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JFNG > 2016 - Final XLS in CSV form - Sheet1 > Flashcards

2016 - Final XLS in CSV form - Sheet1 Flashcards

1
Q

The most accurate description of Standard error is?

A

The same as standard deviation

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2
Q

What are the last 5 phases of lung development? At what weeks do they occur?

A 
Embryonic -3 - 7
 Pseudoglandular - 5-17
 Canalicular - 16-26
 Saccular - 26- 36
 Alveolar - 36+
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3
Q

At which phase do type 2 pneumocytes appear?

A

Canalicular

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4
Q

What pregnancy complications are associated with Multiple Sclerosis?

A

Increased risk of Growth restriction (and of C/section, but less than IUGR)

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5
Q

The most common symptom of appendicitis in pregnancy is?

A

Abdominal pain

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6
Q

periventricular leukomalacia is most commonly associated with what pregnancy complication?
Why does it happen?

A

Intra-amniotic Infection/Chorioamnionitis

Proinflammatory cytokines damage the white matter of the brain

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7
Q

Histologic Chorioamnionitis without clinical signs of infection is associated with what neonatal complications?

A

Interventricular hemorrhage, periventricular leukomalacia and Cerebral palsy

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8
Q

Treatment for toxoplasma in pregnant women?

A

Spiramycin

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9
Q

Common findings in congenital toxoplasmosis?

A

Chorioretinitis, hepatosplenomegaly, periventricular calfications, ventriculomegaly, disseminated purpuric rash

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10
Q

If a parent has a robertsonian translocation 45XXder(14:21)(10q:10q) What is the chance that offspring will have phenotype of T21?

A

1/6 chance that baby is T21, but 3/6 of babies will be miscarriage so depends on if question asks about liveborn or just whether they’ll have trisomy 21. (Because 1/3 of the live births will be T21, but 1 in 6 possible outcomes of which 3 are miscarriage)

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11
Q

Baby delivered at 35 weeks. 30 minutes after delivery, develops severe respiratory distress. Preductal O2sat = 70%. Postductal O2sat = 90%. CXR normal. Diagnosis?

A

Postductal > Preductal, think TGA

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12
Q

Genetic diagnosis most associated with a mom that has preeclampsia?

A

Trisomy 13

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13
Q

Nuchal translucency is 5.4mm. Next best step?

A

CVS (genetic testing)

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14
Q

Which procedure has the greatest risk of alloimmunziation?

Amnio, CVS or Cordocentesis?

A

Cordocentesis (close to 40%)

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15
Q

What clinical scenario should cause you to test for Antiphospholipid Antibodies?

A

Any of the following:

(a) 1+ episode of vascular thrombosis
(b) 1+ death of morphologically normal fetus at 10+ weeks
(c) 1+ birth before 34 weeks due to preeclampsia/eclampsia or features associated with placental insufficiency
(d) 3+ unexplained pregnancy losses before 10 weeks (after maternal/paternal genetic and anatomic/hormonal causes excluded)

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16
Q

18 weeks pregnant with Non-Hodgkins Lymphoma, best treatment?

A

Combination Chemotherapy

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17
Q

What enzyme is associated with Hydantoin syndrome?

A

Epoxide Hydrolase. Teratogenicity of several anticonvulsant medications is associated with elevated level of oxidative metabolites normally eliminated by epoxide hydrolase

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18
Q

Management of Acute Fatty Liver of Pregnancy?

A

Delivery despite gestational age

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19
Q

Most specific finding to distinguish TTP from HELLP

A

LDH to AST ratio (elevated in TTP)

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20
Q

Patient meets clinical criteria for antiphospholipid syndrome. Recommended testing?

A

Lupus Anticoagulant (Kaolin, Dilute russelll venom viper test, B2 Glycoprotein, Anti Cardiolipin Antibody

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21
Q

Omphalocele is associated with which genetic syndrome?

Beckwith wiedemann, kartagener, meckel gruber?

A

Beckwith Wiedemann

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22
Q

Most likely cause of a nonreative tracing in a term fetus

A

Sleep cycle

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23
Q

What is the positive predictive value of an NST for cerebral palsy?

A

<1%

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24
Q

A woman with a prolactinoma wants to breast feed, you advise?

A

Okay for microadenoma prolactinoma to breast feed

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25
Q

Amino acids cross the placenta via what type of movement?

A

Active Transport

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26
Q

Best outcome following in utero repair of myelomeningocele is seen with?

A

Lower limb muscle strength

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27
Q

Which is most associated with aneuploidy:

a. Thickened nuchal fold
b. Short humerus
c. Echogenic bowel
d. EIF

A

Thickened Nuchal Fold

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28
Q

Most likely finding of fetus in mom with hyperparathyroidism:

A

Neonatal Hypocalcemia

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29
Q

20 yo Asian woman with low MCV, HgbA2 2.4%. Most likely cause:

A

Alpha Thalassemia

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30
Q

Woman with MCV of 62, normal ferritin, HgbA2 4.2%. Most likely cause:

A

Beta Thalassemia

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31
Q

What mechanism does cAMP work in B-mimmetic?

