelvic inflammatory disease D) endometritis

Pelvic inflammatory disease

A roughly diamond-shaped, skin-covered muscular tissue that separates the vagina from the anus

Perineum

During your assessment of the victim of a sexual assault, you should: A) ask specific questions about the assault to report to law enforcement B) perform a brief vaginal exam to verify penetration C) place bloody articles in a brown paper bag D) allow the patient to clean up before the medical examination

Place bloody articles in a brown paper bag

If the umbilical cord is seen in the vagina (prolapsed cord) you should

Place the mother in a knee-chest position

If the umbilical cord is seen in the vagina (prolapsed cord), you should: A) insert a gloved hand to gently push the fetus back up the birth canal B) immediately clamp and cut the cord C) place the mother in the knee-chest position D) encourage the mother to continue to push to speed up the delivery

Place the mother in the knee-chest position

The organ that serves as a lifeline of the developing fetus is the

Placenta

Low attachment of the placenta interfering with the cervix

Placenta previa

The abnormal implantation of the placenta on the lower half of the uterine wall, resulting in partial of complete coverage of the cervical opening is called: A) placenta previa B) abruptio placentae C) prolapsed placenta D) nuchal placenta

Placenta previa

The patient is 36 weeks gestation who has been involved in a MVC and is complaining if ABD pain and vaginal bleeding. Which of the following is LEAST likely cause of her condition

Placenta previa

What occurs as a result of abnormal implantation of the placenta on the lower half of the uterine wall

Placenta previa

A delivery that occurs after less than 3 hours of labor is called

Precipitous delivery

Pregnancy toxemia resulting in hypertension, edema, headache, and vision disturbances

Preeclampsia

Which of the following terms refers to the time from conception to birth

Prenatal

What is the primary function of the uterus

Provide a site for fetal development

The Skene and Bartholin glands: A) produce the hormones that trigger menstruation B) are responsible for proper adhesion of a fertilized egg to the uterine wall C) regulate the vascular structures of the endometrium D) provide lubrication during sexual stimulation

Provide lubrication during sexual stimulation

The best management for a victim of sexual assault is

Psychological and emotional support

— and — support are the MOST important elements of care for the sexual assault victim

Psychological, emotional

All of the following structures are located within the pelvic cavity except the: A) Vagina B) Pudendum C) Ovaries D) Fallopian Tube

Pudendum

The ductus arteriosis connects which two strucutres

Pulmonary artery and aorta

You are dispatched to a call of respiratory distress. Upon arrival you find a 36 YOF who is 38 weeks pregnant. She is having severe difficulty breathing that began one hour ago and is getting progressively worse. She has no history of asthma, COPD, or cardiac problems and her pregnancy has been normal with regular prenatal care. What do you suspect the problem to be?

Pulmonary embolism

General guidelines in assessing and caring for a gynecologic emergency patient include: A) packing the vagina with sterile dressings to control excessive bleeding B) performing a thorough internal vaginal exam in the field C) realizing the psychological support may be more important than emergency medical care D) application of direct pressure, over the uterus, to control vaginal hemorrhage

Realizing the psychological support may be more important than emergency medical care.

Complications in a pregnant women with cystic fibrosis are usually the result of

Reduced pulmonary function

The placenta of "organ of pregnancy" A) is an organ that is always present in the female uterus B) is the organ in which the fetus will develop C) secretes hormones necessary for fetal survival D) becomes thick and engorged with blood at the time of fertilization

Secrets hormones necessary for fetal survival

Which sign or symptom differentiates eclampsia from preeclampsia

Seizure

The difference between preeclampsia and eclampsia is the onset of

Seizures

The hallmark of abruptio placente is: A) severe abdominal pain and vaginal bleeding B) increased blood pressure and seizures C) painless, bright red vaginal bleeding D) abdominal pain accompanied by fever

Severe abdominal pain and vaginal bleeding

When a baby's shoulders are larger than the head

Shoulder dystocia

The primary impact on the fetus from a state of shock in the mother includes

Shunting of blood from the fetus

What abnormal presentations or delivery complications absolutely cannot be delivered in the field

Single limb presentation, prolapsed cord and cepahlopelvic disproportion

Another term for miscarriage is

Spontaneous abortion

The commonly used term to describe a pregnancy that ends before 20 weeks gestation is called miscarriage or

Spontaneous abortion

During the delivery of the baby, you should A) pull gently on the umbilical cord to encourage the placenta to deliver B) "milk" the cord towards the baby C) suction the baby's mouth first, then the nose D) administer high-flow, high concentration oxygen to the baby

Suction the baby's mouth first, then the nose

Which of the following best describes the care of a newborn

Suctioning the airway with a bulb syringe as needed, tactile stimulation, drying warming, APGAR determination

