Pregnancy

Question 1

Pregnancy is

Answer 1

a time sensitive endeavor
not a disease
needs little intervention

Question 2

Most important assessment with pregnancy

Answer 2

constant vigilance

Question 3

First trimester

Answer 3

0-12 weeks

Question 4

Second trimester

Answer 4

13-28 weeks

Question 5

Third trimester

Answer 5

29-40 weeks

Question 6

Qualitative lab value for pregnancy

Answer 6

yes/no are you pregnant?

Question 7

Quantitative lab value for pregnancy

Answer 7

an actual value that should double in 48 hours

Question 8

Early vaginal bleeding

Answer 8

do you need to draw quants
what is their blood type (Rhogam)
progesterone

Question 9

First trimester screening

Answer 9

Nuchal Translucency (PAPP-A Blood
HCG
chorionic villus sampling
(these are optional and look at folds on back of the neck)

Question 10

Second trimester screening

Answer 10

gender ultrasound (18-22 weeks)
GDM (24-28wks)
Anemia (24-28 wks)
RhoGam for RH neg moms

Question 11

Third trimester screening

Answer 11

GBS 36-37 weeks

Question 12

Monitor those overdue

Answer 12

NSTs

BPPs

Question 13

Calculate EDD

Answer 13

subtract 3 months + 7 days

Question 14

Goal during preconception

Answer 14

optimize health
minimize risk
folic acid

Question 15

Advanced maternal age

Answer 15

35 years and older

Question 16

Pregnancy visits

Answer 16

Q4 weeks until 28 weeks
Q2 weeks until 36
Q week until delivery

Question 17

components of pregnancy visits

Answer 17

Wt
UA
BP
fetal movment
fundal ht
cervical exam

Question 18

Fundal height at 20 weeks

Answer 18

at umbilicus from symphysis pubis to fundus

Question 19

New OB labs

Answer 19

G/C
UA
Pap
HIV
RPR/VDRL
Type & screen
Hep B
CBC

Question 20

Antidepressant Drug of choice PP

Answer 20

Zoloft

Question 21

Postpartum visit

Answer 21

at 6 weeks and 3 months

Question 22

High risk screen for GDM

Answer 22

at 1st prenatal visit if family hx, prev preg with GDM, PCOS

Question 23

1 hour glucose challenge

Answer 23

50g glucose oral solution

Question 24

Indication of need for 3 hour GTT

Answer 24

1 hour glucose >135

Question 25

Diagnose GDM

Answer 25

2 out of 4 values abnormal in 3 hour

Question 26

Goal of GDM tx

Answer 26

FBS <140 reduce macrosomia reduction of stillbirth

Question 27

Risks with GDM

Answer 27

``` Spont AB IUFD Congenital malformations (VSD) neural tube defects sacral agenesis ```

Question 28

Fetal surveillance with GDM

Answer 28

weekly NSTs starting at 28-32 weeks | serial ultrasounds

Question 29

Chronic HTN in pregnancy

Answer 29

elevated BP < 20 weeks | BP >140 systolic and presists >12 weeks PP

Question 30

Pregnancy induced HTN

Answer 30

elevated BP after 20 weeks

Question 31

Edema in pregnancy

Answer 31

considered normal

Question 32

Risk factors for preeclampsia or eclampsia

Answer 32

``` paternal mother daughters of preeclmaptic mothers sister nulliparity pregnancy with new father less than 20 yo greater than 35 yo ```

Question 33

When is final diagnosis made for gestational hypertension

Answer 33

12 weeks PP if BP returns to normal

Question 34

Mild Preeclampsia

Answer 34

``` diastolic BP <100 trace to 1+ protein No HA No epigastric pain Neg thrombocytopenia normal creatinine mild elevation in lfts ```

Question 35

Severe Preeclampsia

Answer 35

``` SBP >160, DBP >110 2+ protein HA epigastric pain creatinine >1 hyperbilirubinemia thrombocytopenia pulmonary edema oligouria <500ml/24 hours ```

Question 36

Gold standard for protein eval

Answer 36

24 hour urine (>300mg/24 hours)

Question 37

Superimposed Preeclampsia on chronic HTN

Answer 37

new onset proteinuria sudden increase in BP, LFTs decreased plts

Question 38

Acute urethritis caused by

Answer 38

E. coli N. gonorrhea C. trachomatis

Question 39

If there is a hx of recurrent UTIs

Answer 39

test for a cure every trimester screening with culture suppression therapy with macrobid

Question 40

Tx of UTI in pregnancy

Answer 40

Amox 500 TID x 7 days Cephalosporin 250 QID x 7 days Macrobid (Nitrofurantion) 100 BID x 7 days

Question 41

Pyelo in pregnancy

Answer 41

bacterial infection of upper urinary tract unilater usually more common in 2nd and 3rd trimesters

Question 42

Pyelo s/s

Answer 42

fever/chills flank pain hematuria CBC left shift

Question 43

Spont AB

Answer 43

unintended termination before 20 weeks | most occur before 12 weeks

Question 44

If more than 3 SAB

Answer 44

recommend genetic counseling and reproductive endocrine

Question 45

Preterm labor

Answer 45

any time 20weeks to 37 weeks | cervical length 30 mm, no risk

Question 46

Predictors of preterm birth

Answer 46

previous PT del cerv length BV cervicovaginal fibronectin

Question 47

If size > dates

Answer 47

``` inaccurate dates fibroids multiple gestation poly DM Breech presentation LGA ```

Question 48

If size < dates

Answer 48

``` inaccurate dates small mom maternal HTN smoking IUGR abnormal cord insertion fetal anomalies ```