HTN, preconception topics, OB emergencies

Question 1

Three biggest risk factors for pre-eclampsia

Answer 1

Chronic renal disease (RR 20), cHTN (RR 10), APS (RR 10)

Question 2

Anomalies possibly associated with cHTN

Answer 2

Hypospadias, esophageal atresia, cardiac septal defects

Question 3

What types of drugs are dinoprostone and misoprostol?

Answer 3

PGE2 and PGE1

Question 4

Risks of hygroscopic dilators

Answer 4

Endometritis (60% vs 11%)
Neonatal sepsis (12% vs 0%)

Question 5

Half life of pitocin

Answer 5

3-10min

Question 6

Inheritance pattern of CF

Answer 6

Autosomal recessive

Question 7

Inheritance pattern of SMA

Answer 7

Autosomal recessive

Question 8

Highest risk of being CF carrier by ethnicity

Answer 8

Caucasian (1/25), Ashkenazi Jewish (1/24), Hispanic (1/58), African American (1/64), Asian American (1/94)

Question 9

When to screen for fragile X

Answer 9

Family history of mental retardation, premature ovarian failure, elevated FSH prior to age 40

Question 10

Normal adult hemoglobin fractions

Answer 10

A1 >95%
A2 <3.5%
F <2%
S 0%
(suspect beta-thal if dec A1 and inc A2)

Question 11

ACOG recommends screening for which conditions if Ashkenazi Jewish? (4)

Answer 11

CF, Tay-Sachs, Canavan, familial dysautonomia

Question 12

Recommended folic acid supplement for no history and for history of NTD

Answer 12

400 mcg / day or 4 mg / day

typical prenatal vitamin has 1 mg

Question 13

Dose / timing of methergine

Answer 13

0.2 mg IM q2-4 hrs

Question 14

Dose / timing of hemabate

Answer 14

0.25 mg IM q15-90min (max 8 doses)

Question 15

Incidence of accreta by # of prior C/S and previa

Answer 15

0 = 3%
1 = 11%
2 = 40%
3 = 61%
4 = 67%
>4 = 67% (and 4.7% even without a previa)

Question 16

Risk for recurrent accreta if no hysterectomy performed

Answer 16

20% risk

Question 17

Volume / contents of 1 u pRBCs

Answer 17

300 mL (250 mL RBCs and 50 mL plasma)

Question 18

Volume / contents of 1 u plt

Answer 18

50 mL (typically 6-10 u transfused together) -> increase plt by 7500/mm3

Question 19

Volume / contents of 1 u FFP

Answer 19

250 mL (plasma = fibrinogen, antithrombin, factors V, XI, and XII)

Question 20

Volume / contents of 1 u cryo

Answer 20

40 mL (fibrinogen, factor VII, vWF, factor XIII) -> increase fibrinogen by 5-10 mg/dL per unit

Question 21

Local anesthesia causing worst cardiac toxicity

Answer 21

Bupivicaine due to long duration of action