OME

Question 1

When is amniocentesis normally done?

CVS?

Answer 1

> 16 weeks

10-12 weeks

Question 2

What is Gestational HTN?

Answer 2

Elevated BP after 20 weeks in absence of proteinuria

Question 3

What drugs do you give for hyperthyroidism that are safe in pregnancy during 1st trimester?

2nd and 3rd?

Answer 3

PTU

Methimazole

Question 4

What is a + 3 hour glucose tolerance test?

Answer 4

2 of 4 following is
(+)

Fasting > 95
1 hour > 180
2 hour > 155
3 hour > 140

Question 5

Empiric coverage of pregnant woman w/UTI is what 1st line?

2nd line?

Answer 5

Amoxicillin (PO) or Ceftraixone (IV)

Nitrofurantoin/Amoxicillin

Question 6

HTN is pregnancy is BP greater than what values?

What is considered Pre-E w/severe features bc of BP?

Answer 6

140 / 90

> 160/110

Question 7

Asx bacteriuria pregnant pts are at risk for what?

Answer 7

Acute pyelonephritis

Question 8

What’s the order of getting out the placenta if there is prolonged 3rd stage of labor?

Answer 8

Uterine massage
Oxytocin
Manual Retrieval

Question 9

What defines adequate contractions?

Answer 9

3 in 10 minutes

200 Montevideo units in 10 minutes

Question 10

What is Preeclampsia?

Answer 10

BP > 140/90
AND
proteinuria > 300 mg/dL

Question 11

What are the 4 available tocolytics?

Answer 11

Magnesium (for < 32 weeks)
CCB (Nifedipine)
PGE-I (not used in > 32 weeks)
B-agonists

Question 12

BMI of 18.5 - 24.9 should gain how much weight during pregnancy?

25-29.9?

Answer 12

25-35

15-25

Question 13

Monozygotic monochorionic diamniotic twins are at risk for what?

When do they separate?

Answer 13

Twin-twin transfusion

Blastocyst stage days 4-8

Question 14

What can cause an elevated AFP?

What is the MC cause?

Answer 14

NTD, ABD wall defect, multiple gestation, ERROR in gestational age

ERROR

Question 15

When do you give RHOGAM-D?

Mother is what?

Answer 15

28 wks and w/in 72 hours of delivery

Rh-Ag (-) and Rh-Ab (-)

Question 16

what is the DDx for PPH?

Answer 16

Tone - atonic uterus (MC)
Trauma - laceration, hematoma, inversion, rupture
Tissue - retained POC, invasive placenta
Thrombin - coagulopathies

Question 17

When should you never give RHOGAM-D to a mom?

Answer 17

When she is already Rh-Ab(+)

Question 18

When do pts w/HIV deliver via c/s?

Answer 18

Not on HAART

Viral load > 1,000

Question 19

Describe the Hips and knees in footling Breech

Answer 19

Hips extended

knees ANY

Question 20

What happens to MAP in pregnancy?

CO?

SVR?

Answer 20

Dec

Inc

Dec

Question 21

What Abx tx for chorioamnionitis and Endometritis?

Answer 21

IV Amp, Gent, Clinda

Question 22

Why does the small twin do better in twin-twin transfusion?

Answer 22

Reduced bilirubin load

Question 23

What are the main SE of combined OCPs?

Answer 23

HTN
VTE
Liver cyst

Question 24

What presents with lesions that are preceded by a painful, burning prodrome?

Answer 24

HSV1/2

Question 25

Monozygotic/chorionic/amniotic twins are at risk for what? When do these separate? If conjoined?

Answer 25

Cord entanglement Days 9-12 After day 12

Question 26

What does cephalopelvic disproportion mean? Requires what? Presents how?

Answer 26

Macrosomic baby C section Station 0

Question 27

What is pre-term labor?

Answer 27

20-37 weeks

Question 28

How does congenital toxoplasmosis present as?

Answer 28

Diffuse intracranial calcification, hydrocephalus, chorioretinitis Toxo - think TOTAL calcification

Question 29

What is prolonged ROM? What is the biggest risk?

Answer 29

> 18 hours GBS infection

Question 30

A paracervical block may initially present how when local lidocaine is used? What is it used for?

Answer 30

Fetal bradycardia Decrease the pain of cervical dilation

Question 31

Monozygotic, dichorion, diamniontic twins are at risk for what?

Answer 31

Breech C/S Pre-term

Question 32

US should show NT less than what?

Answer 32

5mm

Question 33

Pain of stage I labor comes from what? What type? Stage II?

Answer 33

T10-T12, visceral pain S2-S4, somatic

Question 34

What are the indications for cerclage? When is it placed?

Answer 34

Cervical insufficiency: PID, STI, D&C 2nd trimester

Question 35

How does endometritis present?

Answer 35

Foul smelling discharge High fever Leukocytosis Tender uterus

Question 36

What is the 1st step in the ER for acute ABD?

Answer 36

CT w/IV contrast

Question 37

Firm uterus and bleeding most likely means what? Degree?

Answer 37

Retained POC AIP - EMS

Question 38

If there is a risk of alloimmunization, what is the 1st step? If < 32 weeks do what? > 32 weeks?

