4

Question 1

whats considered post partum hemorrahge

Answer 1

500 cc in vag birth

1000 cc in c sect

Question 2

protocol for post partum hemorrhage

Answer 2

1. uterine massage
2. meds: pitocin
3. balloon tamponade
4. surgery: 1-uterine artery ligation, 2-internal iliac artery ligation, 3-hysterectomy

Question 3

when do we use methotrexate for ectopic pregnancy?

Answer 3

bHCG<5000
less than 3 cm
no fetal heart tones

Question 4

what do we normally use for ectopic?

Answer 4

salpingostomy if no rupture

salpingectomy if rupture

Question 5

uterine perforation signs/symptoms

Answer 5

history: two days after D and C

fever, lower abdominal pain, nausea, scant bleeding (as opposed to retained products of conception where itd be profuse bleeding)

Question 6

most common abnormal karyotype

Answer 6

autosomal trisomies

Question 7

systemic diseases associated with early pregnancy loss

Answer 7

diabetes
chronic renal disease
lupus (antiphosphlipid)
thyroid diseases

Question 8

if anemic and having miscarriage, what should you do?

Answer 8

D and C

Question 9

patients at moderate risk for glucose intolerance tested when?

Answer 9

24-28 weeks with 50 g gluc challenge test

Question 10

should you delay BV treatment in pregnancy?

Answer 10

no

Question 11

risk of pregnant mother with pulm HTN

Answer 11

maternal mortality 25-50%

Question 12

what med for pregnant woman with mitral valve prolapse with chest pain and palpitations

Answer 12

beta blockers

Question 13

major complication of obese pregnant woman

Answer 13

hypertension

Question 14

severe lupus best treated with what in pregnancy

Answer 14

corticosteroids

Question 15

which antidepressant is contraindicated in pregnancy

Answer 15

paroextine

Question 16

which med treats intrahepatic cholestasis of pregnancy

Answer 16

ursodeoxycholic acid

Question 17

how do you diagnose suspected appendicits in pregnant woman?

Answer 17

graded compression US

Question 18

signs/symptoms of magnesium toxicity

Answer 18

muscle weakness
loss of deep muscle tendon reflexes
respiratory depression
nausea

Question 19

what should you give in case of mag tox?

Answer 19

calcium gluconate to restore resp function

Question 20

therapeutic mag level

Answer 20

4-7

Question 21

what factors makes you deliver a woman with severe preclampsia rather than expectant management pre 32 weeks?

Answer 21

platelets below 100,000
AST/ALT x2
inability to control bp despite 2 meds
nonreassuring fetal surveillance
persistent CNS symptoms
oliguria
eclampsia

Question 22

what is risk of isoimmunization if woman decides not to use rhogam after first pregnancy

Answer 22

less than 20%

Question 23

which tests detects severe fetal anemia

Answer 23

middle cerebral artery peak systolic velocity using doppler US

Question 24

fetal signs of Rh disease

Answer 24

fetal hydrops- pericardial effusion, pleural fluid, ascites, scalp edema
polyhydramnios, HSM, placental enlargment

Question 25

how many ccs of fetal blood is neutralized by 300 micrograms of Rhogam?

Answer 25

30 ccs

Question 26

when is rhogam given

Answer 26

• 28 weeks
• within 72 hours of delivery
• following abortion
• following antepartum hemorrhage
• following amniocentesis or chorionic villous sampling

Question 27

treat fetus with Rh disease

Answer 27

if preterm, intrauterine intravascular transfusion