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Study Guides > Obstetrics > Flashcards

Obstetrics Flashcards

1
Q

What are the normal structures and adult levels of the following Hb types?

A
A2
F
Hb H
Hb Bart
A 
A- 2 alpha and 2 beta 97%
A2- 2 alpha and 2 gamma 2.5%
F- 2 alpha and 2 delta <1%
HbH - 4 beta
Hb Bart- 4 alpha
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2
Q

Which Hb type has heintz bodies on peripheral smear?

A

Hb H- 4beta, alpha thalassemia

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3
Q 
Risk of Down's at age:
30
35
40
45
A

30: 1/1000 –> 40: 1/100
35: 1/365 –> 45: 1/36

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4
Q

Risk of aneuploidy risk by maternal age

30
35
40
45

A

30: 1/500
35: 1/180
40: 1/50
45: 1/18

divide the denominator in half from risk of downs

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5
Q

Nuchal translucency cut off for further evaluation

A

> 3mm

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6
Q

Fetal Circulation:
highest PO2
lowest PO2

A

right atrium

right ventricle

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7
Q

Fetal Circulation:
highest PCO2
lowest PCO2

A

right ventricle

right atrium

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8
Q

Placenta crossing

simple diffusion (5)

A

cocaine, O2, CO2, electrolytes, ketones

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9
Q

Placenta crossing

Active transport (4)

A

amino acids
calcium
phosphorus
Iron

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10
Q

Tetrology of Fallot

A

overriding aorta, pulm stenosis, hypertrophic right vent, VSD

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11
Q

Placenta crossing

endocytosis
bulk flow
carried-mediated

A

IgG
water
iodine

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12
Q

Which of the follow can cross the placenta?

  1. PTU
  2. TSH
  3. T3/T4
  4. insulin
  5. propranolol
  6. heparin
  7. predinisone
A

PTU, propanolol

  1. yes
  2. no
  3. no x2 per pubmed
  4. no
  5. yes
  6. no
  7. no
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13
Q

Physiology of pregnancy
Which of the following decrease in pregnancy?

  1. SVR
  2. HR
  3. CO
  4. plasma volume
  5. red cell volume
  6. CO2
A

SVR and CO2

  1. decrease
  2. increase
  3. increase
  4. increase
  5. increase
    6 decrease
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14
Q

Pulm changes in pregnancy
Which of the following decrease?

  1. RV
  2. ERV
  3. VC
  4. TV
  5. IC
  6. TLC
  7. IRV
  8. FRC
A
  1. decrease
  2. decrease
  3. no change
  4. increase
  5. increase
  6. decrease
  7. no change
  8. decrease

decrease: take the RV to the ERv for some TLC bc it’s FRcEE
increase: IC the TV hanging high on the wall

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15
Q

Progesterone effects on lipids (incr, decr)

HDL
LDL

A

HDL decrease

LDL increase

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16
Q

Coagulation Changes in Pregnancy

Which of the following decrease?

  1. protein s
  2. protein c
  3. antithrombin 3
  4. factor 2
  5. factor 5
  6. factor 7
  7. factor 8
  8. factor 9
  9. factor 10
  10. factor 11
  11. factor 13
  12. vWF
  13. plasminogen activator 1
  14. plasminogen activator 2
  15. fibrinogen
A

only 11, 13, and protein s decrease

  1. decrease
  2. no change
  3. no change
  4. no change
  5. no change
  6. increase
  7. increase
  8. no change
  9. increase
  10. decrease
  11. decrease
  12. increase
  13. increase
  14. increase
  15. increase
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17
Q 
thyroid changes in pregnancy (and with OCPs)
incr, decr, no change
1. Iodine
2. total T4
3. free T4
4. RT3U
5. TSH
6. FTI
A
  1. decrease
  2. increase
  3. no change
  4. decrease
  5. no change
  6. no change
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18
Q

measurement for contracted pelvis is an OB conjugate of …

A

<10.5cm

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19
Q

How many cells are in morula?
Is it diploid or haploid?
how many days after fertilization?

