bonus Flashcards
question
answer
For single dose methotrexate therapy, resolution time is defined as serum b-hcg of
A. <100 miu/ml
B. <50 miu/ml
C. 20 miu/ml
D. 15 miu/ml
D. 15 miu/ml
A previous salphigectomy is a sp. Risk factor for this kind of ectopic pregnancy
A. Abdominal
B. Interstitial
C. Cervical
D. Ovarian
B. Interstitial
This type of congenital abnormality seen on sagittal view of an ultrasound showing a defect on dorsal aspect of cranio-axial view
A. Sacrococcygeal Teratoma
B. Lipoma
C. Open Neural Tube Defect
C. Open Neural Tube Defect
Sacrococcygeal Teratoma - sonographically
appears as a solid and/or cystic mass that arises
from the anterior sacrum and usually extends
inferiorly and externally as it grow
Neural Tube Defects include anencephaly,
myelomeningocele (also called spina bifida),
cephalocele, and other rare spinal fusion (or
schisis) abnormalities. They result from
incomplete closure of the neural tube by the
embryonic age of 26 to 28 days.
Women currently have the option of neural-tube
defect screening with MSAFP, sonography, or
both. Targeted sonography is the preferred
diagnostic test, and in addition to characterizing
the neural-tube defect, it may identify other
abnormalities or conditions that also result in
MSAFP elevation.
What is the detection rate in quadruple testing (MSAFP, Estriol, HCG and dimeric inhibin) in younger than 35 y.o patient
A. 65% (screen + 5%)
B. 75 % (screen + 5%)
C.85 % (screen + 5%)
D. 80% (screen + 5%)
A. 65% (screen + 5%)
MSAFP is best measured during this time:
A. 12-14 weeks
B. 14-16 weeks
B. 14-16 weeks
MSAFP
- Routinely measured as a screening test for NTDs from 15-20 wks
- After 12th wk- maternal serum level of AFP will now begin to rise
Based in FIGO what is the low risk for gestational tropho neoplasia
A. less than 4
B. less than 6
C. Less than 8
D. Less than 10
B. less than 6
Marked trophoblast atypia
A. Partial Mole
B. Complete Mole
C. Invasive Mole
D. Choriocarcinoma
B. Complete Mole
35y/o G3P2 (2002), 30 wks AOG. First pregnancy was delivered vaginally and second pregnancy by cesarian section because of footling breech presentation. She wants to know if she can undergo VBAC (vaginal birth after CS) and she asks her chance of having breech presentation again.
A. 1%
B. 5%
C. 10%
D. 28%
C. 10%
the recurrence rate for a second breech presentation was 10 percent, and for a subsequent third breech it was 28 percent
Vaginal delivery a breech baby, requesting ultrasound findings should associate w/ the ff. EXCEPT:
A. Fetal size
B. Degree of neck extension
C. Measurement of midpelvis is >/= 10cm
D. Type of breech
C. Measurement of midpelvis is >/= 10cm
Parametrial phlegmon that suppurates anteriorly may involve the
A. Urinary bladder
B. Iliac fossa
C. Vesicouterine fold
D. Poupart’s ligament
D. Poupart’s ligament
Septic thromboplebitis
A. Spiral arteries
B. Radial artery
C. Ovarian arteries
C. Ovarian arteries
This enzyme secreted by GBS degrades the cervical epithilium barrier favoring ascending infection to cause ptb
A. Glycosaminidase
B. Hyaluronidase
C. Neuraminidase
D. Glycan dessolvent
B. Hyaluronidase
Most common cause of acute glomerulonephritis
A. IgA nephropathy
B. Acute
C. PKD
D. HTN GN
A. IgA nephropathy
Acute kidney damage
A.diabetes B. Hypermesis C. Septicemia C. Hypovolemia D. Diabetes
C. Septicemia
What is the lower limit of uterine contraction pressure required to dilate the cervix
A. 45mmHg
B. 35mmHg
C. 25mmHg
D. 15mmHg
D. 15mmHg
Protraction disorder in cervical dilation
<1.2cm in nulli, <1.5cm in multi
How many hours after giving protaglandin gel can you start oxytocin
A. 30mins
B. 1hr
C. 2hrs
D. 6hrs
D. 6hrs
Use of oxytocin for induction of labor is contraindicated in
A. Fetal demise
B. Hypertonic uterine contraction
C. Hypotonic uterine contraction
C. Hypotonic uterine contraction
Which of the following would lead to a diagnosis of an incompetent cervix?
