Obstetrics Questions

Question 1

cardiomyopathy

• treatment
• definition

Answer 1

• metoprolol is essential, reduced mortality
• defined as CHF in pp period (up to 5 months pp)
• metoprolol reduced preload and afterload, reducing pumonary edema in the context of CHF

Question 2

Breast feeding

- calories needed to support

Answer 2

• 1800 kcal a day

- 500 kcal needed extra to support breast feeding

Question 3

eclamptic seizure area of brain most likely involved?

Answer 3

occipital (visual disturbances)

Question 4

HSV diagnosis details

Neonatal HSV too

Answer 4

• PCR can detect lower viral DNA concentrations than cultures
• with active sores you want viral culture + PCR
• neonatal: usually aquirred through intrapartum. Disease of eyes, skin, mouth (45%), CNS (30%), Disseiminated disease (25%). treat allwith acyclovir 20 mg/kg IV q8h (14 vs 21 days if advanced)

Question 5

fetal blood volume

Answer 5

• 78 mL/kg fetus

- 125 mL/kg fetus + placenta

Question 6

fetal dysmaturity syndrome

Answer 6

• related to term and postterm dates
• placental insufficient related
• the weight starts to lag behind
• also associated with loss of fetal hair, decreased vernix, and long finger nails

Question 7

chronic Hep B most likely aquired through

Answer 7

• neonatal/perinatal period than in adulthood
• therefore more likely to carry long-term health risks
• complications of chronic B infection include: cirrhosis, end stage liver disease, liver cancer

Question 8

Rhogam should be given…

Answer 8

with in 72 hours of sensitizing event, though can be given up to 28 days q

Question 9

use of sequential operative methods, risk for what

Answer 9

• higher rates of subdural, cerebral, and subarachnoid hemorrhage, facial nerve injurty, brachial plexus injuryt, anal sphincter tears, low pH
• it is not associated with urinary incontinence

Question 10

cytstic hygroma most associated with

Answer 10

Turner (45X)
- other associated findngs: coarctation of the aorta
sheild chaped chest
short statures

Question 11

Reasons to use metformin in obstetrics

Answer 11

• safety of compliance issues
• pt refuses insulin
• cannot afford insulin

Do not use metformin for
- chronic kidney disease
-

Question 12

congenital varicella syndrome fetal features

Answer 12

Chicken pox, maternal pruritis, vesicular rash, no lab testing needed

• microcephaly
• skin scaring
• limb hypoplasia
• chorioreintis

Question 13

MC sx of abruption

Answer 13

toco, contractions

Question 14

positive contraction stress test:

Answer 14

• late deceleratins 50%

- equivocal - occasional late decels or variables

Question 15

fetal alcohol syndrome features

Answer 15

• thin vermillion border
• SHORT palpebral fissures
• smooth philtrum
• growth restriction
• CNS issues (abnormal reflexes)

Question 16

2nd degree and 4th degree break down

Answer 16

2nd: come back in 2 weeks
4th: immediate repair assuming no infection

Question 17

most likely maternal platelet count in fetuses affected by neonatal alloimmune thrombocytopenia (NAIT)

Answer 17

• mom makes antibodies to baby’s platelets.
• can affect first pregnancy
• normal platelets maternally numbers because it’s no about maternal thromocytopenia
• diagnosed retrospectively after birth with ooozing penises, or US with intracranial bleeding, hemorrhage
• IVIG at 12-20 weeks

Question 18

lupus quiet for how many months prior to pregnancy to reduce poor outcomes?

Answer 18

• 6 months

- active lupus at time of conception and hx nephritis or lupus pneumonitis

Question 19

anti lewis antibody

Answer 19

• lewis lives, kell kills
• made by IgM type, which is massive, and prevents it from crossing the placenta
• also baby have poor expression of the antigen, so it’s not that triggering
• therefore not associated with erythroblastosis fetalis

Question 20

DIC labs positive

Answer 20

• low fibrinogen
• thrombocytopenia
• increased PTT/PT
• elevated D-Dimer
• decreased factors that promot clotting (5 and 7)

Question 21

thrombocytopenia is pregnancy

Answer 21

• most common is none
• the following common symptoms: ecchymoses, epistaxis (nose bleed), gingival bleeding, petechiae, heavy menstrual bleeding is common

Question 22

matnernal untreated hyperthyroidism effect on baby

treatment of hyperthroidism

Answer 22

• hydrops
• spontaneous abortion

PTU and methimazole

• 1st PTU: hepatotoxicity
• 2nd Methimazole: aplasia cutis and esophageal/choanal atresia

Question 23

protein C or S decreases in pregnancy

Answer 23

• protein S decreases in pregnancy

- protein S is responsible for stopping the clot (anticoagulant), therefore increased risk for VTE

Question 24

obesity increaes risk offffff

Answer 24

neural tube defect

gastroscoscesis

Question 25

pudenal nerve roots are

Answer 25

• S2-4 (vagina and peritoneum)

- ass hole is S5

Question 26

can’t use warfarin, teratogenic

Answer 26

weeks 6-12w

Question 27

SVT first line treatment

Answer 27

digoxin

Question 28

minimal amount of fetal-maternal hemorrhage that can cause RhD alloimmunization

Answer 28

0.1 mL

Question 29

most important consideration when determining a breastfed infants risk of CNS depression from maternal opioid use

Answer 29

relative infant dose in miligrams per kilogram

Question 30

infectious mastitis