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USMLE STEP 2, for real tho > OBGYN > Flashcards

Flashcards in OBGYN Deck (43):
1

What separates normal hemodilution of pregnancy from other anemias

hemodilution does not effect MCV
Thalassemias, Iron, and folate deficiencies do change MCV

2

The increased minute ventilation during pregnancy causes an acid base what?

compensated respiratory alkalosis

ph ↑ co2 and bicarb ↓ (RO)

3

The Resp rate does not change in pregnancy, but the ______ is increased which increases the minute ventilation, which is responsible for the _______ (acid base)

Tidal volume up

respiratory alkalosis in pregnancy is normal acid base status

4

Use of ______ increases the susceptibility of pulmonary edema, especially with the use of isotonic fluids.

multiple tocolytics

5

The cardiac output increases up to 33% due to _______ in pregnant people.

increases in both the heart rate and stroke volume

Up to 95% of women will have a systolic murmur due to the increased volume.

Diastolic murmurs are always abnormal.

6


_____ murmurs are always abnormal in prego

Diastolic

7

what is the symmetry `of hydronephrosis of pregnancy

The dilation is unequal (R > L)

sigmoid cushions left ureter

right ureter compressed by uterus and right ovarian vein complex

8

the _______ are the most common site of metastatic disease in patients with gestational trophoblastic disease (molar prego)

lungs

9

weight gain in pregnancy for underweight (BMI

total weight gain 28 – 40 pounds;

10

weight gain in pregnancy for normal weight (BMI 18.5 – 24.9 kg/m2)

total weight gain 25 – 35 pounds; pounds.

11

weight gain in pregnancy for overweight (BMI 25 – 29.9 kg/m2)

total weight gain 15 - 25 pounds

12

weight gain in pregnancy for obese (BMI > 30 kg/m2)

total weight gain 11 - 20 pounds.

13

How would you screen a couple for sickle cell?

HgB electrophoresis

smear likely wont show sickling, esp. in carriers

14

Valproic acid in prego is is associated with an increased risk for ____________________

neural tube defects, hydrocephalus and craniofacial malformations.

15

Women with poorly controlled DM immediately prior to conception/ during organogenesis have a 8 fold risk of having a fetus with _______________-

central nervous system (neural tube defects) and the cardiovascular defects

16

Chorionic villus sampling (CVS) is a prenatal test that diagnoses ________ by sampling placenta chorionic villi

genetic disorders (tri-21, CF, etc)

17

If there is a history of a FDR with colon cancer before age 60, then begin screening with colonoscopy at age ________, and repeat every five years.

40, or 10 years before the youngest relative diagnosis

18

Bone density screening is recommended for women beginning at age _____ unless they have pre-existing risk factors which warrant earlier screening.

65

Unless they have pre-existing risk factors

19

Risk factors for osteoporosis are:

early menopause
glucocorticoid therapy
sedentary lifestyle
alcohol consumption
hyperthyroidism
hyperparathyroidism
anticonvulsant therapy
vitamin D deficiency
family history of early or severe osteoporosis
chronic liver or renal disease.

20

______________ is the number one killer of women

Heart disease

21

__________ is the most effective screening test for Down syndrome.

Cell-free DNA screening

22

Associated risks of gestational diabetes.

Shoulder dystocia
metabolic disturbances
preeclampsia
polyhydramnios
fetal macrosomia

23

According to ACOG, the recommended dose of folate for non-high risk patients is at least ______

0.6 mg/day.

24

women with a previous pregnancy complicated by a fetal neural tube defect should ingest _____ daily before conception and through the first trimester

4 mg of folic acid

25

Incorrect dating, specifically _________, is the most common explanation for an elevated MSAFP.

under-estimation of gestational age

26

Ibuprofen is safe to take until around ___________, when premature closure of the ductus arteriosis is a risk.

32 weeks gestation

27

All women with + cultures for GBS/ hx of baby with GBS should receive antibiotics in this time frame?

antibiotics in labor always.No culture nessiciary ever

no ab's if a c-section is performed before onset of labor in a woman with intact amniotic membranes.

28

If the fetal heart rate cannot be confirmed using external methods, then the most reliable way to document fetal well-being is to?

apply a fetal scalp electrode

ultrasound is good, but can't do continuous monitoring

29

Umbilical cord prolapse occurs in 1% of births and shows _________ on fetal monitoring

Sustained fetal bradycardia is usually observed.

30

Late decelerations are associated with ___________

uteroplacental insufficiency.

31

Once an umbilical cord prolapse is diagnosed, what do you do?

expeditious cesarean section.

do not replace the umbilical cord into the uterus or allow the patient to continue to labor or perform a forceps-assisted vaginal delivery.

32

_____________ babies are more common with type 1 diabetes than with gestational diabetes

Small

33

_______________ is a warning sign that the infant may be septic.

Fetal tachycardia coupled with minimal variability

A septic infant will typically appear pale, lethargic and have a high temperature.

34

A septic infant will typically appear ____________

pale, lethargic and have a high temperature.

35

Infants born to diabetic mothers are at increased risk for developing?

polycythemia
hyperbilirubinemia
hypoglycemia,
hypocalcemia a
respiratory distress.

36

How do you treat the baby of HIV + moms?

Treat the infant with zidovudine (AZT) immediately after delivery

37

define uterine atony

floppy uterus that wont contract

major cause of postpartum hemorrhage

38

The safest method to suppress lactation is ____________

breast binding, ice packs, and analgesics.

39

After delivery, large amounts of prolactin continue to be secreted, milk is produced after the inhibitory action of ___________ is lifted.

estrogen and progesterone

40

The discriminatory zone for hCG is?

the serum level above which a gestational sac should be visualized by ultrasound examination if an IUP is present

usually= 2000

41

Beta-hCG in a normal pregnancy level should rise by at least ______ until the pregnancy is ____ old

50% every 48 hours

42 days

42

Criteria for methotrexate therapy for treatment of an ectopic pregnancy.

-hemodynamic stability
-non-ruptured ectopic pregnancy
-size of ectopic mass

43

What are the 2 treatments for ectopic

ruptured/ no follow up= laparoscopy
safe/ reliable = methotrexate