Preconceptional care

Question 1

most common deficiency causing miscarriage

Answer 1

iodine deficiency

Question 2

criteria for discontinuation of anti-seizure meds

Answer 2

seizure-free for 2-5 yrs
single seizure type
normal neurologic exam and normal intelligence
normalized EEG w/ trt

Question 3

OGTT sched for low-risk & high-risk DM grp

Answer 3

LR: OGTT at 24-28 wks
HR: immediate OGTT

Question 4

cutoff FBS for GDM

Answer 4

> 92mg/dL - GDM

>126mg/dL - overt GDM

Question 5

what supplement should be given to epileptic women?

Answer 5

4mg folic acid

Question 6

what should be given to prevent recurrent pre-eclampsia?

Answer 6

low dose aspirin (80mg)

Question 7

how long is the recommended delay for pregnancy after receiving live-attenuated vax?

Answer 7

1 month

Question 8

general considerations for vax in pregnancy

Answer 8

never admin in buttocks
confirm completion of childhood/recent vax for MMR & Td before admin
maintain vax record
bigger needle for IM, smaller for SQ
simultaneous vax is not contraindicated
antibiotic trt or breastfeeding is not contraindicated

Question 9

general contraindicated for vax in pregnancy

Answer 9

severe allergy
live attenuated vax
severe immune attenuation
mod-severe acute illness

Question 10

defect with 1-2 per 1000 LB

Answer 10

NTD

Question 11

recommendation for maternal AFP screening

Answer 11

offered in 2nd trimester
can be measured as early as 1st trimester
measured between 14-22 wks

Question 12

low levels of AFP is seen in?

Answer 12

obesity
GDM
trisomies
GTD
fetal death
overestimated gestational age

Question 13

what are included in quad screen?

Answer 13

AFP
estriol
b-hCG
inhibin

detect NTD & certain trisomies, not applicable to multiple gestations

Question 14

what are included in ultra screen?

Answer 14

nuchal translucency in utz
free b-hCG
PAPP-A

newest screening for aneuploidies

Question 15

recommendation for ultra screen

Answer 15

done between 11-13 wks
still needs 2nd trim. MS-AFP for NTD detection
+: proceed to genetic counseling, high resolution utz, amniocentesis, chorionic villous sampling
may be offered to multiple gestations

Question 16

complications of untreated PKU

Answer 16

spontaneous abortion
mental retardation
microcephaly
congenital heart disease
fetal-growth restriction

Question 17

most common risk for aneuploidies and trisomy?

Answer 17

maternal age

Question 18

age grp w/ inc risk for anemia, preterm birth, & preeclampsia

Answer 18

15-19 y/o

Question 19

what is linked to molar pregnancy? paternal or maternal age?

Answer 19

paternal age

Question 20

DES maternal cancer

Answer 20

breast cancer (12-17%)
vaginal clear cell adenocarcinoma

Question 21

DES daughter risk

Answer 21

cervicovaginal clear cell adenocarcinoma
CIN
congenital anomalies of reprod. tract
subfertility
early menopause
breast Ca

Question 22

DES transgenerational effect

Answer 22

slight inc of irreg menses, amenorrhea, preterm birth
inc in birth defect
inc risk of ADHD

Question 23

modern DES

Answer 23

bisphenol-A

- xenoestrogen

Question 24

effect of pre-pregnancy obesity

Answer 24

LGA baby
inc CS
preeclampsia
GDM
late fetal death (3-4x)
early fetal death (2x)

Question 25

effect of pre-pregnancy underweight

Answer 25

preterm birth

SGA baby

Question 26

clinical significance of PROM

Answer 26

cord prolapse

intraamnionic infx

Question 27

most sensitive biometric measurement in diagnosing IUGR w/ false - of <10%

Answer 27

reduced abdominal circumference

Question 28

clinical feat of dysmaturity

Answer 28

actual loss of weight in utero
reduced SQ tissue
scaling & parchment-like skin

Question 29

what can be given in preterm labor bet 24-34 wks?

Answer 29

steroid

Question 30

major cause of premature birth, fetal death, & maternal morbidity

Answer 30

UTI

Question 31

_thyroidism is associated w/ inc LBW while _thyroidism inc stillbirth

Answer 31

hyper: LBW
hypo: stillbirth

Question 32

hexoaminidase A def

neurological motor & mental dysfuction w/ childhood death

Answer 32

tay-sachs ds

Question 33

IKBKAP gene mutation

neurological do, poor feeding, abnormal sweating, pain & temp insensitivity, labile BP, & scoliosis

Answer 33

familial dysautonomia

Question 34

aspartoacylase def

neurological do, dev’l delay, hypotonia, macrocephaly, seizure, blindness, GI reflux, childhood death

Answer 34

canavan ds

Question 35

recessive mutation of any several genes

severe anemia, pancytopenia, dev’l delay, failure to thrive, childhood death

Answer 35

fanconi anemia

Question 36

sphingomyelinase def

neurodegenerative ds, childhood death

Answer 36

niemann-pick ds type A

Question 37

neurodegenerative lysosomal storage do, growth failure, psychomotor retardation, retinal degeneration

Answer 37

mucolipidosis IV

Question 38

inc chromosomal breakage, susceptible to infx & malignancy, growth def, skin findings, mental retardation

Answer 38

bloom syndrome

Question 39

b-glucosidase def
affects spleen, liver, bones
anemia, brusing & bleeding, hepatosplenomegaly, & osteoporosis

Answer 39

Gaucher ds type 1