A

↑ intracellular cAMP-> activates PKA -> Phosphorylates myosin light chain
Kinase (Which inactivates it) -> ↓ intracellular calcium and Muscle Relaxation

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32
Q

What is the origin of cell free dna?

A

apoptosis of placental cells (syncytiotrophoblast)

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33
Q

Best contraceptive option for patient with Hepatitis C and liver disease

A

Copper IUD

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34
Q

Which medication is the best anticoagulant to prevent clot in pregnancy:

A

Lovenox

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35
Q

Treatment for malignant hyperthermia?

A

Dantrolene

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36
Q

The benefit of doing a multivariate analysis in a cohort study is?

A

Decrease confounding

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37
Q

Patient Is 8 weeks pregnant with an IUD in place, strings are visible. You should?

A

Pull string

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38
Q

Fetus at 28 weeks with CCAM type I lesion and hydrops. Management?

A

Thoracoamniotic shunt

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39
Q

Fetus with posterior urethral valves, what findings signify renal impairment?

A

Increases in Ca, Cl, Na, Microglobulin or OsmolaRity

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40
Q

Which cardiac lesion is most specific with T21?

A

AV Canal defect

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41
Q

Maternal death is most associated with?

A

Cardiac Disease

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42
Q

Most likely complication for patients with aortic stenosis in the peripartum period?

A

Arrhythmias

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43
Q

Newborn with Thrombocytopenia and Interventricular Hemorrhage, likely Diagnosis?

A

Alloimmune thrombocytopenia

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44
Q

What does not get absorbed in patient with Roux-En-Y bypass vs. gastric banding?

A

B12 Deficiency

45
Q

What is the most likely cause for an LGA Fetus?

A

Maternal Obesity

46
Q

Mom with uncontrolled hyperthyroidism causes what risk to fetus?

A 
#1: Preeclampsia
 #2: Growth Restriction
 #3: Preterm delivery
47
Q

What would make a medication most likely to cross in to breast milk?

A

Lipid Solube, Not bound to protein, non ionized, small/low molecular weight

48
Q

Which bacterial enzyme is most associated with preterm birth?

A

Phospholipase a2

49
Q

Increased Fluid is most beneficial for what lesion?

A

Aortic Stenosis

50
Q

Most common presentation of Turners syndrome?

A

Short Stature

51
Q

A couple wants to know the likelihood of their baby being affected with PKU. The father has PKU (disorder frequency 1/10,000). What is the likelihood the mother is a carrier?

52
Q 
Pregnancy after endometrial ablation is associated with what outcome most frequently?
 S Ab
 PTD
 Malpresentation
 Placenta Accreta
A

Malpresentation (39%)
Morbidly adherent placenta (26%)
PTD (20%)
Sab (12%)

53
Q

How do you test for familial dysautonomia?

A

DNA analysis

54
Q

What is the disease characterized by a deficiency in aspartoacylase?

55
Q

What antihypertensive medication increases cardiac output?

A

Hydralazine

56
Q

What is the most likely outcome with AS?

a. Arrhythmia
b. Stroke
c. MI
d. Heart failure
e. Maternal death

A 
Heart Failure (7-17%)
 Arrhythmia (3-33%)
57
Q

Which of the following valve lesions as the highest risk of mortality for the mother?
AS, AR, MS, MR?

A

Mitral Stenosis

58
Q

Difference in allele inheritance based on maternal and paternal genes best describes:

A

Imprinting

59
Q

Recurrent achondroplasia in a couple who are not affected are most likely associated with:

A

Germline Mutation AKA Gonadal Mosaicism

60
Q

How is Fragile X inherited?

A

X linked dominant

61
Q

SSA and SSB antibodies are most associated with?

A

Neonatal Lupus (25%), Heart block ( 1-3%), Normal pregnancy most likely

62
Q

What should the work up of a woman with a Spontaneous Abortion at 12 weeks include?

A

Antiphospholipid Antibodies

63
Q

What is the most likely to have a low estriol?

a. IUFD
b. Trisomy 21
c. Placental sulfatase deficiency

A

Placental Sulfatase Deficiency

64
Q

Which statistical test will account for survival accounting for multiple variables?

A

Cox Regression

65
Q

What do you use to compare two means that are normally distributed that are continuous:

66
Q

When does cardiac output increase the most?

A

Immediately postpartum

67
Q

Mitral stenosis worsens with?

A

Increased Preload

68
Q

The fetal organ that receives the highest proportion of cardiac output:

69
Q

The PO2 is lowest in which vessel?

UmbA, Umb V, Uter A , Uter V

A

Umbilical Artery

70
Q

Who is the best candidate for an IUD?

a. Uterine anomaly
b. Benign ovarian tumors
c. AIDS
d. Active chlamydia

71
Q

Hypospadias and congenital anomalies are increased with what REI?

A

IVF with ICSI

72
Q

Which antiseizure drug has the highest risk of NTD?

A

Valproic acid 1-2%

73
Q

What is the primary source of precursor estrogen synthesis in the placenta?

