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CK OB > Prenatal labs > Flashcards

Prenatal labs Flashcards

1
Q

normal values of Hb in pregnancy will reflect the ______

A

dilutional effect of greater plasma volume increase than red blood cell (RBC) mass.

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2
Q

Because hemoglobin and hematocrit reflect pregnancy dilution, ________ may be the most reliable
predictor of true anemia.

A

MCV

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3
Q

A low hemoglobin and low MCV (<80 mm3) most commonly suggests _________

A

iron deficiency, but may also be caused by thalassemia

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4
Q

A low platelet count (<150,000/mm3) is most likely indicative of___________

A

gestational (pregnancy-induced)

thrombocytopenia

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5
Q

White blood cell count in pregnancy is normally up to 16,000/mm3. Leukopenia suggests
__________

A

immune suppression or leukemia.

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6
Q

The presence of rubella ________ rules out a primary infection during the pregnancy

A

antibodies

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7
Q

Antibodies derived from a natural, wild infection lead to ___________ Antibodies from
a__________are not as durable.

A

lifelong immunity.

live-attenuated virus

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8
Q

Rubella immunization is contraindicated in pregnancy because_________ but is recommended after
delivery.

A

it is made from a live virus

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9
Q

_________are expected from a successful vaccination.

A

HBV surface antibodies

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10
Q

_______ indicates high risk for vertical transmission of HBV from the mother to the fetus or neonate.

This is the only specific hepatitis test obtained routinely on the prenatal laboratory panel

A

HBV

surface antigen

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11
Q

The presence of HBV ______ signifies a highly infectious state

A

E antigen

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12
Q

The patient’s blood type and Rh is determined with the direct _________

A

Coombs test.

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13
Q

If the patient is Rh negative, she is at risk for______

A

anti-D isoimmunization.

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14
Q

The presence of atypical RBC antibodies is determined with the __________

A

indirect Coombs test.

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15
Q

Screening cultures for________ and _______ will identify whether the fetus is at risk from
delivery through an infected birth canal.

A

chlamydia and gonorrhea

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16
Q

Syphilis

Nonspecific screening tests _______ and ________ are performed on all pregnant women

A

veneral disease research laboratory [VDRL] or rapid plasma reagin [RPR])

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17
Q

What to do for + screening tests for Syphilis

A

Positive screening tests must be followed up with treponema-specific tests (microhemagglutination assay for antibodies to T. pallidum [MHA-TP] or fluorescent treponema antibody absorption [FTA]).

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18
Q

Syphilis

Treatment of syphilis in pregnancy requires ________to ensure adequate fetal treatment.

A

penicillin

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19
Q

Urinalysis

Assessment of_________ is important to screen
for underlying renal disease, diabetes, and infection

A

proteinuria, ketones, glucose, leukocytes, and bacteria

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20
Q

________ percent of pregnant women

have ASB.

A

Eight

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21
Q

Left untreated, ______of ASB progresses to pyelonephritis, which is associated with septic shock, pulmonary edema, and adult respiratory distress syndrome

A

30%

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22
Q

This screening skin test determines previous exposure to TB. A positive test is induration, not erythema

A

PPD or Tine test

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23
Q

T or F

HIV screening is recommended for all pregnant women as part of the initial lab testing.

A

T

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24
Q

HIV Testing

The CDC recommends ______

A

Informed Refusal (or “Opt Out,” where a patient is tested unless she refuses), rather than Informed Consent (or “Opt In,” where a patient must specifically consent).

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25
Q

Rapid HIV testing in labor is recommended if the ____

A

patient’s HIV status is not known

26
Q

This screening test assesses presence of detectable HIV antibodies

A

ELISA test

27
Q

A ______ lag exists between HIV infection and a positive ELISA test

A

3-month

28
Q

T or F

All babies born to HIV-positive women will
be HIV antibody positive from passive maternal antibodies.

A

T

29
Q

This definitive test identifies the presence of HIV core and envelope antigens

A

Western blot test

30
Q

Triple antiviral therapy is recommended for all HIV-positive women starting at ______weeks and continuing through
delivery.

A

14

31
Q

_______ can identify if the mother has cervical dysplasia or malignancy.

A

Cervical cytologic screening

32
Q

This is the major serum glycoprotein of the embryo. The concentration peaks at 12 weeks in the fetus and amniotic fluid (AF), then rises until 30 weeks in the maternal serum.

