# on 30-Oct-2016 (Sun)

#### Annotation 1328543042828

Discounted Cash Flow Applications
#analyst #has-images #notes #quantitative-methods-basic-concepts

#### Holding Period Return

When analyzing rates of return, our starting point is the total return, or holding period return (HPR). HPR measures the total return for holding an investment over a certain period of time, and can be calculated using the following formula:

• Pt = price per share at the end of time period t
• P(t-1) = price per share at the end of time period t-1, the time period immediately preceding time period t
• Pt - Pt-1 = price appreciation of the investment
• Dt = cash distributions received during time period t: for common stock, cash distribution is the dividend; for bonds, cash distribution is the coupon payment.

It has two important characteristics:

• It has an element of time attached to it: monthly, quarterly or annual returns. HPR can be computed for any time period.
• It has no currency unit attached to it; the result holds regardless of the currency in which prices are denominated.

Example

A stock is currently worth $60. If you purchased the stock exactly one year ago for$50 and received a $2 dividend over the course of the year, what is your holding period return? Rt = ($60 - $50 +$2)/$50 = 0.24 or 24% The return for time period t is the capital gain (or loss) plus distributions divided by the beginning-of-period price (dividend yield). Note that for common stocks the distribution is the dividend; for bonds, the distribution is the coupon payment. The holding period return for any asset can be calculated for any time period (day, week, month, or year) simply by changing the interpretation of the time interval. Return can be expressed in decimals (0.05), fractions (5/100), or as a percent (5%). These are all equivalent. Learning Outcome Statements c. calculate and interpret a holding period return (total return); status not read #### Annotation 1328645016844 Bond Equivalent Yield #has-images #quantitative-methods-basic-concepts #### Periodic bond yields for both straight and zero-coupon bonds are conventionally computed based on semi-annual periods, as U.S. bonds typically make two coupon payments per year. For example, a zero-coupon bond with a maturity of five years will mature in 10 6-month periods. The periodic yield for that bond, r, is indicated by the equation Price = Maturity value x (1 + r)-10. This yield is an internal rate of return with semi-annual compounding. How do we annualize it? The convention is to double it and call the result the bond's yield to maturity. This method ignores the effect of compounding semi-annual YTM, and the YTM calculated in this way is called a bond-equivalent yield (BEY). However, yields of a semi-annual-pay and an annual-pay bond cannot be compared directly without conversion. This conversion can be done in one of the two ways: • Convert the bond-equivalent yield of a semi-annual-pay bond to an annual-pay bond. • Convert the equivalent annual yield of an annual-pay bond to a bond-equivalent yield. Example • A Eurobond pays coupon annually. It has an annual-pay YTM of 8%. • A U.S. corporate bond pays coupon semi-annually. It has a bond equivalent YTM of 7.8%. • Which bond is more attractive, if all other factors are equal? Solution 1 • Convert the U.S. corporate bond's bond equivalent yield to an annual-pay yield: • Annual-pay yield = [1 + 0.078/2]2 - 1 = 7.95% < 8% • The Eurobond is more attractive since it offers a higher annual-pay yield. Solution 2 • Convert the Eurobond's annual-pay yield to a bond equivalent yield (BEY): • BEY = 2 x [(1 + 0.08)0.5 - 1] = 7.85% > 7.8% • The Eurobond is more attractive since it offers a higher bond equivalent yield. status not read #### Annotation 1328780021004 #fixed #income The legal obligation to make the contractual payments is assigned to the bond issuer. The issuer is identified in the indenture by its legal name status not read Legal Identity of the Bond Issuer and its Legal Form 3.1.1. Legal Identity of the Bond Issuer and its Legal Form The legal obligation to make the contractual payments is assigned to the bond issuer. The issuer is identified in the indenture by its legal name. For a sovereign bond, the legal issuer is usually the office responsible for managing the national budget, such as HM Treasury (Her Majesty’s Treasury) in the United Kingdom. The legal #### Annotation 1328781856012 Subject 1. Equity securities in global financial markets #equity-analisis Equity securities play a fundamental role in investment analysis and portfolio management. The importance of this asset class continues to grow on a global scale because of the need for equity capital in developed and emerging markets, technological innovation, and the growing sophistication of electronic information exchange. Given their absolute return potential and ability to impact the risk and return characteristics of portfolios, equity securities are of importance to both individual and institutional investors. Global equity securities have offered an average of annualized real return of 5% based on historical data, while the average annual real return is about just 1% or 2% for government bills and bonds. However, equity securities are more volatile than government bills and bonds. They represent a key asset class for global investors because of their unique return and risk characteristics. status not read #### Annotation 1328783691020 Subject 2. Types and characteristics of equity securities #equity-analisis Common Shares Common shares represent ownership shares in a corporation. The two most important characteristics of common shares are: • Residual claim means the shareholders are the last in line of all those who have a claim on the assets or income of the corporation. • Limited liability means that the greatest amount shareholders can lose in event of failure of the corporation is the original investment. Each share of voting common stock entitles its owner to one vote on any matters of corporate governance that are put to a vote at the corporation's annual meeting. Shareholders who do not attend the annual meeting can vote by proxy, empowering another party to vote in their name. Statutory voting, also known as straight voting, is a procedure of voting for a company's directors in which each shareholders is entitled to one vote per share. For example, if you owned 100 shares, you would have 100 votes. Cumulative voting is another procedure of voting for a company's directors. Each shareholder is entitled one vote per share times the number of directors to be elected. For example, if you owned 100 shares and there were three directors to be elected, you would have 300 votes. This is advantageous for individual investors because they can apply all of their votes toward one person. Common shares can be callable or putable. Callable common shares give the issuer the right to buy back the shares from shareholders at a pre-determined price. Putable common shares give shareholders the right to sell the shares back to the issuer at a pre-determined price. Preference Shares A preferred share, also called preference share, has features similar to both equities and bonds. • Like a bond, it promises to pay to its holder fixed dividends each year. In this sense it is similar to an infinite-maturity bond, that is, a perpetuity. It also resembles a bond in that it does not convey voting power regarding the management of the firm. • A preferred share is an equity investment, however, in the sense that failure to pay the dividend does not precipitate corporate bankruptcy. It has priority over a common share in the payment of dividends and upon liquidation. Preferred dividends can be cumulative; that is, unpaid dividends cumulate and must be paid full before any dividends may be paid to common shareholders. All passed dividends on a cumulative stock are dividends in arrears. A stock that doesn't have this feature is known as a noncumulative or straight preferred stock and any dividends passed are lost forever if not declared. The implication is that the dividend payments are at the company's discretion and are thus similar to payments made to common shareholders. Participating preferred shares offer the holders the opportunity to receive extra dividends if the company achieves some predetermined financial goals. The investors who purchased these shares receive their regular dividends regardless of how well or how poorly the company performs, assuming the company does well enough to make the annual dividend payments. If the company achieves predetermined sales, earnings or profitability goals, the investors receive additional dividends. Most preferred shares are non-participating. Convertible preferred shares give the assurance of a fixed rate of return plus the opportunity for capital appreciation. The fixed-income component offers a steady income stream and some protection of capital. The option to convert these preferred shares into common shares gives the investor the opportunity to gain from a rise in share price. status not read #### Annotation 1328786312460 #equity-analisis Common Shares Common shares represent ownership shares in a corporation. The two most important characteristics of common shares are: • Residual claim means the shareholders are the last in line of all those who have a claim on the assets or income of the corporation. • Limited liability means that the greatest amount shareholders can lose in event of failure of the corporation is the original investment. Each share of voting common stock entitles its owner to one vote on any matters of corporate governance that are put to a vote at the corporation's annual meeting. Shareholders who do not attend the annual meeting can vote by proxy, empowering another party to vote in their name. status not read Subject 2. Types and characteristics of equity securities Common Shares Common shares represent ownership shares in a corporation. The two most important characteristics of common shares are: Residual claim means the shareholders are the last in line of all those who have a claim on the assets or income of the corporation. Limited liability means that the greatest amount shareholders can lose in event of failure of the corporation is the original investment. Each share of voting common stock entitles its owner to one vote on any matters of corporate governance that are put to a vote at the corporation's annual meeting. Shareholders who do not attend the annual meeting can vote by proxy, empowering another party to vote in their name. Statutory voting, also known as straight voting, is a procedure of voting for a company's directors in which each shareholders is entitled to one vote per share. For example, if you owne #### Annotation 1328787885324 #equity-analisis Statutory voting, also known as straight voting, is a procedure of voting for a company's directors in which each shareholders is entitled to one vote per share. For example, if you owned 100 shares, you would have 100 votes. status not read Subject 2. Types and characteristics of equity securities e vote on any matters of corporate governance that are put to a vote at the corporation's annual meeting. Shareholders who do not attend the annual meeting can vote by proxy, empowering another party to vote in their name. <span>Statutory voting, also known as straight voting, is a procedure of voting for a company's directors in which each shareholders is entitled to one vote per share. For example, if you owned 100 shares, you would have 100 votes. Cumulative voting is another procedure of voting for a company's directors. Each shareholder is entitled one vote per share times the number of directors to be elected. For example, if y #### Annotation 1328809381132 #fixed #income Affirmative covenants enumerate what issuers are required to do, whereas negative covenants specify what issuers are prohibited from doing. status not read Covenants 3.1.5. Covenants Bond covenants are legally enforceable rules that borrowers and lenders agree on at the time of a new bond issue. An indenture will frequently include affirmative (or positive) and negative covenants. Affirmative covenants enumerate what issuers are required to do, whereas negative covenants specify what issuers are prohibited from doing. <body><html> #### Annotation 1328812526860 #derivatives risk management is the process by which an organization or individual defines the level of risk it wishes to take, measures the level of risk it is taking, and adjusts the latter to equal the former. Risk management never offers a guarantee that large losses will not occur, and it does not eliminate the possibility of total failure. status not read Open it es abound about how poorly these companies managed risk. Such stories are great attention grabbers and a real boon for the media, but they often miss the point that risk management does not guarantee that large losses will not occur. Rather, <span>risk management is the process by which an organization or individual defines the level of risk it wishes to take, measures the level of risk it is taking, and adjusts the latter to equal the former. Risk management never offers a guarantee that large losses will not occur, and it does not eliminate the possibility of total failure. To do so would typically require that the amount of risk taken be so small that the organization would be effectively constrained from pursuing its primary objectives. Risk taking is inh #### Annotation 1328814361868 #fra-introduction Ideally, for an established company, the analyst would like to see that the primary source of cash flow is from operating activities as opposed to investing or financing activities status not read #### Parent (intermediate) annotation Open it t necessarily when cash is received, and expenses are reported when incurred, not necessarily when paid. The cash flow statement presents another aspect of performance: the ability of a company to generate cash flow from running its business. <span>Ideally, for an established company, the analyst would like to see that the primary source of cash flow is from operating activities as opposed to investing or financing activities.<span><body><html> #### Original toplevel document Open it method of reporting cash flows from operating activities discloses major classes of gross cash receipts and gross cash payments. Examples of such classes are cash received from customers and cash paid to suppliers and employees. <span>The indirect method emphasizes the different perspectives of the income statement and cash flow statement. On the income statement, income is reported when earned, not necessarily when cash is received, and expenses are reported when incurred, not necessarily when paid. The cash flow statement presents another aspect of performance: the ability of a company to generate cash flow from running its business. Ideally, for an established company, the analyst would like to see that the primary source of cash flow is from operating activities as opposed to investing or financing activities. The sum of the net cash flows from operating, investing, and financing activities and the effect of exchange rates on cash equals the net change in cash during the fiscal year. For Volks #### Annotation 1329342057740 Subject 1. The functions of the financial system #analyst-notes #market-organization-and-structure Helping People Achieve Their Purposes in Using the Financial System The financial system helps people: • Save money for the future. Saving here means buying notes, CDs, bonds, stocks, mutual funds or real estate assets. • Borrow money for current use. This is the opposite of the first purpose above. Individuals, companies and governments may need money to spend now (consumption, investment, paying taxes, expenses etc). • Raise equity capital. Companies can sell ownership rights to raise equity capital they need. • Manage risks. People can use financial contracts to offset risks. • Exchange assets for immediate (in spot markets) and future (in the futures markets) deliveries. • Trade on information. Information-motivated traders can (or they believe they can) use the financial system to earn a return in excess of the fair rate of return because they have information whose value declines over time (as it becomes recognized by other market participants). Determining Rate of Return The price in the financial system is the rate of return. It is the interaction of the broad forces of supply and demand. There are many different prices (rates of return) as there are many different types of assets in the financial system. For example, equities have higher rates of return than T-bills. All of these rates are determined in the financial system. Prices rapidly adjust to new information. The prevailing price is fair because it reflects all available information regarding the asset. Capital Allocation Efficiency In the financial markets investors distinguish good firms from bad firms. This lets the market channel capital to good firms and away from problem firms. Timely and accurate information is available on the price and volume of past transactions and the prevailing bid-price and ask-price. Such information facilitates the rapid flow of capital to its highest value uses. status not read #### Annotation 1329348349196 Subject 2. Assets and contracts #analyst-notes #market-organization-and-structure There are many different ways one can use to classify assets and contracts. The most common way is to classify them into one of these categories: debts, equities, currencies, derivatives (contracts), commodities, and real estate. In this subject we briefly describe the numerous assets and contracts available and provide a brief overview of each. Fixed-Income Investments They have a contractually mandated payment schedule. Their investment contacts promise specific payments at predetermined times. Investors who acquire fixed-income securities are really lenders to the issuers. Specifically, you lend some amount of money, the principal, to the borrower. In return, the borrower promises to make periodic interest payments and to pay back the principal at the maturity of the loan. Bonds, notes, bills, CDs, commercial paper, repo agreements, loan agreements, and mortgages are examples of fixed-income investments. Preferred stock is classified as a fixed-income security because its yearly payment is stipulated as either a coupon (e.g. 5% of the face value) or a stated dollar amount. Although preferred dividends are not legally binding as are the interest payments on a bond, they are considered practically binding because of the credit implications of a missed dividend. Equities Equities differ from fixed-income securities because their returns are not contractual. They represent residual ownership in companies after all claims - including any fixed-income liabilities of the company - have been satisfied. Common stocks represent ownership of a firm. Owners of the common stock of a firm share in the company's successes and problems. A warrant allows the holder to purchase the firm's common stock from the firm at a specified price for a given time period. It provides the firm with future common stock capital when the holder exercises the warrant. Pooled Investments Rather than directly buying an individual stock or bond, you may choose to acquire these investments indirectly by buying shares in an investment company that owns a portfolio of individual stocks, bonds, or a combination of the two. People invest in pooled investment vehicles to benefit from the investment management services of their managers. Examples of these pooled investments include money market funds, bond funds, stock funds, balanced funds, etc. Currencies The currency market is a worldwide decentralized over-the-counter financial market for the trading of currencies. The market participants include commercial banks, central banks, retail brokers, etc. Contracts Financial contracts include the following: • Forward contracts allow buyers and sellers to arrange for future sales at pre-determined prices. It is a commitment to buy or sell. • Futures contracts are standardized forward contracts guaranteed by clearing house. They are traded on a futures exchange. • Swap contracts are derivative securities in the form of agreements between two counterparties to exchange cash flows over a period of time, depending on the values of specified market variables. • Options are rights to or sell an underlying instrument at a specified price within a designated time period. Commodities Commodities include agricultural products, energy, metals, etc. Commodities complement the investment opportunities offered by shares of corporation that extensively use these raw materials in their production processes. Real Assets Real assets include tangible assets such as real estate, airplanes, machinery, or lumber stands. They are often illiquid and have high transaction costs compared to stocks and bonds. status not read #### Annotation 1329350184204 Subject 3. Financial intermediaries #analyst-notes #market-organization-and-structure Financial intermediaries are institutions that function as the line of communication between buyers and sellers in the financial system. Functioning as a middleman, a financial intermediary seeks to match investors who have specific financial goals with investments opportunities that can aid in the achievement of those goals. Brokers, Exchanges, and Alternative Trading Systems A broker executes trade orders on behalf of a customer. A block broker helps fill larger orders. Investment banks help their corporate clients raise capital by issuing shares or bonds. They also help their corporate identify and acquire other companies. An exchange is like a market where stocks, bonds, options and futures, and commodities are traded. Most exchanges offer different categories of membership and regulate their members' behavior when trading on the exchange. They also regulate the issuers that list their securities on the exchange. Alternative trading systems (ATSs) are non-exchange trading venues that bring together buyers and sellers of securities. ATSs do not exercise regulatory authority over their subscribers and do not discipline subscribers other than exclusion from trading. For example, an electronic communication network (ECN) connects major brokerages and individual traders so that they can trade directly between themselves without having to go through a middleman. Dark pools are ATSs that don't display the orders which are usually very large. Dealers A dealer trades for its own accounts. Individual dealers provide liquidity to investors by trading the securities for themselves. They buy or sell with one client and hope to do the offsetting transaction later with another client. In practice, most brokerages are in fact broker-dealer firms. That is, as a broker, the brokerage conducts transactions on behalf of clients, and, as a dealer, it trades on its own account. In the U.S. most broker-dealers must register with the SEC. Securitizers Securitization is a structured finance process that distributes risk by aggregating assets in a pool (often by selling assets to a special purpose entity), then issuing new securities backed by the assets and their cash flows. The securities are sold to investors who share the risk and reward from those assets. In most securitized investment structures, the investors' rights to receive cash flows are divided into "tranches": senior tranche investors lower their risk of default in return for lower interest payments, while junior tranche investors assume a higher risk in return for higher interest. Financial intermediaries securitize many assets such as mortgages, car loans,, credit card receivables, and banks loans. Depository Institutions and Other Financial Corporations They accept monetary deposits from savers and investors, and then lend these deposits to borrowers. Both the depositors and borrowers benefit from the services they provide. Depository institutions also provide other services such as transaction services, credit services, etc. Insurance Companies Insurance involves pooling funds from many insured entities (e.g. policyholders) in order to pay for relatively uncommon but severely devastating losses which can occur to these entities. The insured entities are therefore protected from risk for a fee. In other words, risks are transferred from these entities to the insurance company. The insurance company connects customers who want to insure risks with investors who are willing to bear those risks. Insurance companies make money in two ways: • Through underwriting, the process by which insurers select the risks to insure and decide how much in premiums to charge for accepting those risks; • By investing the premiums they c ... status not read #### Annotation 1329352019212 Subject 4. Positions #analyst-notes #market-organization-and-structure A long position is owning or holding securities or contracts. For example, an owner of 100 shares of Apple common stock is said to be "long the stock". Being long indicates an expectation of rising share/contract prices. A short sale allows investors to profit from a decline in a security's price if they believe the security is overpriced. In this procedure an investor (the seller) borrows shares of stock from another investor (the lender) through a broker and sells the shares. The lender keeps the proceeds of the sale as collateral. Later, the investor (the short seller) must repurchase the shares in the market in order to return the shares that were borrowed (covering the short position) to the lender. If the stock price has fallen, the shares will be repurchased at a lower price than that at which they were initially sold, and the short seller reaps a profit equal to the drop in price times the number of shares sold short. For options, to be long means you are the buyer of the option. To be short means you are the seller of the option. Since the put option contract holder (long) has the right to sell the underlying to the option writer, he or she is actually short the underlying instrument. The profit in short selling is limited to the value of the security, but the loss is theoretically unlimited. In practice, as the price of a security rises the short seller will receive a margin call from the broker, demanding that the short seller either to cover his short position (by purchasing the security) or to provide additional cash in order to meet the margin requirement for the security, which effectively places a limit on the amount that can be lost. Leveraged Positions Margin transactions occurs when investors who purchases stocks borrow part of the purchase price of the stock from their brokers, and leave purchased stocks with the brokerage firm because the securities are used as collateral for the loan. The interest rate of the margin credit charged by the broker is typically 1.5% above the rate charged by the bank making the loan. The bank rate (called the call money rate) is normally about 1% below the prime rate. The market value of the collateral stock minus the amount borrowed is called the investor's equity. Investors can achieve greater upside potential, but they also expose themselves to greater downside risk. The leverage equals 1/margin%. Buying stocks on margin increases the investment's financial risk and thus requires a higher rate of return. • Percentage margin. The ratio of the net worth, or "equity value" of the account to the market value of the securities. • Maintenance margin. The required proportion of your equity to the total value of the stock. It protects the broker if the stock price declines. • Margin call. If the percentage margin falls below the maintenance margin, the broker issues a margin call requiring the investor to add new cash or securities to the margin account. If the investor fails to provide the required funds in time, the broker will sell the collateral stock to pay off the loan. Example Suppose an investor initially pays$6,000 toward the purchase of $10,000 worth of stock ($100 shares at $100 per share), borrowing the remaining from the broker. The maintenance margin is set to be 30%. The initial percentage margin is 60%. If the price of the stock falls to$57.14, the value of his stock will be $5,714. Since the loan is$4,000, the percentage margin now is (5,714 - 4,000) / 5714 = 29.9%. The investor will get a margin call.

