Obstetrics

Question 1

MCV in hemodilutional anemia

Answer 1

normal

Question 2

Cause of hemodilutional anemia

Answer 2

greater increase in blood volume than RBC mass

Question 3

Define phsyiologic dyspnea of pregnancy

Answer 3

seen in the third trimester.

Possibly caused by changes in diaphragm positioning, or altered respiratory center sensitivity.

Question 4

Changes in PFTs during pregnancy

Answer 4

• increased in tidal volume
• no change in RR
• Increased minute ventilation
• Increased inspiratory capacity (due to increase tidal volume).

Question 5

Pulmonary edema during preterm labor

Answer 5

often as a result of the use of multiple tocolytics

Question 6

Cause of increased CO during pregnancy =

Answer 6

Increased HR AND stroke volume

Question 7

Etio of increased rate of right sided hydronephrosis =

Answer 7

Compression by markedly dilated R-renal vain complex which lies across the ureter AND compression by the uterus

Question 8

Recommended weight gain during pregnancy

Answer 8

Underweight - 28-40 Lbs
Normal - 25-35
Overweight - 15-25
Obese - 11-20

Question 9

Blood tests for African American couples for preconception care

Answer 9

• CBC

- Hb electrophoresis (rule out all thalasemmias and sickle cell)

Question 10

Issue with sickle cell and peripheral blood smear

Answer 10

• often negative in carriers

- sometimes negative in patients with disease

Question 11

Fetal anomalies associated with type 1 diabetes

Answer 11

cardiac anomalies

neural tube defects

Question 12

5 tests available to check for trisomy 18 and 21 ranked by best detection rate:

Answer 12

(1) Sequential Screen
(2) Serum Integrated Screen
(3) First trimester combined test
(4)

Question 13

Gestational age at which you detect neural tube defects by US

Answer 13

16 to 18 weeks

Question 14

Caudal regression syndrome seen in…

Answer 14

offspring of poorly controlled diabetics

Question 15

Anticoagulation during pregnancy

Answer 15

LMW heparin is best

Warfarin is a teratogen

Question 16

Glucosuria an issue?

Answer 16

Not really, many patients can present with +1 glucose in the urine

Question 17

Signs of maternal dehydration

Answer 17

Tachycardia

Ketonuria

Question 18

Contraction frequency concerning for labor picking up

Answer 18

contractions every 5 minutes for an hour

Question 19

If an intrauterine pressure catheter is placed, and a significant amount of vaginal bleeding is noted…

Answer 19

the possibility of placenta separation or uterine perforation

In this case, withdrawing the catheter, monitoring the fetus and observing for any signs of fetal compromise would be the most appropriate management.