A. painless vaginal bleeding
b. cramping abdominal painc
c. dysuria, fever, and vaginal bleeding
d. watery vaginal discharge
A. painless vaginal bleeding
Which of the following directly stimulates myometrium?
Mifepristone
methotrexate
misoprostol
mithramycin
misoprostol
What is the most common indication of therapeutic abortion?
fetal deformity
Which is associated with first trimester abortion?
A. intraamnionic hyperosmotic fluid
b. menstrul aspiration, oxytocin
c. vaccum aspiration, prostaglandin
d. hysterotomy, laparotomy
c. vaccum aspiration, prostaglandin
Management for patient with incompetent cervix?
A. mcdonald at 8 weeks
b. shirodkar at 12 weeks
b. shirodkar at 12 weeks
any cerclage should be done 12-14 weeks
What are the causes of preterm brith
. Spontaneous preterm labor with intact membranes
. Idiopathic preterm premature rupture of membranes
. Delivery for maternal or fetal indications
. Twins and higher-order multifetal births
What are the 3 most common reasons for preterm birth?
. Spontaneous pretern labor, 40-45%
. Indicated and preterm membrane rupture
Which causes of preterm labor often have multiple factors?
PPROM and spontaneous
What genetic alteration may lead to preterm birth?
inherited mutations in genes regulating collagen assembly may lead to cervical insufficiency or PPROM
How many preterm births are due to higher order pregnancy?
1 in 6
When is group b streptococcal prophylaxis not recommended?
> 34 weeks
32-33 weeks
24-31 weeks
<24 weeks
<24 weeks
Sepsis due to this responds well to prolonged antimicrobial therapy?
group b streptococcus
define PPROM
spontaneous rupture before 37 weeks and before labor onset
what are major predisposing events to PPROM
infection, oxidative stress-induced DNA damage, premature cellular senescence
What are risk factors for PPROM?
socioeconomic status, BMI <19.8, nutritional deficiency, smoking, and prior PPROM
apoptosis in PPROM is likely regulated by
bacterial endotoxin, IL-ib, and TNF-a
what is the likely reason why gbs predisposes to preterm birth?
ability to secrete hyaluronidase
moa of b-adrenergic receptor agonist in preterm labor
reducee intracellular ionized calcium level and prevent activation of myometrial contractile proteins
moa of magnesium sulfate
calcium agonist that can alter myometrial contractility
moa of prostagladin inhibitors
act by inhibiting prostagladin synthesis or by blocking their action on target organs; prostagladin synthase is responsible for the conversation of free arachidonic acid to prostagladin
aetylsalicylate and indomethacin
moa of NO donors
potent smooth muscle relaxants affect the vasculature, gut, and uterus;
moa of calcium channel blockers
myometrial activity is directly related to cytoplasmic free calcium and reduced calcium concentrations inhibit contractions; inhbit calcium entry through cell membrane channels
substance released by streptococcus that can result in preterm birth
a. hyaluronic acid
b. hyaluronidase
b. hyaluronidase
With an intact membrane, the chance for preterm birth is high when fetal fibronectin level is ___
a. 60
b. 28
a. 60
at 31 weeks, Mrs. X was given 2 doses of 12 mg corticosteroid therapy for fetal lung maturity every 24 hours. What type of steroid did she receive?