Answer 38

Transcranial Doppler of MCA PUBS C-section

Question 39

What are the f/u recommendations based on gestational age?

Answer 39

Q4 weeks until 28 weeks q2 weeks until 36 weeks Q1 week until birth

Question 40

What is the main SE of the copper IUD?

Answer 40

Heavier/crampier periods

Question 41

What presents with painful bleeding, shows fetal stress, w/loss of contractions and loss of fetal station?

Answer 41

Uterine RUPTURE

Question 42

What can cause PE in mom? Presents how? What causes DIC?

Answer 42

amniotic fluid embolism Hypoxia w/Tachycardia Placental embolism

Question 43

Large boggy uterus means what?

Answer 43

Uterine atony

Question 44

What is the preferred HAART therapy in pregnancy?

Answer 44

Truvada | Aka Tenofovir + Emtricitabine

Question 45

What are the 3 MAIN consequences of diabetic mother?

Answer 45

Macrosomia Premature delivery Transposition of the Great Vessels

Question 46

What is an O’Leary stitch? B-Lynch compression?

Answer 46

Suture around uterine aa. At the level of INTERNAL OS Compression suture on the uterus

Question 47

What confirms that there has been a rupture of membranes (ROM)?

Answer 47

Nitrazine test (turns BLUE) + Ferning sign Speculum exam shows pooling

Question 48

1st trimester screening can be done when?

Answer 48

10 weeks to 14 weeks

Question 49

What is normal weight gain per week?

Answer 49

.5 to 1 pound

Question 50

What is considered a macrosomic baby?

Answer 50

> 4000g or 8lb and 8oz

Question 51

Premature pROM and less than 24 weeks do what?

Answer 51

Abort

Question 52

What uterotonic drug is contraindicated in HTN? What drug is contraindicated in asthma pts?

Answer 52

Methergine Carboprost (PGF2-a)

Question 53

If a pt has a UTI in pregnancy what medication is best to use? What is CI?

Answer 53

Nitrofurantoin TMP/SMX

Question 54

Describe TSH in pregnancy? Total T4? Free T4?

Answer 54

Normal High Normal

Question 55

What has the triad of ROM, painless bleeding, and fetal bradycardia?

Answer 55

Vasa previa

Question 56

At what time does the nadir in pregnancy occur? How low?

Answer 56

28-30 weeks 10

Question 57

What is the biggest concern for baby when they are post-date term?

Answer 57

Oligohydramnios

Question 58

When is screening for GDM done? What is the 1 hour GCT?

Answer 58

24-28 weeks 50g oral glucose load > 140 is (+)

Question 59

What are ALL the first trimester labs taken during pregnancy?

Answer 59

``` ABO type, Rh Ag Hgb/Hct Rubella Varicella HIV RPR HepB Pap UA/UCx Protein GC/Chlamydia ```

Question 60

What happens to the minute ventilation in pregnancy? TV? RR? FRC? FEV1?

Answer 60

INC by 50% Inc no change Dec by 20% No Change

Question 61

An epidural cannot be placed if the platelets are below what value?

Answer 61

80-100 K

Question 62

An epidural cannot be placed in what condition?

Answer 62

Platelets below 80-100 K

Question 63

When is the triple screen done? Best?

Answer 63

15-23 weeks 16-18

Question 64

What are the severe features seen in pre-eclampsia w/severe features?

Answer 64

``` BP > 160/110 Cr > 1.1 or 2x baseline Plt < 100K Inc AST or ALT 2x uln RUQ/epigastric pain Pulmonary edema HA or Visual disturbance ```

Question 65

What presents w/painless bleeding and has RF of multiparity and multiple gestations? Tx?

Answer 65

Placenta previa C/s

Question 66

What is Hgb? What increases more?

Answer 66

[rbc] / [plasma] Plasma volume

Question 67

What is the major SE of an epidural placed too deeply?

Answer 67

Vasodilation and HoTN (neurogenic shock) | - paralysis of the diaphragm

Question 68

Describe the Hips and knees in Frank Breech

Answer 68

Hips - Flexed | Knees - Extended

Question 69

Describe the 7 movements of the baby through the pelvis

Answer 69

``` Engagement Descent Flexion IR Extension ER (aka Restitution) Expulsion —> Ant. Shoulder FIRST ``` EDF IEEE

Question 70

What defines chronic HTN? Treatment?

Answer 70

> 140/90 BEFORE 20 weeks A-methyldopa

Question 71

Gravida - TPAL stands for what?

Answer 71

Term - 37 weeks or greater Preterm < 37 weeks Abortions (< 20 weeks) Living

Question 72

Cell-free DNA can screen for aneuploidy as early as when? Done in whom?

Answer 72

10 weeks High risk women (> 35 y/o)

Question 73

Before giving RHOGAM D, what must you do first?

Answer 73

Type and screen mom

Question 74

What is the main feature of Levonorgestrel IUD?

Answer 74

Can cause periods to disappear after initial spotting

Question 75

Every gestation beyond 1 baby alters the due date how?

Answer 75

By 4 weeks early

Question 76

What is the process of turning around baby inside of mom called?

Answer 76

External Cephalic Version

Question 77

Describe the Hips and knees in Complete Breech

Answer 77

Hips flexed | Knees flexed