A

AFP

33
Q

__________) result in increased

spillage of AFP into the amniotic fluid and maternal serum.

A

Fetal structural defects (open neural tube defect [NTD] and ventral wall defects

34
Q

AFP changes

Fetal serum Peaks at _______
Amniotic fluid Peaks at ______
Maternal serum Peaks at ______

A

12 weeks

12 weeks

30 weeks

35
Q

Other causes of high AFP

A

Other causes include twin pregnancy, placental bleeding, fetal renal disease, and sacrococcygeal teratoma

36
Q

_____is reported in multiples of the median (MoM) and is always performed as part of multiple
marker screenings

A

MS-AFP

37
Q

A positive high value for MS-AFP is ______

A

> 2.5 MoM

38
Q

The most common cause of an elevated MS-AFP is

________

A

dating error.

39
Q

MS-AFP Testing

In cases of dating error, what to do?

A

repeat the MS-AFP if the pregnancy is still within the 15- to 20-week window

40
Q

MS-AFP

If the dates are correct and no explanation is seen on sonogram, perform ______ and _____

A

amniocentesis for AF-AFP determination and acetylcholinesterase activity.

41
Q

Elevated levels of _______

activity are specific to open NTD

A

AF acetylcholinesterase

42
Q

With unexplained elevated MS-AFP but normal AF-AFP, the pregnancy is statistically at risk for________

A

intrauterine growth restriction (IUGR), stillbirth, and preeclampsia.

43
Q

Low MS-AFP

A positive low value is _______

A

<0.85 MoM

44
Q

The sensitivity of MS-AFP alone for trisomy 21 is only

______

A

20%.

45
Q

The most common cause of a low MS-AFP is ______

A

dating error

46
Q

MS-AFP

If the dates are correct and no explanation is seen on sonogram, perform _______

A

amniocentesis for karyotype.

47
Q

The sensitivity for trisomy 21 detection can be increased to 80% by performing maternal serum screen for not only MS-AFP, but also ______, _______ and ______

The window for testing is also _______

A

hCG, estriol, and inhibin-A

15–20 weeks

48
Q

With Down syndrome, levels for MS-AFP and estriol are decreased, but ______ increased

A

hCG and inhibin-A are,

49
Q

Next step if suspected DS or Edwards

A

Perform an amniocentesis for karyotype.

50
Q

With Edward syndrome, levels for __________ are

decreased. Perform an amniocentesis for karyotype.

A

all 4 markers (MS-AFP, estriol, inhibin-A, and hCG)

51
Q

This screening test is administered to all pregnant women between 24 and 28 weeks’ gestation. No fasting state is needed.

A 50-g glucose load is given, and serum glucose is measured 1 h later.

A

1-h 50-g oral glucose tolerance test (OGTT )

52
Q

1-h 50-g oral glucose tolerance test (OGTT )

A normal value is _____

If abn, _________

A

<140 mg/dL.

3-h 100-g OGTT

53
Q

This is the definitive test for glucose intolerance in pregnancy

A

3-h 100-g OGTT

54
Q

An FBS >125 mg/dL indicates ________

A

overt diabetes

mellitus, and no further testing is performed.

55
Q

If the FBS is <126 mg/dL, administer _______

A

a 100-g

glucose load, followed by glucose levels at 1, 2, and 3 h.

56
Q

What are the N values for 1 hr OGTT

A

Normal values are FBS <95 mg/dL, 1 h

<180 mg/dL, 2 h <155 mg/dL, and 3 h <140 mg/dL.

57
Q

1 hr OGTT

______ is diagnosed if ≥2 values are abnormal.

_______ is diagnosed if only 1 value is abnormal.

A

Gestational diabetes

Impaired glucose intolerance

58
Q

A complete blood count (CBC) should be performed between ________’ gestation
in all women

A

24 and 28 weeks

59
Q

Reason for anemia in 3rd trimester

A

With the increasing diversion of iron to the fetus in the second and third trimester, iron deficiency, which was not present early in pregnancy, may develop

60
Q

Before giving prophylactic RhoGAM to an Rh-negative woman, an indirect Coombs test is performed at _____

A

28 weeks

61
Q

Reason for need to do Atypical Antibody Screen

A

This is obtained to ensure she has not become isoimmunized since
her previous negative AAT earlier in pregnancy

62
Q

T or F

If it is discovered that the patient already has anti-D antibodies, administration of
RhoGAM is futile.

A

T

CK OB (15 decks)

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