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JFNG > 2018 - Final XLS in CSV form - Sheet1 > Flashcards

2018 - Final XLS in CSV form - Sheet1 Flashcards

1
Q

Which cardiac disease is associated with the highest mortality?

A

Pulmonary HTN with VSD and Eisenmengers (Right to Left Shunt)

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2
Q

Which 8 cardiac lesions are considered the highest risk in pregnancy?

A

(1) Pulmonary artery hypertension
(2) Previous peripartum cardiomyopathy with any residual impairment
(3) Severe Left Venricle Dysfunction (EF<30%)
(4) Severe MS
(5) Severe symptomatic AS
(6) Marfan (Aortic Root >45mm)
(7) Aorta > 50mm in bicuspid valve aortopathy
(8) Native Severe Coarctation

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3
Q

In a patient with T2DM and an elevated HbA1c, what is the most common finding on US?

A

Normal Ultrasound

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4
Q

What is the most common complication of Chorioangioma?

A

Polyhydramnios

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5
Q

Most common complication after narcotic anesthesia?

A

Pruritus

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6
Q

What is a sentinel event?

A

unanticipated event in a healthcare setting resulting in death or serious physical or psychological injury to a patient or patients, not related to the natural course of the patient’s illness.

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7
Q

Fish highest in mercury content?

A

King Mackerel (Shark, Swordfish, Tilefish, Ahi Tuna also)

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8
Q

What can explain a discrepancy between amniocentesis results and CVS results?

A

Confined placental mosaicism

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9
Q

Pt. had a CVS w/ Mosaic result, what can explain the birth of a normal baby?

A

Confined placental mosaicism

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10
Q

What is the best way to decrease complications of shoulder dystocia?

A

Send staff for training, simulation

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11
Q

Best way to prevent a retained sponge after a vaginal delivery?

A

Debriefing (via sponge count)

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12
Q

39 week patient with a DVT, management?

A

Therapeutic Heparin

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13
Q

A man of normal height has 3 dwarf children with 3 different mothers, explanation?

A

Gonadal Moasaicism

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14
Q

What is the most common feature of turners syndrome?

A

Short stature

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15
Q

What is a premutation of fragile X (how many repeats)?

A

Between 55-200 (premutation)

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16
Q

What is anticipation? Give an example?

A

Genetic condition passed on to next generation where symptoms worsen and come on early in the next generation, trinucleotide repeats (Huntingtons, Fragile X)

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17
Q

What genetic principle explains a mom with tuberous sclerosus who has a child with heart problems, neurological lesion?

A

Variable Expressivity

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18
Q

In patients with Aortic Stenosis, what changes after epidural can be problematic? How do you avoid this?

A

Decreased SVR -> Decreased Coronary Artery Perfusion –> MI. Avoid via slow epidural, narcotics only

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19
Q

Chorioangioma – most likely complication?

A

Polyhydramnios in 60% vs FGR in 20%

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20
Q

Uncorrected ASD, increases the risk of?

A

Stroke (increased risk of emboli from arrhythmias)

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21
Q

Discrepancy between cfDNA and fetal Karyotype, what can cause this?

A

Confined placental mosaicism

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22
Q

Most likely ultrasound finding in a patient baby with Myotonic Dystrophy?

A

Polyhydramnios

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23
Q

In Mono-Di twins, at what day does cleavage occur?

A

4-8 days

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24
Q

Most common mutation in Osteogenesis Imperfecta?

A

ColA1,2

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25
Q

When in pregnancy is the Cardiac output at its highest?

A

Immediately after delivery (autotransfusion of blood = 50% increase in CO)

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26
Q

Benefit of a SNP Array over CGH Array?

A

SNP Array can detect Triploidy

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27
Q

What is Alpha Error?

A

Type 1 error (False Positive, failing to reject the null hypothesis when you should have)

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28
Q

Which ethical concept is informed consent most closely tied to?

A

Autonomy

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29
Q

Which rash is associated with the worst neonatal / fetal complications?

A

Pemphigus Gestationalis (prematurity, SGA)

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30
Q

Which genetic condition should you consider in a Fetus with Increased Nuchal Translucency, but normal karyotype?

A

Noonan syndrome (10% of euploid with increased NT)

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31
Q

Patient with Preeclampsia with ruptured liver capsule, management?

A
  • Correct Coagulopathies (likely DIC),
    • For surgical management Pack and drain
    • Improve surival with Hepatic Artery Embolization
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32
Q

Most common cause of non-hereditary deafness?

A

CMV (but remember 85% of congenital CMV are asymptomatic)

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33
Q

Which Heart finding is most specific for DiGeorge Syndrome?