Compression of the major vessels by the uterus

Supine hypotensive syndrome

Occurs when the gravid uterus compresses the inferior vena cava when the mother lies in a supine position

Supine hypotensive syndrome

Which of the following is NOT a function of the placenta

Supplying the developing fetus with blood

General management of gynecologic emergencies is focused on `

Supportive care

Indications of imminent delivery include: A) contractions less the 5 min apart for a patient who is pregnant for the first time B) the bulging of the fetal head past the opening of the vagina during a contraction C) pain in the lower back D) all of the above

The bulging of the fetal head past the opening of the vagina during a contraction

An ectopic pregnancy refers to a pregnancy in which: A) delivery occurs within the first 24 weeks of the pregnancy B) the egg has split in two, resulting in maternal twins C) any aspect of it is abnormal D) the fetus is implanted abnormally outside of the uterus

The fetus is implanted abnormally outside of the uterus

When caring for a pregnant patient who has experienced a major trauma, remember that: A) the later in the pregnancy, the less the likelihood of injury to the uterus B) the fetus may be in danger even though the mother is showing no signs of symptoms of shock C) the primary cause of fetal mortality is direct injury to the fetus, while the mother survives D) the amniotic fluid provides little protection to the fetus from blunt trauma

The fetus may be in danger even though the mother is showing no signs of symptoms of shock

What can you measure in centimeters, is generally comparable to the weeks of gestation

The fundal height

Pre-eclampsia commonly occurs during

The last 10 weeks of gestation, labor, the first 48 hours postpartum

"Spontaneous abortion" is the term used to describe: A) an elective termination of pregnancy B) the expulsion of the fetus before 8 weeks gestation C) the loss of a fetus by natural means D) the loss of a fetus due to a traumatic injury to the mother

The loss of fetus by natural means

When a pregnant patient advises that her "water has broken", she means that: A) contractions have begun B) the mucous plug has been expelled. C) the membranes have ruptured. D) she's experiencing vaginal bleeding

The membranes have ruptured

The monthly sloughing off of the uterine lining is referred to as: A) endometriosis B) pelvic inflammatory disease C) The menstrual cycle D) menopause

The menstrual cycle

The easiest means by which an EMS provider can estimate menstrual flow is

The number of tampons or pads used in the past hour

Care for the ecliptic patient may include: A) administration of IV diazepam B) transport of the patient in the left lateral recumbent position C) administration of IV Lasix to reduce edema D) two large-bore IVs of LR solutions, initiating a 250 ml fluid challenge

Transport of the patent in the left lateral recumbent position

Generally pregnancy is divided into

Trimesters

The structure that connects the placenta and the fetus is the

Umbilical cord

The fetus receives its blood form the placenta by means of the: A) umbilical arteries B) umbilical vein C) pulmonary arteries D) pulmonary veins

Umbilical vein

The fundus is the: A) uppermost portion of the uterus, above where the fallopian tubes connect B) lower portion of the uterus, also called the cervix C) upper two-thirds of the uterus, composed of smooth muscle D) body, or corpus of the uterus

Uppermost portion of the uterus, above where the fallopian tubes connect

What drains the urinary bladder

Urethra

Which structure drain urine from the urinary bladder? A) vagina B) mons pubis C) prepuce D) urethra

Urethra

The most common cause of postpartum hemorrhage is

Uterine atony

Occurs when the uterus turns inside out after delivery

Uterine inversion

If your pt complains of excruciating abdominal pain with the onset of labor and shows signs and symptoms of shock without external hemorrhage, consider: A) uterine inversion B) placenta previa C) uterine rupture D) abruptio placentae

Uterine rupture

The actual tearing of the uterus is called

Uterine rupture

An elastic canal that connects the internal and external female genitalia is the

Vagina

The part of the female internal genitalia that provides an outlet for menstrual blood and tissue leaving the body is called the: A) vagina B) uterus C) fallopian tube D) urethra

Vagina

What is the female organ of copulation, form the final passageway for the infant during childbirth, and provide an outlet for menstrual blood to leave the body

Vagina

Which of the following is considered a normal delivery

Vertex position

The female external genitalia are known collectively as the

Vulva or pudendum

A pregnant women is complaining of a severe headache and "feeling ill". Her vital signs are HR of 92, BP 120/82, and respirations of 16. Which of the following questions would be most helpful in identifying a possible pregnancy-related emergency?

What has been a typical BP for you during this pregnancy?

In contrast to gravida 3 mothers, gravida 1 mothers

Will typically take more time to deliver

The term gynecology is derived from the Greek gynaik, which means: A) reproduction B) women C) vulvic D) disease

Women