APGO UWise Questions

Question 1

In addition to not getting stronger, Braxton-Hicks contraction are also ______________.

Answer 1

irregular; true labor presents with regular contractions

Question 2

When would you not swab a pregnant woman for GBS?

Answer 2

If she has had a prior pregnancy in which the child developed sepsis from GBS, then you treat with penicillin during labor (with the assumption that she still has it unless she was treated).

Question 3

The nitrazine test can indicate _____________.

Answer 3

leakage of amniotic fluid (if that is unclear from the history and physical)

Question 4

You might want to recheck the FHR if _______________.

Answer 4

one method shows it to be the same as the mother’s

Question 5

If a significant amount of blood comes out after inserting an intrauterine pressure catheter, then what should you do?

Answer 5

Bleeding with an IUPC could indicate placental abruption. In this case, remove the IUPC and check the FHR. If it’s reassuring (i.e., doesn’t show late decelerations), reinsert the IUPC.

Question 6

List the symptoms of magnesium toxicity.

Answer 6

• Respiratory depression
• Muscle weakness
• Loss of DTRs

Question 7

How do you treat magnesium toxicity?

Answer 7

Calcium gluconate

Question 8

Chronic hypertension, prior cases of preeclampsia, diabetes, and ______________ all increase risk of preeclampsia.

Answer 8

multifetal gestation

Question 9

What are some indications for early delivery in preeclampsia?

Answer 9

• Inability to control HTN on two meds
• Platelets less than 100,000
• Non-reassuring FHTs
• LFTs more than two times normal

Question 10

Fetal anemia presents with what FHR pattern?

Answer 10

• Sinusoidal rhythm

- Tachycardia

Question 11

For patients with preeclampsia in the severe BP range, what diastolic BP should you aim for?

Answer 11

90-100

Question 12

In type 1 diabetics, _____________ is the most common complication.

Answer 12

fetal growth restriction

Question 13

For patients with a strong predisposition to GD (like FMH and obesity), begin screening with GTT at _________________.

Answer 13

the first visit

Question 14

Which disorder has the highest rate of mortality in pregnancy?

Answer 14

Pulmonary hypertension

Question 15

IUPCs can help determine if _____________.

Answer 15

contractions are adequate; for instance, if a woman seems to be having strong contractions every four minutes but her cervical exam is unchanged after several hours, then her contractions might be inadequate

Question 16

If a woman has occasional late decelerations, the first thing you should do is ______________.

Answer 16

have her lie on her left side; the increased preload can improve fetal hypoperfusion

Question 17

Why is there sometimes hydronephrosis in the right kidney during pregnancy?

Answer 17

The dilation of the uterus and ovarian vein compress the ureter. The left side is cushioned by the sigmoid colon.

Question 18

The risk of cerebral palsy in twin pregnancies is __________.

Answer 18

6-7 times higher

Question 19

____-zygotic twins are at increased risk of congenital anomalies.

Answer 19

Mono

The dividing chromosomes correlate with chromosomal abnormalities.

Question 20

What characteristic of early pregnancy in twin pregnancies has been shown to have decreased risk of preterm delivery?

Answer 20

Adequate weight gain in the first 20 weeks

Question 21

True or false: the recipient twin in TTTS is macrosomic.

Answer 21

False.

Although the recipient twin becomes larger, it is called plethoric – not macrosomic.

Question 22

Twins are named such that twin A is ___________.

Answer 22

closer to the cervix

Question 23

The most common cause of PPH is __________.

Answer 23

uterine atony (1/20 deliveries!)

Question 24

The rate of endometritis is ___________ in cesarian deliveries compared to vaginal.

Answer 24

10-times higher

Question 25

_______ is the most common cause of postpartum fever.

Answer 25

Endometritis

Question 26

Endometritis is most often caused by what kinds of organisms (not the specific species, but rather the classifications)?

Answer 26

Aerobic and anaerobic

Question 27

Other than suicidality, what symptom can help differentiate postpartum blues from depression?

Answer 27

Ambivalence toward the newborn (is suggestive of PPD)

Question 28

What is the strongest risk factor for postpartum depression?

Answer 28

History of depression

Question 29

The safest method to suppress lactation is _____________.

Answer 29

breast binding, ice packs, and analgesics

Bromocriptine is associated with hypertension and stroke, and hormone therapy is associated with thromboembolic events.

Question 30

In evaluating PROM, it’s important to test the ___________ fluid.

Answer 30

vaginal

Cervical mucus can cause false positives.

Question 31

In a PPROM patient in labor, why would you give tocolytics?

Answer 31

Although disputed, many people give tocolytics to delay labor for long enough to give steroids.

Question 32

One of the strongest predictors of PROM is ____________.

Answer 32

GU infections during pregnancy

Question 33

PPROM patients not in labor should be given ________________.

Answer 33

ampicillin and erythromycin

Question 34

Ruptured membranes with tender __________ are suggestive of chorioamnionitis.

Answer 34

fundus

Question 35

What medicine has been shown to reduce the risk of preterm labor?

Answer 35

17-alpha hydroxyprogesterone

Question 36

If you’re doing a suction curettage and you notice fatty tissue, what might have happened?

Answer 36

You might have poked through the uterus and sucked up omentum.