Narm Prep

Front 1

What is the dosage for Misoprostol (Cytotec) for postpartum hemorrhage?

Back 1

800-1000 mcg pr
or
600 mcg po

Front 2

Bacteruria:
ACOG suggest treatment when colony levels reach ____ units/mL?

Back 2

25,000-100,000 units/mL

Front 3

What is Goodell's sign?

Back 3

Softening of the cervix

Front 4

Any 1+ protein dip (or greater) requires subsequent testing with clean catch specimen. Finding of 1+ or greater from clean catch requires _____?

Back 4

24 hour urine collection.

Front 5

What is the recommended dosage of folic acid under normal circumstances?

Back 5

400 i.u.

Front 6

What is the recommended dosage of folic acid with history of neural tube defects?

Back 6

5 mg

Front 7

In utero, if Rh+ blood (fetal) enters Rh- blood (maternal), maternal antibodies to Rh+ can pass to fetus. This is known as ____?

Back 7

Sensitization.

Front 8

Protection from anti-D Ig lasts ____ weeks.

Back 8

12 weeks

Front 9

Uterine size, bi manual, in first trimester. How large is the uterus suspected to be at 8 weeks? 10 weeks? 12 weeks?

Back 9

8 weeks: tennis ball
10 weeks: orange
12 weeks: grapefruit

Front 10

What is the normal AFI at 38 weeks?

Back 10

1000 ml or 1 litre.

Front 11

Polyhydramnios: How is it defined?

Back 11

By a fluid volume more than 1500 ml, AFV > 8cm or AFI > 24 cm

Front 12

What are some possible causes of polyhydramnios?

Back 12

Multiple's
NTD's
GDM
Erythroblastosis Fatalis
Fetal malformations of GI tract or CNS

Front 13

What are some risks of polyhydramnios?

Back 13

Malpresentations
abruption
uterine dysfunction
PPH
cord prolapse
PTL
pPROM

Front 14

Oligohydramnios: How is it defined?

Back 14

by a fluid volume < 300 ml

Front 15

What are some causes of oligohydramnios?

Back 15

Congenital anomalies
IUGR
PROM
Post maturity syndrome

Front 16

What are the risks of oligohydramnios?

Back 16

Congenital anomalies
cord compression
lung hypoplasia
limb deformities

Front 17

How does Rhogam work?
and
What is the dosage?

Back 17

Rhogam prevents sensitization by supressing the production of antibodies in response to receipt of RH+ antigen.

Dosage= 300 mcg ~unless otherwise indicated,

Front 18

How is a hematoma assessed and managed?

Back 18

If hematoma is < or equal to 4 cm, and is not enlarging, manage expectantly; apply ice for 24 hours then heat. Order antibiotics.

If hematoma is > 4 cm and/or enlarging, consult physician and transport for possible incision and drainage, ligation of bleeding vessels, closure, and wound packing. Blood loss is > than expected.

Front 19

What do keytones in urine signal?

Back 19

maternal fasting
insufficient dietary intake
dehydration
diabetes

Front 20

What do nitrates in urine signal?

Back 20

UTI

Front 21

High levels of what hormone cause uterine muscle fibers to display oxytocic receptors and form gap junctions with each other?

Back 21

Estrogen

Front 22

What is the preferred treatment for endometritis?

Back 22

Penicillin or Clindamycin in combination with an aminoglycoside.

Front 23

What is subinvolution and what is it's cause?

Back 23

Prolonged involution or failure of involution; caused by retained placenta/products of conception, fibroids

Front 24

What is the dosage for Methergine for PPH?

Back 24

.2mg q 4 hrs for 6 doses

Front 25

What is the dosage for Vitamin K?

Back 25

1 mg IM

Front 26

Where is oxytocin produced?

Back 26

Posterior pituitary

Front 27

Where is prolactin produced?

Back 27

Anterior pituitary

Front 28

LBW is defined as < ____ grams?

Back 28

< 2500 g or 5 1/2 lbs.

Front 29

Describe the Glucose Challenge Test.

Back 29

50 g of glucose is ingested and 1hr later labs are drawn. A 1 hour plasma glucose level < 140 passes. > 140 needs OGTT.

Front 30

Describe the OGTT?

Back 30

After fasting for 8-14 hours, 100 g glucose is ingested. Labs are drawn at 1, 2 and 3 hours. Is diagnostic of GDM when two or more values are exceeded.
Values are:
Fasting: 105 mg/dL
1 hr: 190
2 hr: 160
3 hr: 145

Front 31

Where are the Bartholin's glands?

