Uwise Qbank

Question 0

Idiopathic cardiomyopathy that presents with heart failure secondary to LV systolic dysfunction that occurs during the end of pregnancy or within several months of delivery.

Answer 0

Peripartum Cardiomyopathy

Symptoms: fatigue, SOB, palpitations, edema.

Question 1

Tachycardia, tachypnea, hypoxia, chest pain, and signs of DVT during pregnancy.

Answer 1

Pulmonary Embolism of Pregnancy

Question 2

Common causes of acute pulmonary edema (4)

Answer 2

1) tocolytic use
2) cardiac dz
3) fluid overload, especially isotonic fluids (NS, D5W, LR)
4) preeclampsia

Question 3

Why is there greater dilation in the R>L ureter during pregnancy?

Answer 3

• cushioning provided by sigmoid colon to L ureter
• greater compression of R ureter due to dextrorotation of uterus
• compression by the uterus and R ovarian vein

Question 4

What is the most common site of metastasis with gestational trophoblastic dz?

Answer 4

Lungs

Question 5

Recommended guidelines for weight gain during pregnancy?

Answer 5

Underweight (<18.5) = 28-40 lbs
Normal (18.5-24.9) = 25-35 lbs
Overweight (25-29.9) = 15-25 lbs
Obese (30+) = 11-20 lbs

Question 6

Genetic dz risks for Ashkenazi Jews (7)

Answer 6

1) Fanconi anemia
2) Tay-Sachs
3) CF
4) Niemann-Pick dz
5) Canavan dz
6) Bloom syndrome
7) Gaucher’s dz

Question 7

Beta-Thalassemia anemia is more common in which population?

Answer 7

Mediterranean

Question 8

What fetal defect is noted with valproic acid use during pregnancy?

Answer 8

Neural tube defects

Question 9

What is the risk of poorly controlled diabetes immediately prior to conception?

Answer 9

Increased risk for fetal structural anomalies, especially neural tube defects and CV system defects.

Question 10

Chorionic villus sampling (CVS)

Answer 10

10-12 wks gestation

Samples chorionic frondosum which contains most mitotically active villi in the placenta

Used to assess: fetal chromosomal abnormalities and DNA mutations

Question 11

MCC of inherited mental retardation?

Answer 11

Fragile X syndrome–most cases of Down syndrome are not heritable

Question 12

Goals for blood sugar management during pregnancy?

Answer 12

fasting <120

Question 13

Risk factors for developing gestational diabetes (4)

Answer 13

1) hx of a big baby (+9 lbs)
2) hx of abnormal glucose tolerance
3) pre-pregnancy weight of 110% or more of ideal BW
4) American Indian or Hispanic descent

Question 14

Risks of gestational diabetes (4)

Answer 14

1) polyhydramnios
2) neonatal hypoglycemia
3) preeclampsia
4) macrosomia

Question 15

Recommended dose of folic acid for non-high risk pregnant women? For high-risk pregnant women?

Answer 15

Non-high risk pregnant women = 0.4 mg/day

High risk pregnant women = 4 mg/day

Question 16

Warnings of Labor (3)

Answer 16

1) ctx q5 minutes for one hour
2) fetal movements less than 10 per 2 h
3) vaginal bleeding

Question 17

What to do during an umbilical cord prolapse?

Answer 17

Elevate the fetal head with a hand in the pt’s vagina and perform a c/s.

Elevating the fetal head is an attempt to avoid compression of the umbilical cord.

Question 18

Definition of postpartum hemorrhage in a vaginal delivery? c/s?

Answer 18

vaginal delivery = >500 ml

c/s = >1000 ml

Question 19

Significant blood loss during delivery causes anterior pituitary necrosis, leading to loss of gonadotrophin, TSH, and ACTH production.

Answer 19

Sheehan syndrome

Sx: slow mental function, weight gain, fatigue, difficulty staying warn, no milk production, hypotension, amenorrhea

Tx: E2 and P replacement and supplementation with thyroid and adrenal hormones

Question 20

Tx of Sheehan syndrome

Answer 20

1) E2 and P replacement
2) Thyroid supplementation
3) Adrenal hormone supplementation

Question 21

Inflammation of the endometrium, the inner lining of the uterus.

Answer 21

Endometritis

Question 22

MCC of endometritis?

Answer 22

infection

Question 23

Symptoms of endometritis?

Answer 23

• lower abdominal pain
• fever
• vaginal bleeding
• vaginal discharge

Question 24

Risk factors for endometritis? (6)

Answer 24

• c/s
• prolonged ROM
• prolonged labor with multiple vaginal examinations
• internal fetal monitoring
• manual removal of the placenta
• low SES

Question 25

MCC of postpartum fever?

Answer 25

Endometritis

Question 26

Most causative agents of postpartum endometritis?

Answer 26

• Staph aureus

- Streptococcus

Question 27

MC type of bacterial infection in postpartum endometritis?

Answer 27

Polymicrobial–a mix of aerobic and anaerobic bacteria in the genital tract.

Question 28

Signs and symptoms of depression that lasts for <2 wks postpartum.

Answer 28

postpartum blues

Question 29

Depression occurring within 2 wks to 6 months after delivery?

Answer 29

Postpartum depression

Question 30

How to distinguish postpartum blues from postpartum depression?

Answer 30

ambivalence toward the newborn

Question 31

Most significant risk factor for developing postpartum depression?

Answer 31

prior hx of depression

Question 32

Breastfeeding is associated with a decreased incidence of…?

Answer 32

ovarian cancer

Question 33

Risk factors for using hormonal interventions to prevent lactation?

Answer 33

Bromocriptine is associated with HTN, stroke, and seizures. Hormonal interventions predispose to thrombotic events.