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OBGYN > APGO Unit 2: Obstetrics > Flashcards

APGO Unit 2: Obstetrics Flashcards

1
Q

Acid-base status during normal pregnancy?

A

Physiologically increased minute ventilation causes compensated respiratory alkalosis

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2
Q

Cause of subjective SOB during pregnancy?

A

Inspiratory capacity increases => increased TV => increased MV + decreased FRC (from belly) => subjective dyspnea

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3
Q

Predisposition of decreased plasma osmolarity?

A

Pulmonary edema

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4
Q

Causes of pulmonary edema in pregnancy?

A

Tocolytic use (additive risk with multiple agents)
Cardiac disease
Fluid overload
Pre-eclampsia

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5
Q

Affects of pregnancy on ureters

A

Common for ureter dilation R>L (2/2 sigmoid colon protecting left)
Right ovarian vein complex is uniquely dilated in pregnancy and overlies the right ureter
High levels of progresterone cause ureteral dilation

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6
Q

Thyroid hormone changes in pregnancy?

A

Increased estrogens => increased TBG => increased TOTAL T3 & T4 => normal FREE T3 & T4

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7
Q

Next step after identifying molar pregnancy?

A

CXR => most common site of metastasis in gestational trophoblastic disease

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8
Q

Heterogeneous cystic tissue (snowstorm pattern) on transvaginal ultrasound?

A

Molar pregnancy

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9
Q

Weight gain guidelines

A

Underweight (BMI 30): 11-20 lbs

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10
Q

Preconception counseling for African Americans with no significant history?

A

Hemoglobin electrophoresis and CBC

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11
Q

Increased disease incidence with Ashkenazi Jewish heritage

A 
Fanconi anemia
Tay-Sachs
Cystic Fibrosis
Niemann-Pick
Canavan disease
Bloom syndrome
Gaucher disease
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12
Q

Defects associated with poorly-controlled DMII at time of conception?

A

Structural abnormalities:
Neural tube defects
Cardiac abnormalities

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13
Q

Uses and non-uses of CVS

A

Uses:
Cystic Fibrosis
Karyotype

Non-uses:
Neural tube defects
Omphalocele

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14
Q

What is sequential screen?

A

First trimester nuchal translucency + PAPP-A
Second trimester quad screen

93% detection rate

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15
Q

What is triple screen?

A

Second trimester:
AFP
B-hCG
uE3 (unconjugated estriol)

69% detection rate

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16
Q

What is quad screen?

A 
Second trimester:
AFP
B-hCG
uE3 (unconjugated estriol)
Inhibin A

81% detection rate

17
Q

Risk of fetal loss associated with CVS?

A

1%

Not related to prior miscarriages

18
Q

Most common form of inherited mental retardation?

A

Fragile X syndrome

Down Syndrome = genetic NOT inherited

19
Q

How to resolve discordant physical exam and menstrual cycle gestational dating?

A

First trimester obstetrical ultrasound

Quantitative B-hCG unreliable

20
Q

Risk factors for gestational diabetes

A

Previous baby > 9 lbs
Hx of abnormal glucose tolerance
Pre-pregnancy weight of >110% of ideal body weight
Ethnic group with higher rate of DMII (e.g. American Indian, Hispanic)

21
Q

Associated risks of gestational diabetes

A 
Shoulder dystocia
Metabolic disturbances
Preeclampsia
Polyhydramnios
Fetal macrosomia
22
Q

Dosing of folic acid during pregnancy

A

High-risk (previous neural tube defect): 4 mg/day

Low-risk: 0.4 mg/day

23
Q

Malformations associated with valproate during pregnancy

A 
Spina bifida
Lumbar meningomyelocele
Cardiac defects
Facial clefts
Hypospadius
Craniosynostosus
Limb defects (radial aplasia)
24
Q

Protein recommendations for pregnancy

A

70 grams/day

25
Q

What drug to give if anticoagulation needed during pregnancy?

A

Heparin
LMWH

Warfarin is teratogenic

26
Q

True labor definition

A

Strong, regular uterine contractions that result in progressive cervical dilation and effacement

27
Q

Braxton-Hicks contractions definition

A

Irregular, low intensity contractions described as lower abdominal or groin pain sometimes associated with nausea

28
Q

What are labor warnings?

A

Contractions every 5 min for 1 hour
ROM
Fetal movement less than 10 per 2 hours
Vaginal bleeding

29
Q

Risks of placing IUPC?

A

Placental separation and uterine perforation

30
Q

What are the different decelerations and their causes?

A

Early decel: Head compression
Late decel: Placental insufficiency
Variable decel: Umbilical cord compression

31
Q

What usually causes sustained fetal bradycardia?

A

Umbilical cord prolapse

32
Q

Management of umbilical cord prolapse

A

Cesarean delivery even if fetal monitoring reassuring

33
Q

Indications for episiotomy?

A

None

OBGYN (5 decks)

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