OBGYN

Question 1

What separates normal hemodilution of pregnancy from other anemias

Answer 1

hemodilution does not effect MCV

Thalassemias, Iron, and folate deficiencies do change MCV

Question 2

The increased minute ventilation during pregnancy causes an acid base what?

Answer 2

compensated respiratory alkalosis

ph ↑ co2 and bicarb ↓ (RO)

Question 3

The Resp rate does not change in pregnancy, but the ______ is increased which increases the minute ventilation, which is responsible for the _______ (acid base)

Answer 3

Tidal volume up

respiratory alkalosis in pregnancy is normal acid base status

Question 4

Use of ______ increases the susceptibility of pulmonary edema, especially with the use of isotonic fluids.

Answer 4

multiple tocolytics

Question 5

The cardiac output increases up to 33% due to _______ in pregnant people.

Answer 5

increases in both the heart rate and stroke volume

Up to 95% of women will have a systolic murmur due to the increased volume.

Diastolic murmurs are always abnormal.

Question 6

_____ murmurs are always abnormal in prego

Answer 6

Diastolic

Question 7

what is the symmetry `of hydronephrosis of pregnancy

Answer 7

The dilation is unequal (R > L)

sigmoid cushions left ureter

right ureter compressed by uterus and right ovarian vein complex

Question 8

the _______ are the most common site of metastatic disease in patients with gestational trophoblastic disease (molar prego)

Answer 8

lungs

Question 9

weight gain in pregnancy for underweight (BMI

Answer 9

total weight gain 28 – 40 pounds;

Question 10

weight gain in pregnancy for normal weight (BMI 18.5 – 24.9 kg/m2)

Answer 10

total weight gain 25 – 35 pounds; pounds.

Question 11

weight gain in pregnancy for overweight (BMI 25 – 29.9 kg/m2)

Answer 11

total weight gain 15 - 25 pounds

Question 12

weight gain in pregnancy for obese (BMI > 30 kg/m2)

Answer 12

total weight gain 11 - 20 pounds.

Question 13

How would you screen a couple for sickle cell?

Answer 13

HgB electrophoresis

smear likely wont show sickling, esp. in carriers

Question 14

Valproic acid in prego is is associated with an increased risk for ____________________

Answer 14

neural tube defects, hydrocephalus and craniofacial malformations.

Question 15

Women with poorly controlled DM immediately prior to conception/ during organogenesis have a 8 fold risk of having a fetus with _______________-

Answer 15

central nervous system (neural tube defects) and the cardiovascular defects

Question 16

Chorionic villus sampling (CVS) is a prenatal test that diagnoses ________ by sampling placenta chorionic villi

Answer 16

genetic disorders (tri-21, CF, etc)

Question 17

If there is a history of a FDR with colon cancer before age 60, then begin screening with colonoscopy at age ________, and repeat every five years.

Answer 17

40, or 10 years before the youngest relative diagnosis

Question 18

Bone density screening is recommended for women beginning at age _____ unless they have pre-existing risk factors which warrant earlier screening.

Answer 18

65

Unless they have pre-existing risk factors

Question 19

Risk factors for osteoporosis are:

Answer 19

early menopause
glucocorticoid therapy
sedentary lifestyle
alcohol consumption
hyperthyroidism
hyperparathyroidism
anticonvulsant therapy
 vitamin D deficiency
family history of early or severe osteoporosis
chronic liver or renal disease.

Question 20

______________ is the number one killer of women

Answer 20

Heart disease

Question 21

__________ is the most effective screening test for Down syndrome.

Answer 21

Cell-free DNA screening

Question 22

Associated risks of gestational diabetes.

Answer 22

Shoulder dystocia
metabolic disturbances
preeclampsia
polyhydramnios
 fetal macrosomia

Question 23

According to ACOG, the recommended dose of folate for non-high risk patients is at least ______

Answer 23

0.6 mg/day.

Question 24

women with a previous pregnancy complicated by a fetal neural tube defect should ingest _____ daily before conception and through the first trimester

Answer 24

4 mg of folic acid

Question 25

Incorrect dating, specifically _________, is the most common explanation for an elevated MSAFP.

Answer 25

under-estimation of gestational age

Question 26

Ibuprofen is safe to take until around ___________, when premature closure of the ductus arteriosis is a risk.

Answer 26

32 weeks gestation

Question 27

All women with + cultures for GBS/ hx of baby with GBS should receive antibiotics in this time frame?

Answer 27

antibiotics in labor always.No culture nessiciary ever

no ab’s if a c-section is performed before onset of labor in a woman with intact amniotic membranes.

Question 28

If the fetal heart rate cannot be confirmed using external methods, then the most reliable way to document fetal well-being is to?

Answer 28

apply a fetal scalp electrode

ultrasound is good, but can’t do continuous monitoring

Question 29

Umbilical cord prolapse occurs in 1% of births and shows _________ on fetal monitoring

Answer 29

Sustained fetal bradycardia is usually observed.

Question 30

Late decelerations are associated with ___________

Answer 30

uteroplacental insufficiency.

Question 31

Once an umbilical cord prolapse is diagnosed, what do you do?

Answer 31

expeditious cesarean section.

do not replace the umbilical cord into the uterus or allow the patient to continue to labor or perform a forceps-assisted vaginal delivery.

Question 32

_____________ babies are more common with type 1 diabetes than with gestational diabetes

Answer 32

Small

Question 33

_______________ is a warning sign that the infant may be septic.

Answer 33

Fetal tachycardia coupled with minimal variability

A septic infant will typically appear pale, lethargic and have a high temperature.

Question 34

A septic infant will typically appear ____________

Answer 34

pale, lethargic and have a high temperature.

Question 35

Infants born to diabetic mothers are at increased risk for developing?

Answer 35

polycythemia
hyperbilirubinemia
 hypoglycemia, 
hypocalcemia a
respiratory distress.

Question 36

How do you treat the baby of HIV + moms?

Answer 36

Treat the infant with zidovudine (AZT) immediately after delivery

Question 37

define uterine atony

Answer 37

floppy uterus that wont contract

major cause of postpartum hemorrhage

Question 38

The safest method to suppress lactation is ____________

Answer 38

breast binding, ice packs, and analgesics.

Question 39

After delivery, large amounts of prolactin continue to be secreted, milk is produced after the inhibitory action of ___________ is lifted.

Answer 39

estrogen and progesterone

Question 40

The discriminatory zone for hCG is?

Answer 40

the serum level above which a gestational sac should be visualized by ultrasound examination if an IUP is present

usually= 2000

Question 41

Beta-hCG in a normal pregnancy level should rise by at least ______ until the pregnancy is ____ old

Answer 41

50% every 48 hours

42 days

Question 42

Criteria for methotrexate therapy for treatment of an ectopic pregnancy.

Answer 42

• hemodynamic stability
• non-ruptured ectopic pregnancy
• size of ectopic mass

Question 43

What are the 2 treatments for ectopic

Answer 43

ruptured/ no follow up= laparoscopy

safe/ reliable = methotrexate