Kaplan Review

Question 1

Incidence of chromosomal abnormalities 25 and 35

Answer 1

25 - 1/250

35 - 1/365

Question 2

CVS - risk of pregnancy loss, age optimal, what you find

Answer 2

0.7% risk of pregnancy loss

done at 12-18 weeks

fetal karyotyping

Question 3

amniocentesis - risk of pregnancy loss, age, what you find

Answer 3

0.5% risk of pregnancy loss

done at 15-20 weeks

genetic purposes or Rh isoimmunization

Question 4

risk of NTD

Answer 4

1-2/1000

Question 5

major teratogenic risk week

Answer 5

postconception weeks 4-8

Question 6

hcg is produced by and peaks at

Answer 6

placental syncytiotrophoblast, starts at 10 days peaks at 9-10 weeks

• maintain corpus luteum production of progesterone
• high levels are twin, moles, choriocarcinoma, embryonal carcinoma

Question 7

hpl

Answer 7

similar to growth hormone and prolactin

- contributes to predisposition of pregnancy to glucose tolerance and diabetes

Question 8

progesterone

Answer 8

produced by corpus luteum 6-7, then corpus luteum and placenta 7-9, then placenta 9 weeks

Question 9

estradiol

Answer 9

estrogen during nonpregnant reproductive years

Question 10

estriol

Answer 10

estrogen during pregnancy

Question 11

estrone

Answer 11

estrogen during menopause

Question 12

change in blood pressure

Answer 12

systolic and diastolic decrease, nadir by 24-28 weeks

Question 13

plasma volume is… up, down, same

Answer 13

increased by 50%

Question 14

PVR… up, down, same

Answer 14

decreases by 30%

Question 15

cardiac output… up, down, same

Answer 15

increases by 50%

Question 16

WBC…up, down, same

Answer 16

increases during pregnancy

Question 17

coag factors…up, down, same and which ones

Answer 17

increases, 7, 8, 9, C

Question 18

gastric motility…up, down, same

Answer 18

decreases, emptying time increases

Question 19

tidal volume./…up, down, same

Answer 19

increases

Question 20

minute ventilation…. up, down, same

Answer 20

increases

Question 21

kidneys and GFR/ RPF, creatinine…up, down, same

Answer 21

increases in size, GFR increase, RPF increase, creatinine increases

Question 22

pituitary size… up, down, same

Answer 22

increases by 100%, increasing vascularity

Question 23

adrenal gland…. up, down, same

Answer 23

unchanged but cortisol increases

Question 24

best way to gauge age of fetus

Answer 24

ultrasound in first trimester

Question 25

alpha fetoprotein maternal

Answer 25

glycoprotein in fetus, peaks at 12 weeks

Question 26

elevated alpha fetoprotein

Answer 26

``` dating error NTD, open IUGR still birth preeclampsia ```

Question 27

glucose tolerance tests step 1

Answer 27

1 hour, 50 gram oral glucose, abnormal 140 or above

Question 28

glucose tolerance tests step 2

Answer 28

``` 3 hour, 100 gram normal: fasting under 95 1 hour under 180 2 hour under 155 3 hour under 140 ```

Question 29

congenital rubella

Answer 29

congenital deafness, congenital heart disease, cataracts, mental retardation, HSM, thrombocytopenia, blueberry muffin rash

Question 30

congenital CMV

Answer 30

most common, petechiae, meningoencephalitis, HSM, thrombocytopenia, jaundice

Question 31

congenital syphilis

Answer 31

hutchinson teeth, mulberry molars, saber shins, saddle nose, 8th nerve deafness

Question 32

sx of abruption placenta

Answer 32

pain over uterus, knifelike, vaginal bleeding severe: fetal brady, late decel

Question 33

risk factors for abruptio placenta

Answer 33

previous abruption, hypertension, maternal trauma

Question 34

tx for abruptio placenta

Answer 34

csection, vaginal delivery, in hospital observation

Question 35

placenta previa risk factors

Answer 35

previous placenta previa and multiple gestation

Question 36

tx for placenta previa

Answer 36

c section, hospital, vaginal delivery, scheduled c section

Question 37

sx for vasa previa

Answer 37

rupture of membranes, painless vaginal bleeding, fetal brady

Question 38

sx for uterine rupture

Answer 38

vaginal bleeding, abdominal pain, alteratioins in uterine contractility

Question 39

risk factors for uterine rupture

Answer 39

previous classic uterine incision, myomectomy, excessive oxytocin, grand multiparity

Question 40

tx for uterine rupture

Answer 40

immediate c section

Question 41

most common aneuploidy

Answer 41

turner syndrome, 45 X

Question 42

missed abortion

Answer 42

nonviable pregnancy without vaginal bleeding, uterine cramping, cervical dilation tx: D&C, conservative management

Question 43

threatened abortion

Answer 43

viable pregnancy with vaginal bleeding, no cervical dilation tx: observation, no intervention, half continue to term

Question 44

inevitable abortion

Answer 44

vaginal bleeding, uterine cramping leading to cervical dilation, no products of conception has yet been passed tx: D&C to prevent further blood loss and anemia

Question 45

incomplete abortion

Answer 45

vaginal bleeding and uterine cramping leading to dilation, some products of conception tx: D&C to prevent further blood loss and anemia

Question 46

completed abortion

Answer 46

vaginal bleeding, uterine cramping, all products passed

Question 47

sx of chorioamnitis

Answer 47

maternal fever, uterine tenderness in PROM without URI or UTI