When investors acquire stock or other investments on margin, they are increasing the financial risk of the investment beyond the risk inherent in the security itself. They should increase their required rate of return accordingly.

R...

#### Annotation 1329353854220

Subject 5. Orders
#analyst-notes #market-organization-and-structure
Orders are instructions to trade. They always specify instrument, side (buy or sell), and quantity.

• Bid price: the highest price that a buyer wants to pay for the instrument. The best bid is the highest bid in the market.
• Ask price: the lowest price a seller is willing to accept for the instrument. Also called offer price. The best offer is the lowest in the market.
• Bid-ask spread: the difference between the best bid and the best offer.

Orders usually also provide several other instructions.

Execution Instructions

They indicate how to fill the order.

Market orders are simple buy or sell orders that are to be executed immediately at current market prices. They provide immediate liquidity for someone willing to accept the prevailing market price.

A limit order is an order that sets the maximum or minimum at which you are willing to buy or sell a particular stock. For instance, if you want to buy stock ABC, which is trading at $12, you can set a limit order for$10. This guarantees that you will pay no more than $10 to buy this stock. Once the stock reaches$10 or less, you will automatically buy a predetermined amount of shares. On the other hand, if you own stock ABC and it is trading at $12, you could place a limit order to sell it at$15. This guarantees that the stock will be sold at $15 or more. The primary advantage of a limit order is that it guarantees that the trade will be made at a particular price; however, it's possible that your order will not be executed at all if the limit price is not reached. Traders choose order submission strategies on the basis of how quickly they want to trade, the prices they are willing to accept, and the consequences of failing to trade. Validity Instructions They indicate when the order may be filled. A day order (the most common) is a market or limit order that is in force from the time the order is submitted to the end of the day's trading session. A good-till-canceled order requires a specific canceling order. It can persist indefinitely (although brokers may set some limits, for example, 90 days). An immediate-or-cancel order (IOC) will be immediately executed or canceled by the exchange. Unlike a fill-or-killorder, IOC orders allow for partial fills. An order may be specified on the close or on the open, then it is entered in an auction but has no effect otherwise. Different types of orders allow you to be more specific about how you'd like your broker to fulfill your trades. When you place a stop or limit order, you are telling your broker that you don't want the market price (the current price at which a stock is trading), but that you want the stock price to move in a certain direction before your order is executed. With a stop order, your trade will be executed only when the security you want to buy or sell reaches a particular price (the stop price). Once the stock has reached this price, a stop order essentially becomes a market order and is filled. For instance, if you own stock ABC, which currently trades at$20, and you place a stop order to sell it at $15, your order will only be filled once stock ABC drops below$15. Also known as a "stop-loss order", this allows you to limit your losses. However, this type of order can also be used to guarantee profits. For example, assume that you bought stock XYZ at $10 per share and now the stock is trading at$20 per share. Placing a stop order at $15 will guarantee profits of approximately$5 per share, depending on how quickly the market order can be filled.

Stop orders are particularly advantageous to investors who are unable to monitor their stocks for a period of time, and brokerages may even set these stop orders for no charge.

#### Annotation 1329355689228

Subject 6. Primary security markets
#analyst-notes #market-organization-and-structure
The primary markets are those in which new issues of bonds, preferred stock, or common stock are sold by government units, municipalities, or companies to acquire new capital.

• New issue.
• Key factor: issuer receives the proceeds from the sale.

Two important rules in the primary capital markets:

• Rule 415 allows large firms to register security issues and sell them in piecemeal over the following two years. Such issues are called shelf-registration. It allows a single registration document to be filed that permits the issuance of multiple securities.
• Rule 144A allows corporations (including non-U.S. firms) to place securities privately with large, sophisticated investors. The issuer of a private placement reduces issuing costs because it does not have to complete the extensive registration documents. However, investors will require a higher return since no secondary market exists and thus the liquidity risk is high.

New stock issues are divided into two groups:

• Initial public offerings (IPOs). These are new shares that a firm offers to the public for the first time. They are typically underwritten by investment bankers through negotiated arrangements (the most common form), competitive bids and best-effort arrangements (investment bankers act as brokers, not taking the price risk).
• Seasoned equity issues. These are new shares issued by firms that already have stocks outstanding.

A rights issue is an option that a company can opt for to raise capital under a secondary market offering or seasoned equity offering of shares to raise money. It is a special form of shelf offering or shelf registration. With the issued rights, existing shareholders have the privilege to buy a specified number of new shares from the firm at a specified price within a specified time.

Government bond issues are sold at Federal Reserve auctions.

#### Annotation 1329357524236

Subject 7. Secondary security market and contract market structures
#analyst-notes #market-organization-and-structure

The secondary markets permit trading in outstanding issues; that is, stocks or bonds already sold to the public are traded between current and potential owners.

• Existing owner sells to another party.
• Issuing firm does not receive proceeds and is not directly involved.

Secondary markets support primary markets.

• The secondary market provides liquidity to the individuals who acquired these securities, and the primary market benefits greatly from the liquidity provided by the secondary market because investors would hesitate to acquire securities in the primary market if they thought they could not subsequently sell them in the secondary market.

• Secondary markets are also important to issuers because the prevailing market price of the securities is determined by transactions in the secondary market. New issues of outstanding securities (seasoned securities) in the primary market are based on the prices in the secondary market. Forthcoming IPOs in the primary market are priced based on the prices of comparable stocks in the public secondary market.

Securities exchanges differ in when the stocks are traded.

In a call market, trading for individual stocks takes place at specified times. The intent is to gather all the bids and asks for the stock and attempt to arrive at a single price where the quantity demanded is as close as possible to the quantity supplied.

• This trading arrangement is generally used during the early stages of development of an exchange when there are few stocks listed or a small number of active investors/traders.
• Call markets also are used at the opening for stocks on the NYSE if there is an overnight buildup of buy and sell orders, in which case the opening price can differ from the prior day's closing price.
• The concept is also used if trading is suspended during the day because of some significant new information. The mechanism is considered to contribute to a more orderly market and less volatility in such instances because it attempts to avoid major up and down price swings.

In a continuous market, trades occur at any time the market is open. Stocks are priced either by auction or by dealers. In an auction market, there are sufficient willing buyers and sellers to keep the market continuous. In a dealer market, enough dealers are willing to buy or sell the stock.

Please note that dealers may exist in some auction markets. These dealers provide temporary liquidity and ensure market continuity if the market does not have enough activity.

Although many exchanges are considered continuous, they (e.g. NYSE) also employ a call-market mechanism on specific occasions.

#### Annotation 1329359359244

Subject 8. Well-functioning financial systems
#analyst-notes #market-organization-and-structure
Well-functioning financial systems have the following characteristics:

• Complete markets. The instruments needed to solve investment and risk management problems are available to trade.

• Liquidity. As asset can be bought and sold quickly (that is, it has marketability, which means an asset's likelihood of being sold quickly.) at a price close to the prices for previous transactions (price continuity), assuming no new information has been received. In turn, price continuity requires depth, which means the numerous potential buyers and sellers must be willing to trade at prices above and below the current market price.

• Operational efficiency. Low transaction costs (as a percentage of the value of the trade) include the cost of reaching the market, the actual brokerage costs, and the cost of transferring the asset. This attribute is often referred to as internal efficiency.

• Informational (or external) efficiency. Timely and accurate information is available on the price and volume of past transactions and the prevailing bid-price and ask-price. Prices rapidly adjust to new information; thus the prevailing price is fair because it reflects all available information regarding the asset. Prices will be most informative in liquid markets because information-motivated traders will not invest in information and research if establishing positions based on their analysis is too costly.

A well-functioning financial system promotes wealth by ensuring that capital allocation decisions are well made. It also promotes wealth by allowing people to share the risks associated with valuable products that would otherwise not be undertaken.

#### Annotation 1329361194252

Subject 9. Market regulation
#analyst-notes #market-organization-and-structure
Regulators generally seek to promote fair and orderly markets in which traders can trade at prices that accurately reflect fundamental values without incurring excessive transaction costs. Governmental agencies and self-regulating organizations of practitioners provide regulatory services that attempt to make markets safer and more efficient.

The objectives of market regulation are to:

• control fraud. Customers may not know how to protect themselves since the financial markets are quite complex.
• control agency problems. Financial agents often have different goals from their customers. How to effectively measure the services they provide?
• promote fairness. For example, insider trading is prohibited in most markets as it offends basic notions of fairness.
• set mutually beneficial standards. Common financial standards allow investors to compare companies easily.
• prevent undercapitalized financial firms from exploiting their investors by making excessive risky investments.Regulators generally require that financial firms to maintain minimum levels of capital to reduce the probability that these firms will fail and hurt their customers.
• ensure that long-term liabilities are funded. Insurance companies and pension funds need to maintain adequate reserves to ensure they can pay their liabilities when due.

#### Annotation 1329364864268

Subject 2. Index construction and management
#analyst-notes #has-images #security-market-indices
The steps to construct and manage a security market index:

• To construct an index the first decision is to identify the target market. Which market should the index represent?

• The second decision is to select specific securities to include in the index. How many securities to include? Which ones? The following factors are important:

• The size: the larger, the better - but eventually the costs of taking a larger sample will outweigh the benefits.
• The breadth of the sample: the sample must represent the total population.
• The source of the sample: samples must be taken from each different segment of the population.

• The third decision is to determine the weight to be allocated to each security in the index (discussed below).

• When should the index be rebalanced?

• When should the security selection and weighting decisions be re-examined?

Price Weighting

It is an arithmetic average of current prices. Index movements are influenced by the differential prices of the components.

The weight of each security is calculated using this formula:

The index itself is computed by:

• Adding up the market price of each stock in the index, then
• Dividing this total price by the number of stocks in the index: price-weighted series = sum of stock prices / number of stocks in the series.

