Obstetrics & Gynecology

Question 1

What is pregnancy?

Answer 1

Product of conception implanted typically in uterus or atypically in other locations.

Question 2

What does gravidity refer to?

Answer 2

Number of times a woman has been pregnant.

Question 3

What does parity refer to?

Answer 3

Number of pregnancies that led to birth > 20 weeks AOG or infant > 500 g.

Question 4

What is an embryo?

Answer 4

From time of fertilization until 8 weeks pregnancy (10 weeks’ gestational age [GA]).

Question 5

What is a fetus?

Answer 5

After 8 weeks until time of birth.

Question 6

What defines the 1st trimester?

Answer 6

Period defined from 12 weeks up to 14 weeks’ AOG.

Question 7

What defines the 2nd trimester?

Answer 7

Period defined from 12–14 until 24–28 weeks’ AOG.

Question 8

What defines the 3rd trimester?

Answer 8

Period defined from 24–28 weeks AOG until delivery.

Question 9

What is an infant?

Answer 9

Term for the newborn between delivery and 1 year of age.

Question 10

What does previable mean?

Answer 10

Term for the newborn delivered prior to 23–24 weeks.

Question 11

What does preterm mean?

Answer 11

Term for the newborn delivered between 24–37 weeks.

Question 12

What does term mean?

Answer 12

Term for the newborn delivered between 37–42 weeks.

Question 13

What does postterm mean?

Answer 13

Term for the newborn delivered beyond 42 weeks.

Question 14

What is a nulligravida?

Answer 14

A woman who currently is not pregnant and has never been pregnant.

Question 15

What is a gravida?

Answer 15

A woman who is currently pregnant or has been in the past, irrespective of pregnancy outcome.

Question 16

What is a nullipara?

Answer 16

A woman who has never completed a pregnancy beyond 20 weeks’ gestation; may not have been pregnant or may have had an abortion or an ectopic pregnancy.

Question 17

What is a primipara?

Answer 17

A woman who has been delivered only once of a fetus or fetuses born alive or dead with an estimated AOG of at least 20 weeks.

Question 18

What is a multipara?

Answer 18

A woman who has completed 2 or more pregnancies to 20 weeks’ gestation or more.

Question 19

What is a grand multipara?

Answer 19

A woman who has had at least 5 births (live or stillborn) that are at least 20 weeks age of gestation.

Question 20

How is a multifetal pregnancy counted in TPAL designation?

Answer 20

Counts as 1 for TPA, but number of children alive counts separately for L.

Question 21

What is abortus?

Answer 21

Pregnancy losses before 20 weeks.

Question 22

What is the significance of first trimester sonography?

Answer 22

Embryo fetal crown-rump length in the 1st trimester is accurate ± 5 to 7 days. Most accurate method to establish or reaffirm gestational age.

Question 23

What is gestational age (GA)?

Answer 23

Type of age defined 2 weeks before ovulation and fertilization, 3 weeks before blastocyst implantation.

Question 24

What is ovulation age?

Answer 24

Type of age defined by time in days or weeks from ovulation.

Question 25

What is Naegele’s rule?

Answer 25

EDC/EDD = LMP – 3 months, + 7 days; 280 days after LMP; 266 days after LMP if via assisted reproductive technology.

Question 26

How much can ultrasound readings differ from LMP dating per trimester?

Answer 26

>1 week in the first trimester; >2 weeks in the second trimester; >3 weeks in the third trimester.

Question 27

enlargement from stretching and hypertrophy in the uterus is most marked at which area?

Answer 27

fundus ## Footnote Middle layer of muscles, Inner sphincter-like fibers

Question 28

In which direction does the uterus rotate?

Answer 28

The uterus rotates to the RIGHT (dextrorotation) ## Footnote This is caused by the rectosigmoid on the left side of the pelvis.

Question 29

What are Braxton-Hicks contractions?

Answer 29

They account for 'false labor'; irregular, unpredictable, sporadic contractions which rise in number in the last two weeks of gestation.

Question 30

What small molecule mediates uteroplacental blood flow?

Answer 30

Nitric oxide (a potent vasodilator)

Question 31

Which hormone causes the attenuation of VEGF and PlGF during pregnancy?

Answer 31

Angiotensin II

Question 32

Normal pregnancy has vascular refractoriness to which blood pressure mediator?

Answer 32

Bluish

Question 33

What color does the cervix turn due to increased vascularity and edema?

Answer 33

Cervical ripening

Question 34

What process involves lowering collagen and proteoglycan concentrations and raises water content in the cervix?

Answer 34

Mucus plug ## Footnote Copious amounts of mucus rich in Ig and cytokines produced by endocervical glands causes the formation of this structure. This is expelled at the onset of labor (bloody show).

Question 35

What characteristic pattern of cervical mucus is seen when it is spread and dried on a glass slide?

Answer 35

Beading ## Footnote Caused by progesterone causing poor crystallization.

