OB/GYN pretest

Question 1

rate of twins?

Answer 1

1/250

Question 2

results of 2 vessel cord?

Answer 2

<1% singleton 2.5% of SAB increased in diabetic moms

Question 3

t/f: hydropnephrosis/ hydroureter is benign in pregnancy?

Answer 3

true. gravid uterus compresses structures, progesterone relaxes things

Question 4

how is glucose filtration affected during pregnancy?

Answer 4

GFR is increased, and glucose filtration is decreased

Question 5

whats a succenturiate placenta?

Answer 5

accessory lobe located away from the main placenta –> can give way to PPH

Question 6

whats a fenestrated placenta?

Answer 6

middle is missing

Question 7

define: OB conjugate

Answer 7

shortest distance between promontory of sacrum and symphysis pubis ~10.5 cm

Question 8

types of pelvic shapes

Answer 8

Question 9

what is meant by “mentum transverse”

Answer 9

chin is presenting part

Question 10

what does a saltatory pattern on fetal heart tracing represent?

Answer 10

brief acute hypoxia that is seen in second phase of labor

• characterized by increased variability
• be wary of progression to acidosis

Question 11

who can attempt TOLAC?

Answer 11

pt with history of low transverse

Question 12

diagnostic tests that arereassuring for fetal lung status?

Answer 12

1) + phosphatydal glyercol in amniotic fluid
2) ratio > 2/1 of L/s in blood

Question 13

increased systolic:diastolic cord doppler can signs of….

Answer 13

IUGR

preE

Question 14

progesterone value that indicates a viable fetus?

a non viable fetus?

Answer 14

<5ng/ml vs >25ng/ml

Question 15

nl weight gain ranges during pregnancy?

Answer 15

normal weight= 25-35 lbs

underweight= 40

obese= 15

Question 16

basic phys of LE in pregnancy

Answer 16

increase venous pressure due to compression of IVC + decreased plasma osmolality due to dilutional affect

Question 17

what are indications to proceed with NSVD with breech presentation? what about “stargazer?

Answer 17

frank breech

flexed head

nl fluid

weight between 2500-3800

“stargazer= extended neck= CS!!

Question 18

signs of fetal metabolic acidosis

Answer 18

tachy

0 variability

lates

***signs for emergent section

Question 19

what is the appropriate amount of fetal kicks?

Answer 19

~10/2hr

Question 20

treatment for any imbedded placenta (acc-per)

Answer 20

hyst

Question 21

when do you see ACUTE polyhydramnios?

Answer 21

before 28 weeks, with preterm labor

Question 22

what are complications of polyhydramnios

Answer 22

placental abruption

uterine dysfuntion

PPH

Question 23

indications for cerclage?

Answer 23

hx of >3 2nd/3rd tri losses or hx of preterm deliveries

***cervical length < 25 mm is sketchy

Question 24

when is indomethacid contraindicated?

Answer 24

after 34 weeks

-oligohydramnios –> can decrease fetal urine

Question 25

whats a vasa previa? what are the consequences?

Answer 25

when fetal vessels overlie the os due to valementous cord insertion

can cause rapid exsanguination of fetus (baby doesn’t have a lot of blood to loose to begin with)

Question 26

post delivery risks for IUGR babies?

Answer 26

hypoxia at birth due to placental insufficiency

multiorgan thrombosis due to polycythemia as comp for hypoxia

Question 27

whats the anti-D titer indicative of fetal hemolytic dz?

Answer 27

1:16

Question 28

order of major congenital malformations in patients with preexisting DM?

Answer 28

CARDIAC >> msk > nervous system

Question 29

whats the one diabetic seq that WORSENS in pregnancy?

Answer 29

proliferative neuropathy

Question 30

how is hyperthyroidism treated in pregnancy? effects to baby?

Answer 30

treated with thionimides (PTU) –> crosses placenta –> babies can have goiter and hypothyroidism

Question 31

how do you treat ITP in pregnant women with counts >50,000 and asymptomatic?

Answer 31

you dont.

Question 32

best diagnostic test for suspected DVT?

Answer 32

compression US

Question 33

stillborn with hydrops, petechiae/ purpuric lesions and hypertrophic placenta?

Answer 33

syphillis

**parvo does not have hypertrophic placenta or skin findings

Question 34

are neonates more at risk from mom with crhonic hep B or acute hep B?

Answer 34

ACUTE!!

Question 35

timing of GBS meningitis vs listeriosis?

Answer 35

GBS iswithin one week, listeria withini 3-4

Question 36

montevideo units indicative of appropriate labor contractions?

Answer 36

200MVU, and they should have 3 contractions in 10 minutes, so each should be about 70mmHG in intensity

Question 37

corneal abrasions more likely in…..

Answer 37

forceps over vacuum delivery

Question 38

a third degree tear goes through the rectal ______ but not the rectal _______

Answer 38

sphincter, mucosa

Question 39

how are you “supposed” to handle a prolonged latent phase

Answer 39

pain management so ideally they can go to sleep and wake up in the active phase

Question 40

is external cephalic version appropriate in labor/after broken membranes

Answer 40

no, uterus is too contracted and broken membranes put at risk of cord prolapse

Question 41

when do you use internal podalic version?

Answer 41

in the delivery of the second twin

Question 42

most common uro finding in MS?

Answer 42

detrusor HYPERREFLEXIA

Question 43

cause of fetal demise in Factor V leiden mutation?

Answer 43

uteroplacental artery microthrombosis build up

Question 44

whats greatest risk for pre-eclamptic babies?

Answer 44

restricted growth

Question 45

tests to do for reccurrent second tri losses?

Answer 45

cervical length for cervical insufficiency

hysterosalpingogram to look for uterine anomolies

Question 46

nuchal trans

Question 47

achondroplasia moms and risk

Answer 47

spinal stenosis can make an epidural difficult and c/s are common due to distorted shape of pelvis

-achondroplasia fetus’ should be by c section

Question 48

most common anomalies from fetal alcohol syndrome?

Answer 48

cardiac and joint problems

Question 49

what does cloramphenicol cause? what do sulfa drugs do?

Answer 49

chlor= grey baby syndrome

sulfa= kernicterus