UWise – Unit Two: Obstetrics

Question 0

Change in cardiac output in pregnancy?

Answer 0

Increases 33%. Both stroke volume and heart rate increase

Question 1

Murmur that is part of physiologic dyspnea of pregnancy?

Answer 1

Systolic murmur in upper left sternal border

Question 2

Patient with suspected molar pregnancy (beta hCG high, snowstorm pattern, undetectable TSH, high T4). Next test?

Answer 2

Chest x-ray – most common site of metastatic disease is lungs

Question 3

Most common cause of mental retardation? Most common form of inherited mental retardation?

Answer 3

Down syndrome; fragile X

Question 4

Fetal complications seen in pts with pre-existing diabetes but not gestational diabetes?

Answer 4

IUGR

Question 5

When placing an epidural, this needs to be monitored?

Answer 5

Fetal heart rate via Doppler

Question 6

Stages of labor ?

Answer 6

1. Onset of labor to full cervical dilation
2. Up to delivery
3. Delivery of placenta
4. Until two days postpartum

Question 7

Advantages of midline episiotomy over mediolateral episiotomy? Disadvantages?

Answer 7

Less pain, ease of repair, less blood loss

Increased third and fourth degree tears

Question 8

HIV+ mother - when to give baby AZT? When to test for HIV?

Answer 8

Immediately after delivery; test at 24 hours?

Question 9

Describe Newborn with sepsis?

Answer 9

Lethargic, pale, high temperature

Question 10

Diabetes and infant size?

Answer 10

Gestational - large

Type I - small

Question 11

Twin transfusion syndrome - complications for larger twin? Smaller twin?

Answer 11

Polycythemia, hydra minis, volume overload (leads to HF and hydrops)

IUGR, oligohydramnios,

Question 12

Risks to newborn born to mother with gestational diabetes?

Answer 12

Low - Hypoglycemia, hypoCa

High - polycythemia, hyperbilirubinemia

Respiratory distress

Question 13

Factors related to increased rates of infection?

Answer 13

Prolonged labor, prolonged rupture, many vaginal exams, internal monitoring

Question 14

Postpartum blues vs postpartum depression?

Answer 14

Under vs over 2 weeks

In postpartum depression, get feelings of inability to care for infant

Question 15

Most common type of postpartum infection?

Answer 15

Endometritis

Question 16

Pt with sensitive nipples, pain worse with breast feeding, pink and shiny nipples?

Answer 16

Candida infection

Question 17

Tx for mastitis?

Answer 17

Antibiotics - penicillin and cephalosporin

Question 18

Function of prolactin vs oxytocin? Suckling promotes which?

Answer 18

Breast milk production vs ejection

Oxytocin

Question 19

Signs baby is getting sufficient milk?

Answer 19

3-4 stools per day, 6 wet diapers

Question 20

Wants to lose weight - don’t use this type of contraception?

Answer 20

Progesterone only

Question 21

OD450 measures?

Answer 21

Bilirubin

Question 22

Risks of twin pregnancy?

Answer 22

Increased risk of death, malformations and prematurity

Question 24

Best way to reduce risk of preterm birth in pregnancies?

Answer 24

Early weight gain

Question 25

Recommended weight gain in pregnancy?

Answer 25

Underweight BMI (under 18.5) – 28-40
Normal BMI (18.5 to 25) – 25-35
Overweight BMI (25 to 30) – 15-25
Obese (over 30) – 11-20

Question 26

Effect of pregnancy on ureters?

Answer 26

Dilation (right greater than left) that can lead to hydronephrosis

Question 27

Patient with anemia, extremely high beta-hCG, snowstorm pattern on ultrasound – next step?

Answer 27

Chest x-ray for metastatic disease (from mole)