Example

The shares of firm A sells for $100, and the shares of firm B sells for$25. The initial price index is (100 + 25) / 2 = 62.5. The divisor is therefore 2.

• Normal situation. Suppose that A increases by 10% to $110, and B increases by 20% to$30, the price index would be (110 + 30) /2 = 70. The rate of return would be: (70 - 62.5) / 62.5 = 12%.

#### Flashcard 1410338000140

Tags
#obgyn
Question
Non-invasive prenatal genetic screening should be offered to who?
every pregnant woman

status measured difficulty not learned 37% [default] 0

#### Flashcard 1410341670156

Tags
#ankle
Question
What is a grade 1 ankle sprain ?
Partial rupture of the anterior talofibular ligament and/or the calcaneofibular ligament

status measured difficulty not learned 37% [default] 0

#### Flashcard 1410346126604

Tags
#obgyn
Question
NIPT (Non-Invasive Prenatal Testing):
• Peripheral blood test which analyzes [...] in the maternal circulation
• Screens abnormalities of chromosomes 21, 18, 13, X and Y
• Very high detection rate for Down Syndrome (>99%), as well as Trisomy 18 and 13 when validated in high-risk pregnancies
• Applicable for singleton and uncomplicated twin pregnancies from about 10 weeks
• Cost approx. $500 - Ontario Ministry of Health will cover cost for women aged 40 and over, or with positive screening tests or other major risk factors. Answer cell-free fetal DNA status measured difficulty not learned 37% [default] 0 NIPT NIPT (Non-Invasive Prenatal Testing): • Peripheral blood test which analyzes cell-free fetal DNA in the maternal circulation • Screens abnormalities of chromosomes 21, 18, 13, X and Y • Very high detection rate for Down Syndrome (>99%), as well as Trisomy 18 and 13 whe #### Flashcard 1410347699468 Tags #obgyn Question NIPT (Non-Invasive Prenatal Testing): • Peripheral blood test which analyzes cell-free fetal DNA in the maternal circulation • Screens abnormalities of chromosomes [...] • Very high detection rate for Down Syndrome (>99%), as well as Trisomy 18 and 13 when validated in high-risk pregnancies • Applicable for singleton and uncomplicated twin pregnancies from about 10 weeks • Cost approx.$500 - Ontario Ministry of Health will cover cost for women aged 40 and over, or with positive screening tests or other major risk factors.
21, 18, 13, X and Y

status measured difficulty not learned 37% [default] 0

NIPT
NIPT (Non-Invasive Prenatal Testing): • Peripheral blood test which analyzes cell-free fetal DNA in the maternal circulation • Screens abnormalities of chromosomes 21, 18, 13, X and Y • Very high detection rate for Down Syndrome (>99%), as well as Trisomy 18 and 13 when validated in high-risk pregnancies • Applicable for singleton and uncomplicated twin

#### Flashcard 1410349272332

Tags
#obgyn
Question
NIPT (Non-Invasive Prenatal Testing):
• Peripheral blood test which analyzes cell-free fetal DNA in the maternal circulation
• Screens abnormalities of chromosomes 21, 18, 13, X and Y
• Very high detection rate for Down Syndrome (>99%), as well as Trisomy 18 and 13 when validated in high-risk pregnancies
• Applicable for singleton and uncomplicated twin pregnancies from about [...] weeks
• Cost approx. $500 - Ontario Ministry of Health will cover cost for women aged 40 and over, or with positive screening tests or other major risk factors. Answer 10 status measured difficulty not learned 37% [default] 0 NIPT of chromosomes 21, 18, 13, X and Y • Very high detection rate for Down Syndrome (>99%), as well as Trisomy 18 and 13 when validated in high-risk pregnancies • Applicable for singleton and uncomplicated twin pregnancies from about <span>10 weeks • Cost approx.$500 - Ontario Ministry of Health will cover cost for women aged 40 and over, or with positive screening tests or other major risk factors.<span></body

#### Annotation 1410350845196

CVS - invasive diagnostic testing
#obgyn
Chorionic Villus Sampling (CVS):
• 10-14 wks
• Placental biopsy via transcervical or transabdominal approach
• Preliminary results for very high risk patients may be available in a few days [by fluorescence in-situ hybridization (“FISH”) analysis or QF-PCR (polymerase chain reaction)]; microarray may be done
• Early termination of affected pregnancies can be offered (psychological and physical advantages)
• Procedure related pregnancy loss rate 1-2%
• Slightly higher rate of cell culture failure than amniocentesis
• Rarely, inaccurate results due to placental mosaicism

#### Flashcard 1410352155916

Tags
#obgyn
Question
Chorionic Villus Sampling (CVS):
[...] wks
• Placental biopsy via transcervical or transabdominal approach
• Preliminary results for very high risk patients may be available in a few days [by fluorescence in-situ hybridization (“FISH”) analysis or QF-PCR (polymerase chain reaction)]; microarray may be done
• Early termination of affected pregnancies can be offered (psychological and physical advantages)
• Procedure related pregnancy loss rate 1-2%
• Slightly higher rate of cell culture failure than amniocentesis
• Rarely, inaccurate results due to placental mosaicism
10-14

status measured difficulty not learned 37% [default] 0

CVS - invasive diagnostic testing
Chorionic Villus Sampling (CVS): • 10-14 wks • Placental biopsy via transcervical or transabdominal approach • Preliminary results for very high risk patients may be available in a few days [by fluorescence in-situ h

#### Flashcard 1410353728780

Tags
#obgyn
Question
Chorionic Villus Sampling (CVS):
• 10-14 wks
[...] biopsy via transcervical or transabdominal approach
• Preliminary results for very high risk patients may be available in a few days [by fluorescence in-situ hybridization (“FISH”) analysis or QF-PCR (polymerase chain reaction)]; microarray may be done
• Early termination of affected pregnancies can be offered (psychological and physical advantages)
• Procedure related pregnancy loss rate 1-2%
• Slightly higher rate of cell culture failure than amniocentesis
• Rarely, inaccurate results due to placental mosaicism
Placental

status measured difficulty not learned 37% [default] 0

CVS - invasive diagnostic testing
Chorionic Villus Sampling (CVS): • 10-14 wks • Placental biopsy via transcervical or transabdominal approach • Preliminary results for very high risk patients may be available in a few days [by fluorescence in-situ hybridization (“FISH”)

#### Flashcard 1410355301644

Tags
#obgyn
Question
Chorionic Villus Sampling (CVS):
• 10-14 wks
• Placental biopsy via transcervical or transabdominal approach
• Preliminary results for very high risk patients may be available in a few days [by fluorescence in-situ hybridization (“FISH”) analysis or QF-PCR (polymerase chain reaction)]; microarray may be done
[...] of affected pregnancies can be offered (psychological and physical advantages)
• Procedure related pregnancy loss rate 1-2%
• Slightly higher rate of cell culture failure than amniocentesis
• Rarely, inaccurate results due to placental mosaicism
Early termination

status measured difficulty not learned 37% [default] 0

CVS - invasive diagnostic testing
al or transabdominal approach • Preliminary results for very high risk patients may be available in a few days [by fluorescence in-situ hybridization (“FISH”) analysis or QF-PCR (polymerase chain reaction)]; microarray may be done • <span>Early termination of affected pregnancies can be offered (psychological and physical advantages) • Procedure related pregnancy loss rate 1-2% • Slightly higher rate of cell culture failure than

#### Annotation 1410356874508

amniocentesis
#obgyn
Amniocentesis:
• Normally 15 to 20 weeks but in special circumstances may be done at any time after 15 weeks
• Collection of amniotic fluid transabdominally under ultrasound guidance
• Karyotype of fetal cells obtained from amniotic fluid – FISH or QF-PCR analysis results in 2-3 days, full karyotype from cell culture and microarray may be done
• Pregnancy loss rate traditionally quoted as 1/200; FASTER study data from USA suggests it could be much lower
• Failures may occur if inadequate sample (oligohydramnios), failure of fetal cell culture, or contamination of sample by maternal cells

#### Flashcard 1410358185228

Tags
#obgyn
Question
Amniocentesis:
• Normally [...] weeks but in special circumstances may be done at any time after 15 weeks
• Collection of amniotic fluid transabdominally under ultrasound guidance
• Karyotype of fetal cells obtained from amniotic fluid – FISH or QF-PCR analysis results in 2-3 days, full karyotype from cell culture and microarray may be done
• Pregnancy loss rate traditionally quoted as 1/200; FASTER study data from USA suggests it could be much lower
• Failures may occur if inadequate sample (oligohydramnios), failure of fetal cell culture, or contamination of sample by maternal cells
15 to 20

status measured difficulty not learned 37% [default] 0

amniocentesis
Amniocentesis : • Normally 15 to 20 weeks but in special circumstances may be done at any time after 15 weeks • Collection of amniotic fluid transabdominally under ultrasound guidance • Karyotype of fetal cells

#### Flashcard 1410359758092

Tags
#obgyn
Question
Amniocentesis:
• Normally 15 to 20 weeks but in special circumstances may be done at any time after 15 weeks
• Collection of amniotic fluid [...] under ultrasound guidance
• Karyotype of fetal cells obtained from amniotic fluid – FISH or QF-PCR analysis results in 2-3 days, full karyotype from cell culture and microarray may be done
• Pregnancy loss rate traditionally quoted as 1/200; FASTER study data from USA suggests it could be much lower
• Failures may occur if inadequate sample (oligohydramnios), failure of fetal cell culture, or contamination of sample by maternal cells
transabdominally

status measured difficulty not learned 37% [default] 0

amniocentesis
Amniocentesis : • Normally 15 to 20 weeks but in special circumstances may be done at any time after 15 weeks • Collection of amniotic fluid transabdominally under ultrasound guidance • Karyotype of fetal cells obtained from amniotic fluid – FISH or QF-PCR analysis results in 2-3 days, full karyotype from cell culture and microarray may

#### Flashcard 1410361330956

Tags
#obgyn
Question
Amniocentesis:
• Normally 15 to 20 weeks but in special circumstances may be done at any time after 15 weeks
• Collection of amniotic fluid transabdominally under ultrasound guidance
• Karyotype of [...] obtained from amniotic fluid – FISH or QF-PCR analysis results in 2-3 days, full karyotype from cell culture and microarray may be done
• Pregnancy loss rate traditionally quoted as 1/200; FASTER study data from USA suggests it could be much lower
• Failures may occur if inadequate sample (oligohydramnios), failure of fetal cell culture, or contamination of sample by maternal cells
fetal cells

status measured difficulty not learned 37% [default] 0

amniocentesis
ead><head>Amniocentesis : • Normally 15 to 20 weeks but in special circumstances may be done at any time after 15 weeks • Collection of amniotic fluid transabdominally under ultrasound guidance • Karyotype of fetal cells obtained from amniotic fluid – FISH or QF-PCR analysis results in 2-3 days, full karyotype from cell culture and microarray may be done • Pregnancy loss rate traditionally quoted a

#### Annotation 1410362903820

First prenatal visit
#obgyn
First prenatal visit
• Standard records (Ontario Ministry of Health Antenatal Records 1 and 2)
• Pregnancy considered in trimesters (three in total, each 12 to 14 weeks in length)
• Each pregnancy should be assigned a risk category (see reverse side of AN forms) to ensure appropriate investigations, surveillance and management

#### Flashcard 1410364214540

Tags
#obgyn
Question
First prenatal visit
[...]
• Pregnancy considered in trimesters (three in total, each 12 to 14 weeks in length)
• Each pregnancy should be assigned a risk category (see reverse side of AN forms) to ensure appropriate investigations, surveillance and management
Standard records (Ontario Ministry of Health Antenatal Records 1 and 2)

status measured difficulty not learned 37% [default] 0

First prenatal visit
First prenatal visit • Standard records (Ontario Ministry of Health Antenatal Records 1 and 2) • Pregnancy considered in trimesters (three in total, each 12 to 14 weeks in length) • Each pregnancy should be assigned a risk category (see reverse side of AN forms) to ensu

#### Flashcard 1410365787404

Tags
#obgyn
Question
First prenatal visit
• Standard records (Ontario Ministry of Health Antenatal Records 1 and 2)
• Pregnancy considered in trimesters (three in total, each [...] weeks in length)
• Each pregnancy should be assigned a risk category (see reverse side of AN forms) to ensure appropriate investigations, surveillance and management
12 to 14

status measured difficulty not learned 37% [default] 0

First prenatal visit
First prenatal visit • Standard records (Ontario Ministry of Health Antenatal Records 1 and 2) • Pregnancy considered in trimesters (three in total, each 12 to 14 weeks in length) • Each pregnancy should be assigned a risk category (see reverse side of AN forms) to ensure appropriate investigations, surveillance and management<

#### Annotation 1410367360268

antenatal visit history
#obgyn
First Prenatal Visit History
1. History of Present Pregnancy:
• LMP: first day of last normal period
• Determine EDC (estimated date of confinement)
2. Past Obstetrical History:
• All Ob/Gyn histories include a summary of G and P
• For more complicated patients, can further categorize into GTPAL:
G: any pregnancy (include losses, ectopic, mole, current)
T: term – infants delivered after 37 completed weeks
P: preterm – infants delivered 20 - 36+6 weeks
A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams
L: live – number of currently living children
• If pregnancy loss prior to 20 weeks, inquire:
---• how did loss happen (did they have a termination? or bleed and cramp? did they feels pressure and have PPROM?) - differentiate between causes such as therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix)
---• was a surgical procedure required such as a D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation)
---• was medical intervention required such as misoprostol (for missed abortion or blighted ovum)
• If pregnancy loss after 20 weeks, inquire:
---• date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies.
3. Past Medical and Surgical History
4. Family History:
genetic diseases, congenital malformations, consanguinity
5. Medications, Allergies
6. Social History: smoking, alcohol, recreational drugs, home environment
7. Review of Systems (tailor to patient)

#### Flashcard 1410368670988

Tags
#obgyn
Question
First Prenatal Visit History
1. [...]
• LMP: first day of last normal period
• Determine EDC (estimated date of confinement)
2. Past Obstetrical History:
• All Ob/Gyn histories include a summary of G and P
• For more complicated patients, can further categorize into GTPAL:
G: any pregnancy (include losses, ectopic, mole, current)
T: term – infants delivered after 37 completed weeks
P: preterm – infants delivered 20 - 36+6 weeks
A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams
L: live – number of currently living children
• If pregnancy loss prior to 20 weeks, inquire:
---• how did loss happen (did they have a termination? or bleed and cramp? did they feels pressure and have PPROM?) - differentiate between causes such as therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix)
---• was a surgical procedure required such as a D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation)
---• was medical intervention required such as misoprostol (for missed abortion or blighted ovum)
• If pregnancy loss after 20 weeks, inquire:
---• date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies.
3. Past Medical and Surgical History
4. Family History:
genetic diseases, congenital malformations, consanguinity
5. Medications, Allergies
6. Social History: smoking, alcohol, recreational drugs, home environment
7. Review of Systems (tailor to patient)
History of Present Pregnancy:

status measured difficulty not learned 37% [default] 0

antenatal visit history
First Prenatal Visit History 1. History of Present Pregnancy: • LMP: first day of last normal period • Determine EDC (estimated date of confinement) 2. Past Obstetrical History: • All Ob/Gyn histories include a summary of G

