Ob/Gyn- Normal pregnancy- Dr. Moulton

Question 1

women with no history of Neural Tube Defect should be given what to reduce the incidence of NTD? how much?

Answer 1

Folic acid. 0.4 mg

Question 2

women with history of NTD increase dose to?

Answer 2

4.0 mg of folic acid

Question 3

Gravidity and parity of a women who has birthed 1 term, 1 pre term twins and one failed ectopic.

Answer 3

G3P1113

Question 4

What is a difficult but very important question to ask during the first prenatal visits if patient presents with re-occuring injuries?

Answer 4

abuse, sexual abuse

Question 5

Normal heart finding w/ pregnancy?

Answer 5

systolic murmurs, exaggerated splitting and S3

Question 6

What is striae gravidum?

Answer 6

stretch marks on stomach, purple, bruising looking. its a normal finding associated w/ pregnancy

Question 7

Rh negative pts recieve Rhogam at 28 weeks & anytime ______________

Answer 7

sensitization occurs (threatened abortion, amniocentesis, abdominal trauma)

Question 8

Common lab value in preggos of Hematocrit? (increased or decreased)

Answer 8

decreased (4-7% by 30 weeks)

Question 9

What modality can you use to lock down their due date during their first prenatal visit. earlier in pregnancy the better when using this modality

Answer 9

Ultrasound

Question 10

what week and hCG levels is the gestational sac seen at?

Answer 10

5 weeks. 1500-2000 IU/L

Question 11

what is Crown rump Length?

Answer 11

use ultrasound to measure fetus from head to bottom. if done btw 6-11 wks can determine due date w/ in 7 days

Question 12

fetal demise can be diagnosed if CRL > what?

Answer 12

5mm w/ absence of fetal cardiac activity

Question 13

the number one reason for genetic counseling?

Answer 13

advanced maternal age ( 35 years and older)

Question 14

most common sex chromosome aneuploidy?

Answer 14

turners 45XO

Question 15

for a couple who already had a child with Downs syndrome, what is the risk that the couple has another Downs child?

Answer 15

1% risk

Question 16

physical features of Down’s babies

Answer 16

flattened nose, facies; upward slanting eyes

Question 17

what should be done on couples after 3 or more spontaneous abortions?

Answer 17

Karyotype (chromosomal studies)

Question 18

Most common gene carried in North american Whites, frequency 1 in 25? is genetically screened for. Autosomal recessive

Answer 18

Cystic Fibrosis

Question 19

Can fragile X syndrome be passed down from male to male?

Answer 19

no. caused by recessive genes on X chromosome. primarily affects males

Question 20

most common form of inherited mental retardation?

Answer 20

Fragile X syndrome

Question 21

why should women who have already had a child with a NTD take 4 mg of folic acid in all subsequent pregnancies?

Answer 21

the neural tube closure is complete at 28 days post conception

Question 22

Increased thickness of what in First trimester screening is assoc. w/ chromosomal & congenital abnormalities?

Answer 22

Nuchal Translucency

Question 23

what is the triple screen done in the second trimester?

Answer 23

b-hCG, estriol and alpha fetoprotein ( wks 16-20)

Question 24

what if triple screen comes back elevated, all of them. what most likely happened?

Answer 24

false positive due to improper timing, intervals and cycle is off. (marker meant for 16-20 weeks)

Question 25

What does MaterniT21 plus test for?

Answer 25

test cell free fetal DNA for trisomies and chromosomal abonormalites. DOES NOT TEST FOR NTD

Question 26

what risk patients should MaterniT21 only be ordered in?

Answer 26

HIGH risk. (ex: old maternal age)

Question 27

what weeks can you perform an Amniocenteisis test on the fetus?

Answer 27

16-20 weeks. NOT 11 weeks, cause a deformed extremity.

Question 28

exposure to what teratogen causes phocomelia?

Answer 28

Thalidomide

Question 29

why are more than category A drugs prescribed to pregnant women?

Answer 29

not that many category A drugs. only < 5% of medicines are Cat. A

Question 30

most vulnerable stage for teratogens on fetus?

Answer 30

3-8 weeks

Question 31

A child born with a small head, low nasal bridge, small eyes, thin upper lip was exposed to what common teratogen?

Answer 31

alcohol (fetal alcohol syndrome)

Question 32

fetus exposure to Diethylstilbestrol (DES) ?

Answer 32

t-shaped uterus, vaginal cell carcinoma, testicular abnormalities, infertility, malignancy

Question 33

what is heartburn in pregnant women due to?

Answer 33

progesterone- relaxation of esophageal sphincter

Question 34

what frequency should prenatal office visits occur?

Answer 34

every 4 weeks until 28 weeks
every 2 weeks from 28 to 36 weeks
weekly until delivery

Question 35

what is quickening?

Answer 35

first sensation of movement (baby kicking). avg at 20 weeks

Question 36

at what week should you obtain fetal survey ultrasound?

Answer 36

20 weeks

Question 37

what week should one be screened for gestational diabetes and repeat hemoglobin and hematocrit

Answer 37

28 weeks

Question 38

what week screen for group B strep carrier w/ vaginal culture?

Answer 38

35 weeks

Question 39

what is a reactive Nonstress test (NST) finding?

Answer 39

2 accelerations of at least 15 beats above baseline for at least 15 seconds during 20 mins of monitoring

Question 40

what is a positive finding of the Contraction stress test?

Answer 40

late decelerations are noted w/ majority of contractions. delivery is warranted