prenatal care & diagnosis of pregnancy

Question 1

anatomic changes in breast

Answer 1

E: ductal proliferation &growth; alveolar lobular growth
P: lobular hyperplasia
montgomery’s tubercles hypertrophy

Question 2

cervical mucus for pregnant & nonpregnant

Answer 2

P: beading d/t progesterone
NP: ferning d/t estrogen

Question 3

presumptive symptoms

Answer 3

N/V
disturbance in urination
fatigue
perception of fetal movement
breast symptoms

Question 4

presumptive signs

Answer 4

mens cessation (>10 d)
anatomical breast changes 
changes in vaginal mucosa
skin pigmentation changes
thermal signs

Question 5

false positive & negative pregnancy test

Answer 5

+: choriocarcinoma

-: hook effect (very high causing saturation); very low on day 5

Question 6

probable signs

Answer 6

abdominal enlargement
uterus anatomical changes
cervix anatomical changes
braxton hicks contractions
ballottement
physical outlining of fetus
positive endocrine test

Question 7

first sonographic evidence

Answer 7

gestational sac (week 5) eccentrically

Question 8

fluid collection w/in endometrial cavity w/ an ectopic pregnancy

Answer 8

pseudo-sac

Question 9

single echogenic ring surrounding the gestational sac

Answer 9

intradecidual sign

Question 10

two echogenic ring surrounding the gestational sac

Answer 10

double decidual sign

Question 11

routine obstetric test

Answer 11

CBC
urinalysis, urine culture & sensitivity
blood grp, Rh
RPR, VDRL
hepB surface Ag
rubella titer
pap smear

Question 12

assessment of gestational age

Answer 12

FH: 20-34 wks
FHR: steth (20 wks); doppler (8 wks / 10-12 wks)
utz

Question 13

fundic height per week

Answer 13

12 wk: above symphysis
16 wk: bet symphysis & umbilicus
20 wk: umbilicus
36 wk: below xiphoid process

Question 14

sharp whistling sound sync w/ fetal pulse

Answer 14

fundic souffle

Question 15

soft, blowing sound sync w/ maternal pulse

Answer 15

uterine souffle

Question 16

subsequent assessment

Answer 16

cervical culture for gonorrhea
hgb electrophoresis
HIV titer
glucose screening
MS-AFP

Question 17

effect of overnutrition & undernutrition

Answer 17

O: preeclampsia, GDM, htn
U: CNS devt delay, growth retardation

Question 18

average wt gain & retained

Answer 18

G: 28.6 lb / 12.9 kg
R: 2.1 lb / 1kg

Question 19

recommended daily dietary allowance

Answer 19

calories: 100-300kcal/d
CHON: 1g/kg/d
CHO: 175g
fats: 15-25g

Question 20

mgmt of leg varicosities

Answer 20

left lateral decubitus
elastic stocking
leg elevation
avoid prolong standing

Question 21

mgmt of vulvar varicosities

Answer 21

fitted pantyhose

foam rubber pad

Question 22

mgmt of hemorrhoids

Answer 22

topical anesthetics, warm soaks, stool-softening
incision & removal of clot
hemorrhoidectomy

Question 23

use of cord blood banking

Answer 23

autologous transplant

Question 24

suggested dose of iron supplementation

Answer 24

30-60mg Fe OD (all pregnant)
30-60mg OD Fe w/ 400mcg FA (anemia is prevalent)
60mg OD Fe w/ 400mcg FA (anemia is severe public health problem)
120mg OD Fe w/ 400mcg FA (clinically diagnosed anemia)

Question 25

suggested dose of calcium supplementation

Answer 25

1.5-2 g divided in 3 doses from 20 wks until end

Question 26

what def. can cause acrodermatitis enteropathica?

Answer 26

zinc def.

Question 27

suggested dose of calcium supplementation

Answer 27

400 mcg OD prior to and after 3 months of pregenancy
4000 mcg (women w/ previous NTD baby)

Question 28

vitamins & mineral that may not be needing supplementation

Answer 28

magnesium
potassium
fluoride
pyridoxine
vit. C
vit. A

Question 29

vitamin def. seen in strict vegetarian

Answer 29

Vit. B12

Question 30

dose of caffeine unsafe for pregnancy

Answer 30

> 300mg / >3cups

Question 31

complications of smoking in pregnancy

Answer 31

placenta previa
abruptio placenta
preterm labor
spontaneous abortion
PROM
miscarriage
subfertility
SIDS

cleft lip
hydrocephalus
microcephalus
weaker lungs
NTD

Question 32

fetal alcoholic syndrome criteria

Answer 32

dysmorphic features (>2: short palpebral fissure; thin vermillion upper lip; smooth philtrum)
prenatal/postnatal growth impairment: <10th%
abnormal brain growth, morphogenesis, or physiology (>1: head circumference <10th%; structural brain abnormalities; recurrent nonfebrile seizure)
neurobehavioral impairment (>1.5SD below mean)

Question 33

drug associated w/ Antley-Bixler Syndrome

Answer 33

fluconazole

Question 34

warfarin can be safely used beyond first trim, T or F?

Answer 34

false