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Obstetrics Flashcards

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1
Q

What are the normal structures and adult levels of the following Hb types?

A
A2
F
Hb H
Hb Bart
A 
A- 2 alpha and 2 beta 97%
A2- 2 alpha and 2 gamma 2.5%
F- 2 alpha and 2 delta <1%
HbH - 4 beta
Hb Bart- 4 alpha
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2
Q

Which Hb type has heintz bodies on peripheral smear?

A

Hb H- 4beta, alpha thalassemia

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3
Q 
Risk of Down's at age:
30
35
40
45
A

30: 1/1000 –> 40: 1/100
35: 1/365 –> 45: 1/36

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4
Q

Risk of aneuploidy risk by maternal age

30
35
40
45

A

30: 1/500
35: 1/180
40: 1/50
45: 1/18

divide the denominator in half from risk of downs

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5
Q

Nuchal translucency cut off for further evaluation

A

> 3mm

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6
Q

Fetal Circulation:
highest PO2
lowest PO2

A

right atrium

right ventricle

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7
Q

Fetal Circulation:
highest PCO2
lowest PCO2

A

right ventricle

right atrium

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8
Q

Placenta crossing

simple diffusion (5)

A

cocaine, O2, CO2, electrolytes, ketones

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9
Q

Placenta crossing

Active transport (4)

A

amino acids
calcium
phosphorus
Iron

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10
Q

Tetrology of Fallot

A

overriding aorta, pulm stenosis, hypertrophic right vent, VSD

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11
Q

Placenta crossing

endocytosis
bulk flow
carried-mediated

A

IgG
water
iodine

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12
Q

Which of the follow can cross the placenta?

  1. PTU
  2. TSH
  3. T3/T4
  4. insulin
  5. propranolol
  6. heparin
  7. predinisone
A

PTU, propanolol

  1. yes
  2. no
  3. no x2 per pubmed
  4. no
  5. yes
  6. no
  7. no
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13
Q

Physiology of pregnancy
Which of the following decrease in pregnancy?

  1. SVR
  2. HR
  3. CO
  4. plasma volume
  5. red cell volume
  6. CO2
A

SVR and CO2

  1. decrease
  2. increase
  3. increase
  4. increase
  5. increase
    6 decrease
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14
Q

Pulm changes in pregnancy
Which of the following decrease?

  1. RV
  2. ERV
  3. VC
  4. TV
  5. IC
  6. TLC
  7. IRV
  8. FRC
A
  1. decrease
  2. decrease
  3. no change
  4. increase
  5. increase
  6. decrease
  7. no change
  8. decrease

decrease: take the RV to the ERv for some TLC bc it’s FRcEE
increase: IC the TV hanging high on the wall

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15
Q

Progesterone effects on lipids (incr, decr)

HDL
LDL

A

HDL decrease

LDL increase

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16
Q

Coagulation Changes in Pregnancy

Which of the following decrease?

  1. protein s
  2. protein c
  3. antithrombin 3
  4. factor 2
  5. factor 5
  6. factor 7
  7. factor 8
  8. factor 9
  9. factor 10
  10. factor 11
  11. factor 13
  12. vWF
  13. plasminogen activator 1
  14. plasminogen activator 2
  15. fibrinogen
A

only 11, 13, and protein s decrease

  1. decrease
  2. no change
  3. no change
  4. no change
  5. no change
  6. increase
  7. increase
  8. no change
  9. increase
  10. decrease
  11. decrease
  12. increase
  13. increase
  14. increase
  15. increase
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17
Q 
thyroid changes in pregnancy (and with OCPs)
incr, decr, no change
1. Iodine
2. total T4
3. free T4
4. RT3U
5. TSH
6. FTI
A
  1. decrease
  2. increase
  3. no change
  4. decrease
  5. no change
  6. no change
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18
Q

measurement for contracted pelvis is an OB conjugate of …

A

<10.5cm

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19
Q

How many cells are in morula?
Is it diploid or haploid?
how many days after fertilization?

Study These Flashcards
A

16, diploid, 2-3

20
Q

How many cells are in blastocyst?
Is it diploid or haploid?
how many days after fertilization?

Study These Flashcards
A

32, diploid, 4-5

21
Q

At term how much do these measure?

BPD
femur length

Study These Flashcards
A

bpd 9.3cm

femur length 7.4cm

22
Q

How to calculate weeks gestation from CRL?

Study These Flashcards
A

CRL cm + 6.5cm= weeks gestation

23
Q

rate the mortality risk for these conditions in pregnancy

Which of the following are medium risk?

  1. ASD/VSD
  2. mitral stenosis class 1/2
  3. mitral stenosis class 3/4
  4. porcine valve
  5. artificial valve
  6. prior MI
  7. marfans with normal aorta
  8. uncorrected tet of fallot
  9. pulmonic/tricuspid disease
  10. aortic stenosis
  11. PDA
Study These Flashcards
A

low <1%
med 5-15%
high 25-50%

  1. low
  2. low
  3. med - Mitral stenosis class 3/4
  4. low
  5. med - artificial valve
  6. med - prior MI
  7. med - marfans normal aorta
  8. med - uncorrect tet of fallot
  9. low
  10. med - aortic stenosis
  11. low
24
Q