Question 36

What characteristic pattern of cervical mucus is seen when amniotic fluid violates the cervical canal?

Answer 36

Ferning ## Footnote Caused by estrogen and salts leading to crystallization.

Question 37

What organ produces hCG which maintains the corpus luteum?

Answer 37

Placenta

Question 38

What ovarian structure produces progesterone which maintains the endometrium?

Answer 38

Corpus luteum (CL) ## Footnote It functions maximally until 7 weeks of pregnancy.

Question 39

What reaction involves loss of polarity and pleiomorphism in cervical cells during pregnancy?

Answer 39

Arias-Stella reaction

Question 40

What term describes the marked proliferation of cervical glands leading to the outward displacement of the os?

Answer 40

Eversion

Question 41

What hormone aids in remodeling of reproductive tract connective tissue to accommodate labor?

Answer 41

Relaxin

Question 42

What benign ovarian lesions reflect physiological follicle stimulation linked to elevated serum hCG levels?

Answer 42

Theca lutein cysts ## Footnote Linked to markedly elevated serum hCG levels (e.g. GTD, multifetal gestation).

Question 43

What sign indicates violet discoloration of the vagina and cervix due to increased vascularity?

Answer 43

Chadwick sign

Question 44

What is the thick, yellowish fluid expressed from the nipples by gentle massage called?

Answer 44

Colostrum

Question 45

What skin condition presents as reddish, slightly depressed skin and glistening, silvery lines in multiparas?

Answer 45

Striae gravidarum

Question 46

What occurs when rectus muscles separate in the midline during pregnancy?

Answer 46

Diastasis recti

Question 47

What develops in 90% of women during pregnancy and may be due to the effects of estrogen and progesterone?

Answer 47

Hyperpigmentation

Question 48

What is the brown-black pigmentation in the midline of the anterior abdominal wall called?

Answer 48

Linea nigra

Question 49

What are the irregular brownish patches of varying sizes appearing on the face and neck during pregnancy called?

Answer 49

Chloasma

Question 50

Which hormone is likely responsible for vascular changes during pregnancy?

Answer 50

Estrogen (hyperestrogenemia)

Question 51

What are the minute, red skin papules with radicles branching out from a central lesion called?

Answer 51

Vascular spiders/angiomas

Question 52

What condition refers to increased cutaneous blood flow serving to dissipate excess heat generated by augmented metabolism?

Answer 52

Palmary erythema

Question 53

What are the phases of hair cyclic activity during pregnancy?

Answer 53

Periods of hair growth (anagen), apoptosis-driven involution (catagen), resting period (telogen)

Question 54

What is the term for excessive hair loss in the puerperium?

Answer 54

Telogen effluvium

Question 55

What is the average metabolic rate increase in the 3rd trimester?

Answer 55

20%

Question 56

What is the additional metabolic rate increase with twin gestation?

Answer 56

10%

Question 57

What is the average weight gain during pregnancy?

Answer 57

12.5 kg (27.5 lbs)

Question 58

What is the total extra water during pregnancy?

Answer 58

6.5 L ## Footnote Water content of the fetus, placenta, and AF (~3.5 L) + expanded maternal blood volume and from uterus and breast growth (3.0 L).

Question 59

What are the carbohydrate metabolism characteristics during pregnancy?

Answer 59

Mild fasting hypoglycemia, postprandial hyperglycemia, hyperinsulinemia

Question 60

What hormone is secreted by adipose tissue in non-pregnant humans and is important for implantation, cell proliferation, and angiogenesis?

Answer 60

Leptin

Question 61

What is produced in maternal fat, inversely correlated with adiposity, and reduced in patients with GDM?

Answer 61

Adiponectin

Question 62

What hormone is secreted by the stomach and placenta in response to hunger?

Answer 62

Ghrelin

Question 63

What hormone, when elevated, impairs uterine contractility?

Answer 63

Visfatin

Question 64

What refers to the decrease in hemoglobin concentration due to plasma expansion during pregnancy?

Answer 64

Physiologic anemia of pregnancy

Question 65

Which clotting factors do not increase during pregnancy?

Answer 65

Factors XI and XIII

Question 66

What is the most common ECG change during pregnancy?

Answer 66

Left axis deviation

Question 67

What syndrome is caused by compression of the great vessels by the uterus in the supine position?

Answer 67

Supine hypotensive syndrome

Question 68

Which hormone is likely responsible for refractoriness to angiotensin II during pregnancy?

Answer 68

Progesterone

Question 69

What pulmonary volumes decrease during pregnancy?

Answer 69

Functional residual capacity (FRC), total lung capacity

Question 70

What pulmonary volumes may be unchanged or increased during pregnancy?

Answer 70

Inspiratory capacity (IC), tidal volume (TV)

Question 71

Layers of uterus

Answer 71

Outer hoodlike layer * Middle layer of muscles * Inner sphincter-like fibers