OB

Question 1

recurrence risk vs baseline risk for fetal neural tube defect

Answer 1

3.2% recurrence risk with affected sibling vs 0.04% baseline risk

Question 2

action of engagement cardinal movement

Answer 2

biparietal diameter enters pelvic inlet; leading edge of head is at or below station 0, fetal head enters pelvis transversely

Question 3

action of flexion cardinal movement

Answer 3

fetal chin brought towards chest, shifting the occipitofrontal diameter of 12cm to a shorter suboccipitobregmatic diameter of 9.5cm

Question 4

action of internal rotation cardinal movement

Answer 4

occiput moves toward pubic symphysis and away from a transverse axis, resulting in direct OA or OP

Question 5

action of external rotation cardinal movement

Answer 5

aka restitution

occiput and fetal body rotate into transverse position, therefore rotating bisacromial diameter

Question 6

what occurs during extension cardinal movement

Answer 6

delivery of fetal head

Question 7

what occurs during expulsion cardinal movement

Answer 7

delivery of anterior and posterior shoulders

Question 8

who is candidate for physical-exam indicated cerclage and when to place?

Answer 8

painless 1-4cm dilation

- place on dx during 2nd tri

Question 9

who is candidate for US-indicated cerclage and when to place?

Answer 9

hx spontaneous birth <34wk & CL <25mm on US

- place at 16-24wk

Question 10

who is candidate for hx-indicated cerclage and when to place?

Answer 10

clear hx cervical insufficiency (one or more 2nd-tri preg losses related to painless cervical dilation, prior cerclage for that reason)
- place 13-14wk

Question 11

when is cardiac output highest in preg

Answer 11

increases throughout pregnancy, highest immediately postpartum

Question 12

when can you change dating if LMP & US differ by more than 5 days

Answer 12

<9.0

Question 13

when can you change dating if LMP & US differ by more than 7 days

Answer 13

9.0-15.6 (and lower)

Question 14

when can you change dating if LMP & US differ by more than 10 days

Answer 14

16.0-21.6 (and lower)

Question 15

when can you change dating if LMP & US differ by more than 14 days

Answer 15

22.0-27.6 (and lower)

Question 16

when can you change dating if LMP & US differ by more than 21 days

Answer 16

always (28.0-up)

Question 17

recommended weight gain in pregnancy: underweight

Answer 17

28-40lb

Question 18

recommended weight gain in pregnancy: normal weight

Answer 18

25-35lb

Question 19

recommended weight gain in pregnancy: overweight

Answer 19

15-25lb

Question 20

recommended weight gain in pregnancy: obese

Answer 20

11-20lb

Question 21

Friedman prolonged latent phase: nullip

Answer 21

> 20 hrs to get to active phase

Question 22

Friedman prolonged latent phase: multip

Answer 22

> 14 hrs to get to active phase

Question 23

Recommended daily iron supplementation amount

Answer 23

At least 27mg daily
(total 1000mg pregnancy)

Question 24

misoprostol drug class

Answer 24

PGE1

Question 25

dinoprostone drug class

Answer 25

PGE2

Question 26

Upper limit Vitamin D daily intake in preg & recc daily dose

Answer 26

- upper limit 4,000 IU - in deficiency, take 1-2K IU daily

Question 27

TB tx in pregnancy

Answer 27

Active = treat now with isoniazid, rifampin, ethambutol Latent = treat 2-3mo postpartum with isoniazid (unless high risk progression then treat if not 1st tri)

Question 28

most common inherited bleeding disorder in American women

Answer 28

von willebrand disease

Question 29

MOA of placental separation postpartum

Answer 29

cleavage along the plane of the decidua basalis due to uterine contractions