A

16, diploid, 2-3

20
Q

How many cells are in blastocyst?
Is it diploid or haploid?
how many days after fertilization?

A

32, diploid, 4-5

21
Q

At term how much do these measure?

BPD
femur length

A

bpd 9.3cm

femur length 7.4cm

22
Q

How to calculate weeks gestation from CRL?

A

CRL cm + 6.5cm= weeks gestation

23
Q

rate the mortality risk for these conditions in pregnancy

Which of the following are medium risk?

  1. ASD/VSD
  2. mitral stenosis class 1/2
  3. mitral stenosis class 3/4
  4. porcine valve
  5. artificial valve
  6. prior MI
  7. marfans with normal aorta
  8. uncorrected tet of fallot
  9. pulmonic/tricuspid disease
  10. aortic stenosis
  11. PDA
A

low <1%
med 5-15%
high 25-50%

  1. low
  2. low
  3. med - Mitral stenosis class 3/4
  4. low
  5. med - artificial valve
  6. med - prior MI
  7. med - marfans normal aorta
  8. med - uncorrect tet of fallot
  9. low
  10. med - aortic stenosis
  11. low
24
Q

peripartum cardiomyopathy

  1. how to make dx?
  2. time frame from delivery
  3. most common cause
  4. risk factors (4)
  5. buzz words (3)
  6. ejection fraction
A
  1. dx of exclusion
  2. last month of pregnancy to 5 months postpartum
  3. myocarditis
  4. PEC, anemia, multiples, short interval pregnancy
  5. soluble FMS-like tyrosine kinase, oxidative stress, impaired VEGF signaling
  6. less than or equal to 45%
25
Q

peripartum cardiomyopathy rx and why?

4 things

A
  1. diuretics to decrease preload (central vasc)
  2. hydralazine to decrease afterload (peripheral vasc)
  3. Digoxin to increase CO unless complex arrhythmia noted
  4. anticoagulation for VTE
26
Q

peripartum cardiomyopathy prognosis

Good prognosis: ____% of women will regain vent function within ___ months

Bad prognosis: black, what age, what EF?

A

Good prognosis: 50% of women will regain vent function within 6 months

Bad prognosis: black, age 35-40, EF <25%

27
Q

Inheritance pattern

  1. marfans
  2. PKU
  3. huntington’s
  4. CF
  5. galactosemia
  6. von willebrand’s dz
  7. placental sulfatase deficiency
  8. hemophilia
A
  1. marfans - AD
  2. PKU - AR
  3. huntington’s - AD
  4. CF - AR
  5. galactosemia - AR
  6. von willebrand’s dz - AD
  7. placental sulfatase deficiency - sex-linked
  8. hemophilia - sex-linked
28
Q

Inheritance pattern

  1. neural tube defect
  2. tay sachs
  3. mucopolysaccaridosis
  4. muscular dystrophy
  5. thalassemia
  6. mullerian agenesis
  7. AIS/androgen receptor deficiency
  8. CAH
A
  1. NTD- multifactorial
  2. tay sachs- AR
  3. mucopolysaccaridosis - AR
  4. muscular dystrophy- sex-linked
  5. thalassemia - AR
  6. mullerian agenesis- multifactorial
  7. AIS/androgen receptor deficiency- sex-linked
  8. CAH- AR
29
Q

recurrence rate for multifactorial inheritance?

chromosomal errors?
sex-linked?

A

3-5%, 1%, 50%

30
Q

survival rate for turners?

A

<10% survive to 1 year

31
Q

high or low MsAFP

  1. GTD
  2. cystic hygroma
  3. osteogenesis imperfecta
  4. congenital nephrosis
A
  1. low
  2. high
  3. high
  4. high
32
Q

normal EFW at the follow gest ages

20
28
32
34

growth after 34wks??