A

C19 Precursor DHEAS from the Fetal Adrenal (Fetal Zone)

74
Q

Which HIV medication is worst for liver toxicity?

A

Nevirapine (most), Ritonavir/lopinavir (if its not there)

75
Q

A patient is newly diagnosed with HIV not previously on any medication. What is the best way to prevent HIV transmission?

A

AZT (zidovudine)

76
Q

Which Interleukin is Anti-inflammatory

77
Q

What increases the risk of preterm birth

a. IL-6 maternal serum
b. IL-6 amniotic fluid
c. IL-10 maternal serum
d. IL-10 amniotic fluid

A

Amniotic Fluid IL6

78
Q

Foot drop is associated with what nerve injury:

79
Q

What is a contraindication to breast feeding?

a. CMV
b. HCV
c. HBV
d. Genital HSV
e. Active TB

A

Active untreated TB, or HSV on breast (not genitals), HIV

80
Q

Which characteristic will increase passage into milk during lactogenesis

A

Lipid Soluble, Non Protein Bound, Non Ionized, Low Weight will increase passage into milk during lactogenesis.

81
Q

Baby delivered at 35 weeks. 30 minutes after delivery, develops severe respiratory distress. Preductal O2sat = 90%. Postductal O2sat = 70%. CXR normal. Diagnosis?

A

PPHN, Persisent fetal circulation

82
Q

Treatment of NAIT should be? At what gestational age?

A

IVIG, starting at 12 weeks

83
Q

What is the most appropriate US surveillance for MCDA twins?

A

US every other week at 16 weeks

84
Q

What is the most likely outcome with demise of one twin in a MCDA pair?

A

Neurologic Sequelae in the surviving twin (15-25%)

85
Q

Which elevated value is the most predictive for poor kidney function?

a. Osmolality
b. Na
c. Chloride
d. B2-microglobulin

A

All are predictive if elevated

86
Q

What is the likelihood of poor neurological outcome after the death of one twin in a MCDA twin?

87
Q

A women has preeclampsia and oliguria. What is indicative of pre-renal process?

88
Q

What happens to beta cells in pregnancy?

A

Beta cell islet hypertrophy

89
Q

What are the findings of Neonatal Myasthenia Gravis?

A

Poor cry, decreased muscle tone, respiratory muscle weakness

90
Q

What is the follow-up for 6 mm bilateral pyelectasis and normal karyotype?

A

Repeat at 32 weeks

91
Q

Most likely genetic cause of early IUGR?

A

<26 weeks think Triploidy

> 26 weeks think T18

92
Q

What is the most likely outcome for patient on dialysis?

A

Preterm Delivery (50-80%)
Polyhydramnios (40%)
Anemia (100%)
Hypertension (100%)

93
Q

The difference between quality and safety is:

A

Quality measures efficient effective care that gets the right job done at the right cost (doing things well), safety is preventing harm

94
Q

Mother refuses a CS for fetal decelerations remote from delivery, what do you do?

A

Continue to manage her do not do cesarean against her will

95
Q

Your primary ethical responsibilities to the patient are:

A

Beneficence and autonomy (more so than nonmaleficence)

96
Q

A physician practices evidence-based medicine. This represents

97
Q

When should you get the flu vaccine in pregnancy?

A

As early as possible

98
Q

Highest risk of Preterm birth is in what uterine anomaly? What about miscarriages?

A

PTD: Bicornuate uterus 60-70%

Sab: Septate

99
Q

Who is microarray most appropriate for?

a. Abnormal integrated screen
b. VSD
c. Partner with Robertsonian translocation
d. CPC

A

VSD
microarray analysis helpful to reveal more than karyotype in
6.0% with a structural anomaly and
1.7% of AMA or positive serum screen

100
Q

Hyperparathyroidism is most associated with:

a. Neonatal hypocalcemia
b. IUGR
c. PTL
d. SAB

A

50% risk of neonatal hypocalcemia (over production of calcium suppresses babies PTH and then when delivered he cant raise Ca2+ levels once he loses the moms calcium)
~10 % SAB rate

101
Q

Patient with uncontrolled hyperthyroidism most likely to present with:

A 
#1: Preeclampsia
 #2: Growth Restriction
 #3: Preterm delivery
102
Q

Betamethasone is metabolized in the placenta by:

A

11β-hydroxysteroid dehydrogenase type 2

103
Q

Placenta degrades _____ the most:

a. Betamethasone
b. Prednisone
c. Insulin
d. Heparin

A

Prednisone

104
Q

What hormone decreases after delivery to allow for lactation?

105
Q

What increases alveolirization in the lungs?

A

Thyroxine or Vitamin A

106
Q

Club foot after oligo is the best example of a:

Malformation, Deformation, Disruption?

A

Deformation

107
Q

What is the highest complication associated for 10 rads exposure at 15 weeks?

A

prior to 2 weeks: sab (all or none)
2-8 weeks: growth restriction/anomalies
8-15weeks: Intellectual Disability

108
Q

Diabetic nephropathy most common pregnancy complications?

A

Preeclampsia (53%)
Preterm delivery (51%)
IUGR (11%)

JFNG (9 decks)

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