Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

My Neo Board Quickfacts > MFM > Flashcards

MFM Flashcards

1
Q

Prevalence of single umbilical artery (2 vessel cord)

A

</= 1%

3-4x more likely in twins
may be associated with urogenital or cardiac anomalies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

SEVERE Pre-Eclampsia definition

A

Hypertension and proteinuria + one or more:

  • BP >/= 160/110
  • Proteinuria >/= 5g in 24hrs or >/=3+ protein x2 samples
  • Vision changes
  • HA
  • Oliguria
  • Any HELLP symptoms (Hemolysis, Elevated Liver enzymes, Low Platelets)
  • Pulmonary edema
  • FGR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Preeclampsia definition

A

Hypertension (SBP >=140 OR DBP >=90 more that 2x)
- after 20 weeks
- a/w with proteinuria (?)

*severe 160/110

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pre-E prevalence

A

5-10% of pregnant women
(most common complication of pregnancy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Increases risk of Pre-E

A

Primaparity
Twin gestation
cHTN
Diabetes
Obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

FAS prevalence

A

0.5-2 per 1000 live births in the US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

TTS prevalence

A

*most common in Mono/Di

5-15% of mono/di; fewer in mono/mono
(even though 85% have vascular anastomoses)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Calcium acretion amount/timeline

A

80% between 25-40 wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Antenatal steroids reduce:

A
  • mortality
  • IVH (severe?)
  • RDS (but not chronic lung disease)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Choroid plexus cysts (fetal US) %

A

< 1% (0.5% of fetuses)

usually detected as early as 11 wks; usually disappear by 26 wks

*small number may have Tri 18 (but usually nothing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

pH of:
normal vaginal fluid
amniotic fluid
what is suggestive of ROM

A

normal vaginal fluid: pH 4.5-5.5
amniotic fluid: 7-7.5
ROM suspected: >/= 6.5

*Nitrazine yellow–>blue in ROM
*false positives can occur with blood, semen, BV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Vaccination (for mother if needed)

A

recommended vaccines: tetanus, diphtheria, inactivated flu

ok, but give in 2nd or 3rd trimester if needed: pneumococcal, meningococcal, hepB, inactivated polio

*no live vaccines (eg MMR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Risk of congenital malformation when HbA1C ~10 prior to conception

A

20-25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Most common type of twin

A

Di-zygotic (2/3 of all twins)
(so two eggs/two sperms; fraternal; di/di)

monozygotic twins 1 per 250 (higher with ART)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Monozygotic twin type + timing of split

A

Days:

0-3 - mono/mono (~25%)
3-8 - mono/di (~75%)
8-13 - mono/mono (~1%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Timing of maternal diabetes screening0

A

24-28 wks

50g load
–> glu >130-140 –> retest with 3hr/100g
—> glu >200 = GDM (no 3hr test)

100g load; 3 checks 1 hr apart
–> GDM if at least 2 abnormal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Maternal ITP vs gestational thrombocytopenia platelet counts

A

ITP <70,000
gestational thromobocypenia >70,000 (usually)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Maternal ITP –> significant thrombocytopenia in neonate (<50k) how often?

A

<10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Maternal mumps vs measles (paramyxovirus)

A

Transmission:
Mumps - saliva transmission
Measles - transplacental (hematogenous)
Both- respiratory droplets, fomites

Incubation
Mumps: 12-25d
Measles: 8-12d (info from onset of sx to 3d post rash)

Pregnancy
Mumps: increased risk of FIRST trimester abortions
Measles: increased risk of prematurity, NO increased risk of abortion, NO teratogenic effects
Both: no increased severity of symptoms

Congenital infections:
Mumps: very rare, most w/ mild sx
Measles: if sx <10 d of life, increased mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Predominant fetal thyroid hormone

A

rT3

(D3 inactivates most of maternal T4; T3 persevered in brain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Associations with 2 vessel cord (single umbilical artery)

A

cardiac anomalies
IUGR
renal anomalies
preterm birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Quad screen profiles

A

Tri 13 - quad screen not helpful

Tri 18
Low AFP, Low b-hCG, Low uE3, nml inhibin
(60% risk)

Tri 21
Low AFP, High b-hCG, Low uE3, High inhibin
(75% risk)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Estimation of fetal gestation

A

Crown-rump length (CRL) at 7-10 weeks
(predicts GA within 3 days)

Bipariatal distance (BPD) at 14-20 weeks
(predicts GA w/in 7 days)

US biometric measurements most accurate prior to 20 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Partial vs Complete Molar pregnancy

A

Molar pregnancies: abnormal chorionic villi w/ trophoblastic proliferation and villous edema w/in uterine cavity

