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OBGYN > Day 1 Learning > Flashcards

Day 1 Learning Flashcards

1
Q

When should an echo be done for a fetus in utero?

A

22-24 weeks

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2
Q

What does AMA stand for in OBGYN?

A

Advanced medical age

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3
Q

Where should the cord exit the placenta and what are common deviations?

A

Centrally; common to see it exit marginally with twins

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4
Q

What are the 4 main conditions searched for on carrier screenings?

A

CF, Fragile-X, Sickle-cell, Spinal Muscular Atrophy

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5
Q

What do positive anti/Ro and anti/La antibodies increase risk for in baby?

A

Neonatal lupus and fetal heart block (may need pacemaker if block is bad enough)

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6
Q

When is an amniocentesis usually done?

A

16-22 weeks

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7
Q

What antidepressant is good to give in pregnancy?

A

Sertraline

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8
Q

What does hx of anxiety and depression in pregnancy lead to?

A

Increased risk of postpartum depression

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9
Q

Can cleft palates be ruled out on US? What is an indicator?

A

No; look for lips - if normal appearing, decreased risk for cleft palate

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10
Q

What are complications that can occur on baby with mom having GDM?

A

Macrosomia, neonatal hypoglycemia, hyperbilirubenemia, shoulder dystocia, birth trauma

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11
Q

When is screening for GDM performed?

A

24-28 weeks

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12
Q

What is the screening process for GDM?

A

2-step:
1) 50g oral glucose followed by 1 hour venous glucose determination
2) 100g, 3 hour diagnostic OGTT (oral glucose tolerance test)

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13
Q

What medication(s) is given to women in preterm labor?

A

Magnesium sulfate and steroids

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14
Q

Why is mag sulfate given to women in preterm labor?

A

Neonate neuroprophylaxis and tocolysis (slow/stop contractions)

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15
Q

When and why are steroids given to pregnant women?

A

If women goes into preterm labor 2 doses 24 hours apart…2 more doses 2 weeks later 24 hours apart; given to help advance fetal lung maturity

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16
Q

What drug can be given along with magnesium sulfate and corticosteroids in a patient in preterm labor and why?

A

Nifedipine - can be given for tocolysis (tocolytics are not always indicated nowadays)

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17
Q

What is considered AMA and what testing is recommended in this patient?

A

35 or older by the estimated due date and amniocentesis is recommended

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18
Q

What medication is given to patients with an increased risk for preeclampsia, preterm labor, or poor fetal growth, why, and how when should it be given?

A

Baby aspirin; to reduce risk of all of the mentioned complications; started between 12-28 weeks and continued throughout the rest of the pregnancy

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19
Q

What does a BP of greater than 160/110 in a pregnant women increase risk for?

A

Greatly increase risk of MI and stroke in mom

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20
Q

What can surgery in the abdomen during pregnancy increase the risk of?

A

Labor and bleeding at surgical site due to stretching

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21
Q

What is the inheritance pattern for sickle cell disease?

A

Autosomal recessive

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22
Q

What medication and what dosage should be given to patients with previous anencephaly?

A

4 mg of folate

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23
Q

What is echogenic bowel and what is it associated with?

A

Bowel appears bright like bone on US; increased risk for chromosomal abnormalities (i.e. Down’s syndrome, CF, etc.)

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24
Q

What is vasa previa?

A

Umbilical vessels lying over or near the birthing canal

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25
Q

What is considered fetal growth restriction?

A

Fetal weight or abdominal circumference less than 10th percentile

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26
Q

What are the qualifications for small gestational age (SGA)?

A

Newborns whose birth weight is less than the 10th percentile

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27
Q

What infection accounts for most cases of infection-related fetal growth restriction worldwide?

A

Malaria

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28
Q

What are the four biometric measures most commonly used to assess for fetal growth restriction?

A

Biparietal diameter, head circumference, abdominal circumference, and femur length

29
Q

What should be performed at each prenatal care visit after 24 weeks gestation?

A

Fundal height measurements

30
Q

What does a discrepancy between weeks of gestational age and fundal height measurement of greater than 3 mean?

A

May have fetal growth restriction

31
Q

What should be assessed once fetal growth restriction is diagnosed?

A

Serial umbilical artery Doppler velocimetry

32
Q

When is delivery suggested in a women with a baby measuring 3rd-10th percentile with a normal umbilical artery Doppler?

A

38 0/7 - 39 0/7 weeks

33
Q

When is delivery suggested in a women with a baby measuring less than the 3rd percentile with a normal umbilical artery Doppler?

A

37 0/7 weeks

34
Q

When is delivery suggested in a women with a baby measuring 3rd-10th percentile with an abnormal umbilical artery Doppler?

A

Earlier than 37 0/7 weeks

35
Q

What type of diet is recommended in a patient with GDM?

