Pregnancy / Childbirth

Question 1

Trisomy 21

Chromosome 21 nondisjunction during…?

Answer 1

Oogenesis (associated with advanced maternal age). Not seen in spermatogenesis or in post-zygotic mitotic errors

Question 2

Neural tube defects: findings at screening

Answer 2

High AFP in amniotic fluid and maternal serum
Increased acetylcholinesterase in amniotic fluid

Neural tube defects can result from maternal folic acid deficiency and use of folic acid antagonists

Question 3

Omphalocele and gastroschisis: findings at screening

Answer 3

High AFP in amniotic fluid and maternal serum

Question 4

Down syndrome: findings at screening

Answer 4

Low levels of maternal serum AFP and estriol

Increased levels of βHCG and inhibin A

Question 5

Septic abortion: clinical presentations?

Answer 5

Fever, abdominal pain, chills, uterine tenderness, foul-smelling discharge
Common pathogens: Staphylococcus aureus and Escherichia coli

Question 6

Placental abruption mechanism?

Answer 6

Maternal vessels rupture at the uteroplacental interface. The bleeding causes placental separation from the uterine myometrium

Risk factors: hypertension, abdominal trauma, tobacco or cocaine use (vasoconstrictors)

Question 7

Placental abruption high-frequency contractions: why?

Answer 7

Blood acumulation: uterine irritability

Question 8

Placenta accreta: typically diagnosed in antepartum or postpartum?

Answer 8

Postpartum, when the placenta does not detach from the uterine wall, resulting in postpartum hemorrhage

Question 9

Mole: risk factors?

Answer 9

Extremes of maternal age, prior molar pregnancy and prior miscarriage

Question 10

hPL (human placental lactogen) increases insulin resistance (preserving glucose and amino acids for fetus) and lipolysis, resulting in … to provide energy to the mother?

Answer 10

Free fatty acids and ketones

Question 11

Preeclampsia: most likely caused by … ? (pathophisiology)

Answer 11

Narrowed uteroplacental spiral artery formation and abnormal placentation, which lead to placental hypoperfusion and ischemia. These changes trigger the release of antiangiogenic factors that cause widespread maternal vasoconstriction, endothelial cell damage and end-organ damage

Question 12

Sofrimento fetal: pH fetal abaixo de … ?

Sangue fetal: padrão ouro para avaliar sofrimento, mas não muito utilizado (procedimento complexo)

Answer 12

7,15 - 7,2

Question 13

O feto deve apresentar aceleração transitória (coração) com duração de pelo menos … ? E FC normal entre … ?

Answer 13

15s

110 - 160

Question 14

Desaceleração (coração) é precoce (normal) quando é relacionada no tempo com … ?

Answer 14

Contração uterina

Question 15

Healthy pregnant patients have … baseline serum creatinine levels due to blood volume expansion and … GFR

Answer 15

Decreased
Increased

A normal-appearing creatinine level during pregnancy typically indicates renal compromise

Question 16

Pregnant women with severe preeclampsia can develop HELLP syndrome, which stands for… ?

Answer 16

Hemolysis
Elevated Liver enzymes
Low Platelet count

It causes widespread endothelial dysfunction

Question 17

Abruptio placentae: maternal complications?

Answer 17

Hemorrhage and disseminated intravascular coagulation

Question 18

A rise in GFR occurs with increased renal circulation mediated by the hormone…?

Answer 18

Relaxin, which is in turn stimulated by β-hCG

Relaxin also increases joint laxity

Question 19

Pregnancy hormones … urethral tone and relax the … muscles

Answer 19

decrease / pelvic floor

Question 20

Medicine for ectopic pregnancy?

Answer 20

Methotrexate
(It can be harmful for a new baby to come, so use of contraception for at least 3 months after treatment is necessary. Also, drinking soon after receiving a dose of methotrexate can damage the liver)