American Board Of Family Medicine (Abfm)

Front 1

Define Arrested Labor?

Back 1

2-4 hrs of active labor without change in dilation
One hour of active labor without descent

Front 2

What are the six types of malpresentation

Back 2

OP
Breech (Frank 45-50%, Footling 35-45%, Complete 10-15%)
Transverse Lie/Shoulder
Brow
Face
Compound Presentation.

Front 3

Vacuum Extraction Acronym A-J:
A

Back 3

Ask for help
Address the patient
Anesthesia adequate?

Front 4

Vacuum Extraction Acronym A-J:
B

Back 4

Bladder is empty

Front 5

Vacuum Extraction Acronym A-J:
C

Back 5

Cervix is completely dilated

Front 6

Vacuum Extraction Acronym A-J:
D

Back 6

Determine position of fontanel (Ant is larger than Post)
THINK shoulder Dystocia

Front 7

Vacuum Extraction Acronym A-J:
E

Back 7

Equipment and Extraction ready

Front 8

Vacuum Extraction Acronym A-J:
F

Back 8

Apply cup over the sagital suture and three cm in front of posterior Fontanel. Clear all maternal tissues

Front 9

Vacuum Extraction Acronym A-J:
G

Back 9

Gentle extraction @ the right angles to plane of cup.

Front 10

Vacuum Extraction Acronym A-J:
H

Back 10

Halt traction when the contraction is over. (3 pop-offs or 3 pulls without progress)
No more than 20 min to total application

Front 11

Vacuum Extraction Acronym A-J:
I

Back 11

Evaluate for Incision of Episiotomy

Front 12

Vacuum Extraction Acronym A-J:
J

Back 12

Remove vacumm cup with JAW is reachable.

Front 13

HELPERR for Shoulder Dystocia:
H

Back 13

Call for Help/Assistance

Front 14

HELPERR for Shoulder Dystocia:
E

Back 14

Evaluate for Episiotomy

Front 15

HELPERR for Shoulder Dystocia:
L

Back 15

Legs (McRoberts Maneuver)

Front 16

HELPERR for Shoulder Dystocia:
P

Back 16

Suprapubic Pressure

Front 17

HELPERR for Shoulder Dystocia:
E (second E)

Back 17

Enter (Rubin/Woods/ Reverse Woods)

Front 18

HELPERR for Shoulder Dystocia:
R

Back 18

Remove the posterior arma

Front 19

HELPERR for Shoulder Dystocia:
R (second)

Back 19

Roll the patient to all Fours

Front 20

Zavanelli Maneuver

Back 20

Cephalic replacement, give tocolytics, turn off pitocin, etc.

Front 21

Coumadin used during pregnancy and postpartum?

Back 21

Contraindicated during pregnancy, crosses placenta.
Used cautiously in breastfeeding mothers...not in breast milk.

Front 22

What is First Degree AV Block?

Back 22

Prolonged PR interval (>.20sec)
All sinus impulses conduct to the ventricles.

Front 23

Causes of First Degree AV clock?

Back 23

Inferior MI, Other cardiac diseases, digitalis, ? B-Blocker, Degenerative Changes with Aging.

Front 24

What are the natural history and treatment of First Degree Block

Back 24

Relative benign, rarely advances to complete block.
No tx if chronic; observation if new or progressive.

Front 25

What is the incidence of Venous Thromboembolism in pregnancy compare to non-pregnant women?

Back 25

Four times greater .75-1.72 per 1000 pregnancies.

Front 26

What is the leading cause of maternal death in the developed world?

Back 26

Pulmonary Embolism.

Front 27

When does DVT and PE occur in pregnancy?

Back 27

2/3 of DVT occurs in the antepartum period and distributed equally among all three trimesters.
50% (43-60%) of PE occurs in the postpartum period.

Front 28

Where does DVT occur in a pregnant women?

Back 28

Left leg (70-90%) Left iliac vein due to compression by the crossing right iliac artery.

Front 29

Between VQ Scan and CTPA, which one delivers a higher fetal dose of radiation?
How about for mothers

Back 29

VQ >>CTPA to fetus
CTPA>>VQ to mothers

Front 30

What is the VQ scan radiation effect on mother and infant compare to CTPA?

Back 30

Slightly higher risk of childhood cancer in offspring.
Lower risk of maternal Breast Cancer.