A

Similar to keto but can have some complex carbs

36
Q

What is the composition of hemoglobin A?

A

2 alpha-chains and 2 beta-chains

37
Q

What is the composition of hemoglobin F?

A

2 alpha-chains and 2 gamma-chains

38
Q

What is the composition of hemoglobin A2?

A

2 alpha-chains and 2 delta-chains

39
Q

What chromosome are genes that code for alpha-globin located on?

A

16

40
Q

What chromosome are genes that code for beta-globin located on?

A

11

41
Q

What is the genetic mutation that causes sickle cell disease?

A

Single nucleotide substitution of valine for glutamic acid coding for beta-globin polypeptide

42
Q

What is Hb SS, what organ complication is associated with it and what does this result in?

A

Hb SS - hemoglobin structure in sickle cell disease; patients with Hb SS are functionally asplenic due to autosplenectomy by adolescence; increased incidence and severity of infection

43
Q

Look up video on velamentous placenta!!

A

Do it

44
Q

What is the most significant threat to patients with sickle cell disease and what does this entail?

A

Acute chest syndrome; pulmonary infiltrate with fever that leads to hypoxemia and acidosis - infiltrates are not infectious in origin but are due to vasoocclusion from sickling or embolization of marrow from long bones affected by sickling

45
Q

How are hemoglobinopathies diagnosed?

A

Hemoglobin electrophoresis and CBC

46
Q

What do thalassemias ultimately result in?

A

Microcytic anemia

47
Q

What are the different categories of alpha-thalassemia and their associated sxs?

A

1 alpha mutation - silent mutation - no effect
2 alpha mutations - alpha-thal trait/minor - mild asymptomatic microcytic anemia
3 alpha mutations - HbH - mild to moderate hemolytic anemia
4 alpha mutations - Hb Bart’s - hydrops fetalis

48
Q

What ethnicity is commonly associated with trans deletion in alpha thalassemia trait and what effect does this have on inheritance?

A

African; Hb Bart’s not typically developed in patients of African origin due to (alpha - / alpha -)

49
Q

What ethnicity is commonly associated with a cis deletion in alpha-thalassemia trait?

A

Asian

50
Q

What type of hemoglobin is absent in beta-thalassemia?

A

HbA

51
Q

What are the classifications of beta-thalassemia?

A

Beta-thal minor - heterozygous mutation
Beta-thal intermedia - homozygous mutation with less severe clinical complications
Beta-thal major - homozygous mutation with more severe clinical complications

52
Q

What are the complications associated with beta-thal major?

A

Sever anemia with resultant extramedullary hematopoesis, delayed sexual development, and poor growth. Elevated HbF levels and death usually occurs by age 10 unless early intervention by blood transfusions.

53
Q

What ethnicities are at higher risk for hemoglobinopathies and should therefore be offered carrier screenings?

A

African, southeast Asian, and Mediterranean

54
Q

What is recommended for expecting parents where both parents are carriers for potential disorders?

A

Genetic counseling

55
Q

When should chorionic villus sampling (CVS) be done?

A

10-12 weeks

56
Q

How much folate should a patient with sickle cell disease take and why?

A

4 mg; continual turnover of red blood cells

57
Q

What drug is commonly used in patients with lupus and can it be used in Pregnancy?

A

Hydroxyurea - reduces the frequency of painful crises; cannot be used in pregnancy because it is teratogenic

58
Q

What are pregnant women with sickle cell disease at an increased risk for?

A

Spontaneous abortion, preterm labor, IUGR, and stillbirth

59
Q

When is the best time to deliver a pregnant patient with oligohydramnios?

A

36-38 weeks

60
Q

What is an EIF and why is it significant?

A

A bright spot on the heart (similar to bone); indicates increased risk for Down Syndrome

61
Q

What does EIF stand for?

A

Echogenic intracardial focus

62
Q

What is a common risk factor associated with obesity?

A

Stillbirth

63
Q

What is the treatment plan for a neonate with an ASD?

A

Prostaglandins can be given initially; if unsuccessful, cardiac catheterization

64
Q

What are the best medications for HTN post-parturition?

A

Labetalol (1st line); can use nifedipine (procardia) if cannot use labetalol

65
Q

What does an absent nasal bone on US indicate?

A

Increased risk of Down Syndrome

66
Q

What is “normal” fetal positioning?

A

Head first

67
Q

What is breech fetal positioning?

A

Feet/butt first

68
Q

What is fetal fibronectin and what does it test used for?

A

The “glue” that holds the amniotic sac to the lining of the uterus; tested to see if the patient is at higher risk for preterm labor

69
Q

What is velamentous cord insertion?

A

An abnormal cord insertion in which the umbilical vessels diverge as they traverse between the amnion and chorion before reaching the placenta

OBGYN (3 decks)

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