OBGYN-2

Question 1

___________ is used in pregnancy to treat migraine headaches.

Answer 1

Amitriptyline

Question 2

The most common cause of sepsis in pregnancy is ___________

Answer 2

acute pyelonephritis.

Question 3

When do obese women with Family Hx of DM-2 get oral glucose test

Answer 3

ASAP

Only normal risk women get screened 24-28 weeks

Question 4

Do you treat mitral prolapse in prego?

Answer 4

yes if they have symptoms

Question 5

One SSRI ____________ has been changed to a category D drug because of the increased risk of fetal cardiac malformations and persistent pulmonary hypertension.

Answer 5

paroxetine (Paxil)

Question 6

How do you treat pruritus gravidarum (mild variant of intrahepatic cholestasis of pregnancy) s/s= pruritus.

Answer 6

Ursodeoxycholic acid

Question 7

The classic signs of magnesium toxicity include

Answer 7

muscle weakness
loss of deep tendon reflexes
nausea
respiratory depression.

Question 8

magnesium sulfate overdose treatment

Answer 8

calcium gluconate

Question 9

Twenty-four hour urine protein values greater that _____ are required for the diagnosis of mild preeclampsia.

Answer 9

300 mg

Question 10

UA protein greater than ________ is required for the diagnosis of severe preeclampsia

Answer 10

~5000 mg (or 5 g)
or
~SBP >160 or DBP >110)

Question 11

___________ is often the antihypertensive agent of choice for controlling elevated blood pressures in the acute setting of preeclampsia

Answer 11

Hydralazine

Question 12

____________ is the treatment of choice for eclampsia,

Answer 12

Magnesium sulfate

Question 13

HELLP acronym

Answer 13

hemolysis, elevated liver enzymes, low platelets” and can lead to swelling of the liver capsule and possibly liver rupture.

Question 14

Define preecampsia

Answer 14

new onset htn (140/90+) x 2 w/ proteinuria or end organ damage AFTER 20 weeks

Question 15

When do you start anti-htn in preeclamps

Answer 15

htn >160/110 + and get ultrasound

Question 16

when do you deliver sever preecamps babies

Answer 16

deliver after 34 weeks

Question 17

The use of middle cerebral artery peak systolic velocity in the management of fetuses at risk for anemia because of red cell alloimmunization has emerged as the best test for the noninvasive diagnosis of____________

Answer 17

fetal anemia.

Question 18

The use of _____________ in the management of fetuses at risk for anemia because of red cell alloimmunization has emerged as the best test for the noninvasive diagnosis of fetal anemia.

Answer 18

middle cerebral artery peak systolic velocity

Question 19

Fetal hydrops is easily diagnosed on ultrasound, defined as a collection of fluid in two or more body cavities, such as _________________.

Answer 19

ascites, pericardial and/or pleural fluid and scalp edema

Placentomegaly (placental edema) and polyhydramnios are also seen on ultrasound

Question 20

At 28-weeks gestation, ____________ is routinely administered after testing for sensitization with an indirect Coombs’ test.

Answer 20

300 micrograms of Rh-immune globulin

*Administration is given following amniocentesis at any gestational age.

Question 21

The current recommendations for Rh-negative women without evidence of Rh immunization is prophylactically at:

Answer 21

• 28-weeks gestation (after an indirect Coombs’ test)
• within 72 hours of delivering an Rh-positive baby
• following abortion
• following antepartum hemorrhage
• following amniocentesis or chorionic villus sampling.

Question 22

If the father of the fetus is known to be Rh-negative, ____________ is not necessary since the fetus will be Rh-negative and not at risk for hemolytic disease.

Answer 22

RhoGAM

Question 23

IgM antibodies and do not cross the placenta, therefore are not associated with isosensitization or hemolytic disease of the fetus.

Answer 23

Lewis antibodies

Question 24

Amniotic fluid ________, an acute-phase reactant, is associated with spontaneous preterm delivery

Answer 24

ferritin

Question 25

Values in Zone 3 of the Liley curve indicate the presence of severe hemolytic disease, with hydrops and fetal death likely within 7-10 days, thus demanding immediate delivery or fetal transfusion.

Answer 25

Intravascular transfusion into the umbilical vein is the preferred method.

Maternal plasmapheresis is used in severe disease when intrauterine transfusions are not possible.

Question 26

Ultrasound markers suggestive of dizygotic (non-identical) twins include

Answer 26

• a dividing membrane thickness greater than 2 mm, twin peak (lambda) sign
• different fetal genders
• two separate placentas (anterior and posterior).

Question 27

The risk for development of cerebral palsy in twin infants is _____________ vs singletons.

Answer 27

five to six times higher

Question 28

Fifty-eight percent of twins deliver prematurely, with an average gestational age at delivery of __________

Answer 28

35 weeks

Question 29

The incidence of _____________ is increased in twins, particularly monozygotic twins, compared to singletons.

Answer 29

congenital anomalies

Question 30

Adequate weight gain in the first 20-24 weeks of pregnancy is critical for women carrying multiples and may help to reduce the risk of having preterm and low-birth weight babies because ______

Answer 30

early weight gain aids in development of the placenta, possibly improving its ability to pass along nutrients to the babies.

Question 31

Twin-twin transfusion syndrome is the result of an intrauterine blood transfusion from one twin to the other. It most commonly occurs in ____________

Answer 31

monochorionic, diamniotic twins

Question 32

Clues to the presence of the twin-twin transfusion syndrome include______

Answer 32

large weight discordance
polyhydramnios around the larger (recipient) twin
oligohydramnios around the smaller (pump) twin.

Question 33

Monozygotic conceptions may have either monochorionic or dichorionic placentation, depending upon the time of division of the zygote. Dizygotic conceptions always have __________.

Answer 33

dichorionic placentas

Question 34

Monozygotic conceptions may have____________, depending upon the time of division of the zygote. Dizygotic conceptions always have dichorionic placentas.

Answer 34

monochorionic or dichorionic placentation

Question 35

Diamniotic dichorionic placentation occurs with division prior to the morula state ______

Answer 35

(within three days post fertilization).

Question 36

Diamniotic monochorionic placentation occurs with division between days ____________

Answer 36

four and eight post fertilization.

Question 37

. Monoamniotic, monochorionic placentation occurs with division between days_________

Answer 37

eight and 12 post fertilization.

Question 38

Superfecundation is___________

Answer 38

the fertilization of two different ova at two separate acts of intercourse in the same cycle.

Question 39

Excessive volume can lead to _______________ for the recipient twin in twin-twin syndrome.

Answer 39

cardiomegaly, tricuspid regurgitation, ventricular hypertrophy and hydrops fetalis.

Although the recipient twin is plethoric, it is not macrosomic.

Question 40

prematurity consequences are increased risk of

Answer 40

respiratory distress syndrome (RDS)
 intracranial hemorrhage
cerebral palsy
 blindness
 low birth weight.

Question 41

fetal sonogram means?

Answer 41

ultrasound

Question 42

fetal doppler means?

Answer 42

heart beat