Partial:
- 2 sperm enter 1 egg (usually)
- Karyotype 69 XXX,XXY, or XYY
- nonviable fetus and amnion often present

Complete:
- mostly 46XX of PATERNAL origin (empty egg)
- No fetus of amnion present
- ~20% develop into trophoblastic tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Chorioangiomas vs Choriocarcinomas

A

ChorioANGIOMAS - benign placental tumors

ChorioCARCINOMAS - malignant trophoblastic tumors
- rapid growth
-can invade uterine muscle and blood vessels
- can met to lungs and vagina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Radiation risk to fetus

A

risk to fetus >20 rad

procedure <5 rad not expected to cause harm
*should still discuss with mother

(barium enema 4 rad; abd CT 3.5 rad; chest or head CT 1 rad)

27
Q

Anatomy scan sensitivity

A

18-20wks

90% of congenital anomalies w/o risk factors
CNS - 88%
Urinary tract - 85%
Digestive system - 52%
TEF - 7.4%

28
Q

Fetal lung maturity testing

A

Used after 32 weeks (tests on amniotic fluid)

Fluorescent polarization - probe binds to albumin and surfactant; measures albumin:surfactant ration

Lecithin/sphingomyelin ration: lecithin increases with increasing gestation; sphingomyelin stays the same; uses thin layer chromatography to get ratio; at least 2 = adeq surf stores

Phosphatidylglycerol: commonest of surfactant detected later than lecithin (indicates more mature)

Lamellar bodies: “high number” = maturity

29
Q

High maternal AFP

A

Neurological (open neural tube defect)
GI (e.g. liver necrosis, obits, omph, gastrosch(
Renal
Masses

Low BW, low Maternal weight, oligo, multiple test, underset of GA, osteogenesis imperfect, placental chorioangioma

*if unexplained - increased risk of IUGR or fetal death)

30
Q

CVS vs amnio

A

CVS can be done after 9 weeks gestation but may have both normal and abnormal karyotype (2% of the time) and require repeat amnio later

Amnio - after 14 wks (increased risk of talipes equinovarus, pregnancy loss, and failure to culture fetal cells if done earlier)

31
Q

BPP scoring

A

Fetal movement - 3 in 30 mins

Breathing - 30s continuous breathing in 30 mins

Fetal tone: 1 extension/flexion cycle w/ rapid return to flexed position in 30 mins

AFV: single vertical pocket >2cm

+/- NST: 2 accelerations (15 bpm for >15s) within 20 minutes a/w fetal movement

32
Q

BPP Score meaning

A
33
Q

Definition of oligo/polyhydramnios

A

Normal AFI 8-18cm
Oligo: AFI < 5 (0.5-8%)
Poly: AFI >24 (0.1-3%)

*poly is more associated with genetic syndromes (tri 18, tri 21, turner, BWS)

34
Q

How to calculate Ponderal index

A

Ponderal index = [weight (g) x 100] / (crown-heel)^3

35
Q

placenta with hemorrhage at the edge

A

likely 2/2 chorioamnionitis
local hemorrhage caused by inflammation and destruction of decius and foraying membranes

36
Q

Amnion nodosum

A

observed w/ severe and longstanding oligohydramnios
(eg PPROM, TTTS, severe DM w/ placental vascular disease)

raised, yellowing, ovoid nodules - squamous cells embedded in degenerative amorphous debris

hypothesis: from degeneration of epithelial layer of amnion and rubbing of fetal skin against membranes results in deposition of vernix and skin cells into the focal defects

37
Q

Vanishing twin risks and considerations

A

Higher risk of premature birth and low birth weight

Chorionicity important prognostic factor (dichorionic LESS risk for double IUFD)

Monochroinonic twins at higher risk for neurodeveolpmental injury after single IUFD
–> some evidence earlier gestational age = less neurodevelopment injury in surviving twin

Single IUFD (in mono and di chorionic) a/w preterm labor and delivery

Monochorionic - single IUFD can result it muliticystic encephalomalacia and mutiorgan damage in surviving twin (rapid blood loss from surviving twin to demised twin –> hypotension –> ischemic damage)
**No interventions available to reduce risk after single demise (can offer ligation of cord if pending demise)

Survival rate of other twin(??):
8-16% if IUFD at 20-24wks
92-100% after 37wks

Demised fetus may be incorporated into membranes and difficult to identify; occasionally flattened/compressed (fetus papyraceus)

38
Q

Produced by the syncytiotrophoblast

A

(originates from outer cell layer of the blastocyst - layer of specialized epithelial cells, serves as a barrier b/w maternal and fetal circulation and and endocrine organ)

hCG, HPL, leptin, progesterone, estrogens, Insulin-like growth factor (NOT insulin)