#### Flashcard 1410370243852

Tags
#obgyn
Question
First Prenatal Visit History
1. History of Present Pregnancy:
• LMP: first day of last normal period
• Determine EDC (estimated date of confinement)
2. [...]
• All Ob/Gyn histories include a summary of G and P
• For more complicated patients, can further categorize into GTPAL:
G: any pregnancy (include losses, ectopic, mole, current)
T: term – infants delivered after 37 completed weeks
P: preterm – infants delivered 20 - 36+6 weeks
A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams
L: live – number of currently living children
• If pregnancy loss prior to 20 weeks, inquire:
---• how did loss happen (did they have a termination? or bleed and cramp? did they feels pressure and have PPROM?) - differentiate between causes such as therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix)
---• was a surgical procedure required such as a D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation)
---• was medical intervention required such as misoprostol (for missed abortion or blighted ovum)
• If pregnancy loss after 20 weeks, inquire:
---• date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies.
3. Past Medical and Surgical History
4. Family History:
genetic diseases, congenital malformations, consanguinity
5. Medications, Allergies
6. Social History: smoking, alcohol, recreational drugs, home environment
7. Review of Systems (tailor to patient)
Past Obstetrical History:

status measured difficulty not learned 37% [default] 0

antenatal visit history
First Prenatal Visit History 1. History of Present Pregnancy: • LMP: first day of last normal period • Determine EDC (estimated date of confinement) 2. Past Obstetrical History: • All Ob/Gyn histories include a summary of G and P • For more complicated patients, can further categorize into GTPAL: G: any pregnancy (include losses, ectopic, mole,

#### Flashcard 1410371816716

Tags
#obgyn
Question
First Prenatal Visit History
1. History of Present Pregnancy:
• LMP: first day of last normal period
• Determine EDC (estimated date of confinement)
2. Past Obstetrical History:
• All Ob/Gyn histories include a summary of G and P
• For more complicated patients, can further categorize into GTPAL:
G: any pregnancy (include losses, ectopic, mole, current)
T: term – infants delivered after 37 completed weeks
P: preterm – infants delivered 20 - 36+6 weeks
A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams
L: live – number of currently living children
• If pregnancy loss prior to 20 weeks, inquire:
---• how did loss happen (did they have a termination? or bleed and cramp? did they feels pressure and have PPROM?) - differentiate between causes such as therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix)
---• was a surgical procedure required such as a D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation)
---• was medical intervention required such as misoprostol (for missed abortion or blighted ovum)
• If pregnancy loss after 20 weeks, inquire:
---• date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies.
3. [...]
4. Family History:
genetic diseases, congenital malformations, consanguinity
5. Medications, Allergies
6. Social History: smoking, alcohol, recreational drugs, home environment
7. Review of Systems (tailor to patient)
Past Medical and Surgical History

status measured difficulty not learned 37% [default] 0

antenatal visit history
on, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies. 3. <span>Past Medical and Surgical History 4. Family History: genetic diseases, congenital malformations, consanguinity 5. Medications, Allergies 6. Social History: smoking, alcohol, recreational drugs, home

#### Flashcard 1410373389580

Tags
#obgyn
Question
First Prenatal Visit History
1. History of Present Pregnancy:
• LMP: first day of last normal period
• Determine EDC (estimated date of confinement)
2. Past Obstetrical History:
• All Ob/Gyn histories include a summary of G and P
• For more complicated patients, can further categorize into GTPAL:
G: any pregnancy (include losses, ectopic, mole, current)
T: term – infants delivered after 37 completed weeks
P: preterm – infants delivered 20 - 36+6 weeks
A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams
L: live – number of currently living children
• If pregnancy loss prior to 20 weeks, inquire:
---• how did loss happen (did they have a termination? or bleed and cramp? did they feels pressure and have PPROM?) - differentiate between causes such as therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix)
---• was a surgical procedure required such as a D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation)
---• was medical intervention required such as misoprostol (for missed abortion or blighted ovum)
• If pregnancy loss after 20 weeks, inquire:
---• date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies.
3. Past Medical and Surgical History
4. [...]:
genetic diseases, congenital malformations, consanguinity
5. Medications, Allergies
6. Social History: smoking, alcohol, recreational drugs, home environment
7. Review of Systems (tailor to patient)
Family History

status measured difficulty not learned 37% [default] 0

antenatal visit history
delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies. 3. Past Medical and Surgical History 4. <span>Family History: genetic diseases, congenital malformations, consanguinity 5. Medications, Allergies 6. Social History: smoking, alcohol, recreational drugs, home environment 7. Re

#### Flashcard 1410374962444

Tags
#obgyn
Question
First Prenatal Visit History
1. History of Present Pregnancy:
• LMP: first day of last normal period
• Determine EDC (estimated date of confinement)
2. Past Obstetrical History:
• All Ob/Gyn histories include a summary of G and P
• For more complicated patients, can further categorize into GTPAL:
G: any pregnancy (include losses, ectopic, mole, current)
T: term – infants delivered after 37 completed weeks
P: preterm – infants delivered 20 - 36+6 weeks
A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams
L: live – number of currently living children
• If pregnancy loss prior to 20 weeks, inquire:
---• how did loss happen (did they have a termination? or bleed and cramp? did they feels pressure and have PPROM?) - differentiate between causes such as therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix)
---• was a surgical procedure required such as a D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation)
---• was medical intervention required such as misoprostol (for missed abortion or blighted ovum)
• If pregnancy loss after 20 weeks, inquire:
---• date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies.
3. Past Medical and Surgical History
4. Family History:
genetic diseases, congenital malformations, consanguinity
5.
[...] 6. Social History: smoking, alcohol, recreational drugs, home environment
7. Review of Systems (tailor to patient)
Medications, Allergies

status measured difficulty not learned 37% [default] 0

antenatal visit history
t or classical); were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies. 3. Past Medical and Surgical History 4. Family History: genetic diseases, congenital malformations, consanguinity 5. <span>Medications, Allergies 6. Social History: smoking, alcohol, recreational drugs, home environment 7. Review of Systems (tailor to patient)<span><body><html>

#### Flashcard 1410376535308

Tags
#obgyn
Question
First Prenatal Visit History
1. History of Present Pregnancy:
• LMP: first day of last normal period
• Determine EDC (estimated date of confinement)
2. Past Obstetrical History:
• All Ob/Gyn histories include a summary of G and P
• For more complicated patients, can further categorize into GTPAL:
G: any pregnancy (include losses, ectopic, mole, current)
T: term – infants delivered after 37 completed weeks
P: preterm – infants delivered 20 - 36+6 weeks
A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams
L: live – number of currently living children
• If pregnancy loss prior to 20 weeks, inquire:
---• how did loss happen (did they have a termination? or bleed and cramp? did they feels pressure and have PPROM?) - differentiate between causes such as therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix)
---• was a surgical procedure required such as a D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation)
---• was medical intervention required such as misoprostol (for missed abortion or blighted ovum)
• If pregnancy loss after 20 weeks, inquire:
---• date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies.
3. Past Medical and Surgical History
4. Family History:
genetic diseases, congenital malformations, consanguinity
5. Medications, Allergies
6. [...]: smoking, alcohol, recreational drugs, home environment
7. Review of Systems (tailor to patient)
Social History

status measured difficulty not learned 37% [default] 0

antenatal visit history
ntepartum, intrapartum or postpartum complications and/or fetal anomalies. 3. Past Medical and Surgical History 4. Family History: genetic diseases, congenital malformations, consanguinity 5. Medications, Allergies 6. <span>Social History: smoking, alcohol, recreational drugs, home environment 7. Review of Systems (tailor to patient)<span><body><html>

#### Flashcard 1410378108172

Tags
#obgyn
Question
First Prenatal Visit History
1. History of Present Pregnancy:
• LMP: first day of last normal period
• Determine EDC (estimated date of confinement)
2. Past Obstetrical History:
• All Ob/Gyn histories include a summary of G and P
• For more complicated patients, can further categorize into GTPAL:
G: any pregnancy (include losses, ectopic, mole, current)
T: term – infants delivered after 37 completed weeks
P: preterm – infants delivered 20 - 36+6 weeks
A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams
L: live – number of currently living children
• If pregnancy loss prior to 20 weeks, inquire:
---• how did loss happen (did they have a termination? or bleed and cramp? did they feels pressure and have PPROM?) - differentiate between causes such as therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix)
---• was a surgical procedure required such as a D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation)
---• was medical intervention required such as misoprostol (for missed abortion or blighted ovum)
• If pregnancy loss after 20 weeks, inquire:
---• date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies.
3. Past Medical and Surgical History
4. Family History:
genetic diseases, congenital malformations, consanguinity
5. Medications, Allergies
6. Social History: smoking, alcohol, recreational drugs, home environment
7. [...] (tailor to patient)
Review of Systems

status measured difficulty not learned 37% [default] 0

antenatal visit history
3. Past Medical and Surgical History 4. Family History: genetic diseases, congenital malformations, consanguinity 5. Medications, Allergies 6. Social History: smoking, alcohol, recreational drugs, home environment 7. <span>Review of Systems (tailor to patient)<span><body><html>

#### Flashcard 1410379681036

Tags
#obgyn
Question
First Prenatal Visit History
1. History of Present Pregnancy:
• LMP: [...]
• Determine EDC (estimated date of confinement)
2. Past Obstetrical History:
• All Ob/Gyn histories include a summary of G and P
• For more complicated patients, can further categorize into GTPAL:
G: any pregnancy (include losses, ectopic, mole, current)
T: term – infants delivered after 37 completed weeks
P: preterm – infants delivered 20 - 36+6 weeks
A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams
L: live – number of currently living children
• If pregnancy loss prior to 20 weeks, inquire:
---• how did loss happen (did they have a termination? or bleed and cramp? did they feels pressure and have PPROM?) - differentiate between causes such as therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix)
---• was a surgical procedure required such as a D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation)
---• was medical intervention required such as misoprostol (for missed abortion or blighted ovum)
• If pregnancy loss after 20 weeks, inquire:
---• date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies.
3. Past Medical and Surgical History
4. Family History:
genetic diseases, congenital malformations, consanguinity
5. Medications, Allergies
6. Social History: smoking, alcohol, recreational drugs, home environment
7. Review of Systems (tailor to patient)
first day of last normal period

status measured difficulty not learned 37% [default] 0

antenatal visit history
First Prenatal Visit History 1. History of Present Pregnancy: • LMP: first day of last normal period • Determine EDC (estimated date of confinement) 2. Past Obstetrical History: • All Ob/Gyn histories include a summary of G and P • For more complicated patients, c

#### Flashcard 1410381253900

Tags
#obgyn
Question
First Prenatal Visit History
1. History of Present Pregnancy:
• LMP: first day of last normal period
• Determine
[...] 2. Past Obstetrical History:
• All Ob/Gyn histories include a summary of G and P
• For more complicated patients, can further categorize into GTPAL:
G: any pregnancy (include losses, ectopic, mole, current)
T: term – infants delivered after 37 completed weeks
P: preterm – infants delivered 20 - 36+6 weeks
A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams
L: live – number of currently living children
• If pregnancy loss prior to 20 weeks, inquire:
---• how did loss happen (did they have a termination? or bleed and cramp? did they feels pressure and have PPROM?) - differentiate between causes such as therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix)
---• was a surgical procedure required such as a D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation)
---• was medical intervention required such as misoprostol (for missed abortion or blighted ovum)
• If pregnancy loss after 20 weeks, inquire:
---• date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies.
3. Past Medical and Surgical History
4. Family History:
genetic diseases, congenital malformations, consanguinity
5. Medications, Allergies
6. Social History: smoking, alcohol, recreational drugs, home environment
7. Review of Systems (tailor to patient)
EDC (estimated date of confinement)

status measured difficulty not learned 37% [default] 0

antenatal visit history
First Prenatal Visit History 1. History of Present Pregnancy: • LMP: first day of last normal period • Determine EDC (estimated date of confinement) 2. Past Obstetrical History: • All Ob/Gyn histories include a summary of G and P • For more complicated patients, can further categorize into GTPAL: G: any pregnan

#### Flashcard 1410382826764

Tags
#obgyn
Question
First Prenatal Visit History
1. History of Present Pregnancy:
• LMP: first day of last normal period
• Determine EDC (estimated date of confinement)
2. Past Obstetrical History:
• All Ob/Gyn histories include a summary of [...]
• For more complicated patients, can further categorize into GTPAL:
G: any pregnancy (include losses, ectopic, mole, current)
T: term – infants delivered after 37 completed weeks
P: preterm – infants delivered 20 - 36+6 weeks
A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams
L: live – number of currently living children
• If pregnancy loss prior to 20 weeks, inquire:
---• how did loss happen (did they have a termination? or bleed and cramp? did they feels pressure and have PPROM?) - differentiate between causes such as therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix)
---• was a surgical procedure required such as a D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation)
---• was medical intervention required such as misoprostol (for missed abortion or blighted ovum)
• If pregnancy loss after 20 weeks, inquire:
---• date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies.
3. Past Medical and Surgical History
4. Family History:
genetic diseases, congenital malformations, consanguinity
5. Medications, Allergies
6. Social History: smoking, alcohol, recreational drugs, home environment
7. Review of Systems (tailor to patient)
G and P

status measured difficulty not learned 37% [default] 0

antenatal visit history
natal Visit History 1. History of Present Pregnancy: • LMP: first day of last normal period • Determine EDC (estimated date of confinement) 2. Past Obstetrical History: • All Ob/Gyn histories include a summary of <span>G and P • For more complicated patients, can further categorize into GTPAL: G: any pregnancy (include losses, ectopic, mole, current) T: term – infants delivered after 37 complet

#### Flashcard 1410384399628

Tags
#obgyn
Question
First Prenatal Visit History
1. History of Present Pregnancy:
• LMP: first day of last normal period
• Determine EDC (estimated date of confinement)
2. Past Obstetrical History:
• All Ob/Gyn histories include a summary of G and P
• For more complicated patients, can further categorize into GTPAL:
G: any pregnancy (include losses, ectopic, mole, current)
T: [...]
P: preterm – infants delivered 20 - 36+6 weeks
A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams
L: live – number of currently living children
• If pregnancy loss prior to 20 weeks, inquire:
---• how did loss happen (did they have a termination? or bleed and cramp? did they feels pressure and have PPROM?) - differentiate between causes such as therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix)
---• was a surgical procedure required such as a D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation)
---• was medical intervention required such as misoprostol (for missed abortion or blighted ovum)
• If pregnancy loss after 20 weeks, inquire:
---• date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies.
3. Past Medical and Surgical History
4. Family History:
genetic diseases, congenital malformations, consanguinity
5. Medications, Allergies
6. Social History: smoking, alcohol, recreational drugs, home environment
7. Review of Systems (tailor to patient)
term – infants delivered after 37 completed weeks

status measured difficulty not learned 37% [default] 0

antenatal visit history
ment) 2. Past Obstetrical History: • All Ob/Gyn histories include a summary of G and P • For more complicated patients, can further categorize into GTPAL: G: any pregnancy (include losses, ectopic, mole, current) T: <span>term – infants delivered after 37 completed weeks P: preterm – infants delivered 20 - 36+6 weeks A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams L: live – number of currently living ch

