UWise Question Review

Question 1

How does the use of tocolytics (mag, nifedipine) affect respiratory system?

Answer 1

Can worsten pulmonary edema. Plasma osmolarity is already decreased during pregnancy, worstened with mag use. Causes crackles and shit.

Question 2

Cardiac changes during pregnancy

Answer 2

SV and HR increase by a lot, CO increases by about 33%

Question 3

What causes hydronephrosis in pregnancy?

Answer 3

Compression of the ureter by dextrorotation of the uterus.

Question 4

Effect of estrogens on thyroid function

Answer 4

Increased estrogen increases TBG, so while total thyroid hormone levels increase, free thyroid levels remain constant.

Question 5

How to treat shoulder dystocia

Answer 5

McRoberts Maneuver- hyperflex maternal hips to straighten sacrum, apply pressure so shoulders can pass under symphysis pubis

Question 6

Most common sign of uterine rupture?

Answer 6

Fetal heart rate abnormality

Question 7

Mag toxicity, treatment?

Answer 7

Hyporeflexia and respiratory suppression. Treat by giving calcium gluconate.

Question 8

Treatment for hellp syndrome after 34 weeks?

Answer 8

Induce labor for vaginal delivery

Question 9

When to suction newborn if amniotic fluid is stained with meconium?

Answer 9

Nose, mouth and glottis if the infant is depressed (not vigorous)

Question 10

Size of baby in type I diabetes vs gestational diabetes?

Answer 10

Small in type I and large in gestational diabetes

Question 11

HCG level below which a transvaginal ultrasound isn’t useful for assessing intrauterine pregnancy?

Answer 11

2000, should just trend HCGs and assess if double in 48 hours

Question 12

Most common cause of spontaneous abortion?

Answer 12

Chromosomal abnormalities (mostly autosomal trisomies)

Question 13

Medical risk factor for spontaneous abortion?

Answer 13

Diabetes

Question 14

How to further decrease risk of vertical HIV transmission in addition to giving neonate zidovudine?

Answer 14

Give intrapartum IV zidovudine to mom

Question 15

Most common cause of sepsis in pregnancy?

Answer 15

Pyelonephritis

Question 16

Which SSRI cannot be used in pregnancy?

Answer 16

Paroxetine causes fetal cardiac abnormalities and PPH

Question 17

Which complication of severe preeclampsia is an indication to deliver immediately?

Answer 17

Thrombocytopenia

Question 18

Sinusoidal fetal tracing suggestive of?

Answer 18

Fetal anemia

Question 19

What does Rh disease cause in newborn?

Answer 19

Hydrops, so fluid collection (can cause pericardial effusion)

Question 20

Finding in amniotic fluid that suggests Rh disease?

Answer 20

High bilirubin

Question 21

Vital lab test to order after missed abortion?

Answer 21

Type and screen for ruling out isoimmunization and to give rhogam if necessary

Question 22

How to medically evacuate missed abortion?

Answer 22

Misoprostol

Question 23

How to induce before giving pitocin?

Answer 23

Give misoprostol to ripen cervix

Question 24

Important drug to give in preterm labor?

Answer 24

Ampicillin because GBS status likely unknown

Question 25

What drug reduces the risk of premature labor?

Answer 25

17 alpha hydroxyprogesterone

Question 26

Which drug should NOT be given to patients with uterine atony and preeclampsia?

Answer 26

Methergine because it’s a vasocontrictor and can worsten hypertension

Question 27

Which drug should NOT be given to patients with uterine atony and asthma

Answer 27

PGF2Alpha – potent bronchoconstrictor

Question 28

Lots of c-sections increases risk for

Answer 28

Placenta accreta

Question 29

Amnioinfusion

Answer 29

Saline into amniotic sac reduces repetitive variable decelerations

Question 30

How to induce in unfavorable cervix?

Answer 30

Give prostaglandins

Question 31

Difference in cancer risk between combined OCP and progesterone IUD?

Answer 31

Both protect against endometrial cancer but combined OCP decreases risk of ovarian cancer as well.

Question 32

Is factor V leiden associated with recurrent first trimester pregancy loss?

Answer 32

No, only APLA

Question 33

Treatment for APLA

Answer 33

Aspirin and heparin

Question 34

Most common cause of IUGR?

Answer 34

Uteroplacental insufficiency

Question 35

Triad of cervical cancer?

Answer 35

Back pain, sciatic leg pain, hydroureter

Question 36

Risk factor for polyhydramnios?

Answer 36

Maternal diabetes!

Question 37

Funneled lower uterine segment means?

Answer 37

Cervical incompetence

Question 38

How to work up suspected TB in pregnancy?

Answer 38

Get a CXR, benefits outweigh risk

Question 39

Common other abnormality in mullerian agenesis?

Answer 39

Renal problems

Question 40

Asymmetric vs symmetric IUGR

Answer 40

Asymmetric IUGR is a maternal issue like HTN or diabetes. Symmetric IUGR is due to fetal factor like aneuploidy or early intrauterine infection.

Question 41

Risk of choriocarc higher or lower in partial mole compared to complete?

Answer 41

Lower

Question 42

How do OCPs improve dysmenorrhea

Answer 42

By inducing endometrial atrophy, which reduces the amount of prostaglandins produced in the endometrium.

Question 43

Enlarged soft boggy uterus with dysmenorrhea suggestive of?

Answer 43

Adenomyosis

Question 44

What should be given in preterm labor

Answer 44

Steroids for lung maturity and mgso4 for neuroprotection (CP)