Obstetrics & Gynecology

Question 1

Weeks gestation for uterine fundus to grow out of pelvis?

Answer 1

12 weeks (level of pubic symphisis)

Question 2

Weeks gestation for uterine fundus to reach umbilicus

Answer 2

20 weeks

Question 3

Weeks gestation for uterine fundus to reach xiphoid process?

Answer 3

36 weeks

Question 4

Effects of pregnancy on respiratory system

Answer 4

Vt increases while FRC decreases 2/2 elevation of diaphragm (RR remains unchanged)

Question 5

Effects of pregnancy on cardiovascular system

Answer 5

CO increases 2/2 increased blood volume & resting HR (by 10-15 bpm); SVR decreased overall with DBP decreased (primarily in 1st trimester)

Question 6

Effects of pregnancy on renal & metabolic systems

Answer 6

• Increased kidney size, renal blood flow & GFR

- Increased peripheral resistance to insulin

Question 7

Effects of pregnancy on hematopoietic system

Answer 7

Hb decreases 2/2 volume dilution while WBC increases (mildly)

Question 8

Course of asthma in pregnancy?

Answer 8

1/3 worsen, 1/3 stay stable, 1/3 improve

Question 9

How quickly following maternal arrest should perimortem cesarean section be performed to provide favorable neurological outcome for mother & fetus?

Answer 9

5 minutes

Question 10

Antibiotics for endometritis

Answer 10

Clindamycin + gentamicin (add ampicillin or use ampicillin-sulbactam if GBS colonized)

Question 11

What asthma medication should be avoided in pregnancy?

Answer 11

Epinephrine (teratogenicity during first trimester; may also cause uterine vasoconstriction & reduced fetal oxygenation)

Question 12

Unique anti-HTN medicine in pregnancy

Answer 12

Methyldopa (centrally acting alpha agonist)

Question 13

Pre-eclampsia diagnostic criteria

Answer 13

HTN (>=140/>=90) after 20w pregnancy + proteinuria or other signs of end-organ dysfunction