Extras: OB / Gyn

Question 1

meds for mild vs severe chronic HTN in pregnancy

Answer 1

1. mild chronic: ASA for last 12 weeks

2. severe: labetolol, nifedipine, etc.

Question 2

Dx of preeclampsia

Answer 2

HTN + proteinuria + edema

Question 3

Tx for preeclampsia with severe features

Answer 3

hospitalize, deliver is 34+ wks, give BP meds

Question 4

HELLP stands for?

Answer 4

hemolysis, elevated liver enzymes, low platelets

Question 5

Tx for HELLP syndrome

Answer 5

immediate delivery

Question 6

5, 6, 7 weeks on US and hCG levels

Answer 6

1. 5weeks: gestational sac**, hcg 1500-2000
2. 6weeks: fetal pole, hcg 5200
3. 7 weeks: cardiac activity, hcg 17,500

Question 7

when pregnant, one should see the OBGYN q4 weeks until ___wks, when one starts going every 2 weeks

Answer 7

28 weeks

Question 8

normal amount of fetal movements felt by mom

Answer 8

10 movements in 2 hrs

Question 9

normal NST

Answer 9

2 accels of 15+ bmp for 15+ seconds

Question 10

valproid acid during pregnancy causes?

Answer 10

open spina bifida

Question 11

quadruple screen for genetic anomalies in 2nd trimester

Answer 11

hCG, estriol, AFP, Inhibin A

Question 12

normal range of fetal heart rate

Answer 12

110-160

Question 13

when are prolonged decels seen?

Answer 13

while pushing

Question 14

7 cardinal movements of labor

Answer 14

1. engagement
2. descent
3. flexion
4. internal rotation
5. extension
6. external rotation
7. expulsion

Question 15

MVUs sufficient for labor

Answer 15

200+ per 10mis for 2+ hrs

Question 16

labor with head positioning: OA, OT, OP

Answer 16

1. OA: normal
2. OT: need to rotate head manually
3. OP: longer labor and more back pain

Question 17

long end of stage 1 of labor for nulliparous and multiparous women (more = prolonged labor)

Answer 17

1. nullip: 20 hours

2. multip: 14 hours

Question 18

how to treat prolonged latent phase of labor

Answer 18

morphine for therapeutic sleep

Question 19

fetal descent rates for nullip vs multip women in active stage 1

Answer 19

1. nullip: 1cm/hr

2. multip: 2cm/hr

Question 20

when to give pitocin in active stage of labor

Answer 20

1. <3 contractions per 10 min

2. contractions <25 mmHg

Question 21

definition of retained placenta

Answer 21

no delivery within 30 mins of birth

Question 22

erb-duschenne palsy vs klumpke palsy

Answer 22

1. erb: C5 and C6 injury -> upper arm palsy

2. klumpke: C7 and T1 injury -> lower arm palsy

Question 23

which type of twin has no risk factors and is present in 1 in 250 births worldwide

Answer 23

monozygotic

Question 24

arterial to arterial anastomosis presentation

Answer 24

acardiac twin

Question 25

what presentation can only deliver by cesarean

Answer 25

brow

Question 26

Kleinhauer-Betke test

Answer 26

tests how much fetal blood is in mom’s blood so extra Rhogam can be given if necessary

Question 27

MCA doppler

Answer 27

checks for fetal anemia

Question 28

four prevention pathways for PTL

Answer 28

cervical, placenta-vascular, stress, uterine stretch

Question 29

treatment for PROM

Answer 29

Admit -> 48hrs Ampicillin + erythro, then 5 days of Amoxil + erythro, deliver at 34 weeks

Question 30

how to dx IUGR

Answer 30

fundal height is 3cm behind age

Question 31

when does labor need to be induced by to avoid post-term pregnancy complications

Answer 31

42 weeks

Question 32

mc cause of DIC in pregnancy

Answer 32

placental abruption

Question 33

blood loss that qualifies as PPH in vaginal vs cesarean

Answer 33

1. vaginal: 500cc+

2. cesarean: 1000cc+

Question 34

primary vs secondary PPH

Answer 34

primary: within first 24hrs after labor

secondary 24hrs - 12 weeks after labor

Question 35

biggest cause of PPH

Answer 35

uterine atony

Question 36

two Abx to give for puerperal sepsis

Answer 36

Ampicillin + Gentamycin

Question 37

ovarian vein thrombophlebitis vs deep septic pelvic thrombophlebitis

Answer 37

1. ovarian V: appear clinically ill, can see 20% on radiography
2. deep septic pelvic: dont appear ill, just have unlocalized fever unresponsive to Abx, not seen on XR