A

Interrupted Aorta (They said is Correct- not sure bout that), Tetralogy of Fallot (26%), Interrupted Aortic Arch (10%), Pulmonary Atresia wit VSD (24%), VSD (19%) - I think what they meant was if you have Interrupted Aortic Arch you are at 50-89% likely to have DiGeorge, but overall it is rare

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34
Q

What is the heart ultrasound finding most commonly associated with DiGeorge?

A

Interrupted Aortic Arch

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35
Q

What bacteria is associated with Alkaline Urine UTI’s?

A

Proteus Mirabilis

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36
Q

At what gestational age woud you deliver a patient with a subchorionic hemorrhage?

A

At term

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37
Q

What is the most likely US finding for a fetus if mom has an HbA1c of >10%.

A

Normal (only 10-20% increased risk of anomaly, so the majority will be normal)

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38
Q

Patient with recurrent cholelithiasis, management?

A

Lap Cholecystectomy

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39
Q

Simulation training has helped improve outcomes most in?

A

Brachial Plexus Injury (reduction by 60-90%)

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40
Q

What is the ethical principal which states that action is done for the benefit of others?

A

Beneficence

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41
Q

What is the ethical principal which states a physician must refrain from providing ineffective treatments or acting with malice toward patients

A

Non-maleficence

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42
Q

When are the periods with the highest risk of developing a hemorrhagic stroke in pregnancy?

A

Highest during the delivery period and up to 2 weeks postpartum

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43
Q

At what CD4 Count are you at risk of pneumocystic pneumonia?

A

<200

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44
Q

Most likely fetal outcome of radiation exposure in the first trimester?

A

Microcephaly - (also growth restriction and intellectual disability)

45
Q

Preeclampsia - most common finding on pathology of placenta?

A

Parenchymal infarction

46
Q

What is the management for a patient with Preterm Contractions but is closed?

A

Prolonged observation

47
Q

What added step should you do in a cesarean section of a Morbidly obese patient?

A

Closed Subcutaneous layer

48
Q

Obese patient comes to you with complaint sof fatigue and forgetfulness, what test should you order?

A

Sleep Study

49
Q

Patient presents with IUFD, severe iugr + omphalocele, + large kidneys, what lab should you send?

A

Karyotype and Microarray

50
Q

What is fastest onset anesthetic medication?

A

Lidocaine : 1-2 mins

51
Q

Greatest finding of the MOMS trial?

A

Trial stopped early because of efficacy. Need for shunt placement during first year of life was lower in fetal surgery group (40% vs 82%). Ambulation fetal (45%) vs postnatal repair (24%)

52
Q

What is the most common complication in pregnancy of women with Acromegaly?

A

Gestational Diabetes

53
Q

In a mother that is Rh sensitized but has a low titer, what is the next step in management?

A

Continue to follow titers

54
Q

Anemia, Thrombocytopenia and Renal Failure, Diagnosis?

A

HUS

55
Q

Anemia, Thrombocytopenia, Renal Failure, Neurologic Abnormalities, and Fever

A

TTP

56
Q

How much of the screen should a cervix take up for a cervical length?

A

3/4 of screen

57
Q

Newborn with nose hypoplasia, stippled epiphyses, and limb hypoplasia, dx?

A

Warfarin embryopathy

58
Q

Standard Error is interchangeable with Standard Deviation?

A

YES. Standard error is the estimation of the standard deviation

59
Q

Cord Blood Gases – You have table, what is it?

A

Respiratory, metabolic, mixed?

60
Q

pCO269, HCO3 20, BE -2

A

Respiratory

61
Q

Which headache gets worse with sitting standing and better with laying flat?

A

Spinal Headache

62
Q

Patient presents postpartum with fever, renal failure, anemia. Dx? Tx?

A

TTP, Plasmapheresis

63
Q

What do you use to Differentiate TTP and HELLP

A

Fever

64
Q

Mechanism of Progesterone IUD?

A

Cervical Mucous(most correct). Anovulation. Affecting Sperm Motility, preventing implantation

65
Q

Most common complication of SSRI used in pregnancy used in a neonate?

A

Neonatal Abstinence

66
Q

What statistical test do you use for evaluation of proportions?

A

Chi Square

67
Q

What test do you use for evaluation of Means?

A

t-test

68
Q

Pregnant patient with ab pain and bloody stool?

A

Stool culture

69
Q

Delayed cord clamping improves which outcome in preterm infants? What about in term infants?

A

Preterm: Decreased: Necrotizing Enterocolitis, IVH, need for transfusion
Term: Increased Hb and Iron stores

70
Q

At what gestational age is Warfarin exposure at greatest risk for causing warfarin embryopathy?

A

6-9 weeks

71
Q

What are the features of Warfarin Embryopathy?

