OB/Repro Exam 1

Question 1

ovarian cycle - follicular phase

Answer 1

• starts day 1 of menstruation
• one dominant follicle
• estrogen

Question 2

ovarian cycle - ovulatory phase

Answer 2

• LH surge triggers ovulation on day 14
• fertile window: 5 days before ovulation - the day after ovulation (sperm live for 5 days)

Question 3

ovarian cycle - luteal phase

Answer 3

• corpus luteum
• progesterone

Question 4

endometrial cycle - proliferative phase

Answer 4

• estrogen causes endometrium to thicken

Question 5

endometrial cycle - secretory phase

Answer 5

• progesterone

Question 6

endometrial cycle - menstruation

Answer 6

• occurs due to change in hormones
• endometrial tissues sloughs & is expelled

Question 7

neural tube closes at

Answer 7

week 4

Question 8

fetus most susceptible to teratogens

Answer 8

first 8 weeks

Question 9

heart tones heard on a doppler

Answer 9

week 12

Question 10

testosterone becomes present

Answer 10

week 8, if not by week 10 then develops into F

Question 11

lungs begin to produce surfactant

Answer 11

week 24

Question 12

function of the placenta

Answer 12

• serves as a barrier between maternal and fetal blood
• nutrient & electrolyte exchange

Question 13

purpose of preconception counseling

Answer 13

• enhance health prior to pregnancy
• provide anticipatory guidance

Question 14

why is folic acid supplementation important

Answer 14

• prevent neural tube defects/spina bifida

Question 15

presumptive s/s of pregnancy

Answer 15

probable/positive s/s of pregnancy
- missed period
- nausea
- breast tenderness
- urinary frequency
- fatigue
- quickening (fetal movement)

Question 16

probable s/s of pregnancy

Answer 16

objective s/s perceived by HCP, can have other causes, not diagnostic
- chadwick’s sign (bluish discoloration of uterus due to increased vascularization)
- uterine/abdominal growth
- positive pregnancy test

Question 17

positive s/s of pregnancy

Answer 17

objective, noted by HCP, can only be attributed to fetus
- fetus visualized by ultrasound (4-5 weeks)
- fetal heart tones (10-12 weeks)
- fetal movement (20 weeks)

Question 18

GTPAL

Answer 18

G: gravida - total # of pregnancies
T: term - total # of term pregnancies
P: preterm - total # of preterm pregnancies
A: abortion - total # of abortions (before 20 weeks)
L: living - total # of living children

Question 19

gravida & para

Answer 19

gravida: total # of pregnancies
para: total # of births after 20 weeks

Question 20

fundal height measurement

Answer 20

• 36-38 weeks: fundus right up under sternum
• 40 weeks: fundus drops below 38 week level (dropping down into pelvis)

Question 21

nuchal translucency test

Answer 21

• week 11-13
• assess fluid behind neck of fetus
• enlarged = chromosomal abnormalities or neural tube defects

Question 22

anatomy ultrasound

Answer 22

week 20

Question 23

gestational diabetes screening

Answer 23

week 24-28

Question 24

rh

Answer 24

routinely given at week 28

Question 25

GBS

Answer 25

week 35-37

Question 26

cardiovascular changes

Answer 26

- increase blood volume by 50% - increase HR, WBC, & RBC - increased venous pressure & decreased blood flow to extremities results in varicose veins, hemorrhoids, edema

Question 27

respiratory changes

Answer 27

- physiological dyspnea - increased resp rate & O2 consumption

Question 28

renal changes

Answer 28

- increased renal blood flow leads to urinary frequency

Question 29

GI changes

Answer 29

- changes in metabolism lead to N/V - increased progesterone relaxes smooth muscle leading to bloating, constipation, gas

Question 30

integumentary changes

Answer 30

- increased melanin (linea nigra, malasma) - increased blood flow & metabolic rate can lead to hot flashes, sweating, facial flushing

Question 31

ultrasound

Answer 31

- done to confirm pregnancy - evaluate fetal presentation, anatomy, amniotic fluid volume, placental position, cardiac activity, gestational measurements - assess blood flow through uterine vessels

Question 32

non-stress test

Answer 32

- monitor FHR patterns/accelerations for 20 mins as indication of fetal well-being - reactive: FHR increases 15 beats above baseline for 15 seconds 2 times+ in 20 mins

Question 33

amniocentesis

Answer 33

- *most common; used to look for intrauterine infection, hemolytic disease, fetal lung maturity - week 15-20, results in 2 weeks - needle inserted through abdomen to collect amniotic fluid

Question 34

chorionic villus sampling

Answer 34

- aspiration of placental tissue for chromosomal, metabolic, & DNA testing - week 10-13, results in 1 week - catheter inserted through cervix or abdominally to assess placenta

Question 35

importance of thyroid hormone

Answer 35

- pts w hypothyroidism will need up to 30% increased doses - maternal thyroid hormone is important for fetal CNS dev in early pregnancy

Question 36

hyperemesis gravidarum

Answer 36

- severe N/V that leads to dehydration - may need hospitalization for IV hydration & correction of electrolytes

Question 37

cervical insufficiency

Answer 37

- inability for cervix to retain a pregnancy -"premature cervical dilation" - painless cervical dilation before 24 weeks - difficult to diagnose, more likely if cervical trauma or LEEP procedure

Question 38

preterm labor & birth

Answer 38

- leading cause of neonatal mortality - most common reason for hospitalization during pregnancy - tocolytic drugs can prolong birth up to 48 hours (given steroids to promote surfactant)

Question 39

preterm premature rupture of membranes (PPROM)

Answer 39

- rupture of membranes before onset of labor & 37 weeks - usually secondary to ascending infection, but cause is usually unknown

Question 40

gestational diabetes

Answer 40

- tested 24-28 weeks

Question 41

preeclampsia

Answer 41

- hypertension & proteinuria - asymptomatic or HA, blurred vision, N/V, RUQ pain, hyperreflexia, angioedema - magnesium sulfate as seizure precaution

Question 42

placenta previa

Answer 42

- placenta attaches over/near cervical opening - hemorrhage risk to mom - presents as painless vaginal bleeding in 3rd trimester

Question 43

placental abruption

Answer 43

- sudden onset of intense localized uterine pain - placenta separates from uterine wall before baby is born

Question 44

ectopic pregnancy

Answer 44

- pregnancy that occurs outside uterus, usually fallopian tube - increased risk in pts with PID - can result in tubal rupture & intense bleeding - pelvic/abdominal pain esp unilaterally - can be managed with methotrexate in early pregnancy (unruptured)

Question 45

HELLP syndrome

Answer 45

- Hemolysis, Elevated, Liver enzymes, Low, Platelet levels - RUQ pain (liver enzymes increase due to ischemia to liver causing RUQ pain) - only definite cure is immediate delivery