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MFM BOARDS CW > 2022 Qs > Flashcards

2022 Qs Flashcards

1
Q

Etiology of Hydranencephaly

A

ischemic stroke of both carotid arteries, progressive necrosis of areas affected by infarct

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2
Q

Reason to use VV ECMO?

A

ARDS

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3
Q

Reason to use VA ECMO?

A

Cardiogenic Shock, PE with RV failure

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4
Q

Isotrentinoin fetal effects

A

CNS malformations, microtia or anotia, micrognathia, cleft palate, conotruncal cardiac and great vessel defects, thymic abnormalities, eye malformations, and intellectual disability

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5
Q

Time to wait before conceiving if on isoretinoin?

A

1 month

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6
Q

PEC patient with dyspnea, how do you explain symptoms?

A

low colloid oncotic pressure causing leading to pulmonary edema

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7
Q

which respiratory parameter changes the most?

A

50% increase in TV

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8
Q

What leads to increase plasma volume in pregnancy

A

nitric oxide–mediated vasodilation, which induces the renin-angiotensin-aldosterone system and stimulates sodium and water retention

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9
Q

What pregnancy adaptation leads to shorter half life for medications?

A

increased renal clearance (GFR)

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10
Q

US findings toxo

A

Ventriculomegaly, intracranial calcifications, microcephaly, hepatomegaly, liver calcifications, placentomegaly, growth restriction, or ascites

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11
Q

US findings zika

A

microcephaly, cerebral calcifications, ventriculomegaly, fetal growth restriction, arthrogryposis

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12
Q

Most common cause of ARDS in pregnancy

A

Viral infection/pneumonia

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13
Q

Diagnose NAIT to predict risk in subsequent pregnancy?

A

1Maternal anti platelet antibodies, #2 parental and infant platelet antigen genotype

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14
Q

Hydropic fetus with Parvo IgM+, next step?

A

PUBS with IUT. By the time hydrops is present, HCT likely < 20%

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15
Q

What is the incidence of short cervix in pregnancy in patients with prior preterm birth?

A

About 30%

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16
Q

Nullip with CL 1.5 cm, next step?

A

Vaginal progesterone

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17
Q

US features of arcuate uterus?

A

serosal indentation/ Arcuate distance <1cm angle >90 degrees

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18
Q

US features of bicornuate uterus

A

serosal indentation of >1cm

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19
Q

Decrease the risk of loss of pregnancy with triplet with monochorionic pair?

A

KCL of both MONO chorionic pair. NEXT best? KCL the singleton

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20
Q

Monochorionic twins, demise of one twin at 26 weeks, next step?

A

expectant management until 34 weeks

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21
Q

Unstable patient after CPR with ROSC, vaginal bleeding, next step to direct management?

A

echo (more accurate at measuring pulmonary pressures than PAC! both are estimates)

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22
Q

how does perimortem cesarean improve maternal suvivability

A

Decrease compression of the IVC which improves venous return *

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23
Q

Most effective opioid for patient controlled analgesia in labor

A

Remifentanil

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24
Q

What monitoring necessary for a patient with remifentanil administration

A

Continuous oxygen saturation monitoring (may cause respiratory depression)

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25
Q

Above what level are patients at risk of autonomic dysreflexia?

A

T6

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26
Q

Treatment autonomic dysreflexia during labor (what position)

A

Epidural extending to the level of the 10th thoracic segment, Sit upright (will reduce arterial BP)

27
Q

Risk of chromosomal abnormality with isolated msucular VSD?

A

Not significant, sporadic!

28
Q

Most likely chromosome abnormality with membranous VSD?

A

Likely T21

29
Q

What is the best way to test for maternal CMV infection?

A

PCR (or IgM which could demonstrate recent infection)

30
Q

what is the mechanism of action of methimazole?

A

Blocks production of new thyroid hormone by inhibiting thyroid peroxidase and organification of iodine

31
Q

Molar triploidy most likely associated with???