Back 31

Posterior part of labia majora

Front 32

What is the vestibule?

Back 32

area enclosed by labia minora

Front 33

UTI's are associated with...

Back 33

Pyelonephritis
PTL
LBW infant
PROM
IUGR

Front 34

What hormone maintains the integrity of the decidua so shedding does not take place after conception?

Back 34

Progesterone

Front 35

High levels of what hormone suppress production of FSH?

Back 35

Estrogen

Front 36

Hemoglobin: what are desired levels through each trimester?

Back 36

1st trimester: > 11
2nd trimester: > 10.5
3rd trimester: > 11

Front 37

Hematocrit: what are desired levels through each trimester?

Back 37

1st: > 33%
2nd: > 32%
3rd: > 33%

Front 38

Name the DEEP muscles of the pelvic floor:

Back 38

Levator Ani muscles:
Pubococcygeus
Iliococcygeus
Ischiococcygeus

Front 39

Name the three layers of the embryonic plate:

Back 39

Ectoderm: skin and CNS

Mesoderm: muscles, bones, heart, blood vessels

Endoderm: mucous membranes and glands

Front 40

What does the Ductus Venosus connect to in the fetal circulatory system?

Back 40

Ductus Venosus connects the umbilical vein to the inferior vena cava.

* from vein to vein*

Front 41

When do hCG levels peak?

Back 41

7-10 weeks

Front 42

Which hormones are under pituitary control?

Back 42

FSH
LH
Prolactin
Oxytocin

Front 43

Edema: If edema reaches the knees, affects the face, or is increasing in fingers, it may be indicative of ___________, if other markers are present.

Back 43

Gestational Hypertesion, Pre-Eclampsia

Front 44

Fetal circulation: follow fetal blood from the Left Atrium to the Right Atrium

Back 44

Left Atrium
Left Ventricle
Aorta
Systemic Circulation
Umbilical Arteries
Placenta
Umbilical Vein
Ductus Venosus
Inferior Vena Cava
Right Atrium
(Foramen Ovale)

Front 45

What is the normal newborn temperature range?

Back 45

96.8-98.6

Front 46

IUGR/SGA

How is this evaluated?

Back 46

Evaluate growth: if < 2 cm growth in 4 weeks, confirm with ultrasound by 2 ultrasounds < or equal to 4 weeks apart.

Front 47

What is Down's Syndrome otherwise known as and what is it associated with in maternal serum?

Back 47

Trisomy 21, associated with low AFP.

Front 48

When does the embryonic period begin?

Back 48

conception

Front 49

When does the fetal period begin?

Back 49

9-11 weeks

Front 50

Teratogen's have three periods of susceptibility. Describe them.

Back 50

a. Resistant period: week 1 of development

b. Maximum susceptibility period: weeks 3-8

c. Lowered susceptibility period: weeks 9-38

Front 51

Which category of drug is 'absolutely contraindicated' in pregnancy?

Back 51

Category X

Front 52

Which category of drug shows 'Definite risk' to fetus?

Back 52

Category D.

Front 53

Describe pre-eclampsia and explain the risks.

Back 53

Development of elevated blood pressure with proteinuria occuring after 20-24 weeks.
Risks: kidney, liver failure, seizures, hemorrhage.

Front 54

Describe Gestational Hypertension and list the risks.

Back 54

Increased BP with no proteinuria. Risks: cardiac problems, peripheral edema

Front 55

What is Erythroblastosis Fatalis otherwise known as?

Back 55

Hemolytic disease of newborn

Front 56

Describe DIC.

Back 56

Disseminated Intravascular Coagulation: Due to massive release of thromboplastins into the circulation, widespread clotting will occur throughout the body, depleting available circulating platelets.

Front 57

Describe Post Maturity Syndrome.

Back 57

Occurs in 25% of postdates pregnancies

Due to uteroplacental ineffeciency

Risks: respiratory distress syndrome, hypoglycemia, polycythemia, temperature instability

Front 58

What is the standard doseage of Vitamin K?

Back 58

1 mg IM

Front 59

What is Hegar's sign?

Back 59

Softening of the isthmus

Front 60

What is Homan's sign?

Back 60

calf pain, when sharply flex foot, DVT

Front 61

What is Chadwick's sign?

Back 61

bluish discoloration of vaginal walls and cervix

Front 62

Where is AFP secreted?

Back 62

first secreted by yolk sac, then by fetal liver

Front 63

What are the five components of the BPP?