#### Flashcard 1410385972492

Tags
#obgyn
Question
First Prenatal Visit History
1. History of Present Pregnancy:
• LMP: first day of last normal period
• Determine EDC (estimated date of confinement)
2. Past Obstetrical History:
• All Ob/Gyn histories include a summary of G and P
• For more complicated patients, can further categorize into GTPAL:
G: any pregnancy (include losses, ectopic, mole, current)
T: term – infants delivered after 37 completed weeks
P: [...]
A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams
L: live – number of currently living children
• If pregnancy loss prior to 20 weeks, inquire:
---• how did loss happen (did they have a termination? or bleed and cramp? did they feels pressure and have PPROM?) - differentiate between causes such as therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix)
---• was a surgical procedure required such as a D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation)
---• was medical intervention required such as misoprostol (for missed abortion or blighted ovum)
• If pregnancy loss after 20 weeks, inquire:
---• date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies.
3. Past Medical and Surgical History
4. Family History:
genetic diseases, congenital malformations, consanguinity
5. Medications, Allergies
6. Social History: smoking, alcohol, recreational drugs, home environment
7. Review of Systems (tailor to patient)
preterm – infants delivered 20 - 36+6 weeks

status measured difficulty not learned 37% [default] 0

antenatal visit history
n histories include a summary of G and P • For more complicated patients, can further categorize into GTPAL: G: any pregnancy (include losses, ectopic, mole, current) T: term – infants delivered after 37 completed weeks P: <span>preterm – infants delivered 20 - 36+6 weeks A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams L: live – number of currently living children • If pregnancy loss prior to 20 weeks, i

#### Flashcard 1410387545356

Tags
#obgyn
Question
First Prenatal Visit History
1. History of Present Pregnancy:
• LMP: first day of last normal period
• Determine EDC (estimated date of confinement)
2. Past Obstetrical History:
• All Ob/Gyn histories include a summary of G and P
• For more complicated patients, can further categorize into GTPAL:
G: any pregnancy (include losses, ectopic, mole, current)
T: term – infants delivered after 37 completed weeks
P: preterm – infants delivered 20 - 36+6 weeks
A: [...]
L: live – number of currently living children
• If pregnancy loss prior to 20 weeks, inquire:
---• how did loss happen (did they have a termination? or bleed and cramp? did they feels pressure and have PPROM?) - differentiate between causes such as therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix)
---• was a surgical procedure required such as a D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation)
---• was medical intervention required such as misoprostol (for missed abortion or blighted ovum)
• If pregnancy loss after 20 weeks, inquire:
---• date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies.
3. Past Medical and Surgical History
4. Family History:
genetic diseases, congenital malformations, consanguinity
5. Medications, Allergies
6. Social History: smoking, alcohol, recreational drugs, home environment
7. Review of Systems (tailor to patient)
abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams

status measured difficulty not learned 37% [default] 0

antenatal visit history
more complicated patients, can further categorize into GTPAL: G: any pregnancy (include losses, ectopic, mole, current) T: term – infants delivered after 37 completed weeks P: preterm – infants delivered 20 - 36+6 weeks A: <span>abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams L: live – number of currently living children • If pregnancy loss prior to 20 weeks, inquire: ---• how did loss happen (did they have a termination? or bleed and cramp? d

#### Flashcard 1410389118220

Tags
#obgyn
Question
First Prenatal Visit History
1. History of Present Pregnancy:
• LMP: first day of last normal period
• Determine EDC (estimated date of confinement)
2. Past Obstetrical History:
• All Ob/Gyn histories include a summary of G and P
• For more complicated patients, can further categorize into GTPAL:
G: any pregnancy (include losses, ectopic, mole, current)
T: term – infants delivered after 37 completed weeks
P: preterm – infants delivered 20 - 36+6 weeks
A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams
L: [...]
• If pregnancy loss prior to 20 weeks, inquire:
---• how did loss happen (did they have a termination? or bleed and cramp? did they feels pressure and have PPROM?) - differentiate between causes such as therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix)
---• was a surgical procedure required such as a D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation)
---• was medical intervention required such as misoprostol (for missed abortion or blighted ovum)
• If pregnancy loss after 20 weeks, inquire:
---• date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies.
3. Past Medical and Surgical History
4. Family History:
genetic diseases, congenital malformations, consanguinity
5. Medications, Allergies
6. Social History: smoking, alcohol, recreational drugs, home environment
7. Review of Systems (tailor to patient)
live – number of currently living children

status measured difficulty not learned 37% [default] 0

antenatal visit history
ude losses, ectopic, mole, current) T: term – infants delivered after 37 completed weeks P: preterm – infants delivered 20 - 36+6 weeks A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams L: <span>live – number of currently living children • If pregnancy loss prior to 20 weeks, inquire: ---• how did loss happen (did they have a termination? or bleed and cramp? did they feels pressure and have PPROM?) - different

#### Flashcard 1410390691084

Tags
#obgyn
Question
First Prenatal Visit History
1. History of Present Pregnancy:
• LMP: first day of last normal period
• Determine EDC (estimated date of confinement)
2. Past Obstetrical History:
• All Ob/Gyn histories include a summary of G and P
• For more complicated patients, can further categorize into GTPAL:
G: any pregnancy (include losses, ectopic, mole, current)
T: term – infants delivered after 37 completed weeks
P: preterm – infants delivered 20 - 36+6 weeks
A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams
L: live – number of currently living children
• If pregnancy loss prior to 20 weeks, inquire:
---• how did loss happen ([...]?) - differentiate between causes such as therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix)
---• was a surgical procedure required such as a D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation)
---• was medical intervention required such as misoprostol (for missed abortion or blighted ovum)
• If pregnancy loss after 20 weeks, inquire:
---• date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies.
3. Past Medical and Surgical History
4. Family History:
genetic diseases, congenital malformations, consanguinity
5. Medications, Allergies
6. Social History: smoking, alcohol, recreational drugs, home environment
7. Review of Systems (tailor to patient)
did they have a termination? or bleed and cramp? did they feels pressure and have PPROM

status measured difficulty not learned 37% [default] 0

antenatal visit history
ed 20 - 36+6 weeks A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams L: live – number of currently living children • If pregnancy loss prior to 20 weeks, inquire: ---• how did loss happen (<span>did they have a termination? or bleed and cramp? did they feels pressure and have PPROM?) - differentiate between causes such as therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix) ---• was a surgical procedure required such

#### Flashcard 1410392263948

Tags
#obgyn
Question
First Prenatal Visit History
1. History of Present Pregnancy:
• LMP: first day of last normal period
• Determine EDC (estimated date of confinement)
2. Past Obstetrical History:
• All Ob/Gyn histories include a summary of G and P
• For more complicated patients, can further categorize into GTPAL:
G: any pregnancy (include losses, ectopic, mole, current)
T: term – infants delivered after 37 completed weeks
P: preterm – infants delivered 20 - 36+6 weeks
A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams
L: live – number of currently living children
• If pregnancy loss prior to 20 weeks, inquire:
---• how did loss happen (did they have a termination? or bleed and cramp? did they feels pressure and have PPROM?) - differentiate between causes such as [...]
---• was a surgical procedure required such as a D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation)
---• was medical intervention required such as misoprostol (for missed abortion or blighted ovum)
• If pregnancy loss after 20 weeks, inquire:
---• date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies.
3. Past Medical and Surgical History
4. Family History:
genetic diseases, congenital malformations, consanguinity
5. Medications, Allergies
6. Social History: smoking, alcohol, recreational drugs, home environment
7. Review of Systems (tailor to patient)
therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix)

status measured difficulty not learned 37% [default] 0

antenatal visit history
of currently living children • If pregnancy loss prior to 20 weeks, inquire: ---• how did loss happen (did they have a termination? or bleed and cramp? did they feels pressure and have PPROM?) - differentiate between causes such as <span>therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix) ---• was a surgical procedure required such as a D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation) ---• was medical intervention required such as misop

#### Flashcard 1410393836812

Tags
#obgyn
Question
First Prenatal Visit History
1. History of Present Pregnancy:
• LMP: first day of last normal period
• Determine EDC (estimated date of confinement)
2. Past Obstetrical History:
• All Ob/Gyn histories include a summary of G and P
• For more complicated patients, can further categorize into GTPAL:
G: any pregnancy (include losses, ectopic, mole, current)
T: term – infants delivered after 37 completed weeks
P: preterm – infants delivered 20 - 36+6 weeks
A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams
L: live – number of currently living children
• If pregnancy loss prior to 20 weeks, inquire:
---• how did loss happen (did they have a termination? or bleed and cramp? did they feels pressure and have PPROM?) - differentiate between causes such as therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix)
---• was a surgical procedure required such as a [...]
---• was medical intervention required such as misoprostol (for missed abortion or blighted ovum)
• If pregnancy loss after 20 weeks, inquire:
---• date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies.
3. Past Medical and Surgical History
4. Family History:
genetic diseases, congenital malformations, consanguinity
5. Medications, Allergies
6. Social History: smoking, alcohol, recreational drugs, home environment
7. Review of Systems (tailor to patient)
D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation)

status measured difficulty not learned 37% [default] 0

antenatal visit history
d and cramp? did they feels pressure and have PPROM?) - differentiate between causes such as therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix) ---• was a surgical procedure required such as a <span>D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation) ---• was medical intervention required such as misoprostol (for missed abortion or blighted ovum) • If pregnancy loss after 20 weeks, inquire: ---• date of delivery, loca

#### Flashcard 1410395409676

Tags
#obgyn
Question
First Prenatal Visit History
1. History of Present Pregnancy:
• LMP: first day of last normal period
• Determine EDC (estimated date of confinement)
2. Past Obstetrical History:
• All Ob/Gyn histories include a summary of G and P
• For more complicated patients, can further categorize into GTPAL:
G: any pregnancy (include losses, ectopic, mole, current)
T: term – infants delivered after 37 completed weeks
P: preterm – infants delivered 20 - 36+6 weeks
A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams
L: live – number of currently living children
• If pregnancy loss prior to 20 weeks, inquire:
---• how did loss happen (did they have a termination? or bleed and cramp? did they feels pressure and have PPROM?) - differentiate between causes such as therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix)
---• was a surgical procedure required such as a D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation)
---• was medical intervention required such as [...]
• If pregnancy loss after 20 weeks, inquire:
---• date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies.
3. Past Medical and Surgical History
4. Family History:
genetic diseases, congenital malformations, consanguinity
5. Medications, Allergies
6. Social History: smoking, alcohol, recreational drugs, home environment
7. Review of Systems (tailor to patient)
misoprostol (for missed abortion or blighted ovum)

status measured difficulty not learned 37% [default] 0

antenatal visit history
abortion, fetal anomaly, maternal issues (incompetent cervix) ---• was a surgical procedure required such as a D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation) ---• was medical intervention required such as <span>misoprostol (for missed abortion or blighted ovum) • If pregnancy loss after 20 weeks, inquire: ---• date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneo

#### Flashcard 1410396982540

Tags
#obgyn
Question
First Prenatal Visit History
1. History of Present Pregnancy:
• LMP: first day of last normal period
• Determine EDC (estimated date of confinement)
2. Past Obstetrical History:
• All Ob/Gyn histories include a summary of G and P
• For more complicated patients, can further categorize into GTPAL:
G: any pregnancy (include losses, ectopic, mole, current)
T: term – infants delivered after 37 completed weeks
P: preterm – infants delivered 20 - 36+6 weeks
A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams
L: live – number of currently living children
• If pregnancy loss prior to 20 weeks, inquire:
---• how did loss happen (did they have a termination? or bleed and cramp? did they feels pressure and have PPROM?) - differentiate between causes such as therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix)
---• was a surgical procedure required such as a D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation)
---• was medical intervention required such as misoprostol (for missed abortion or blighted ovum)
• If pregnancy loss after 20 weeks, inquire:
---• [...]; were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies.
3. Past Medical and Surgical History
4. Family History:
genetic diseases, congenital malformations, consanguinity
5. Medications, Allergies
6. Social History: smoking, alcohol, recreational drugs, home environment
7. Review of Systems (tailor to patient)
date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical)

status measured difficulty not learned 37% [default] 0

antenatal visit history
as a D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation) ---• was medical intervention required such as misoprostol (for missed abortion or blighted ovum) • If pregnancy loss after 20 weeks, inquire: ---• <span>date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any antepartum, intrapartum or postpartum complications and/or fetal anomalies. 3. Past Medical and Surgical History 4. Family History: genetic diseases, congeni

#### Flashcard 1410398555404

Tags
#obgyn
Question
First Prenatal Visit History
1. History of Present Pregnancy:
• LMP: first day of last normal period
• Determine EDC (estimated date of confinement)
2. Past Obstetrical History:
• All Ob/Gyn histories include a summary of G and P
• For more complicated patients, can further categorize into GTPAL:
G: any pregnancy (include losses, ectopic, mole, current)
T: term – infants delivered after 37 completed weeks
P: preterm – infants delivered 20 - 36+6 weeks
A: abortions – pregnancy loss prior to 20 weeks and/or fetus weighing <500 grams
L: live – number of currently living children
• If pregnancy loss prior to 20 weeks, inquire:
---• how did loss happen (did they have a termination? or bleed and cramp? did they feels pressure and have PPROM?) - differentiate between causes such as therapeutic abortion, spontaneous abortion, fetal anomaly, maternal issues (incompetent cervix)
---• was a surgical procedure required such as a D and C (Dilatation and Curettage) or D and E (Dilatation and Evacuation)
---• was medical intervention required such as misoprostol (for missed abortion or blighted ovum)
• If pregnancy loss after 20 weeks, inquire:
---• date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any [...].
3. Past Medical and Surgical History
4. Family History:
genetic diseases, congenital malformations, consanguinity
5. Medications, Allergies
6. Social History: smoking, alcohol, recreational drugs, home environment
7. Review of Systems (tailor to patient)
antepartum, intrapartum or postpartum complications and/or fetal anomalies

status measured difficulty not learned 37% [default] 0

antenatal visit history
• If pregnancy loss after 20 weeks, inquire: ---• date of delivery, location, sex, birth weight, gestational age at delivery, mode of delivery (vaginal – assisted or spontaneous; Cesarean – low segment or classical); were there any <span>antepartum, intrapartum or postpartum complications and/or fetal anomalies. 3. Past Medical and Surgical History 4. Family History: genetic diseases, congenital malformations, consanguinity 5. Medications, Allergies 6. Social History:

#### Annotation 1410400128268

First Prenatal Visit Physical Exam
#obgyn
First Prenatal Visit Physical Examination
1. General: Vital signs, Weight (calculate BMI)
• thyroid exam
• chloasma
• gums/mucous membranes: hyperemic/swollen; epulis of pregnancy
3. Chest:
• elevated diaphragm
4. Heart:
• increased heart rate
• murmurs: flow versus possible pathologic
5. Breast:
• leakage
• physiologic changes
6. Abdomen:
• striae
• linea nigra
• rectus diastasis
• uterus
7. Pelvic Examination:
• External Genitalia Inspection:
---• lesions: condyloma, ulcers, varicosities
---• previous surgeries: female genital mutilation
• Internal Genitalia:
---• Speculum Exam
• Inspection:
---• Vagina:
------• vaginitis (yeast is common)
---• Cervix:
------• Ectropion
------• Polyps
• Cultures:
---• Chlamydial culture is taken from just inside the external os
---• Gonorrheal culture from os/cervix
• Pap:
---• Do not use intracervical brush during pregnancy - spatula or external brush only
• The cervix is often friable during pregnancy and may bleed from Pap - reassure patient that you are nowhere near the pregnancy and that spotting is normal after a Pap smear in pregnancy
• Bimanual Examination:
---• largely replaced by first trimester ultrasound.
---• Cervix: Hegar’s sign (softening)
• Uterus
---• size (ensure it is consistent with dates)
---• shape (expect it to be symmetrically enlarged)
---• consistency (expect soft)
---• if the uterus is firm, smaller than expected, irregularly enlarged, then reconsider dates, viability, uterine anomaly, ectopic pregnancy
• Adnexa: masses, their size, shape, consistency, mobility, tenderness
8. Extremities: check for edema and varicosities

#### Annotation 1410420051212

THE GOAL OF AN ARGUMENT
#rhetoric
Ask yourself what you want at the end of an argument:

Get it to do something or stop doing it?

