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Board Studying > Obstetrics > Flashcards

Obstetrics Flashcards

1
Q

Alloimmunization

A

Maternal antibodies against fetal blood cells

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2
Q

Potentially sensitizing events in rh-d negative women

A 
Chorionic villi sampling, amniocentesis, cordocentesis
Threatened miscarriage
Ectopic pregnancy
Evacuation of molar pregnancy
Termination of pregnancy
Antepartum hemorrhage
Abdominal trauma
Intrauterine fetal death
External cephalic version
Delivery
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3
Q

Minimum volume of maternal-fetal hemorrhage that can lead to alloimmunization

A

0.1ml

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4
Q

Kleihauer-Betke test

A

Method for determining percentage of fetal blood in maternal circulation

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5
Q

At what gestational age should rhogam be given for threatened miscarriage

A

12 weeks

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6
Q

Rhogam for miscarriage?

A

50-120mcg before 12 weeks, especially after D&C

300 mcg after 12 weeks

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7
Q

Postpartum depression diagnostic criteria

A

5 out of 9 symptoms in the first four weeks after delivery

  1. Depressed mood
  2. Anhedonia
  3. Decreased energy
  4. Changes in sleep pattern
  5. Feelings of guilt or worthlessness
  6. Psychomotor slowing or agitation
  7. Suicidal ideation
  8. Decreased concentration
  9. Weight changes
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8
Q

Postpartum psychosis

A

Hallucinations, delusions, and profound thought disorganization that occurs in the first 2 weeks postpartum

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9
Q

Postpartum blues

A

Mild depressive symptoms, irritability, tearfulness, decreased concentration in the first 2-3 days postpartum and resolve by 10 days postpartum

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10
Q

Jarisch-Herxheimer reaction

A

Reaction to penicillin G with uterine contractions, fetal heart rate decelerations, and preterm labor, fever, myalgia
Usually resolves 24-48 hours

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11
Q

Ultrasound abnormalities associated with syphilis

A 
Nonimmune hydrops
Hepatomegaly
Placentomegaly
Polyhydramnios
Ascites
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12
Q

Ultrasound indicated cerclage

A

Performed if cervical length during cervical length screening is <2.5cm

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13
Q

3-6 months postpartum
Autoimmune thyroid dysfunction
Major risk factor is positive thyroid antibodies in the first trimester and GDM
Thyrotoxicosis –> transient hypothyroidism –> euthyroid at 12 months PP
Antithyroid treatments aren’t helpful, use beta blocker

A

Postpartum thyroiditis

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14
Q

Kidney changes during pregnancy

A

Kidney size increases 1-1.5cm, decreases in 6 months PP

Mild to moderate hydronephrosis and hydroureter, particularly on the right side

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15
Q

The IUD insertion approach in a breastfeeding woman that is considered category 1 (no restrictions) according to US Medical Eligibility Criteria is:

A

copper IUD within 10 minutes of placental separation

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16
Q

Preferred treatment for depression in pregnancy

A

CBT, psychotherapy

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17
Q

Edinburgh Postnatal Depresson Scale positive score

A

> 10

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18
Q

Division of embryo before day 4

A

Dichorionic twins (and diamniotic)

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19
Q

Embryo division days 4-8

A

Monochorionic diamniotic twins

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20
Q

Embryo division day 9-13

A

Monochorionic monoamniotic twins

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21
Q

Embryo division after 13 days

A

Conjoined twins

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22
Q

Risk of listeria in pregnancy

A

13 times more likely than nonpregnant patients

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23
Q

Type of cheese that should be avoided in pregnancy

A

queso fresco

soft unpasteurized

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24
Q

Type of tuna that should be limited in pregnancy (to one serving per week)

A

Canned albacore tuna
Fresh tuna
(canned light tuna is very low in methylmercury)

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25
Q

Fish that should be avoided in pregnancy

A 
Tilefish from Gulf of Mexico
shark
swordfish
marlin
orange roughy
bigeye tuna
king mackerel
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26
Q

Huntington procedure

A

For correcting uterine inversion

Serial clamping and upward traction on the round ligaments to restore uterine position