Back 63

NST
Tone
Movements
Breathing efforts
AFV

Front 64

Define 'lysis'

Back 64

Disintegration, break down

Front 65

What layer of the decidua does the placenta form?

Back 65

Decidua Basalis

Front 66

Is the 'indirect' Coombs test for maternal or fetal testing?

Back 66

Maternal

Front 67

Is the 'direct' Coombs test for maternal or fetal testing?

Back 67

Fetal

Front 68

What is Couvade syndrome?

Back 68

"sympathetic pregnancy"
Someone close to the mother, most often her partner, experiences symptoms of pregnancy.

Front 69

Define 'diaphoretic'

Back 69

Sweating

Front 70

The anterior fontanel closes at _______ months.

Back 70

18 months

Front 71

True or False.
Head compression causes vagal nerve stimulation.

Back 71

True.

Front 72

Define hypertrophy.

Back 72

cells increase in size

Front 73

Define hyperplasia.

Back 73

cells increase in number

Front 74

When does the fetal heart begin beating?

Back 74

4 weeks post conception

Front 75

When should an infant double it's birth weight? Triple?

Back 75

Double by 6 months
Triple by 12 months

Front 76

Define 'Iatrogenic'

Back 76

Caused by 'care providor.'
Iatra=greek word for doctor

Front 77

Define 'Eutocia'

Back 77

normal labor

Front 78

Explain values in Rubella Titres

Back 78

>1:10 = current immunity

>1:64 = current infection

Front 79

List some hormones produced by the placenta:

Back 79

progesterone
estrogen
hcg
human placental lactogen

Front 80

What occurs just before menstruation to stimulate shedding?

Back 80

Progesterone drops>>>
the corpus luteum degerates>>>
shedding is stimulated

Front 81

What makes the vaginal pH acidic?

Back 81

Doderlein's bacillus:
An anerobic lactobacillus normally present in the vagina where it continually converts glycogen molecules to produce lactic acid which destroys or inhibits some potentially harmful bacteria entering the vaginal canal.
http://www.definition-of.com/Doderlein+bacillus

Front 82

Define Priapism

Back 82

Priapism is the presence of a persistent, usually painful, erection of the penis unrelated to sexual stimulation or desire. It is a true urologic emergency that may lead to permanent erectile dysfunction and penile necrosis if left untreated. Priapism is frequently idiopathic in etiology but is associated with a number of important medical conditions and pharmacologic agents.
http://emedicine.medscape.com/article/777603-overview

Front 83

Define Pyloric Stenosis

Back 83

Pyloric stenosis is a narrowing of the pylorus, the opening from the stomach into the small intestine.
First symptom in the infant is usually projectile vomiting

Front 84

Define Gastroschisis

Back 84

Gastroschisis is a birth defect in which an infant's intestines stick
out of the body through a defect on one side of the umbilical cord.

Front 85

Define ecchymosis

Back 85

Bruising

Front 86

In fetal circulation, what allows blood to enter the left atrium from the right atrium?

Back 86

Foramen Ovale

Front 87

In fetal circulation, what allows blood to bypass the lungs?

Back 87

Ductus Arteriosis

Front 88

Define analgesia

Back 88

absence of the sense of pain without loss of consciousness

Front 89

Define anesthesia

Back 89

loss of bodily sensation with or without loss of consciousness

Front 90

Define anesthetic

Back 90

Relating to or resembling anesthesia. Causing anesthesia. Insensitive.

Front 91

Where are the Skene's glands?

Back 91

Near the urethra. 'periurethral'

Front 92

Explain spinnbarkeit

Back 92

fertile cervical mucous

Front 93

Define Meiosis

Back 93

Meiosis is a special type of cell division that produces gametes with half as many chromosomes

Front 94

Define Mitosis

Back 94

Mitosis is the process by which a eukaryotic cell separates the chromosomes in its cell nucleus into two identical sets in two nuclei.[1]
http://en.wikipedia.org/wiki/Mitosis

Front 95

What is Piskacek's sign?

Back 95

asymmetric enlargement of the body of the pregnant uterus as a result of its enlargement in the cornual region, usually over the site of implantation.

Front 96

Define hypoxemia

Back 96

Hypoxemia refers to refers to a condition when oxygen content in the arterial blood is low as also the partial pressures in the arterial blood.

Front 97

Define Asphyxia

Back 97

Asphyxia is the absence of oxygen along with the accumulation of carbon dioxide.

Front 98

Define hypoxia

Back 98

Hypoxia is the deficiency of oxygen in some specific part of the body.

Front 99

What is the Mantoux test also know as?

Back 99

The TB screen