#### Annotation 1410421886220

STEPS TO CONVINCE
#rhetoric
Start by changing the mood, turn it into a receptive audience, eager to hear your solution.

Then change its mind. Convince that something is the best way to achieve something.

Finally, fill it with the desire to act. Show them that the action you want to take is the best one, and inspire it. This requires stronger emotions that turn a decision into a commitment.

#### Annotation 1410423721228

#rhetoric
Self-deprecating humor is an acceptable way to brag. Mentioning a moment of boneheadedness at my former company beats the far more obnoxious “I was a high-level manager at a publishing company that had twenty-three million customers the year I left.” The term du jour for this device: humblebrag.

#### Annotation 1410425556236

#rhetoric
Self-deprecating humor is an acceptable way to brag. Mentioning a moment of boneheadedness at my former company beats the far more obnoxious “I was a high-level manager at a publishing company that had twenty-three million customers the year I left.” The term du jour for this device: humblebrag.

#### Annotation 1410427391244

#rhetoric
You have your personal goal (what you want out of the argument) and your audience goals (mood, mind, action). Now, before you begin arguing, ask yourself one more question: What’s the issue? According to Aristotle, all issues boil down to just three (the Greeks were crazy about that number):
Blame
Values
Choice

#### Annotation 1410429226252

#rhetoric
THE THREE CORE ISSUES: Blame, values, choice.

#### Flashcard 1410431061260

Tags
#rhetoric
Question
THE THREE CORE ISSUES: Blame, [...], choice.
values

status measured difficulty not learned 37% [default] 0

Open it
THE THREE CORE ISSUES: Blame, values, choice.

#### Flashcard 1410432634124

Tags
#rhetoric
Question
THE THREE CORE ISSUES: [...], values, choice.
Blame

status measured difficulty not learned 37% [default] 0

Open it
THE THREE CORE ISSUES: Blame, values, choice.

#### Flashcard 1410434206988

Tags
#rhetoric
Question
THE THREE CORE ISSUES: Blame, values, [...]
choice.

status measured difficulty not learned 37% [default] 0

Open it
THE THREE CORE ISSUES: Blame, values, choice.

#### Flashcard 1410435779852

Tags
#rhetoric
Question
THE THREE CORE ISSUES:
Blame, Values and Choice

status measured difficulty not learned 37% [default] 0

Open it
THE THREE CORE ISSUES: Blame, values, choice.

#### Annotation 1410439449868

#rhetoric
Who moved my cheese? This, of course, is a blame issue. Whodunit?

Should abortion be legal? Values. What’s morally right or wrong about letting a woman choose whether or not to end the budding life inside her own body? (My choice of words implies the values each side holds— a woman’s right to her own body, and the sanctity of life.)

Should we build a plant in Camden? Choice: to build or not to build, Camden or not Camden.

Should Tom Cruise and Katie Holmes have split up? Values— not moral ones, necessarily, but what you and your interlocutor value. Were they just too cute to separate?

Did O.J. do it? Blame.

Shall we dance? Choice: to dance or not to dance.

#rhetoric
Blame = Past

Values = Present

Choice = Future

#### Annotation 1410443119884

#rhetori
The rhetoric of the past, he said, deals with issues of justice. This is the judicial argument of the courtroom. Aristotle called it “forensic” rhetoric, because it covers forensics.

#### Annotation 1410444954892

#rhetoric
The rhetoric of the present handles praise and condemnation, separating the good from the bad, distinguishing groups from other groups and individuals from each other. It's called Demonstrative.

#### Annotation 1410448887052

#rhetoric
Present-tense (demonstrative) rhetoric tends to finish with people bonding or separating.

#### Annotation 1410450722060

#rhetoric
Present-tense (demonstrative) rhetoric tends to finish with people bonding or separating.

Past-tense (forensic) rhetoric threatens punishment.

Future-tense (deliberative) argument promises a payoff.

You can see why Aristotle dedicated the rhetoric of decision making to the future.

#### Annotation 1410452557068

#rhetoric
Consider “What should we do about it?” and “How can we keep it from happening again?” as rhetorical versions of WD-40 lubricant. The past and present can help you make a point, but any argument involving a decision eventually has to turn to the future.

#### Annotation 1410454392076

Facts do not exist in the future. We can know that the sun came up yesterday and that it shines now, but we can only predict that the sun will come up tomorrow.

#### Annotation 1410456489228

#rhetoric
A good persuader anticipates the audience’s objections. Ideally, you want to produce them even before the audience can. The technique makes your listeners more malleable. They begin to assume you’ll take care of all their qualms, and they lapse into a bovine state of persuadability. (Oh, wait. You’re the audience here. Scratch “bovine.”)

#### Annotation 1410458324236

Instead of helping us to find some elusive truth, deliberative argument deliberates, weighing one choice against the other, considering the circumstances. Choices: Beach or mountains this summer? Should your company replace its computers or hire a competent tech staff? Will Frodo come out as a gay Hobbit?

#### Annotation 1410460421388

#rhetoric
When you argue about values, you use demonstrative rhetoric, not deliberative. If you rely on a cosmic authority— God, or Bono— then the audience has no choice to make.

Eternal truths will answer these: Is there a God?

Is homosexuality immoral?

Should all students know the Ten Commandments?

In each case the argument has to rely on morals and metaphysics. And it takes place mostly in the present tense, the language of demonstrative rhetoric. It can be particularly maddening in a marital dispute, because it comes across as preachy. (Demonstrative rhetoric is the rhetoric of preachers, after all.) Besides, it is far more difficult to change someone’s values than to change her mind. After all, eternal truths are supposed to be … eternal.

#### Annotation 1410463042828

#rhetoric
Practical concerns are open to deliberative debate. Because deliberation has to do with choices, everything about it depends— on the circumstances, the time, the people involved, and whatever “public” you mean when you talk about public opinion. Deliberative argument relies on public opinion, not a higher power, to resolve questions.

The audience’s opinion will answer these: Should the state legislature raise taxes to fund decent schools?

Should you raise your kid’s allowance?

#### Annotation 1410464877836

#rhetoric
SPOT THE INARGUABLE: It’s what is permanent, necessary, or undeniably true. If you think your opponent is wrong— if it ain’t necessarily so— then try to assess what the audience believes. You can challenge a belief, but deliberative argument prefers to use beliefs to persuasion’s advantage.

#### Annotation 1410466712844

Control the issue.
#rhetoric
Do you want to fix blame?

Define who meets or abuses your common values?

Or get your audience to make a choice?

The most productive arguments use choice as their central issue. Don’t let a debate swerve heedlessly into values or guilt. Keep it focused on choices that solve a problem to your audience’s (and your) advantage.

#### Annotation 1410468547852

#rhetoric
Control the clock. Keep your argument in the right tense. In a debate over choices, make sure it turns to the future.

#### Flashcard 1410471169292

Tags
#obgyn
Question
First Prenatal Visit Physical Examination
1. General: [...]
• thyroid exam
• chloasma
• gums/mucous membranes: hyperemic/swollen; epulis of pregnancy
3. Chest:
• consider anatomic and physiologic effects of pregnancy
• elevated diaphragm
4. Heart:
• increased heart rate
• murmurs: flow versus possible pathologic
• if murmur is pathologic, consider maternal tolerance of pregnancy, echocardiogram, need for antibiotics for endocarditis prophylaxis during labour
5. Breast:
• leakage
• physiologic changes
6. Abdomen:
• striae
• linea nigra
• rectus diastasis
• uterus
7. Pelvic Examination:
• External Genitalia Inspection:
---• lesions: condyloma, ulcers, varicosities
---• previous surgeries: female genital mutilation
• Internal Genitalia:
---• Speculum Exam
• Inspection:
---• Vagina:
------• vaginitis (yeast is common)
---• Cervix:
------• Ectropion
------• Polyps
• Cultures:
---• Chlamydial culture is taken from just inside the external os
---• Gonorrheal culture from os/cervix
• Pap:
---• Do not use intracervical brush during pregnancy - spatula or external brush only
• The cervix is often friable during pregnancy and may bleed from Pap - reassure patient that you are nowhere near the pregnancy and that spotting is normal after a Pap smear in pregnancy
• Bimanual Examination:
---• largely replaced by first trimester ultrasound.
---• Cervix: Hegar’s sign (softening)
• Uterus
---• size (ensure it is consistent with dates)
---• shape (expect it to be symmetrically enlarged)
---• consistency (expect soft)
---• if the uterus is firm, smaller than expected, irregularly enlarged, then reconsider dates, viability, uterine anomaly, ectopic pregnancy
• Adnexa: masses, their size, shape, consistency, mobility, tenderness
• Bony pelvis (clinical pelvimetry to assess adequacy of pelvis for labour):
---• Type of pelvis:
------• gynecoid
------• android
------• anthropoid
------• platypelloid
---• Pelvic inlet:
------• sub-pubic arch (should not be narrow)
------• prominence of sacrum (should not be too prominent)
------• symphysis-sacral distance
---• Midpelvis: prominence of spines (should not be too prominent)
---• Pelvic outlet: inter-tuberous distance
8. Extremities: check for edema and varicosities
Vital signs, Weight (calculate BMI)

status measured difficulty not learned 37% [default] 0

First Prenatal Visit Physical Exam
First Prenatal Visit Physical Examination 1. General : Vital signs, Weight (calculate BMI) 2. Head and Neck : • thyroid exam • chloasma • gums/mucous membranes: hyperemic/swollen; epulis of pregnancy 3. Chest : • consider anatomic and physiolog

#### Flashcard 1410472742156

Tags
#obgyn
Question
First Prenatal Visit Physical Examination
1. General: Vital signs, Weight (calculate BMI)
[...] exam
• chloasma
• gums/mucous membranes: hyperemic/swollen; epulis of pregnancy
3. Chest:
• consider anatomic and physiologic effects of pregnancy
• elevated diaphragm
4. Heart:
• increased heart rate
• murmurs: flow versus possible pathologic
• if murmur is pathologic, consider maternal tolerance of pregnancy, echocardiogram, need for antibiotics for endocarditis prophylaxis during labour
5. Breast:
• leakage
• physiologic changes
6. Abdomen:
• striae
• linea nigra
• rectus diastasis
• uterus
7. Pelvic Examination:
• External Genitalia Inspection:
---• lesions: condyloma, ulcers, varicosities
---• previous surgeries: female genital mutilation
• Internal Genitalia:
---• Speculum Exam
• Inspection:
---• Vagina:
------• vaginitis (yeast is common)
---• Cervix:
------• Ectropion
------• Polyps
• Cultures:
---• Chlamydial culture is taken from just inside the external os
---• Gonorrheal culture from os/cervix
• Pap:
---• Do not use intracervical brush during pregnancy - spatula or external brush only
• The cervix is often friable during pregnancy and may bleed from Pap - reassure patient that you are nowhere near the pregnancy and that spotting is normal after a Pap smear in pregnancy
• Bimanual Examination:
---• largely replaced by first trimester ultrasound.
---• Cervix: Hegar’s sign (softening)
• Uterus
---• size (ensure it is consistent with dates)
---• shape (expect it to be symmetrically enlarged)
---• consistency (expect soft)
---• if the uterus is firm, smaller than expected, irregularly enlarged, then reconsider dates, viability, uterine anomaly, ectopic pregnancy
• Adnexa: masses, their size, shape, consistency, mobility, tenderness
• Bony pelvis (clinical pelvimetry to assess adequacy of pelvis for labour):
---• Type of pelvis:
------• gynecoid
------• android
------• anthropoid
------• platypelloid
---• Pelvic inlet:
------• sub-pubic arch (should not be narrow)
------• prominence of sacrum (should not be too prominent)
------• symphysis-sacral distance
---• Midpelvis: prominence of spines (should not be too prominent)
---• Pelvic outlet: inter-tuberous distance
8. Extremities: check for edema and varicosities
thyroid

status measured difficulty not learned 37% [default] 0

First Prenatal Visit Physical Exam
First Prenatal Visit Physical Examination 1. General : Vital signs, Weight (calculate BMI) 2. Head and Neck : • thyroid exam • chloasma • gums/mucous membranes: hyperemic/swollen; epulis of pregnancy 3. Chest : • consider anatomic and physiologic effects of pregnancy • elevated

#### Flashcard 1410474315020

Tags
#obgyn
Question
First Prenatal Visit Physical Examination
1. General: Vital signs, Weight (calculate BMI)
• thyroid exam
[...]
• gums/mucous membranes: hyperemic/swollen; epulis of pregnancy
3. Chest:
• consider anatomic and physiologic effects of pregnancy
• elevated diaphragm
4. Heart:
• increased heart rate
• murmurs: flow versus possible pathologic
• if murmur is pathologic, consider maternal tolerance of pregnancy, echocardiogram, need for antibiotics for endocarditis prophylaxis during labour
5. Breast:
• leakage
• physiologic changes
6. Abdomen:
• striae
• linea nigra
• rectus diastasis
• uterus
7. Pelvic Examination:
• External Genitalia Inspection:
---• lesions: condyloma, ulcers, varicosities
---• previous surgeries: female genital mutilation
• Internal Genitalia:
---• Speculum Exam
• Inspection:
---• Vagina:
------• vaginitis (yeast is common)
---• Cervix:
------• Ectropion
------• Polyps
• Cultures:
---• Chlamydial culture is taken from just inside the external os
---• Gonorrheal culture from os/cervix
• Pap:
---• Do not use intracervical brush during pregnancy - spatula or external brush only
• The cervix is often friable during pregnancy and may bleed from Pap - reassure patient that you are nowhere near the pregnancy and that spotting is normal after a Pap smear in pregnancy
• Bimanual Examination:
---• largely replaced by first trimester ultrasound.
---• Cervix: Hegar’s sign (softening)
• Uterus
---• size (ensure it is consistent with dates)
---• shape (expect it to be symmetrically enlarged)
---• consistency (expect soft)
---• if the uterus is firm, smaller than expected, irregularly enlarged, then reconsider dates, viability, uterine anomaly, ectopic pregnancy
• Adnexa: masses, their size, shape, consistency, mobility, tenderness
• Bony pelvis (clinical pelvimetry to assess adequacy of pelvis for labour):
---• Type of pelvis:
------• gynecoid
------• android
------• anthropoid
------• platypelloid
---• Pelvic inlet:
------• sub-pubic arch (should not be narrow)
------• prominence of sacrum (should not be too prominent)
------• symphysis-sacral distance
---• Midpelvis: prominence of spines (should not be too prominent)
---• Pelvic outlet: inter-tuberous distance
8. Extremities: check for edema and varicosities
chloasma

status measured difficulty not learned 37% [default] 0

First Prenatal Visit Physical Exam
First Prenatal Visit Physical Examination 1. General : Vital signs, Weight (calculate BMI) 2. Head and Neck : • thyroid exam • chloasma • gums/mucous membranes: hyperemic/swollen; epulis of pregnancy 3. Chest : • consider anatomic and physiologic effects of pregnancy • elevated diaphragm 4. He

