uworld

Question 1

acute onset of constant RUQ pain in pregnant woman

Answer 1

appendicitis; uterus displaces appendic to RUQ area

Question 2

Acute respiratory distress syndrome

Answer 2

Included pic

Question 3

Asherman syndrome

Answer 3

intrauterine adhesions that cause amenorrhea, infertility, abnormal bleeding

Question 4

BP Meds used in mothers with HTN

Answer 4

S( hydralazine, labetalol, nifedipine) L ( nifedipine, labetalol )

Question 5

cerclage placed

Answer 5

when cervix < or equal 2.5cm to prevent preterm labor

Question 6

complications of inadequate weight gain during pregnancy

Answer 6

• fetal growth restriction
• preterm labor

Question 7

HPV vaccine age

Answer 7

11-26

Given up to 45 years of age

Question 8

intermitten RUQ pain in pregnant woman cause

Answer 8

symptomatic cholethiasis, MOA: inc estrogen increases cholesterol secretion in the bile, inc progesterone decreases gallbladder motility- powers combined causes gallbladder stones that cannot pass the cystic duct

Question 9

low dose ASA for pre-ecclampsia prevention is given at?

Answer 9

12-28 weeks, optimally before 16 weeks

Dec28 —— 3 days after Christmas cuz we get fat on xmas

Question 10

low lose ASA is given for _____to patient with:

Answer 10

preeclampsia prevention for high risk patient: DM, chronic HTN, multiple gestation ( ie twin)

Caused by uterine artery abnormality that causes placental hypoperfusion and mom’s bp elevates to improve perfusion

Question 11

most common cause for unilateral bloody nipple disharge

Answer 11

intraductal papilloma

Question 12

most common cause for unilateral green nipple disharge

Answer 12

duct ectasia

Question 13

Muscle weakness that worsens with movement

Answer 13

myasthenia gravis, increased risk in postpartum

Question 14

oligohydramnios

Answer 14

AFI less than or equal to 5cm; speculum exam to examine; ROM most common cause

Question 15

post partum urinary retention cause

Answer 15

-regional anesthesia ,vaginal delivery perineal injury, c-section,

Question 16

post-partum thyroiditis treatment?

Answer 16

triggered by pregnancyi mmune system attacks thyroid, will see hyperthroid smpotoms, treat with betablocers ( propranolol)

Question 17

PPROM is when menbranes rupture at?

Answer 17

<37 weeks

Question 18

Pregnant woman with bilateral enlargement of kidneys should be managed by

Answer 18

nothing, typical pathophysiologic change, where right kidney is larger than left

Question 19

Preterm labor

Answer 19

regular painful contractions causing cervial change (dilation, effacement) before 37 weeks

Question 20

preterm labor management

Answer 20

<32 weeks: MgSO4 ( neuroprotection) indomethacin (tocolysis), betamethasone, GBS abx
32-34 weeks: nifedipine, betamethasone, GBS abx
34- 37 weeks, betamethsone for fetal lungs, prepare for delivery, gbs abx
***no tocolysis

Question 21

Risk factors for PPROM

Answer 21

1) prior PPROM 2) GU infection 3) Antepartum bleeding

Question 22

Risk factors for shoulder dystocia

Answer 22

big mbaby, mom, conditions that increase baby size ( gestaitonal DM, postterm pregnancy)

Question 23

Round ligament pain

Answer 23

Lower abdominal area and ipsilateral labia

Question 24

TPO vs TRH antibodies

Answer 24

TPO elevated with post partum thyroiditis, autoimmune diseasel TRH antibodies stimulate TSH receptor, trigger thyroid hormone release, seen with graves disease

Question 25

Treatment for hypothyrpoipdism in pregnancy

Answer 25

levothyroxine

Question 26

TX for postpartum urinary retention

Answer 26

self-limited, intermittent cetheterization (1) urthral (2) suprapubic

Question 27

US with singleton fetus at 24 weeks with bilatersal small underdevelopeed kidneys and bladder with min urine, low AFI suggests?

Answer 27

fetal renal hypoplasia can be a ADR of mother taking ACE/ ARB

Question 28

uterine inversion treatment

Answer 28

1)immediate manual replacement of the uterus by placing hand in vagina and pushing prolapsed uterus through
2) laparotomy, relaxants can help push it back through but can increase bleeding risk

***uterotonics ie oxytocin should be d/c because they make uterus contract ant it’ll be hard to push it back through

Question 29

Vaginal foreign body in prepubescent girl, management

Answer 29

Anesthetic warm flush 2) vaginiscopy; never do a speculum exam

Question 30

ways to improve upteroplacental insufficiency during labor

Answer 30

Improve venous return : 1) lay mother on left side to dec compresssion of IVC 2) fluid bolus 3) vasopressors to improve hypotension –> if these measures don;t help go to c-section

Question 31

when can baby’s heart beat be detected?

Answer 31

10-12 weeks gestation

Question 32

preecclampsia with severe features increasees rish for

Answer 32

acute stroke from endothelial cell a damage that causes vascular microthrombi formation/ cerebral vessel occlussion
- dysregulated cerebral blood flow that causes inappropriate cerebral vasospasm

Question 33

indomethacin for tocolysis can cause

Answer 33

oligohydramnios ( AFI less than or equal to 5cm) from decreased renal perfusion

Question 34

Vaginal progesterone is given

Answer 34

• no history of preterm labor but cervical length
  </=2.5cm in 2nd trimester
  im/vaginal progesterone given when prior history of preterm labor

Question 35

polyhydramnios

Answer 35

AFI > 25
- too much amniotic fluid, typically caused by ipaired fetal swallowing