Keppler - Lecture 2

Question 1

SVD

Answer 1

spontaneous vaginal deliveries

Question 2

most tests in pregnancy are

Answer 2

screening tests

Question 3

many decisions about screening are based on

Answer 3

prior hx

risk factors

Question 4

common screening tests

Answer 4

DM/GDM

anemia

hemoglobinopathies

genetic syndromes/dz

infectious dz

alloimmunization

HTN/preeclampsia

aneuploidy

fetal anomalies

fetal growth abnormalities

substance use/abuse

mental illness/dpn

STDs

Question 5

steps in prenatal care (6)

Answer 5

1. establish estimated due date (EDD)
2. identify rf
3. PE +/- cervical ca screening
4. prenatal screening labs
5. counseling/ed
6. schedule f/u

Question 6

US is most accurate to establish EDD in

Answer 6

first trimester

Question 7

what 2 pe exams are recommended for routine prenatal care

Answer 7

breast

pelvic: uterine size, adnexal masses, cervical ca screen, STDs, +/- clinical pelvimetry

Question 8

screening based on rf

Answer 8

early GDM

hbg electrophoresis → hemoglobinopathies

genetic

aneuploidy

urine drug screen

Question 9

t/f clinical pelvimetry can accurately predict woman’s likelihood of delivering vaginally

Answer 9

f

Question 10

what is clinical pelvimetry

Answer 10

estimating the size of a woman’s pelvis → not very accurate

Question 11

t/f: most tests done in pregnancy are diagnostic tests

Answer 11

f!

most are screening tests

Question 12

only way to predict if a woman can delivery vaginally

Answer 12

try it!

Question 13

if it happened before in a pregnancy…

Answer 13

risk that it will happen again

Question 14

2 abnormal findings during pregnancy

Answer 14

vaginal bleeding

severe pain

Question 15

first trimester bleeding ddx (3)

Answer 15

ectopic pregnancy

spontaneous abortion (miscarriage)

gestational trophoblastic dz

Question 16

2nd and 3rd trimester bleeding ddx (3)

Answer 16

preterm labor/labor

placental abruption

placenta previa/vasa previa

Question 17

mc cause of bleeding in pregnancy

Answer 17

trick question dummy!

no vaginal bleeding during pregnancy is common/normal

Question 18

expected wt gain during pregnancy for normal weight woman

Answer 18

25-35 lb

Question 19

most wt gain during pregnancy is during

Answer 19

second/third trimester

Question 20

normal weight gain for pregnancy underweight woman

Answer 20

35-45 lb

Question 21

normal weight gain during pregnancy for overweight/obese woman

Answer 21

15-25 lb

Question 22

normal wt gain during pregnancy for morbidly obese pt

Answer 22

11-20 lb

Question 23

nutrients to focus on for pregnant pt

Answer 23

fiber

proteins

carbs

Question 24

folate needs for pregnant pt

Answer 24

400 mcg

4 mg if hx NTD

Question 25

does sex increase risk to uncomplicated pregnancies

Answer 25

no!

Question 26

t/f high risk pregnancy should consider not traveling

Answer 26

t!

Question 27

which of the following is not a common complaint of pregnant pt

a. breast tenderness
b. dysuria
c. nausea
d. GERD

Answer 27

b. dysuria

Question 28

t/f bleeding is always considered abnormal in pregnancy

Answer 28

t!

Question 29

for which class of drugs should you increase folate micronutrient supplementation in pregnancy

a. anticholinergics
b. antihypertensives
c. anticonvulsants
d. antidepressants

Answer 29

c. anticonvulsants

Question 30

general rule for prescription meds in pregnancy

Answer 30

less or none is better

Question 31

highest teratogenic risk of prescription meds in pregnancy

Answer 31

organogenesis (2-10 weeks)

Question 32

meds w. withdrawal risks (3)

Answer 32

opioids

antidepressants

antipsychotics/mood stabilizers

Question 33

which med is related to neonatal withdrawal syndrome

Answer 33

opioids

also antidepressants and mood stabilizers/antipsychotics

Question 34

drugs commonly used in pregnancy

Answer 34

acetaminophen

antihistamines

H2 blockers

topical tx: inhaled corticosteroids

bp

Question 35

what 2 bp meds are commonly used in pregnancy

Answer 35

labetalol

nefedipine

Question 36

most pregnancy meds are class

Answer 36

C: lacking good evidence of safety but no e.o harm in retrospective studies

Question 37

prescription meds generally contraindicated in pregnancy

Answer 37

anticonvulsants

renal meds

NSAIDs

retinoids

certain abx → doxy

Question 38

what class of meds can cause closure of the ductus arteriosus

Answer 38

NSAIDs

Question 39

tobacco/nicotine increase risk for (5)

Answer 39

IUGR and low birth wt

placental abruption

preterm delivery

fetal demise/perinatal mortality

SIDS

Question 40

t/f: opiates in pregnancy increase risk of teratogenesis if given during embryogenesis

Answer 40

F → but risk for fetal withdrawal

Question 41

prenatal visits in uncomplicated pregnancy occur

Answer 41

monthly thru 32 weeks

then q 2 weeks until term

then weekly thru delivery

Question 42

most practices recommend inducing delivery at/after __ if labor has not occurred spontaneously

Answer 42

41 weeks

Question 43

cutoff for advanced maternal age

Answer 43

35 yo

Question 44

the majority of prenatal care involves (3)

Answer 44

screening

counseling

education

Question 45

__ and

__ complications help identify risk and screening for current pregnancy

Answer 45

maternal morbidity

prior obstetric complications

Question 46

routine labs at onset of care (6)

Answer 46

CBC

STI

infectious dz screening

rubella immunity

blood type

abs screen

Question 47

t/f some common symptoms during pregnancy may indicate underlying dz and should not be ignored

Answer 47

t!

Question 48

__ is never normal in pregnancy

Answer 48

bleeding

Question 49

the greatest risk of teratogenesis is btw __

and __ weeks

Answer 49

2

10 (13)