Prenatal Care

Question 0

Presumptive signs

Answer 0

Changes in breast
Cessation of menses
Chadwick sign
Changes in mucus
Thermal signs
Inc skin pigmentation

Question 1

Changes related to hormones

Not uterus and fetus

Answer 1

Presumptive

Question 2

Presumptive sx

Answer 2

NV
Breast tenderness
Urinary disturbance
Fatigue

Question 3

Changes related to uterus or placenta

Answer 3

Probable

Enlargement of abdomen
Ballottement
Physical outlining
Braxton Hick's
Hegar's sign
Goodell's sign
Changes in cervix
Positive pregnancy test

Question 4

Changes related to fetus

Answer 4

Definitive

Fetal heart tones
Fetal movement
Utz

Question 5

Fetal heart
Ultrasound
Doppler
Stethoscope

Answer 5

5 w
10 w
17-19 w

Question 6

Naegele’s rule

Answer 6

Add 7 days

Subtract 3 mos

Question 7

Asx bacteriura tx

Answer 7

Nitrofurantoin
Amoxicillin
First gen ceohalosporin
X 7d

Question 8

Follow up

Answer 8

Every 4 weeks until 28
2 until 36
Weekly

Question 9

Weight gain for BMI 19.8-26

Answer 9

25-35 lbs

Question 10

Iron supplement

Answer 10

27-30 mg

Question 11

Zinc

Answer 11

12 mg/day

Question 12

Iodine

Answer 12

220 mcg/day pregnant

290 lactating

Question 13

Safe immunization

Answer 13

Hepa A and B pre and post exposure
Pneumococcus HR
Meningococcus outbreaks
Influenza

Question 14

Pathologic causes of leukorrhea

Answer 14

BV metro
Trichinoniasis metro
Candidiasis mico clotri nystatin

Question 15

Discrepancy of fundal size

Answer 15

+/- 3 cm

Question 16

Obstetrical milestones

16-18 wks

Answer 16

Maternal screening for NTDs and chromosomal abnormalities

Question 17

Obstetrical milestones

24-28 wks

Answer 17

GDM screening
Rhogam administration
Fetal counting at 28: 8-10/2 h

Question 18

Obstetrical milestones

28-32 wks

Answer 18

Repeat Hgb and Hct

Question 19

Obstetrical milestones

35-37 wks

Answer 19

GBS infection screening

Question 20

Obstetrical milestones

>41 wks

Answer 20

Non stress test

Question 21

Indications for GBS prophylaxis

Answer 21

Previous infant
GBS bacteriuria
Positive GBS screening
Unknown GBS + delivery of 18h/ intrapartum temp >38

Question 22

Intrapartum prophylaxis

Answer 22

PenG alt: Ampicillin

Allergy: LR Cefazolin HR Erythromycin or Clindamycin

Question 23

Fetal Assessment

Answer 23

Kick count
NST
CST
BPP

Question 24

Reactive NST

Answer 24

2 or more FHR accelerations in 20 mins that peak at least 15 bpm above baseline lasting for 15 sec Rpt weekly

Question 25

Negative CST

Answer 25

3 contractions in 10 minutes | No late decelerations

Question 26

Positive CST

Answer 26

Repetitive late decelerations in 3UCs in 10 mins | Deliver

Question 27

Equivocal suspicious

Answer 27

Int late decel | Significant variable decel

Question 28

Equivocal hyperstimulatory

Answer 28

UCs more freq than every 2 min or lasting longer than 90 s

Question 29

5 BPP components

Answer 29

``` FHR acceleration reactive NST Fetal breathing 1/30s Fetal movements 3/30m Fetal tone 1/30m AFV >2 cm ```

Question 30

``` BPP 10 to 8 normal AFV 8 abnormal AFV 4-6 0-2 ```

Answer 30

Norm rpt test wkly and twice wkly for DM and post term Chronic asphyxiated >37 deliver 36 or AFV ABNORMAL deliver 6 observe Almost certain fetal asphyxia deliver

Question 31

Single most important indicator of an adequately oxygenated fetus

Answer 31

Baseline or beat to beat variability | 6-25

Question 32

Causes of deceleration Early mirror image Variable Late

Answer 32

Head compression UC compression Uteroplacental insufficiency

Question 33

Candidates for Prenatal Diagnosis

Answer 33

``` Primigravid >35 Twin gestation >31 Autosomal trisomy Triple X or Klinefelter Chromosomal abnormalities Spontaneous abortions Major structural defect ```

Question 34

Most common isolated structural defects

Answer 34

Congenital Heart Defects

Question 35

Second most common

Answer 35

NT defects | RF: FH

Question 36

Major serum protein in the embryo-fetus

Answer 36

Maternal Serum AFP screening 14-22 wks Multiple of median

Question 37

Five cranial signs of NTD

Answer 37

Small BPD Ventriculomegaly Frontal bone scalloping "Lemon sign" Elongation and downward displacement of the cerebellum "Banana sign" Effacement or obliteration of Cisterna Magnus

Question 38

Down syndrome

Answer 38

Low AFP Low estriol High HCG High Inhibin