A

fetal growth restriction

32
Q

likely cause of fetal demise in preeclampsia

A

placenta infarction

33
Q

can microarray detect balanced translocations?

A

no

34
Q

persistent sepsis despite IVF and antibiotics?

A

transfer to ICU!

35
Q

most common complication in Sickle Cell in preg

A

Vasoocclusive event (50%)

36
Q

what hormone is elevated in baby with smith lemli opitz?

A

7-dehydrocholesterol

37
Q

what is the direct precursor to placental estriol synthesis?

A

16 alpha OH- DHEAS

38
Q

most commonly affected part in a etus with treacher collins syndrome?

A

Mandible hypoplastic versus eyes downward slant palpebral fissures

39
Q

characteristic finding of affected infants of congenital varicella

A

IUGR, scarring skin lesions, ocular defects, limb abnomralities (hypoplasia of bone and muscles), CNS ab

40
Q

most common effect of fetal CMV infection

A

SENSORINEURAL HEARING LOSS

41
Q

which anesthetic is cardiotoxic if injected intravascularly during epidural placement

A

BUPIVICAINE! one of the most cardiotoxic local anesthetic agents

42
Q

which anesthetic has the shortest half life?

A

2-chloroprocaine

43
Q

what is the most likely risk from regional anesthesia

A

toxicity from local anesthetic

44
Q

post regional headache

A

traction on pain sensitive structures- intracranial hypotension related to CSF leak may cause sagging of intracranial structures and stretch of sensory intracranial nerves, causing paina nd cn palsies

45
Q

Major side effect of volatile anesthetics (halothane)

A

fulminant hepatic necrosis

46
Q

AIDS: when PCP prophylaxis and what agent

A

CD4< 200, Bactrim DS

47
Q

AIDS: When Histoplasmosis prophylaxis, what agent?

A

CD4 < 150, itraconazole

48
Q

AIDS: when MAC prophylaxis and what agent

A

CD4 < 50, Azithromycin weekly (or clarithro)

49
Q

AIDS- when toxo prophylaxis and what agent

A

IgG positive, CD4 < 100, Bactrim

50
Q

acute HIV treatment

A

Dolutegravir plus tenofovir or tenofovir with emtricitabine

51
Q

Treatment of lyme disease in pregnancy

A

Oral amoxicillin TID x 2-3 weeks. If encephalitis: ceftriaxone 2g IV qD 14-28 days

52
Q

Treatment of Toxoplasmosis

A

< 18 weeks: Spiramycin, >18 weeks pyrimethamine, sulfadiazine, leucovorin. Check PCR of AF

53
Q

Critical Titer?

A

16

54
Q

high insulin in umbilical cord is associated with?/

A

MACROSOMIA

55
Q

acute cord occlusion what are the gasses?

A

wide difference between venous and arterial values usually associated with normal or near normal gasses

56
Q

most likely explanation for inconclusive cffdna

A

low fetal fraction

57
Q

limitation of cfDNA in low risk population

A

low PPV

58
Q

why use cfDNA instead of integrated screen

A

increased sensitivity for T21

59
Q

how to diagnosis TAPS?

A

MCA Dopplers

60
Q

Best prediction of prognosis in TRAP?

A

Ratio of weight of perfused twin to weight of pump twin: 30% chance of cardiac failure when ratio is greater than 0.7, compared with 10% when less than 0.7

61
Q

first trimester radiation exposure associated with?

A

Increased risk of microcephaly/ID/growth deficiency (between 10-17 wks)

62
Q

200 mGy exposure at or after 8 weeks gestation, associated with….

A

microcephaly, severe ID

63
Q

200 mGy exposure 2-8 weeks after fert (during organogenesis)

A

congenital anomalies (skeleton, eyes, genitals),FGR

MFM BOARDS CW (7 decks)

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