A 
SLIMNECk
 Stippled Epiphysis
 Limb Defects
 IUGR
 MR
 Nasal Hypoplasia
 Eye Defects
 CNS
 k - Vit K Antagonist Warfarin
72
Q

Twins, when do you not do a CVS?

A

With Alloimmunication

73
Q

Patient has nose bleeds with a platelet count of 20,000, treatment? When do you treat thrombocytopenia?

A

Steroids, plt<30,000 or if symptomatic, or consider Transfusion if preparing for surgery.

74
Q

A pt. has Epistaxis, Telangiectasia. Diagnosis? Mode of inheritance?

A

Ossler Webber Rondu (AD)

75
Q

Which medication needs adjustment for Increased GFR?

A

Digoxin

76
Q

What is an early sign of TTTS?

A

NT and CRL discordance

77
Q

Baby has an amniotic band, do you remove them?

A

Yes if it is wrapped around a limb and there is some sort of blood flow disruption in post band vs. pre band.

78
Q

Duodenal Atresia in baby with Polyhydramnios. How does the amniotic fluid get absorbed if the baby has an obstruction?

A

Intramembranous absorption

79
Q

Which Prostaglandin causes muscle relaxation?

A

Prostacyclin (PGI2)

80
Q

Which enzyme that the fetus lacks does the placenta have and what is its function?

A

3 Beta - Hydroxysteroid Dehydrogenase

It converts Pregnenalone to Progesterone which is the primary source of progesterone.

81
Q

What is the main source of PGI2 in pregnancy?

A

The Myometrium

82
Q

Which statistic test is used to differentiate between dependent and independent variables?

A

Logistic Regression

83
Q

3+ groups which statistical test?

A

ANOVA

84
Q

Evaluate the effect of Smoking on Lung Cancer, what type of study?

A

Case Control

85
Q

Type I CPAM with Hydrops, what is the treatment?

A

Shunt for Drainage of Cyst

86
Q

How do you treat a patient with Pulmonary hypertension, and you want to give general anesthesia.

A

Viagra

87
Q

Most common complication with general anesthesia?

A

Failed Intubation

88
Q

What enzyme is deficient in Canavans?

A

Aspartoacylase

89
Q

What enzyme is deficient in Tay Sachs?

A

Hexosaminidase A

90
Q

What enzym is deficient in Gaucher?

A

Glucocerebrosidase

91
Q

What enzyme is deficient in Niemann Pick?

A

Sphingomyelinase

92
Q

What are the last 3 phases of lung development? At wat weeks do they occur?

A

Cannalicular - 16-26
Saccular - 26- 36
Alveolar - 36+

93
Q

At which phase do type 2 pneumocytes appear?

A

Cannalicular

94
Q

Least likely to be transmitted in banked breast milk?

A

Syphilis

95
Q

Which Aneuploidy is most common with CDH?

A

T18

96
Q

Balanced translocation 14:21, what are the possible outcomes of baby?

A

1) 21,14 (normal)
2) 21:14 (balanced translocation like mom)
3) 21:14 (translocation + normal 21 (tri 21)
4) 21:14 (translocation + normal 14 (tri 14 - SAB)
5) Monosomy 14 (Sab)
6) Monosomy 21 (Sab)

97
Q

If the father has a balanced translocation how does that change the risk to child compared to a mother?

A

Decreased risk with father (<5%) compared to mother (1/6)

98
Q

Early Varicella Infection, whats the most common finding of baby?

A

Skin Scars

99
Q

Fetus with intraabdominal Calcifications, Hepatosplenomegaly, Differential Diagnosis?

A

CMV/Toxo

100
Q

Prerenal Azotemia with Preeclampsia,what lab is suggestive of this?

A

Urine osmolality >450

101
Q

Most common complication of IUD in pregnancy?

A

Abortion

102
Q

Most common Uterine Anomaly with Pregnancy loss?

A

Septate Uterus

103
Q

At 30 seconds of resuscitation of a neonate, the HR is still low, Next step?

A

PPV

104
Q

Kid got narcotic, what is the first sign of acidosis in tracing?

A

Loss of variability

105
Q

Which part of the BPP is most closely correlated with Acidosis?

A

Loss of tone

106
Q

Baby delivered and tried to resuscitate, Post ductal O2: 70%, Preductal 90%, likely diagnosis?

A

Persistent fetal circulation

107
Q

What enzyme is deficient in Smith Lemli Optiz?

A

Dehydrocholesterol Reductase (DHCR7)

108
Q

What medications can decrease the effectiveness of OCP’s

A

Phenytoin, Carbamezapine, Rifampin

109
Q

Characteristic of Med to freely pass into breast milk?

A

Non protein bound, Lipid soluble, Non-ionized, Low molecular weight
(All the same things for crossing placenta)

JFNG (9 decks)

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