#### Flashcard 1410475887884

Tags
#obgyn
Question
First Prenatal Visit Physical Examination
1. General: Vital signs, Weight (calculate BMI)
• thyroid exam
• chloasma
• gums/mucous membranes: hyperemic/swollen; epulis of pregnancy
3. Chest:
• consider anatomic and physiologic effects of pregnancy
• elevated [...]
4. Heart:
• increased heart rate
• murmurs: flow versus possible pathologic
• if murmur is pathologic, consider maternal tolerance of pregnancy, echocardiogram, need for antibiotics for endocarditis prophylaxis during labour
5. Breast:
• leakage
• physiologic changes
6. Abdomen:
• striae
• linea nigra
• rectus diastasis
• uterus
7. Pelvic Examination:
• External Genitalia Inspection:
---• lesions: condyloma, ulcers, varicosities
---• previous surgeries: female genital mutilation
• Internal Genitalia:
---• Speculum Exam
• Inspection:
---• Vagina:
------• vaginitis (yeast is common)
---• Cervix:
------• Ectropion
------• Polyps
• Cultures:
---• Chlamydial culture is taken from just inside the external os
---• Gonorrheal culture from os/cervix
• Pap:
---• Do not use intracervical brush during pregnancy - spatula or external brush only
• The cervix is often friable during pregnancy and may bleed from Pap - reassure patient that you are nowhere near the pregnancy and that spotting is normal after a Pap smear in pregnancy
• Bimanual Examination:
---• largely replaced by first trimester ultrasound.
---• Cervix: Hegar’s sign (softening)
• Uterus
---• size (ensure it is consistent with dates)
---• shape (expect it to be symmetrically enlarged)
---• consistency (expect soft)
---• if the uterus is firm, smaller than expected, irregularly enlarged, then reconsider dates, viability, uterine anomaly, ectopic pregnancy
• Adnexa: masses, their size, shape, consistency, mobility, tenderness
• Bony pelvis (clinical pelvimetry to assess adequacy of pelvis for labour):
---• Type of pelvis:
------• gynecoid
------• android
------• anthropoid
------• platypelloid
---• Pelvic inlet:
------• sub-pubic arch (should not be narrow)
------• prominence of sacrum (should not be too prominent)
------• symphysis-sacral distance
---• Midpelvis: prominence of spines (should not be too prominent)
---• Pelvic outlet: inter-tuberous distance
8. Extremities: check for edema and varicosities
diaphragm

status measured difficulty not learned 37% [default] 0

First Prenatal Visit Physical Exam
t (calculate BMI) 2. Head and Neck : • thyroid exam • chloasma • gums/mucous membranes: hyperemic/swollen; epulis of pregnancy 3. Chest : • consider anatomic and physiologic effects of pregnancy • elevated <span>diaphragm 4. Heart : • increased heart rate • murmurs: flow versus possible pathologic • if murmur is pathologic, consider maternal tolerance of pregnancy, echocardiogram, ne

#### Flashcard 1410477460748

Tags
#obgyn
Question
First Prenatal Visit Physical Examination
1. General: Vital signs, Weight (calculate BMI)
• thyroid exam
• chloasma
• gums/mucous membranes: [...]
3. Chest:
• consider anatomic and physiologic effects of pregnancy
• elevated diaphragm
4. Heart:
• increased heart rate
• murmurs: flow versus possible pathologic
• if murmur is pathologic, consider maternal tolerance of pregnancy, echocardiogram, need for antibiotics for endocarditis prophylaxis during labour
5. Breast:
• leakage
• physiologic changes
6. Abdomen:
• striae
• linea nigra
• rectus diastasis
• uterus
7. Pelvic Examination:
• External Genitalia Inspection:
---• lesions: condyloma, ulcers, varicosities
---• previous surgeries: female genital mutilation
• Internal Genitalia:
---• Speculum Exam
• Inspection:
---• Vagina:
------• vaginitis (yeast is common)
---• Cervix:
------• Ectropion
------• Polyps
• Cultures:
---• Chlamydial culture is taken from just inside the external os
---• Gonorrheal culture from os/cervix
• Pap:
---• Do not use intracervical brush during pregnancy - spatula or external brush only
• The cervix is often friable during pregnancy and may bleed from Pap - reassure patient that you are nowhere near the pregnancy and that spotting is normal after a Pap smear in pregnancy
• Bimanual Examination:
---• largely replaced by first trimester ultrasound.
---• Cervix: Hegar’s sign (softening)
• Uterus
---• size (ensure it is consistent with dates)
---• shape (expect it to be symmetrically enlarged)
---• consistency (expect soft)
---• if the uterus is firm, smaller than expected, irregularly enlarged, then reconsider dates, viability, uterine anomaly, ectopic pregnancy
• Adnexa: masses, their size, shape, consistency, mobility, tenderness
• Bony pelvis (clinical pelvimetry to assess adequacy of pelvis for labour):
---• Type of pelvis:
------• gynecoid
------• android
------• anthropoid
------• platypelloid
---• Pelvic inlet:
------• sub-pubic arch (should not be narrow)
------• prominence of sacrum (should not be too prominent)
------• symphysis-sacral distance
---• Midpelvis: prominence of spines (should not be too prominent)
---• Pelvic outlet: inter-tuberous distance
8. Extremities: check for edema and varicosities
hyperemic/swollen; epulis of pregnancy

status measured difficulty not learned 37% [default] 0

First Prenatal Visit Physical Exam
First Prenatal Visit Physical Examination 1. General : Vital signs, Weight (calculate BMI) 2. Head and Neck : • thyroid exam • chloasma • gums/mucous membranes: hyperemic/swollen; epulis of pregnancy 3. Chest : • consider anatomic and physiologic effects of pregnancy • elevated diaphragm 4. Heart : • increased heart rate • murmurs: flow versus possibl

#### Flashcard 1410479820044

Tags
#obgyn
Question
First Prenatal Visit Physical Examination
1. General: Vital signs, Weight (calculate BMI)
• thyroid exam
• chloasma
• gums/mucous membranes: hyperemic/swollen; epulis of pregnancy
3. Chest:
• elevated diaphragm
4. Heart:
• increased [...]
• murmurs: flow versus possible pathologic
5. Breast:
• leakage
• physiologic changes
6. Abdomen:
• striae
• linea nigra
• rectus diastasis
• uterus
7. Pelvic Examination:
• External Genitalia Inspection:
---• lesions: condyloma, ulcers, varicosities
---• previous surgeries: female genital mutilation
• Internal Genitalia:
---• Speculum Exam
• Inspection:
---• Vagina:
------• vaginitis (yeast is common)
---• Cervix:
------• Ectropion
------• Polyps
• Cultures:
---• Chlamydial culture is taken from just inside the external os
---• Gonorrheal culture from os/cervix
• Pap:
---• Do not use intracervical brush during pregnancy - spatula or external brush only
• The cervix is often friable during pregnancy and may bleed from Pap - reassure patient that you are nowhere near the pregnancy and that spotting is normal after a Pap smear in pregnancy
• Bimanual Examination:
---• largely replaced by first trimester ultrasound.
---• Cervix: Hegar’s sign (softening)
• Uterus
---• size (ensure it is consistent with dates)
---• shape (expect it to be symmetrically enlarged)
---• consistency (expect soft)
---• if the uterus is firm, smaller than expected, irregularly enlarged, then reconsider dates, viability, uterine anomaly, ectopic pregnancy
• Adnexa: masses, their size, shape, consistency, mobility, tenderness
• Bony pelvis (clinical pelvimetry to assess adequacy of pelvis for labour):
---• Type of pelvis:
------• gynecoid
------• android
------• anthropoid
------• platypelloid
---• Pelvic inlet:
------• sub-pubic arch (should not be narrow)
------• prominence of sacrum (should not be too prominent)
------• symphysis-sacral distance
---• Midpelvis: prominence of spines (should not be too prominent)
---• Pelvic outlet: inter-tuberous distance
8. Extremities: check for edema and varicosities
heart rate

status measured difficulty not learned 37% [default] 0

First Prenatal Visit Physical Exam
Vital signs, Weight (calculate BMI) 2. Head and Neck : • thyroid exam • chloasma • gums/mucous membranes: hyperemic/swollen; epulis of pregnancy 3. Chest : • elevated diaphragm 4. Heart : • increased <span>heart rate • murmurs: flow versus possible pathologic 5. Breast : • leakage • physiologic changes 6. Abdomen : • striae • linea nigra • rectus diastasis&#

#### Flashcard 1410481392908

Tags
#obgyn
Question
First Prenatal Visit Physical Examination
1. General: Vital signs, Weight (calculate BMI)
• thyroid exam
• chloasma
• gums/mucous membranes: hyperemic/swollen; epulis of pregnancy
3. Chest:
• elevated diaphragm
4. Heart:
• increased heart rate
• murmurs: flow versus possible pathologic
5. Breast:
[...]
• physiologic changes
6. Abdomen:
• striae
• linea nigra
• rectus diastasis
• uterus
7. Pelvic Examination:
• External Genitalia Inspection:
---• lesions: condyloma, ulcers, varicosities
---• previous surgeries: female genital mutilation
• Internal Genitalia:
---• Speculum Exam
• Inspection:
---• Vagina:
------• vaginitis (yeast is common)
---• Cervix:
------• Ectropion
------• Polyps
• Cultures:
---• Chlamydial culture is taken from just inside the external os
---• Gonorrheal culture from os/cervix
• Pap:
---• Do not use intracervical brush during pregnancy - spatula or external brush only
• The cervix is often friable during pregnancy and may bleed from Pap - reassure patient that you are nowhere near the pregnancy and that spotting is normal after a Pap smear in pregnancy
• Bimanual Examination:
---• largely replaced by first trimester ultrasound.
---• Cervix: Hegar’s sign (softening)
• Uterus
---• size (ensure it is consistent with dates)
---• shape (expect it to be symmetrically enlarged)
---• consistency (expect soft)
---• if the uterus is firm, smaller than expected, irregularly enlarged, then reconsider dates, viability, uterine anomaly, ectopic pregnancy
• Adnexa: masses, their size, shape, consistency, mobility, tenderness
• Bony pelvis (clinical pelvimetry to assess adequacy of pelvis for labour):
---• Type of pelvis:
------• gynecoid
------• android
------• anthropoid
------• platypelloid
---• Pelvic inlet:
------• sub-pubic arch (should not be narrow)
------• prominence of sacrum (should not be too prominent)
------• symphysis-sacral distance
---• Midpelvis: prominence of spines (should not be too prominent)
---• Pelvic outlet: inter-tuberous distance
8. Extremities: check for edema and varicosities
leakage

status measured difficulty not learned 37% [default] 0

First Prenatal Visit Physical Exam
; • chloasma • gums/mucous membranes: hyperemic/swollen; epulis of pregnancy 3. Chest : • elevated diaphragm 4. Heart : • increased heart rate • murmurs: flow versus possible pathologic 5. Breast : • <span>leakage • physiologic changes 6. Abdomen : • striae • linea nigra • rectus diastasis • uterus 7. Pelvic Examination : • External Genitalia Inspection:&

#### Flashcard 1410482965772

Tags
#obgyn
Question
First Prenatal Visit Physical Examination
1. General: Vital signs, Weight (calculate BMI)
• thyroid exam
• chloasma
• gums/mucous membranes: hyperemic/swollen; epulis of pregnancy
3. Chest:
• elevated diaphragm
4. Heart:
• increased heart rate
• murmurs: flow versus possible pathologic
5. Breast:
• leakage
• physiologic changes
6. Abdomen:
[...]
• linea nigra
• rectus diastasis
• uterus
7. Pelvic Examination:
• External Genitalia Inspection:
---• lesions: condyloma, ulcers, varicosities
---• previous surgeries: female genital mutilation
• Internal Genitalia:
---• Speculum Exam
• Inspection:
---• Vagina:
------• vaginitis (yeast is common)
---• Cervix:
------• Ectropion
------• Polyps
• Cultures:
---• Chlamydial culture is taken from just inside the external os
---• Gonorrheal culture from os/cervix
• Pap:
---• Do not use intracervical brush during pregnancy - spatula or external brush only
• The cervix is often friable during pregnancy and may bleed from Pap - reassure patient that you are nowhere near the pregnancy and that spotting is normal after a Pap smear in pregnancy
• Bimanual Examination:
---• largely replaced by first trimester ultrasound.
---• Cervix: Hegar’s sign (softening)
• Uterus
---• size (ensure it is consistent with dates)
---• shape (expect it to be symmetrically enlarged)
---• consistency (expect soft)
---• if the uterus is firm, smaller than expected, irregularly enlarged, then reconsider dates, viability, uterine anomaly, ectopic pregnancy
• Adnexa: masses, their size, shape, consistency, mobility, tenderness
• Bony pelvis (clinical pelvimetry to assess adequacy of pelvis for labour):
---• Type of pelvis:
------• gynecoid
------• android
------• anthropoid
------• platypelloid
---• Pelvic inlet:
------• sub-pubic arch (should not be narrow)
------• prominence of sacrum (should not be too prominent)
------• symphysis-sacral distance
---• Midpelvis: prominence of spines (should not be too prominent)
---• Pelvic outlet: inter-tuberous distance
8. Extremities: check for edema and varicosities
striae

status measured difficulty not learned 37% [default] 0

First Prenatal Visit Physical Exam
epulis of pregnancy 3. Chest : • elevated diaphragm 4. Heart : • increased heart rate • murmurs: flow versus possible pathologic 5. Breast : • leakage • physiologic changes 6. Abdomen : • <span>striae • linea nigra • rectus diastasis • uterus 7. Pelvic Examination : • External Genitalia Inspection: ---• lesions: condyloma, ulcers, varicosities ---•

#### Flashcard 1410484538636

Tags
#obgyn
Question
First Prenatal Visit Physical Examination
1. General: Vital signs, Weight (calculate BMI)
• thyroid exam
• chloasma
• gums/mucous membranes: hyperemic/swollen; epulis of pregnancy
3. Chest:
• elevated diaphragm
4. Heart:
• increased heart rate
• murmurs: flow versus possible pathologic
5. Breast:
• leakage
• physiologic changes
6. Abdomen:
• striae
[...]
• rectus diastasis
• uterus
7. Pelvic Examination:
• External Genitalia Inspection:
---• lesions: condyloma, ulcers, varicosities
---• previous surgeries: female genital mutilation
• Internal Genitalia:
---• Speculum Exam
• Inspection:
---• Vagina:
------• vaginitis (yeast is common)
---• Cervix:
------• Ectropion
------• Polyps
• Cultures:
---• Chlamydial culture is taken from just inside the external os
---• Gonorrheal culture from os/cervix
• Pap:
---• Do not use intracervical brush during pregnancy - spatula or external brush only
• The cervix is often friable during pregnancy and may bleed from Pap - reassure patient that you are nowhere near the pregnancy and that spotting is normal after a Pap smear in pregnancy
• Bimanual Examination:
---• largely replaced by first trimester ultrasound.
---• Cervix: Hegar’s sign (softening)
• Uterus
---• size (ensure it is consistent with dates)
---• shape (expect it to be symmetrically enlarged)
---• consistency (expect soft)
---• if the uterus is firm, smaller than expected, irregularly enlarged, then reconsider dates, viability, uterine anomaly, ectopic pregnancy
• Adnexa: masses, their size, shape, consistency, mobility, tenderness
• Bony pelvis (clinical pelvimetry to assess adequacy of pelvis for labour):
---• Type of pelvis:
------• gynecoid
------• android
------• anthropoid
------• platypelloid
---• Pelvic inlet:
------• sub-pubic arch (should not be narrow)
------• prominence of sacrum (should not be too prominent)
------• symphysis-sacral distance
---• Midpelvis: prominence of spines (should not be too prominent)
---• Pelvic outlet: inter-tuberous distance
8. Extremities: check for edema and varicosities
linea nigra

status measured difficulty not learned 37% [default] 0

First Prenatal Visit Physical Exam
gnancy 3. Chest : • elevated diaphragm 4. Heart : • increased heart rate • murmurs: flow versus possible pathologic 5. Breast : • leakage • physiologic changes 6. Abdomen : • striae • <span>linea nigra • rectus diastasis • uterus 7. Pelvic Examination : • External Genitalia Inspection: ---• lesions: condyloma, ulcers, varicosities ---• previous surgeries

#### Flashcard 1410486111500

Tags
#obgyn
Question
First Prenatal Visit Physical Examination
1. General: Vital signs, Weight (calculate BMI)
• thyroid exam
• chloasma
• gums/mucous membranes: hyperemic/swollen; epulis of pregnancy
3. Chest:
• elevated diaphragm
4. Heart:
• increased heart rate
• murmurs: flow versus possible pathologic
5. Breast:
• leakage
• physiologic changes
6. Abdomen:
• striae
• linea nigra
[...]
• uterus
7. Pelvic Examination:
• External Genitalia Inspection:
---• lesions: condyloma, ulcers, varicosities
---• previous surgeries: female genital mutilation
• Internal Genitalia:
---• Speculum Exam
• Inspection:
---• Vagina:
------• vaginitis (yeast is common)
---• Cervix:
------• Ectropion
------• Polyps
• Cultures:
---• Chlamydial culture is taken from just inside the external os
---• Gonorrheal culture from os/cervix
• Pap:
---• Do not use intracervical brush during pregnancy - spatula or external brush only
• The cervix is often friable during pregnancy and may bleed from Pap - reassure patient that you are nowhere near the pregnancy and that spotting is normal after a Pap smear in pregnancy
• Bimanual Examination:
---• largely replaced by first trimester ultrasound.
---• Cervix: Hegar’s sign (softening)
• Uterus
---• size (ensure it is consistent with dates)
---• shape (expect it to be symmetrically enlarged)
---• consistency (expect soft)
---• if the uterus is firm, smaller than expected, irregularly enlarged, then reconsider dates, viability, uterine anomaly, ectopic pregnancy
• Adnexa: masses, their size, shape, consistency, mobility, tenderness
• Bony pelvis (clinical pelvimetry to assess adequacy of pelvis for labour):
---• Type of pelvis:
------• gynecoid
------• android
------• anthropoid
------• platypelloid
---• Pelvic inlet:
------• sub-pubic arch (should not be narrow)
------• prominence of sacrum (should not be too prominent)
------• symphysis-sacral distance
---• Midpelvis: prominence of spines (should not be too prominent)
---• Pelvic outlet: inter-tuberous distance
8. Extremities: check for edema and varicosities
rectus diastasis

status measured difficulty not learned 37% [default] 0

First Prenatal Visit Physical Exam
st : • elevated diaphragm 4. Heart : • increased heart rate • murmurs: flow versus possible pathologic 5. Breast : • leakage • physiologic changes 6. Abdomen : • striae • linea nigra • <span>rectus diastasis • uterus 7. Pelvic Examination : • External Genitalia Inspection: ---• lesions: condyloma, ulcers, varicosities ---• previous surgeries: female genital mutilat

#### Flashcard 1410487684364

Tags
#obgyn
Question
First Prenatal Visit Physical Examination
1. General: Vital signs, Weight (calculate BMI)
• thyroid exam
• chloasma
• gums/mucous membranes: hyperemic/swollen; epulis of pregnancy
3. Chest:
• elevated diaphragm
4. Heart:
• increased heart rate
• murmurs: flow versus possible pathologic
5. Breast:
• leakage
• physiologic changes
6. Abdomen:
• striae
• linea nigra
• rectus diastasis
• uterus
7. Pelvic Examination:
• External Genitalia Inspection:
---• lesions: condyloma, ulcers, varicosities
---• previous surgeries: female genital mutilation
• Internal Genitalia:
---• Speculum Exam
• Inspection:
---• Vagina:
------• [...] sign (bluish discoloration)
------• vaginitis (yeast is common)
---• Cervix:
------• Ectropion
------• Polyps
• Cultures:
---• Chlamydial culture is taken from just inside the external os
---• Gonorrheal culture from os/cervix
• Pap:
---• Do not use intracervical brush during pregnancy - spatula or external brush only
• The cervix is often friable during pregnancy and may bleed from Pap - reassure patient that you are nowhere near the pregnancy and that spotting is normal after a Pap smear in pregnancy
• Bimanual Examination:
---• largely replaced by first trimester ultrasound.
---• Cervix: Hegar’s sign (softening)
• Uterus
---• size (ensure it is consistent with dates)
---• shape (expect it to be symmetrically enlarged)
---• consistency (expect soft)
---• if the uterus is firm, smaller than expected, irregularly enlarged, then reconsider dates, viability, uterine anomaly, ectopic pregnancy
• Adnexa: masses, their size, shape, consistency, mobility, tenderness
• Bony pelvis (clinical pelvimetry to assess adequacy of pelvis for labour):
---• Type of pelvis:
------• gynecoid
------• android
------• anthropoid
------• platypelloid
---• Pelvic inlet:
------• sub-pubic arch (should not be narrow)
------• prominence of sacrum (should not be too prominent)
------• symphysis-sacral distance
---• Midpelvis: prominence of spines (should not be too prominent)
---• Pelvic outlet: inter-tuberous distance
8. Extremities: check for edema and varicosities

status measured difficulty not learned 37% [default] 0

First Prenatal Visit Physical Exam
; • External Genitalia Inspection: ---• lesions: condyloma, ulcers, varicosities ---• previous surgeries: female genital mutilation • Internal Genitalia: ---• Speculum Exam • Inspection: ---• Vagina: ------• <span>Chadwick’s sign (bluish discoloration) ------• vaginitis (yeast is common) ---• Cervix: ------• Ectropion ------• Polyps • Cultures: ---• Chlamydial culture is take

#### Flashcard 1410489257228

Tags
#obgyn
Question
First Prenatal Visit Physical Examination
1. General: Vital signs, Weight (calculate BMI)
• thyroid exam
• chloasma
• gums/mucous membranes: hyperemic/swollen; epulis of pregnancy
3. Chest:
• elevated diaphragm
4. Heart:
• increased heart rate
• murmurs: flow versus possible pathologic
5. Breast:
• leakage
• physiologic changes
6. Abdomen:
• striae
• linea nigra
• rectus diastasis
• uterus
7. Pelvic Examination:
• External Genitalia Inspection:
---• lesions: condyloma, ulcers, varicosities
---• previous surgeries: female genital mutilation
• Internal Genitalia:
---• Speculum Exam
• Inspection:
---• Vagina:
------• [...] (yeast is common)
---• Cervix:
------• Ectropion
------• Polyps
• Cultures:
---• Chlamydial culture is taken from just inside the external os
---• Gonorrheal culture from os/cervix
• Pap:
---• Do not use intracervical brush during pregnancy - spatula or external brush only
• The cervix is often friable during pregnancy and may bleed from Pap - reassure patient that you are nowhere near the pregnancy and that spotting is normal after a Pap smear in pregnancy
• Bimanual Examination:
---• largely replaced by first trimester ultrasound.
---• Cervix: Hegar’s sign (softening)
• Uterus
---• size (ensure it is consistent with dates)
---• shape (expect it to be symmetrically enlarged)
---• consistency (expect soft)
---• if the uterus is firm, smaller than expected, irregularly enlarged, then reconsider dates, viability, uterine anomaly, ectopic pregnancy
• Adnexa: masses, their size, shape, consistency, mobility, tenderness
• Bony pelvis (clinical pelvimetry to assess adequacy of pelvis for labour):
---• Type of pelvis:
------• gynecoid
------• android
------• anthropoid
------• platypelloid
---• Pelvic inlet:
------• sub-pubic arch (should not be narrow)
------• prominence of sacrum (should not be too prominent)
------• symphysis-sacral distance
---• Midpelvis: prominence of spines (should not be too prominent)
---• Pelvic outlet: inter-tuberous distance
8. Extremities: check for edema and varicosities
vaginitis

status measured difficulty not learned 37% [default] 0

First Prenatal Visit Physical Exam
: condyloma, ulcers, varicosities ---• previous surgeries: female genital mutilation • Internal Genitalia: ---• Speculum Exam • Inspection: ---• Vagina: ------• Chadwick’s sign (bluish discoloration) ------• <span>vaginitis (yeast is common) ---• Cervix: ------• Ectropion ------• Polyps • Cultures: ---• Chlamydial culture is taken from just inside the external os ---• Gonorr

#### Flashcard 1410490830092

Tags
#obgyn
Question
First Prenatal Visit Physical Examination
1. General: Vital signs, Weight (calculate BMI)
• thyroid exam
• chloasma
• gums/mucous membranes: hyperemic/swollen; epulis of pregnancy
3. Chest:
• elevated diaphragm
4. Heart:
• increased heart rate
• murmurs: flow versus possible pathologic
5. Breast:
• leakage
• physiologic changes
6. Abdomen:
• striae
• linea nigra
• rectus diastasis
• uterus
7. Pelvic Examination:
• External Genitalia Inspection:
---• lesions: condyloma, ulcers, varicosities
---• previous surgeries: female genital mutilation
• Internal Genitalia:
---• Speculum Exam
• Inspection:
---• Vagina:
------• vaginitis ([...] is common)
---• Cervix:
------• Ectropion
------• Polyps
• Cultures:
---• Chlamydial culture is taken from just inside the external os
---• Gonorrheal culture from os/cervix
• Pap:
---• Do not use intracervical brush during pregnancy - spatula or external brush only
• The cervix is often friable during pregnancy and may bleed from Pap - reassure patient that you are nowhere near the pregnancy and that spotting is normal after a Pap smear in pregnancy
• Bimanual Examination:
---• largely replaced by first trimester ultrasound.
---• Cervix: Hegar’s sign (softening)
• Uterus
---• size (ensure it is consistent with dates)
---• shape (expect it to be symmetrically enlarged)
---• consistency (expect soft)
---• if the uterus is firm, smaller than expected, irregularly enlarged, then reconsider dates, viability, uterine anomaly, ectopic pregnancy
• Adnexa: masses, their size, shape, consistency, mobility, tenderness
• Bony pelvis (clinical pelvimetry to assess adequacy of pelvis for labour):
---• Type of pelvis:
------• gynecoid
------• android
------• anthropoid
------• platypelloid
---• Pelvic inlet:
------• sub-pubic arch (should not be narrow)
------• prominence of sacrum (should not be too prominent)
------• symphysis-sacral distance
---• Midpelvis: prominence of spines (should not be too prominent)
---• Pelvic outlet: inter-tuberous distance
8. Extremities: check for edema and varicosities
yeast

status measured difficulty not learned 37% [default] 0

First Prenatal Visit Physical Exam
, ulcers, varicosities ---• previous surgeries: female genital mutilation • Internal Genitalia: ---• Speculum Exam • Inspection: ---• Vagina: ------• Chadwick’s sign (bluish discoloration) ------• vaginitis (<span>yeast is common) ---• Cervix: ------• Ectropion ------• Polyps • Cultures: ---• Chlamydial culture is taken from just inside the external os ---• Gonorrheal cu

#### Flashcard 1410492402956

Tags
#obgyn
Question
First Prenatal Visit Physical Examination
1. General: Vital signs, Weight (calculate BMI)
• thyroid exam
• chloasma
• gums/mucous membranes: hyperemic/swollen; epulis of pregnancy
3. Chest:
• elevated diaphragm
4. Heart:
• increased heart rate
• murmurs: flow versus possible pathologic
5. Breast:
• leakage
• physiologic changes
6. Abdomen:
• striae
• linea nigra
• rectus diastasis
• uterus
7. Pelvic Examination:
• External Genitalia Inspection:
---• lesions: condyloma, ulcers, varicosities
---• previous surgeries: female genital mutilation
• Internal Genitalia:
---• Speculum Exam
• Inspection:
---• Vagina:
------• vaginitis (yeast is common)
---• Cervix:
------• [...]
------• Polyps
• Cultures:
---• Chlamydial culture is taken from just inside the external os
---• Gonorrheal culture from os/cervix
• Pap:
---• Do not use intracervical brush during pregnancy - spatula or external brush only
• The cervix is often friable during pregnancy and may bleed from Pap - reassure patient that you are nowhere near the pregnancy and that spotting is normal after a Pap smear in pregnancy
• Bimanual Examination:
---• largely replaced by first trimester ultrasound.
---• Cervix: Hegar’s sign (softening)
• Uterus
---• size (ensure it is consistent with dates)
---• shape (expect it to be symmetrically enlarged)
---• consistency (expect soft)
---• if the uterus is firm, smaller than expected, irregularly enlarged, then reconsider dates, viability, uterine anomaly, ectopic pregnancy
• Adnexa: masses, their size, shape, consistency, mobility, tenderness
• Bony pelvis (clinical pelvimetry to assess adequacy of pelvis for labour):
---• Type of pelvis:
------• gynecoid
------• android
------• anthropoid
------• platypelloid
---• Pelvic inlet:
------• sub-pubic arch (should not be narrow)
------• prominence of sacrum (should not be too prominent)
------• symphysis-sacral distance
---• Midpelvis: prominence of spines (should not be too prominent)
---• Pelvic outlet: inter-tuberous distance
8. Extremities: check for edema and varicosities
Ectropion

status measured difficulty not learned 37% [default] 0

First Prenatal Visit Physical Exam
ies: female genital mutilation • Internal Genitalia: ---• Speculum Exam • Inspection: ---• Vagina: ------• Chadwick’s sign (bluish discoloration) ------• vaginitis (yeast is common) ---• Cervix: ------• <span>Ectropion ------• Polyps • Cultures: ---• Chlamydial culture is taken from just inside the external os ---• Gonorrheal culture from os/cervix • Pap: ---• Do not us

#### Flashcard 1410493975820

Tags
#obgyn
Question
First Prenatal Visit Physical Examination
1. General: Vital signs, Weight (calculate BMI)