OB Part 1

Question 1

what is term?

Answer 1

37-40 weeks

Question 2

parturient=

Answer 2

pregnant or in labor

Question 3

gravida=

Answer 3

number of pregnancies

Question 4

para=

Answer 4

number of births >20 weeks

Question 5

nulligravida/nulliparous=

Answer 5

no pregnancies/births

Question 6

minimum expected weight gain?

Answer 6

12 kg

Question 7

uterus + amniotic fluid wt?

Answer 7

1 kg each

Question 8

fetal weight + placenta weight?

Answer 8

4 kg

Question 9

fat and protein stores weight?

Answer 9

4 kg

Question 10

blood volume increase weight?

Answer 10

2 kg

Question 11

underweight BMI total weight gain + rate of gain?

Answer 11

28-40 lb
1 lb/wk

Question 12

normal BMI total weight gain + rate of gain?

Answer 12

25-35 lb
1 lb/wk

Question 13

overweight BMI total weight gain + rate of gain?

Answer 13

15-25 lb
0.6 lb/wk

Question 14

obese BMI total weight gain + rate of gain?

Answer 14

11-20 lb
0.5 lb/wk

Question 15

what is the typical % blood volume increase? when is this mostly complete by?

Answer 15

30-35%
24 weeks

Question 16

does plasma or RBC increase more?

Answer 16

plasma

Question 17

how many weeks PP is blood volume back to normal?

Answer 17

6 weeks

Question 18

pregnant BV (ml/kg)?

Answer 18

85-90 ml/kg

Question 19

CO is increased by _____% at term

Answer 19

40%

Question 20

increase in maternal HR occurs by:

Answer 20

6 weeks

Question 21

increase in maternal SV occurs by:

Answer 21

8-10 weeks

Question 22

what is the mechanism by which blood volume is expanded in pregnancy?

Answer 22

increased plasma renin activity–>increased aldosterone concentration=increased Na+ reabsorption, H2O retention=increased plasma volume

Question 23

why does CO increase in pregnancy?

Answer 23

increased volume=increased preload=increased SV=increased CO

Question 24

how much does UBF increase in pregnancy?

Answer 24

10-20X increase

Question 25

how many ml/min is UBF at term

Answer 25

700 ml/min

Question 26

what causes the increase in skin temp/flushing/itching?

Answer 26

3-4x increase in skin blood flow

Question 27

SVR decreases by approx ___% in pregnancy

Answer 27

20%

Question 28

what 4 hormones contribute to decreased SVR?

Answer 28

progesterone, prostacyclin, relaxin, estrogen

Question 29

what 3 things contribute to a high flow + low resistance state?

Answer 29

maternal vasodilation, low resistance placenta, decreased renal vascular resistance

Question 30

what kind of LV hypertrophy occurs in pregnancy? what % increase by term?

Answer 30

eccentric, 50%

Question 31

in pregnancy the heart shifts _____ d/t _____elevation

Answer 31

anterior and left diaphragm

Question 32

PMI shifts _____ to the:

Answer 32

up and to the left 4th IC space, MCL

Question 33

what may appear enlarged on chest Xray in pregnancy?

Answer 33

heart d/t positioning shift

Question 34

what happens to the QRS in the 3rd trimster?

Answer 34

left shift

Question 35

what effect does the increased sympathetic activity in 3rd trimester have on the PR interval?

Answer 35

shortened d/t accelerated AV node conduction

Question 36

T wave inversions may be seen in lead ___in pregnancy

Answer 36

III

Question 37

what are the 2 positive leads?

Answer 37

I, aVL

Question 38

what are the 3 negative leads?

Answer 38

II, III, aVF

Question 39

what is the most common arrhythmia in pregnancy?

Answer 39

tachydysrhythmias, PACs, PVCs

Question 40

what 4 things contribute to the arrhythmias seen in pregnancy?

Answer 40

changes in ion channel conduction, increased heart size, changes in autonomic tone,hormones

Question 41

valvular changes that are seen in 90% of pregnant pts?

Answer 41

tricuspid and pulmonic regurgitation

Question 42

valvular changes that are seen in 25-30% of pregnant pts?

Answer 42

mitral regurgitation