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27
Q

Haultain procedure

A

For correcting uterine inversion

Cervical ring is incised posteriorly to aid in repositioning of the uterus

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28
Q

Treatment of mastitis abscess

A

Drainage and culture (keep dicloxicillin going)

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29
Q

17 y/o with painless fluctuant, fluid filled 6cm mass on left lateral vagina, 4cm cephalad to hymenal ring

A

Mesonephric duct remnant

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30
Q

Major modifiable risk factors for obstetric anal sphincter injuries

A

Forceps-assisted delivery
Vacuum extraction
Prolonged second stage
Midline episiotomy

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31
Q

Most likely fetal karyotype with Tetralogy of Fallot

A

46 XY

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32
Q

Tetralogy of Fallot

A

VSD
Overriding aorta
Pulmonic valve stenosis
Right ventricular hypertrophy

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33
Q

Type of prenatal diagnostic test to perform if it’s because you find congenital heart disease

A

Genomic microarray

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34
Q

Congenital heart defect associated with Down syndrome

A

ASD

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35
Q

What is the infectious disease for which prepregnancy interventions are most likely to improve perinatal outcome?

A

HIV

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36
Q

Low PAPP-A correlates with

A

Low birth weight

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37
Q

Advantages of delivering at higher level NICU

A 
Lower mortality
Decreased severe intracranial hemorrhage
Decreased respiratory distress syndrome
Decreased patent ductus arteriosis
Decreased nosocomial infections
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38
Q

Contraindicated vaccines in pregnancy

A

Live influenza
MMR
Varicella
Zoster

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39
Q

Most common nutrient abnormalities after Roux-en-Y gastric bypass

A 
Protein
Iron
Vitamins B12 and D
Folic acid
Calcium
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40
Q

Highest risk for infection after needle stick

A

Hepatitis C

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41
Q

In history of alloimmunization in previous pregnancy, next step to address alloimmunization in this pregnancy if paternity is different

A

Determine rhesus type of the fetus

42
Q

Treatment of moderate to severe persistent asthma

A

Inhaled corticosteroid + short acting beta-2 agonist

Add long-acting beta-2 agonist

43
Q

Off label treatment that best increases milk supply

A

metoclopramide (Reglan)

44
Q

Safest mood stabilizer for breastfeeding

A

valproic acid (L2)

45
Q

HIV+ individual in pregnancy and hepatitis B anti-HB surface antigen is negative

A

Single booster dose of hepatitis B vaccine

retest anti-HB surface antigen in 1 month, and if <10 give other two doses of the vaccine on normal schedule

46
Q

Women at high risk of aneuploidy

A

> 35 y/o
Ultrasound findings suggestive of aneuploidy
History of prior pregnancy with trisomy
Increased risk of aneuploidy on traditional serum screening
Maternal or paternal balanced roberstonian translocation involving chromosome 21 or 13

47
Q

Suspicious adnexal mass, do CA-125 or refer to gyn onc?

A

Refer to gyn onc

CA-125 can be normal in some malignancies

48
Q

Best imaging modality for intracavitary lesions, intracavitary fibroids

A

Sonohysterography

49
Q

Management of chronic bronchitis (besides smoking cessation)

A

Beta-2 agonist

50
Q

The most appropriate way for pregnant patients to monitor her level of exercise intensity

A

Perceived exertion rate

51
Q

Anomaly that is the highest attributable increased risk from obesity

A

Neural tube defects

52
Q

Management of pregnant women with known influenza exposure

A

Chemoprophylaxis with oseltamivir

53
Q

Only recommended intervention with previable premature rupture of membranes

A

Antibiotics

Mag and steroids not until 23 weeks

54
Q

To reduce risk of fetal intellectual disability and birth defects, patients with PKU should ensure a diet

A

Low in protein

55
Q

Preeclampsia signs but accompanied by hypoglycemia?