a. Dexamethasone
b. betamethasone
b. betamethasone
pregnant women who indulge in Zumba exercises are at increased risk for preterm labor
a. true
b. false
a. true
shape of the cervix which has a higher risk for cervical dilatation
a. U shape
b. Y shape
a. U shape
A neuroprotective agent given to pregnant women at risk for preterm birth
a. Nifedipine
b. MgSO4
b. MgSO4
most important risk factor for preterm birth
a. Maternal infection
b. Prior TB
b. Prior TB
Uterine stretch from multifetal pregnancy activates
this substance to cause preterm labor
a. Interleukin B
b. CRH
b. CRH
management of preterm birth due to cervical insufficiency
a. McDonalds procedure
b. Micronized progesterone
a. McDonalds procedure
question
answer
For single dose methotrexate therapy, resolution time is defined as serum b-hcg of
A. <100 miu/ml
B. <50 miu/ml
C. 20 miu/ml
D. 15 miu/ml
D. 15 miu/ml
A previous salphigectomy is a sp. Risk factor for this kind of ectopic pregnancy
A. Abdominal
B. Interstitial
C. Cervical
D. Ovarian
B. Interstitial
This type of congenital abnormality seen on sagittal view of an ultrasound showing a defect on dorsal aspect of cranio-axial view
A. Sacrococcygeal Teratoma
B. Lipoma
C. Open Neural Tube Defect
C. Open Neural Tube Defect
Sacrococcygeal Teratoma - sonographically
appears as a solid and/or cystic mass that arises
from the anterior sacrum and usually extends
inferiorly and externally as it grow
Neural Tube Defects include anencephaly,
myelomeningocele (also called spina bifida),
cephalocele, and other rare spinal fusion (or
schisis) abnormalities. They result from
incomplete closure of the neural tube by the
embryonic age of 26 to 28 days.
Women currently have the option of neural-tube
defect screening with MSAFP, sonography, or
both. Targeted sonography is the preferred
diagnostic test, and in addition to characterizing
the neural-tube defect, it may identify other
abnormalities or conditions that also result in
MSAFP elevation.
What is the detection rate in quadruple testing (MSAFP, Estriol, HCG and dimeric inhibin) in younger than 35 y.o patient
A. 65% (screen + 5%)
B. 75 % (screen + 5%)
C.85 % (screen + 5%)
D. 80% (screen + 5%)
A. 65% (screen + 5%)
MSAFP is best measured during this time:
A. 12-14 weeks
B. 14-16 weeks
B. 14-16 weeks
MSAFP
- Routinely measured as a screening test for NTDs from 15-20 wks
- After 12th wk- maternal serum level of AFP will now begin to rise
Based in FIGO what is the low risk for gestational tropho neoplasia
A. less than 4
B. less than 6
C. Less than 8
D. Less than 10
B. less than 6
Marked trophoblast atypia
A. Partial Mole
B. Complete Mole
C. Invasive Mole
D. Choriocarcinoma
B. Complete Mole
35y/o G3P2 (2002), 30 wks AOG. First pregnancy was delivered vaginally and second pregnancy by cesarian section because of footling breech presentation. She wants to know if she can undergo VBAC (vaginal birth after CS) and she asks her chance of having breech presentation again.
A. 1%
B. 5%
C. 10%
D. 28%
C. 10%
the recurrence rate for a second breech presentation was 10 percent, and for a subsequent third breech it was 28 percent
Vaginal delivery a breech baby, requesting ultrasound findings should associate w/ the ff. EXCEPT:
A. Fetal size
B. Degree of neck extension
C. Measurement of midpelvis is >/= 10cm
D. Type of breech
C. Measurement of midpelvis is >/= 10cm
Parametrial phlegmon that suppurates anteriorly may involve the
A. Urinary bladder
B. Iliac fossa
C. Vesicouterine fold
D. Poupart’s ligament
D. Poupart’s ligament
Septic thromboplebitis
A. Spiral arteries
B. Radial artery
C. Ovarian arteries
C. Ovarian arteries
This enzyme secreted by GBS degrades the cervical epithilium barrier favoring ascending infection to cause ptb
A. Glycosaminidase
B. Hyaluronidase
C. Neuraminidase
D. Glycan dessolvent
B. Hyaluronidase
Most common cause of acute glomerulonephritis
A. IgA nephropathy
B. Acute
C. PKD
D. HTN GN
A. IgA nephropathy
Acute kidney damage
A.diabetes B. Hypermesis C. Septicemia C. Hypovolemia D. Diabetes
C. Septicemia
What is the lower limit of uterine contraction pressure required to dilate the cervix
A. 45mmHg
B. 35mmHg
C. 25mmHg
D. 15mmHg
D. 15mmHg
Protraction disorder in cervical dilation
<1.2cm in nulli, <1.5cm in multi
How many hours after giving protaglandin gel can you start oxytocin
A. 30mins
B. 1hr
C. 2hrs
D. 6hrs
D. 6hrs
Use of oxytocin for induction of labor is contraindicated in
A. Fetal demise
B. Hypertonic uterine contraction
C. Hypotonic uterine contraction
C. Hypotonic uterine contraction
Which of the following would lead to a diagnosis of an incompetent cervix?
A. painless vaginal bleeding
b. cramping abdominal painc
c. dysuria, fever, and vaginal bleeding
d. watery vaginal discharge
A. painless vaginal bleeding
Which of the following directly stimulates myometrium?
Mifepristone
methotrexate
misoprostol
mithramycin
misoprostol
What is the most common indication of therapeutic abortion?
fetal deformity
Which is associated with first trimester abortion?
A. intraamnionic hyperosmotic fluid
b. menstrul aspiration, oxytocin
c. vaccum aspiration, prostaglandin
d. hysterotomy, laparotomy
c. vaccum aspiration, prostaglandin
Management for patient with incompetent cervix?
A. mcdonald at 8 weeks
b. shirodkar at 12 weeks
b. shirodkar at 12 weeks
any cerclage should be done 12-14 weeks
What are the causes of preterm brith
. Spontaneous preterm labor with intact membranes
. Idiopathic preterm premature rupture of membranes
. Delivery for maternal or fetal indications
. Twins and higher-order multifetal births
What are the 3 most common reasons for preterm birth?
. Spontaneous pretern labor, 40-45%
. Indicated and preterm membrane rupture
Which causes of preterm labor often have multiple factors?
PPROM and spontaneous
What genetic alteration may lead to preterm birth?
inherited mutations in genes regulating collagen assembly may lead to cervical insufficiency or PPROM
How many preterm births are due to higher order pregnancy?
1 in 6
When is group b streptococcal prophylaxis not recommended?
> 34 weeks
32-33 weeks
24-31 weeks
<24 weeks
<24 weeks
Sepsis due to this responds well to prolonged antimicrobial therapy?
group b streptococcus
define PPROM
spontaneous rupture before 37 weeks and before labor onset
what are major predisposing events to PPROM
infection, oxidative stress-induced DNA damage, premature cellular senescence
What are risk factors for PPROM?
socioeconomic status, BMI <19.8, nutritional deficiency, smoking, and prior PPROM
apoptosis in PPROM is likely regulated by
bacterial endotoxin, IL-ib, and TNF-a
what is the likely reason why gbs predisposes to preterm birth?
ability to secrete hyaluronidase
moa of b-adrenergic receptor agonist in preterm labor
reducee intracellular ionized calcium level and prevent activation of myometrial contractile proteins
moa of magnesium sulfate
calcium agonist that can alter myometrial contractility
moa of prostagladin inhibitors
act by inhibiting prostagladin synthesis or by blocking their action on target organs; prostagladin synthase is responsible for the conversation of free arachidonic acid to prostagladin
aetylsalicylate and indomethacin
moa of NO donors
potent smooth muscle relaxants affect the vasculature, gut, and uterus;
moa of calcium channel blockers
myometrial activity is directly related to cytoplasmic free calcium and reduced calcium concentrations inhibit contractions; inhbit calcium entry through cell membrane channels
substance released by streptococcus that can result in preterm birth
a. hyaluronic acid
b. hyaluronidase
b. hyaluronidase
With an intact membrane, the chance for preterm birth is high when fetal fibronectin level is ___
a. 60
b. 28
a. 60
at 31 weeks, Mrs. X was given 2 doses of 12 mg corticosteroid therapy for fetal lung maturity every 24 hours. What type of steroid did she receive?
a. Dexamethasone
b. betamethasone
b. betamethasone
pregnant women who indulge in Zumba exercises are at increased risk for preterm labor
a. true
b. false
a. true
shape of the cervix which has a higher risk for cervical dilatation
a. U shape
b. Y shape
a. U shape
A neuroprotective agent given to pregnant women at risk for preterm birth
a. Nifedipine
b. MgSO4
b. MgSO4
most important risk factor for preterm birth
a. Maternal infection
b. Prior TB
b. Prior TB
Uterine stretch from multifetal pregnancy activates
this substance to cause preterm labor
a. Interleukin B
b. CRH
b. CRH
management of preterm birth due to cervical insufficiency
a. McDonalds procedure
b. Micronized progesterone
a. McDonalds procedure
