Pregnancy Flashcards

1
Q

if the rectus abdominis is transected horizontally, the ________ arteries must be ID’d and ligated bilaterally to prevent bleeding complications

A

inferior epigastric

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2
Q

an _______ pregnancy is characterized by implantation outside of the uterus. Uterine curettage would reveal ________ in the endometrium due to progesterone secretion but no embryonic or trophoblastic tissue

A

ectopic

decidual changes (dilated, coiled endometrial glands and edematous stroma)

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3
Q

38 weeks of uncomplicated pregnancy, newly found gallstones that weren’t present 1 year ago. THis is due to ______ induced cholesterol hypersecretion and __________ induced gallbladder hypomotility

A

estrogen

progesterone

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4
Q

infant becomes hypertonic, tremors, seizures, sweating, sneezing, diarrhea, vomiting, feeding intolerance, mother with schizophrenia and +HepC =

treatment with

A

neonatal abstinence syndrome (opioid withdrawal)

methadone

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5
Q

____________ syndrome is characterized by neonatel defects of the head (microcephaly), cataracts (white pupils), deafness, PDA (machine like murmur)

prevented by mother accepting a _____________

A

congential rubella

live attenuated rubella virus vaccine

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6
Q

Unbalanced Robertsonian translocations ___________ are responsible for a minority of ________syndrome cases

A

46 XX t(14,21)

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7
Q

bhCG levels become detectable in serum _______ after fertilization. It is produced by the syncytiotrophoblast after implantation. It is detectable in the urine 14 days after fertilization

A

8 days

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8
Q

28 weeks, markedly eleavted amniotic fluid levels. Patient feels SOB when supine, history of epilepsy controlled with medication, abdominal circumference larger than expected for gestation age = ___________ most likely due to ____________ from _____________ exposure

A

polyhydraminos

anencephaly

anti-epileptic

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9
Q

valproate decreases levels of ______ and increases risks of _________ like meningocele

A

folic acid

neural tube defects

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10
Q

pulmonary hypoplasia, flat facies, and limb deformities =

due to ______ from a urinary tract anomaly leading to anuria/oliguria in utero

mother was hypertensive and unaware she was pregnant, so most likely due to maternal use of ______ or ________, as AngII is required for normal renal development

A

Potter sequence

oligohydramnios

ACEI or ARBs

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11
Q

Diabetes during pregnancy is associated with premature delivery, fetal malformatons, polycythemia and hyperviscosity, respiratory distress, fetal ________, and transient ________

A

macrosomia

hypoglycemia

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12
Q

open neural tube defects, ventral wall defects, and multiple gestation result in ______ AFP

aneuploidies result in ______ AFP. Trisomy 21 is associated with decreased estriol, and increased bHCG and inhibin A as well

A

increased

decreased

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13
Q

Pre-eclampsia is characterized by new onset elevated blood pressure at >20 weeks gestation and _______ or signs of end organ damage

Eclampsia is characterized by pre-eclampsia and _______

Gestational HTN is pre-eclampsia without ________

A

proteinuria

grand mal seizures

proteinuria or end organ damage

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14
Q

______ is commonly used to treat bipolar disorder. Its use during pregnancy is associated with Ebstein’s anomaly, which is characterized by ___________, decreased right ventricular volume, and atrialization of the right ventricle

A

Lithium

apical displacement of the tricuspid valve leaflets

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15
Q

a __________ will have a triploid karyotype (69, XXX or XXY) and contain fetal tissue with some edematous villi with focal trophoblastic proliferation and normal appearing villi. Patients present with vaginal bleeding, and prior miscarriage is a risk factor

A

parial mole

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16
Q

primary oocytes are completely developed in female embryos by the 5th month of gestation, at which point they are arrested in _______________. Normal menstrual cycle hormones stimulate the primary oocyte to resume differentiation. Prior to fertilization, secondary oocytes are arrested in _____________

A

prophase of meiosis I

metaphase of meiosis II

17
Q

_________ increases maternal insulin resistance during the second and third trimesters, leading to a rise in serum glucose that helps provide adequate nutrition to the growing fetus. Gestational diabetes occurs when the compensatory rise in maternal insulin secretion is inadequate to prevent serum glucose levels from reaching excessively high levels

A

human placental lactogen

18
Q

isotretinoin is used to treat severe acne with significant scarring. Pregnancy is absolute contrainindication due to the risk of teratogenicity. Sexually active women should be advised to use 2 forms of contraception and take monthly pregnancy tests that measure ________

A

urine beta-hCG

19
Q

high ________ levels inhibit lactation through negative feedback on prolactin in the anterior pituitary

A

progesterone

20
Q

patients with a history of ________ are at risk for inaccurate pregnancy dating which can lead to falsely low levels of AFP

A

irregular menses

21
Q

________ converts androgens into estrogens in the ovaries, testes, placenta, and other peripheral tissues. Placental _________ deficiency causes accumulation of androgens during pregnancy, resulting in ambiguous external genitalia in female infants and maternal virlization

A

Aromatase

aromatase

22
Q

a ________ is composed of multiple cystic edematous hydropic villi as a result of trophoblast proliferation. Serial measurements of _______ should be performed following evacuation of a hydatidiform mole. Persistently elevated or rising levels signify development of an invasive mole or choriocarcinoma

A

complete mole

Beta hCG

23
Q

teeth staining =

gray baby syndrome =

neural tube defects =

otoxicity, vestibulotoxicity =

antibiotics contraindicated during pregnancy

A

tetracyclines

chloramphenicol

TMP-SMX

aminoglycosides

24
Q

________ is a malignant form of gestational trophoblastic disease composed of anaplastic ____________ without villi. It often presents as dyspnea/hemoptysis due to pulmonary metastasis from hematogenous spread and can be found after delivery

A

Choriocarcinoma

cytotrophoblasts and syncytiotrophoblasts

25
Q

dizygotic twins result from fertilization of 2 oocytes by 2 different sperm and always have 2 amnions and 2 chorions.

Dichorionic/diamnioic is the most ______ and occurs at days (_____)

monochorionic diamniotic occurs at days _____

monochorionic monoamniotic occurs at days ______

monochorinoic monoamniotic conjoined occurs at _____

A

common, 0-4

4-8

8-12

> 13

26
Q

shortly after delivery, patient has chest pain and difficulty breathing, cardiogenic shock, hypoxemic respiratory failure, DIC, seizures and coma =

A

amniotic fluid embolism

27
Q

immigrant from middle east, develops low grade fever, maculopapular rash that spreads from face and chest to trunk and extremities with posauricular LAD =

mother at risk for

congenital defect

A

rubella

polyarthralgia

deafness

28
Q

postpartum hemorrhage is an obstetric emergency and can result from ________. Prior uterine surgery can impair decidualization, resulting in myometrial invasion by villous tissue and a placenta that is abnormally adherent to the myometrium (_______)

premature detachment of placenta prior to delivery

acute abdominal pain, profuse vaginal bleeding, fetal distress

most common cause of postpartum hemorrhage is ________ which is the failure of the uterus to contract adequately after delivery

A

abdnormal placentation

placenta accreta

placental abruption

uterine rupture

uterine atony

29
Q

child prefers to hold head tilted to one side =

most commonly a result of _______ ____ in utero

A

congenital torticollis

malposition of the head