A

Acute fatty liver of pregnancy

test ammonia and look out for altered mental status

56
Q

Prognosis for women who recover from peripartum cardiomyopathy with EF of 50%

A

Recurrence risk of 21% and no increased risk of mortality

57
Q

Prognosis for patients who have persistent cardiac dysfunction after peripartum cardiomyopathy, EF <50%

A

Recurrence risk of 48% and maternal mortality risk of 16%

58
Q

HIV viral load to warrant zidovudine prior to delivery

A

1000 copies

59
Q

Best way to reduce vertical transmission in patients with undetectable viral load of HIV

A

Avoid breastfeeding

60
Q

Contraindication to IR embolization for vulvar hematoma

A

Persistent coagulopathy

61
Q

Most common cause of severe polyhydramnios (>35cm)

A

Fetal abnormality like tracheo-esophageal fistula

62
Q

When to resume LMWH after vaginal delivery without epidural

A

4-6 hours

63
Q

Next step after diagnosing IUGR with abnormal dopplers at 35 weeks

A

BPP

64
Q

Activity restriction with short cervix

A

None

65
Q

Measles infection during pregnancy is associated with

A

Spontanous abortion
Still birth
Low birth weight
Risk of preterm delivery

66
Q

What does binge drinking increase during pregnancy

A

Stillbirth

67
Q

What perinatal infection accounts for the most cases of FGR worldwide

A

Malaria

68
Q

SGA newborns are predisposed to

A

Hypoglycemia
Hypothermia
IVH
RDS

69
Q

What percent of pregnancy loss are due to fetal chromosomal abnormalities

A

50%

70
Q

VBAC is associated with lower

A

VTE
Hemorrhage
Recovery time
Infection

71
Q

What % of diet should be obtained from protein when managing diabetes in pregnancy

A

15-30%

72
Q

Signs and symptoms of Zika

A

Fever
Rash
Arthralgias
Conjunctivitis

73
Q

What risk factor carries the highest rate of stillbirth

A

SLE

74
Q

Gestational age threshold for lung hypoplasia in women with ruptured membranes

A

23 weeks

75
Q

Which trisomy is most associated with spontaneous abortions

A

Trisomy 18

76
Q

Most maternal life-threatening complications of HSV

A

HSV hepatitis

77
Q

What typically happens to umbilical artery resistance

A

Progressively decreases throughout pregnancy

78
Q

Mother has BRCA1, what is patient’s baseline risk of inheriting the gene?

A

50%

79
Q

Amniocentesis test to provide the most rapid result in determining if fetus has down syndrome

A

FISH

80
Q

Chorioangiomas associated with

A

Normal pregnancy
Arterial venous shunting
Fetal anemia
FGR

81
Q

Benefits of delayed cord clamping

A

Improved blood count
Decreased need for transfusion
Decreased sepsis
Decreased intraventricular hemorrhage

82
Q

Ratio of chest compressions to breaths per minute in a term neonate

A

90:30

83
Q

Zika virus NAT negative and non-negative IgM, next step

A

Plaque reduction neutralization test

84
Q

Mechanism of RhoD immunoglobulin

A

Blocks D antigenic determinants on the erythrocyte membrane

85
Q

Leading cause of septic shock in pregnancy

A

Pyelonephritis

86
Q

Perinatal period

A

20 weeks to 4 weeks postpartum

87
Q

Kidd antibody that doesn’t require fetal assessment

A

JKa

88
Q

How is iodide transported across the placenta

A

Carrier mediated

89
Q

How to prevent pulmonary edema during evacuation of molar pregnancy in patient with hyperthyroidism

A

Beta blocker

90
Q

Most likely source of PPH after FAVD

A

Genital tract laceration

91
Q

Epidural analgesia prolongs the second stage of labor by how many minutes

A

5-10

92
Q

How is water transferred across the placenta

A

Bulk flow

93
Q

How many women develop DM in the next 25 years after GDM

A

70%

94
Q

Sacral agenesis occurs when

A

3-7 weeks

95
Q

VACTERL

A

Mullerian agenesis/uterine anomalies
Cardiovascular anomalies
TE fistula

96
Q

Beta thalassemia electrophoresis

A

HBA 96%, HBA2 > 3.5%

97
Q

Third leading cause of cancer among women

A

Colon

98
Q

Heart sound heard during pregnancy

A

S1 split

99
Q

Most common pelvic retroperitoneal mass related to urinary tract

A

Pelvic kidney

100
Q

Largest diameter of the fetal head at term

A

Supra occipital mental

101
Q

How to treat Donovan bodies

A

Azithromycin

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