peripartum cardiomyopathy

  1. how to make dx?
  2. time frame from delivery
  3. most common cause
  4. risk factors (4)
  5. buzz words (3)
  6. ejection fraction
Study These Flashcards
A
  1. dx of exclusion
  2. last month of pregnancy to 5 months postpartum
  3. myocarditis
  4. PEC, anemia, multiples, short interval pregnancy
  5. soluble FMS-like tyrosine kinase, oxidative stress, impaired VEGF signaling
  6. less than or equal to 45%
25
peripartum cardiomyopathy rx and why? 4 things
1. diuretics to decrease preload (central vasc) 2. hydralazine to decrease afterload (peripheral vasc) 3. Digoxin to increase CO unless complex arrhythmia noted 4. anticoagulation for VTE
26
peripartum cardiomyopathy prognosis Good prognosis: ____% of women will regain vent function within ___ months Bad prognosis: black, what age, what EF?
Good prognosis: 50% of women will regain vent function within 6 months Bad prognosis: black, age 35-40, EF <25%
27
Inheritance pattern 1. marfans 2. PKU 3. huntington's 4. CF 5. galactosemia 6. von willebrand's dz 7. placental sulfatase deficiency 8. hemophilia
1. marfans - AD 2. PKU - AR 3. huntington's - AD 4. CF - AR 5. galactosemia - AR 6. von willebrand's dz - AD 7. placental sulfatase deficiency - sex-linked 8. hemophilia - sex-linked
28
Inheritance pattern 9. neural tube defect 10. tay sachs 11. mucopolysaccaridosis 12. muscular dystrophy 13. thalassemia 14. mullerian agenesis 15. AIS/androgen receptor deficiency 16. CAH
9. NTD- multifactorial 10. tay sachs- AR 11. mucopolysaccaridosis - AR 12. muscular dystrophy- sex-linked 13. thalassemia - AR 14. mullerian agenesis- multifactorial 15. AIS/androgen receptor deficiency- sex-linked 16. CAH- AR
29
recurrence rate for multifactorial inheritance? chromosomal errors? sex-linked?
3-5%, 1%, 50%
30
survival rate for turners?
<10% survive to 1 year
31
high or low MsAFP 1. GTD 2. cystic hygroma 3. osteogenesis imperfecta 4. congenital nephrosis
1. low 2. high 3. high 4. high
32
normal EFW at the follow gest ages 20 28 32 34 growth after 34wks??
300 1000 1600 2000 250g per week after 34 wks
33
Bishop score rules 1. SVE to get max points? 2. SVE to 1 point each?
5/80/+1/soft/anterior | 1-2/40-50/-2/med/mid-position
34
what percentage of brachial plexus injuries have significant lasting effects?
15%
35
which muscles are impacted during erb's palsy? (3)
deltoid infraspinatus flexor
36
top 3 vaccuum injuries
scalp lac, cephalohematoma, subgleal hematoma
37
TORCH congenital hearing loss, blueberry muffin baby
CMV
38
TORCH fetal effects of varicella (6)
``` limb hypoplasia neonatal death chorioretinitis cataracts cutaneous scarring pna ```
39
toxoplasmosis rx parvovirus rx cmv rx varicella rx
spiramycin none none acyclovir, valacyclovir, Ig
40
Pulm changes in pregnancy Which of the following increase? 1. RV 2. ERV 3. VC 4. TV 5. IC 6. TLC 7. IRV 8. FRC
1. decrease 2. decrease 3. no change 4. increase 5. increase 6. decrease 7. no change 8. decrease decrease: take the RV to the ERv for some TLC bc it's FRcEE increase: IC the TV hanging high on the wall
41
Pulm changes in pregnancy Which of the following do not change? 1. RV 2. ERV 3. VC 4. TV 5. IC 6. TLC 7. IRV 8. FRC
VC, IRV 1. decrease 2. decrease 3. no change 4. increase 5. increase 6. decrease 7. no change 8. decrease
42
Coagulation Changes in Pregnancy Which of the following increase? 1. protein s 2. protein c 3. antithrombin 3 4. factor 2 5. factor 5 6. factor 7 7. factor 8 8. factor 9 9. factor 10 10. factor 11 11. factor 13 12. vWF 13. plasminogen activator 1 14. plasminogen activator 2 15. fibrinogen
factor 7, factor 8, factor 10, vWF, PA 1, PA 2, fibrinogen 1. decrease 2. no change 3. no change 4. no change 5. no change 6. increase 7. increase 8. no change 9. increase 10. decrease 11. decrease 12. increase 13. increase 14. increase 15. increase
43
severe range BP - IV labetalol ``` start with ___ recheck in ___ min give ____ recheck in ___ min give _____ recheck in ___ min give ____ ```
severe range BP - IV labetalol ``` start with 20mg IV recheck in 10 min give 40mg IV recheck in 10 min give 80mg IV recheck in 10 min hydralazine 10mg ```
44
severe range BP - IV hydralazine ``` start with ___ recheck in ___ min give ____ recheck in ___ min give _____ recheck in ___ min give ____ ```
severe range BP - IV hydralazine ``` start with 5 or 10mg IV recheck in 20 min give 10mg IV recheck in 20 min give labetalol 20mg recheck in 10 min give labetalol 40mg IV ```
45
severe range BP - PO Nifedipine ``` start with ___ recheck in ___ min give ____ recheck in ___ min give _____ ```
severe range BP - PO Nifedipine ``` start with 10mg recheck in 20 min give 20mg recheck in 20 min give labetalol 40mg ```
46
what is the MOST sensitive week for NT screening?
13 weeks However, the 99% sensitivity cut off is the same at any week from 10 to 14.
47
list the 4 stages of parturition
1. mild ctx, softening the cervix before labor 2. cervical ripening 3. all the stages of labor 4. pp recovery

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