Pregnancy

Question 1

if the rectus abdominis is transected horizontally, the ________ arteries must be ID’d and ligated bilaterally to prevent bleeding complications

Answer 1

inferior epigastric

Question 2

an _______ pregnancy is characterized by implantation outside of the uterus. Uterine curettage would reveal ________ in the endometrium due to progesterone secretion but no embryonic or trophoblastic tissue

Answer 2

ectopic

decidual changes (dilated, coiled endometrial glands and edematous stroma)

Question 3

38 weeks of uncomplicated pregnancy, newly found gallstones that weren’t present 1 year ago. THis is due to ______ induced cholesterol hypersecretion and __________ induced gallbladder hypomotility

Answer 3

estrogen

progesterone

Question 4

infant becomes hypertonic, tremors, seizures, sweating, sneezing, diarrhea, vomiting, feeding intolerance, mother with schizophrenia and +HepC =

treatment with

Answer 4

neonatal abstinence syndrome (opioid withdrawal)

methadone

Question 5

____________ syndrome is characterized by neonatel defects of the head (microcephaly), cataracts (white pupils), deafness, PDA (machine like murmur)

prevented by mother accepting a _____________

Answer 5

congential rubella

live attenuated rubella virus vaccine

Question 6

Unbalanced Robertsonian translocations ___________ are responsible for a minority of ________syndrome cases

Answer 6

46 XX t(14,21)

Question 7

bhCG levels become detectable in serum _______ after fertilization. It is produced by the syncytiotrophoblast after implantation. It is detectable in the urine 14 days after fertilization

Answer 7

8 days

Question 8

28 weeks, markedly eleavted amniotic fluid levels. Patient feels SOB when supine, history of epilepsy controlled with medication, abdominal circumference larger than expected for gestation age = ___________ most likely due to ____________ from _____________ exposure

Answer 8

polyhydraminos

anencephaly

anti-epileptic

Question 9

valproate decreases levels of ______ and increases risks of _________ like meningocele

Answer 9

folic acid

neural tube defects

Question 10

pulmonary hypoplasia, flat facies, and limb deformities =

due to ______ from a urinary tract anomaly leading to anuria/oliguria in utero

mother was hypertensive and unaware she was pregnant, so most likely due to maternal use of ______ or ________, as AngII is required for normal renal development

Answer 10

Potter sequence

oligohydramnios

ACEI or ARBs

Question 11

Diabetes during pregnancy is associated with premature delivery, fetal malformatons, polycythemia and hyperviscosity, respiratory distress, fetal ________, and transient ________

Answer 11

macrosomia

hypoglycemia

Question 12

open neural tube defects, ventral wall defects, and multiple gestation result in ______ AFP

aneuploidies result in ______ AFP. Trisomy 21 is associated with decreased estriol, and increased bHCG and inhibin A as well

Answer 12

increased

decreased

Question 13

Pre-eclampsia is characterized by new onset elevated blood pressure at >20 weeks gestation and _______ or signs of end organ damage

Eclampsia is characterized by pre-eclampsia and _______

Gestational HTN is pre-eclampsia without ________

Answer 13

proteinuria

grand mal seizures

proteinuria or end organ damage

Question 14

______ is commonly used to treat bipolar disorder. Its use during pregnancy is associated with Ebstein’s anomaly, which is characterized by ___________, decreased right ventricular volume, and atrialization of the right ventricle

Answer 14

Lithium

apical displacement of the tricuspid valve leaflets

Question 15

a __________ will have a triploid karyotype (69, XXX or XXY) and contain fetal tissue with some edematous villi with focal trophoblastic proliferation and normal appearing villi. Patients present with vaginal bleeding, and prior miscarriage is a risk factor

Answer 15

parial mole

Question 16

primary oocytes are completely developed in female embryos by the 5th month of gestation, at which point they are arrested in _______________. Normal menstrual cycle hormones stimulate the primary oocyte to resume differentiation. Prior to fertilization, secondary oocytes are arrested in _____________

Answer 16

prophase of meiosis I

metaphase of meiosis II

Question 17

_________ increases maternal insulin resistance during the second and third trimesters, leading to a rise in serum glucose that helps provide adequate nutrition to the growing fetus. Gestational diabetes occurs when the compensatory rise in maternal insulin secretion is inadequate to prevent serum glucose levels from reaching excessively high levels

Answer 17

human placental lactogen

Question 18

isotretinoin is used to treat severe acne with significant scarring. Pregnancy is absolute contrainindication due to the risk of teratogenicity. Sexually active women should be advised to use 2 forms of contraception and take monthly pregnancy tests that measure ________

Answer 18

urine beta-hCG

Question 19

high ________ levels inhibit lactation through negative feedback on prolactin in the anterior pituitary

Answer 19

progesterone

Question 20

patients with a history of ________ are at risk for inaccurate pregnancy dating which can lead to falsely low levels of AFP

Answer 20

irregular menses

Question 21

________ converts androgens into estrogens in the ovaries, testes, placenta, and other peripheral tissues. Placental _________ deficiency causes accumulation of androgens during pregnancy, resulting in ambiguous external genitalia in female infants and maternal virlization

Answer 21

Aromatase

aromatase

Question 22

a ________ is composed of multiple cystic edematous hydropic villi as a result of trophoblast proliferation. Serial measurements of _______ should be performed following evacuation of a hydatidiform mole. Persistently elevated or rising levels signify development of an invasive mole or choriocarcinoma

Answer 22

complete mole

Beta hCG

Question 23

teeth staining =

gray baby syndrome =

neural tube defects =

otoxicity, vestibulotoxicity =

antibiotics contraindicated during pregnancy

Answer 23

tetracyclines

chloramphenicol

TMP-SMX

aminoglycosides

Question 24

________ is a malignant form of gestational trophoblastic disease composed of anaplastic ____________ without villi. It often presents as dyspnea/hemoptysis due to pulmonary metastasis from hematogenous spread and can be found after delivery

Answer 24

Choriocarcinoma

cytotrophoblasts and syncytiotrophoblasts

Question 25

dizygotic twins result from fertilization of 2 oocytes by 2 different sperm and always have 2 amnions and 2 chorions. Dichorionic/diamnioic is the most ______ and occurs at days (_____) monochorionic diamniotic occurs at days _____ monochorionic monoamniotic occurs at days ______ monochorinoic monoamniotic conjoined occurs at _____

Answer 25

common, 0-4 4-8 8-12 >13

Question 26

shortly after delivery, patient has chest pain and difficulty breathing, cardiogenic shock, hypoxemic respiratory failure, DIC, seizures and coma =

Answer 26

amniotic fluid embolism

Question 27

immigrant from middle east, develops low grade fever, maculopapular rash that spreads from face and chest to trunk and extremities with posauricular LAD = mother at risk for congenital defect

Answer 27

rubella polyarthralgia deafness

Question 28

postpartum hemorrhage is an obstetric emergency and can result from ________. Prior uterine surgery can impair decidualization, resulting in myometrial invasion by villous tissue and a placenta that is abnormally adherent to the myometrium (_______) premature detachment of placenta prior to delivery acute abdominal pain, profuse vaginal bleeding, fetal distress most common cause of postpartum hemorrhage is ________ which is the failure of the uterus to contract adequately after delivery

Answer 28

abdnormal placentation placenta accreta placental abruption uterine rupture uterine atony

Question 29

child prefers to hold head tilted to one side = most commonly a result of _______ ____ in utero

Answer 29

congenital torticollis malposition of the head