Rosh (12/5-12/21)

Question 1

Diagnosis of pregnancy failure

Answer 1

• > 7 mm CRL without CA
• > 25 mm GS without embryo
• 2 weeks after GS and still no embryo
• 11 days after GS and yolk sac and still no embryo

Question 2

Weight gain recommendations by BMI

Answer 2

<18.5 … 28-40
Up to 25 … 25-35
Up to 30 … 15-25
>30 … 11-20

Question 3

Severe features

Answer 3

Platelets <100
LFTs double upper limit of normal
Cr >1.1 or double baseline
Pulmonary edema
Neurologic symptoms

Question 4

Risk of pulmonary hypoplasia after PPROM

Answer 4

Previable 30%
Decreases by 46% weekly
>26 wga 1.4%

Question 5

Recurrence of SGA

Answer 5

20%

Question 6

Dating criteria

Answer 6

Never use size of GS
Under 8.6 wga, use LMP unless discrepancy is >5 days (CRL)
Up through 13.6 wga, use LMP unless discrepancy is >7 days (CRL)
To 15.6 wga, use LMP unless discrepancy is >7 days (biometry)
To 21.6 wga, use LMP unless discrepancy is >10 days
To 27.6 wga, use LMP unless discrepancy is >14 days
At 28.0 wga and beyond, use LMP unless discrepancy is >21 days

Question 7

Delivery timing for previa

Answer 7

36 to 37.6 wga

Question 8

RPL work-up

Answer 8

Peripheral karyotypic analysis of the parents, maternal thyroid stimulating hormone, prolactin and screening for antiphospholipid antibody syndrome when the patient has had three consecutive first trimester losses

Question 9

Labs for APLS

Answer 9

anti-b-2-glycoprotein antibody, lupus anticoagulant and anticardiolipin antibody

Question 10

Common steps where ureteral injury occurs during TLH, BSO

Answer 10

Ligation of ovarian vessels, ligation of uterine vessels, closure of angles of vaginal cuff

Question 11

Transient fetal complication of indomethacin use

Answer 11

Oligohydramnios

Question 12

Medications to give if trying to reduce inverted uterus

Answer 12

Terbutaline, nitroglycerin, inhaled anesthetics

Question 13

What should be avoided during hysteroscopy of someone with Essure coils?

Answer 13

Monopolar cautery

Question 14

Recommendations for extra calories in second and third trimesters

Answer 14

340 and 450

Question 15

Amount of water intake recommended in pregnancy

Answer 15

3 liters

Question 16

Indications for dialysis

Answer 16

A - acidosis
E - electrolyte abnormalities
I - intoxication (ie. methanol)
O - overload (volume)
U - uremia (pericarditis, encephalopathy)

Question 17

Arrest of descent times in second stage

Answer 17

Multip without epidural = 2 hrs
Primip without epidural = 3 hrs
+1 hr each with epidural

Question 18

Contents of cryoprecipitate

Answer 18

Fibrinogen, factors VIII and XIII, and vWF

Question 19

Indication for platelet transfusion

Answer 19

<50,000 and ongoing bleeding / surgical procedure

Question 20

When can an infant receive Tdap vaccine?

Answer 20

6 wks of life (immunity is passed in breast milk within 2 wks of mother receiving the vaccine)

Question 21

Most common pathophysiology of soft tissue damage from radiation

Answer 21

Progressive, obliterative endarteritis

Question 22

Muscles of the perineal body

Answer 22

Bulbocavernosus, ischiocavernosus, superficial transverse perineal

Question 23

Dating criteria

Answer 23

Never use GS size
Up to 8.6 wga, use LMP unless discrepancy >5 days
Up to 13.6 wga, use LMP unless discrepancy >7 days (CRL)
Up to 15.6 wga, use LMP unless discrepancy >7 days (biometry)
Up to 21.6 wga, use LMP unless discrepancy > 10 days
Up to 27.6 wga, use LMP unless discrepancy >14 days
At 28.0 wga and beyond, use LMP unless discrepancy > 21 days

Question 24

Delivery timing for previa

Answer 24

36.0 to 37.6 wga