39
Q

Inadequate maternal caloric intake increases the risk for ________ in adulthood (for the fetus)

A

Type 2 DM
cardiovascular disease
hypertension
dyslipidemia

40
Q

Albuterol

A

decreased risk of gestational HTN

41
Q

Oral glucocorticoids

A

low birthweight

*ORAL glucocorticoids do not cross the placental in significant amounts, so no effect on adrenal glands

42
Q

Overall risk of congenital malformations

A

2-3%

43
Q

How to reduce lead levels

A

Calcium

44
Q

Epidural may prolong _____ stage of labor

A

2nd

45
Q

Only acceptable response to concerns in pregnant women with decreased fetal movements

A

BPP

46
Q

NRP epi doses (IV and ETT)

A

IV: 0.02 mg/kg/dose (0.2ml/kg)

ETT: 0.1mg/kg (1ml/kg)

*concentration 1:10,000 (0.1mg/ml)

47
Q

SInusoidal pattern =

A

Severe anemia

48
Q

Leading cause of mortality in late preterm

A

congenital malformations

49
Q

More common/higher risk in late preterm (than term)

A

IUGR
(higher mortality rate)
Maternal complications (preE, HTN, DM)
Respiratory distress
apnea
hypoglycemia
temp instability
feeding difficulties
jaundice

50
Q

SGA or LGA higher risk for MSF

A

SGA

51
Q

Symptoms of Sheehans

A

*failure of lactation

tachycardia
persistent hypotension
hypoglycemia

52
Q

lymphocytic hypophysitis

A

lymphocytic infiltration and enlargement of the pituitary —> destruction of pituitary cells

cause unknown; occurs late in pregnancy or in postpartum

*headache out of proportion to size of the lesion (+signs of hypo pit)

53
Q

pituitary apoplexy

A

sudden hemorrhage in pituitary; often into an adenoma

*dramatic presentation
*acute onset of severe headache, diplopia (pressure on oculomotor nerves) and hypo pit

54
Q

Most common infection post c/s

A

Endometritis (up to 30% of cases)

> 5% for wound infx, sepsis, pelvic abscess, thrombophlebitis

55
Q

sign in chorioamniotits that infant is at increased risk for chronic lung diesease

A

Subnecrosing funisitis = chronic chorio

56
Q

Histologic timeline for chorioamnionitis

A

< 6 hrs: mat neutrophils in fibrin below chorionic plate

6-24 hrs: neutrophils infiltrate entire chorionic plate and full thickness of membranes
*fetal response occurs
–>fetal neutrophil across fetal vessel walls
—>chorionic vasculitis, umbilical phlebitis, umbilical arteritis

> 24 hrs:
- pervasculitis (fetal PMNs infiltrate umbilical cord stroma
- necrotizing chorioamnionitis (necrosis of the amnion)

Chronic (days to weeks): subnectrotizing funisitis (perivascular umbilical arcs of calcific debris, glycoprotein, neovasculariazation)

57
Q

how to minimize perinatal risk of macrosomia

A

C-section (but must be discussed)

58
Q

Leading risk factor for shoulder dystocia

A

Maternal diabetes

risk doubles across all birth weight categories; overall increases risk by 70%

small risk from (increase of 2-8%):
AMA
>= 42wks
Obesity, multiparty
prev infant >4kg
excessive weight gain (>= 20kg)
short stature

59
Q

Potential effects on fetus of abundant intrauterine glucose supply

A
  • altered pancreatic development with decreased beta-cell mass
  • diabetes later in life
  • impaired insulin secretion/glucose intolerance
  • increased fetal growth
60
Q

Reactive NST

A

(NST detects fetal heart rate, fetal movement, and uterine activity)

reactive if at least:
2 accelerations (HR 15bpm above baseline for 15s) in 20 mins
–> need to be a/w fetal movements

*if fetus sleeping, may need to retest within 20 mins

61
Q

Mechanism of indomethacin for tx of poly

A

prostaglandin synthetase inhibitor

  • decreases fetal urine production
  • enhances fluid absorption by the lungs
  • increases transmemiranous absorption
62
Q

Blood vessels that break in subgaleal

A

emissary veins that connect the dural sinuses to the superficial veins of the scalp

63
Q

Triple screen for

Tri18
Tri 21

A

Tri18: low AFP, low B-hCG, low uE3

Tri21: low AFP, HIGH B-hCG, low uE3

64
Q

approx ____% of fetal blood flow goes to the placenta via the umbilical arteries

A

45%

My Neo Board Quickfacts (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions