Old Exams Flashcards

1
Q

5 contraindications to external cephalic version

A
  • Uterine anomalies
  • Third-trimester bleeding
  • Multiple gestation
  • Oligohydramnios
  • Evidence of uteroplacental insufficiency
  • A nuchal cord identified by US
  • Previous cesarean delivery or other significant uterine surgery
  • Obvious Cephalopelvic disproportion (CPD)

Source: Creasy & Resnik’s, Chapter 43

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2
Q

Why irradiate blood before intrauterine transfusion?

A

To prevent graft-versus-host reaction

Source: Creasy & Resnik’s, Chapter 38, p. 639

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3
Q

What is the Barker Hypothesis?

A

This hypothesis proposes that early-life environment has long-term effects on the latter life

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4
Q

Name 3-4 differential diagnoses for a fetal anterior neck

A
  • Goiter
  • Cervical teratoma
  • Anterior lymphangioma
  • Cystic hygroma
  • Thyroglossal duct cyst
  • Branchial cleft cyst
  • Soft tissue tumors (All rare : hemangioma, fibromatosis, myofibromatosis, fibrosarcoma, rhabdomyosarcoma, neuroblastoma)
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5
Q

Name 3-4 differential diagnoses for a fetal sacral mass

A
  • Sacrococcygeal teratoma
  • Myelomeningocele
  • Terminal Myelocystocele
  • Lipoma
  • Vestigial tail
  • Sirenomelia
  • Other solid tumors (sarcoma)
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6
Q

One neonatal contraindication to give Naloxone

A

Opioid-dependent mother /Neonatal abstinence syndrome

“during neonatal resuscitation, naloxone should not be administered to a newborn of an opioid-dependent mother because of the risk of precipitating acute withdrawal and seizures.”

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7
Q

Name the effects of Magnesium Sulphate

A

Act on cell membranes to

  • slow or block neuromuscular and cardiac conducting system transmission
  • decrease smooth muscle contractility (decrease uterine contractility)
  • depress CNS irritability (desired anticonvulsant effect)
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8
Q

Name the potential adverse effects associated with MgSO4 toxicity?

A
  • Loss of deep tendon reflexes
  • Respiratory depression/paralysis
  • Electrocardiographic changes
  • Cardiac arrest
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9
Q

In case of respiratory failure due to Mg toxicity, Name the antidote and the dose needed

A

Calcium gluconate 10ml of 10% solution injected IV over 3 minutes

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10
Q

In case of cardiac arrest due to Mg toxicity, Name the antidote and the dose needed

A

Calcium gluconate 15-30ml of 10% solution injected IV over 3 minutes (1500-3000mg)

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11
Q

What does level I-A evidence mean?

A

Strong recommendation, high quality of evidence, can apply to most patients in most circumstances without reservation

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12
Q

5 differential diagnoses of postpartum headaches.

A
  • Postnatal headache/Migraine
  • Tension headache
  • Cluster headache
  • Postpartum Preeclampsia
  • Post dural puncture headache
  • Cerebral venous sinus thrombosis
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13
Q

screening tools for PTB with good NPV

A
  • Transvaginal ultrasound (TVU) measurement of cervical length
  • Testing for fetal fibronectin in cervico-vaginal fluid
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14
Q

Patient with Hepatitis C wants invasive testing? Which method of invasive testing has the most evidence in order to counsel this patient?

A

Amniocentesis

“In women with chronic hepatitis C infection, amniocentesis is recommended over chorionic villus sampling due to the limited data available on chorionic villus sampling (conditional, low).”
“Amniocentesis in women with a chronic hepatitis C infection does not appear to significantly increase the risk of vertical transmission of the virus; however, there is limited published cohort data, and this information should be shared with the patient during the informed consent process (conditional, low). “

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15
Q

What is a unique complication of early CVS?

A

Limb-reduction defects

Oromandibular-limb hypogenesis syndrome

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16
Q

3 conditions to screen for in Ashkenazi Jewish couple

A
  • Tay-Sachs disease
  • Canavan disease
  • Familial dysautonomia
  • Cystic fibrosis
17
Q

Patient with AFLP – what is the neonatal condition you have to test for?

A

Fatty acid oxidation defect - LCHAD deficiency

18
Q

3 fetal complications associated with maternal dialysis in pregnancy

A
  • IUGR/low birth weight
  • Fetal demise
  • Preterm delivery
19
Q

Indications for EXIT (Ex utero intrapartum treatment) Procedure

A

1- Disorders with potential to cause congenital airway obstruction

  • Congenital high airway obstruction syndrome (CHAOS)
  • Large head
  • Neck tumors

2- Upper airway problems that might cause difficult intubation
- Micrognathia

3- Need for fetal cardiopulmonary support during surgery (EXIT-to-ECMO)

20
Q

Patient is 11 weeks pregnant. Her brother has Hemophilia A, and she is a carrier. NIPT showed that the fetus is a male. She wants diagnostic testing because she will consider TOP if her fetus is affected. Which invasive testing will you offer her? And why? Name 2 advantages.

A

CVS

  • results will be available earlier
  • reducing anxiety
  • allowing earlier & safer TOP if results are abnormal
21
Q

Epileptic patient at 13 weeks. Stable on Keppra x 1 years. Admitted for hyperemesis gravidarum. You are called because she just had a seizure. Name 3 reasons to explain the decreased threshold for seizures.

A
  • Reduced gastric motility secondary to No/Vo
  • Decreased serum levels of Keppra without appropriate - dose adjustment to maintain plasma levels at prepregnancy value
  • Fatigue & sleep deprivation
  • Reduced absorption of anticonvulsant drug secondary to use of antacids
22
Q

Name 1 pituitary hormone that accelerate fetal lung maturity.

A

ACTH

23
Q

Most common enzyme deficiency in CAH?

A

21-hydroxylase deficiency

24
Q

What do you recommend for management of maternal PKU to optimize fetal outcomes?

A
  • Maternal dietary treatment (dietary restriction of phenylalanine intake)
  • Monitoring of phenylalanine concentrations before conception and at least biweekly throughout pregnancy to maintain levels between 120-360𝜇mol/L
25
Q

What are the most common maternal malignant tumors that metastasize to the placenta?

A
  • melanoma
  • leukemia
  • lymphoma
  • breast cancer

Source: Williams Obstetrics, 25th Ed

26
Q

Medications to manage alcohol withdrawal in pregnancy?

A
  • Thiamine 100mg po od x 3 days & folic acid 5mg po od
  • Diazepam 20mg po q1-2h until minimal symptoms
  • lorazepam 2-4mg sl/po q2-4h prn during labour

Also need to monitor hydration status and electrolyte levels

Source: SOGC No.349