A

300
1000
1600
2000

250g per week after 34 wks

33
Q

Bishop score rules

  1. SVE to get max points?
  2. SVE to 1 point each?
A

5/80/+1/soft/anterior

1-2/40-50/-2/med/mid-position

34
Q

what percentage of brachial plexus injuries have significant lasting effects?

A

15%

35
Q

which muscles are impacted during erb’s palsy? (3)

A

deltoid
infraspinatus
flexor

36
Q

top 3 vaccuum injuries

A

scalp lac, cephalohematoma, subgleal hematoma

37
Q

TORCH

congenital hearing loss, blueberry muffin baby

A

CMV

38
Q

TORCH

fetal effects of varicella (6)

A 
limb hypoplasia
neonatal death
chorioretinitis
cataracts
cutaneous scarring
pna
39
Q

toxoplasmosis rx
parvovirus rx
cmv rx
varicella rx

A

spiramycin
none
none
acyclovir, valacyclovir, Ig

40
Q

Pulm changes in pregnancy
Which of the following increase?

  1. RV
  2. ERV
  3. VC
  4. TV
  5. IC
  6. TLC
  7. IRV
  8. FRC
A
  1. decrease
  2. decrease
  3. no change
  4. increase
  5. increase
  6. decrease
  7. no change
  8. decrease

decrease: take the RV to the ERv for some TLC bc it’s FRcEE
increase: IC the TV hanging high on the wall

41
Q

Pulm changes in pregnancy
Which of the following do not change?

  1. RV
  2. ERV
  3. VC
  4. TV
  5. IC
  6. TLC
  7. IRV
  8. FRC
A

VC, IRV

  1. decrease
  2. decrease
  3. no change
  4. increase
  5. increase
  6. decrease
  7. no change
  8. decrease
42
Q

Coagulation Changes in Pregnancy

Which of the following increase?

  1. protein s
  2. protein c
  3. antithrombin 3
  4. factor 2
  5. factor 5
  6. factor 7
  7. factor 8
  8. factor 9
  9. factor 10
  10. factor 11
  11. factor 13
  12. vWF
  13. plasminogen activator 1
  14. plasminogen activator 2
  15. fibrinogen
A

factor 7, factor 8, factor 10, vWF, PA 1, PA 2, fibrinogen

  1. decrease
  2. no change
  3. no change
  4. no change
  5. no change
  6. increase
  7. increase
  8. no change
  9. increase
  10. decrease
  11. decrease
  12. increase
  13. increase
  14. increase
  15. increase
43
Q

severe range BP - IV labetalol

start with \_\_\_
recheck in \_\_\_ min
give \_\_\_\_
recheck in \_\_\_ min
give \_\_\_\_\_
recheck in \_\_\_ min
give \_\_\_\_
A

severe range BP - IV labetalol

start with 20mg IV
recheck in 10 min
give 40mg IV
recheck in 10 min
give 80mg IV
recheck in 10 min
hydralazine 10mg
44
Q

severe range BP - IV hydralazine

start with \_\_\_
recheck in \_\_\_ min
give \_\_\_\_
recheck in \_\_\_ min
give \_\_\_\_\_
recheck in \_\_\_ min
give \_\_\_\_
A

severe range BP - IV hydralazine

start with 5 or 10mg IV
recheck in 20 min
give 10mg IV
recheck in 20 min
give labetalol 20mg
recheck in 10 min
give labetalol 40mg IV
45
Q

severe range BP - PO Nifedipine

start with \_\_\_
recheck in \_\_\_ min
give \_\_\_\_
recheck in \_\_\_ min
give \_\_\_\_\_
A

severe range BP - PO Nifedipine

start with 10mg
recheck in 20 min
give 20mg
recheck in 20 min
give labetalol 40mg
46
Q

what is the MOST sensitive week for NT screening?

A

13 weeks

However, the 99% sensitivity cut off is the same at any week from 10 to 14.

47
Q

list the 4 stages of parturition

A
  1. mild ctx, softening the cervix before labor
  2. cervical ripening
  3. all the stages of labor
  4. pp recovery

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