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
