obstetrics

Question 1

What is preclampsia

Answer 1

pregnancy-induced HTN

Question 2

triad of preclampia

Answer 2

HTN, protein urea, edema

Question 3

Clinical signs of preclampsia

Answer 3

SBP > 140
DBP >90
Proteinuria
edema to hands/feet
oliguria
headache, visual disturbances, RUQ pain

Question 4

risks of preclampsia

Answer 4

over 40 yrs
twins
diabetes
family hx
chronic HTN
renal disease
DIC

Question 5

what is eclampsia

Answer 5

Convulsions that occur during pregnancy , associated with HTN, no other cause

Question 6

Pre hospital Treatment for eclampsia

Answer 6

**delivery is definitive treatment **

magnesium sulfate
4-6g over 20mins

if seizure persists, can give 4g IV over 5mins

followed by 1-2g per hour

if patient still seizing consider midazolam

Question 7

What is definition of HELLP syndrome

Answer 7

life threatening complications of pregnancy ancy which can be a variant of preclampsia

occurs in later stages of pregnancy and sometimes 24-48 hours after

Question 8

acronym of HELLP

Answer 8

Hemolytic anemia
Elevated Liver (enzymes)
Low Platelets

Question 9

3 stages of labour

Answer 9

stage 1: contractions gradually open cervix
stage 2: active delivery
stage 3: delivery of placenta

Question 10

how long after delivery should placenta deliver?

Answer 10

10 mins

Question 11

risks of shoulder dystocia

Answer 11

gestational diabetes
post date pregnancies
abnormal pelvic anatomy

Question 12

Post pardum hemorrhage- the 4 Ts

Answer 12

Tone
Trauma
Tissue
Thrombin

Question 13

PPH - causes of “tone”

Answer 13

caused by uterine atony

Question 14

most common cause of PPH?

Answer 14

uterine atony

Question 15

causes of PPH - Trauma

Answer 15

cervical, vaginal, peroneal lacerations, pelvic hematoma, uterine inversion

Question 16

causes of PPH - Tissue

Answer 16

retained tissue and placental acceta, abnormally deep attachment of placenta

Question 17

causes of PPH - thrombin

Answer 17

coagulopathies, vonwillebrand disease, hemophillia

Question 18

what is the foreman ovale and what is its function

Answer 18

hole in inter-atrial septum to shunt blood from right to left atria
-allows blood coming from umbilical vein via inferior vena cava to bypass the pulmonary circulation

Question 19

ducts arteriosus

Answer 19

blood vessel connecting the main pulmonary artery to the proximal descending aorta that allows most of the blood from right ventricle to bypass the fetus’s fluid-filled non-,functioning lungs

Question 20

ductus venosus

Answer 20

shunts a portion of the left umbilical vein blood flow directly into the inferior vena cava. Oxygenated blood bypasses the liver.

Question 21

what type of breech birth is most common

Answer 21

frank breech - legs extended at hip, could have foot presenting

Question 22

what type of breech birth is LEAST common?

Answer 22

complete breech presentation - where baby’s bottom faces the cervix

Question 23

does preclampsia only occur during pregnancy?

Answer 23

no, it can occur post pardom. usually within 48 hours can be 6 weeks of longer after

Question 24

true or false: in premature delivery breech delivery is more common

Answer 24

true

Question 25

what 4 components make up tetrology of fallot

Answer 25

ventricular septal defect over riding aorta pulmonary stenosis right ventricular hypertrophy

Question 26

What is given to keep ductus arteriosus open in neonate

Answer 26

prostsglandin E1

Question 27

What is croactation of the aorta

Answer 27

congenital defect- narrowing of the aorta

Question 28

What is patent ductus arteriosus

Answer 28

the ductus remains open after birth. Between aorta and pulmonary artery

Question 29

what are the acyanotic congenital defects

Answer 29

atrial dental defect ventricular septal defect patent ductus arteriosus *left to right shunts* *increased pulmonary blood flow*

Question 30

what are cyanotic congenital defects

Answer 30

tetrology of fallot transposition of the great arteries persistent truncus arteriosus

Question 31

where do you measure pre ductile o2 sat?

Answer 31

the right hand

Question 32

Patho of eclampsia

Answer 32

Not well understood, but thought to result from vasogenic or cytotoxic edema and endothelial dysfunction secondary to abnormal cerebral autoregulation - results in hyper or hypo perfusion stemming from hypertension

Question 33

What is the most common MAJOR congenital anomaly?

Answer 33

congestive heart failure

Question 34

Define truncus arteriosus

Answer 34

there is one large blood vessel leading out of the heart instead of 2

Question 35

what are the 2 major issues caused by truncus arteriosus?

Answer 35

- oxygen poor blood mixes withoxygrn rich blood, reducing the amount of oxygenated blood delivered to the body - increases amount of blood sent to thr lungs

Question 36

Which other condition do babies with truncus arteriosus usually have ?

Answer 36

ventricular septal defect

Question 37

true or false: lesions that depend on the ductus arteriosus for pulmonary or systemic circulation typically present with cyanosis and shock within the first week of life as the ductus closes. Lesions that result in pulmonary overcirculation leading to CHF more often present in the 2nd or 3rd month of life as falling pulmonary vascular resistance increases left-to-right shunting, resulting in pulmonary edema.

Answer 37

true

Question 38

what is the common presentation of uterine rupture?

Answer 38

-hypotension -vaginally bleeding -hematuria -sudden drop in fetal heart rate - sudden abdominal pain

Question 39

What is definitive treatment of eclampsia?

Answer 39

delivery

Question 40

what is uterine rupture?

Answer 40

complete division of all 3 layers of the uterus

Question 41

what does TOLAC stand for?

Answer 41

trial of labour after cesarean

Question 42

true or false: women who decide to have TOLAC are at higher risk of uterine rupture

Answer 42

true