Ob Gyn Blueprints 1

Front 1

Diagnostic results of 3hour GTT?

Back 1

Fasting greater than 105

Subsequent 1 hour checks at 190,165, or 145

Front 2

What does the BPP look at?

Back 2

NST

fetal tone

Fetal breathing movements

Fetal activity

Amniotic fluid levels

Front 3

Definition of recurrent pregnancy loss?

Back 3

3 or more spontaneous Abortions

Front 4

Presentation of tay Sachs?

Back 4

Death by 4. Extreme neuroma/developmental dysfunction. Cherry red macula. Hyperalertness

Front 5

What EZ is effected in tay Sachs?

Back 5

Hexosamindase-A

Front 6

Which is covered by a membrane? Gastroschisis or omphalocoele? Which is better to have?

Back 6

Omphalocoele has a membrane, but is associated with generic diseases!!

Front 7

Clenched fists, rocket bottom feet, overlapping digits. DX?

Back 7

Edward's (18)

Front 8

Agenesis of many parts, club foot, overlapping fingers, polydactyly. DX?

Back 8

Patau's (13)

Front 9

Coarctation of the aorta is associated with what genetic disease?

Back 9

Turners

Front 10

Duodenal atresia is associated with what genetic disease?

Back 10

Downs

Front 11

Which generic disease has small firm testes? Why?

Back 11

Klinefelter's syndrome (xxy)

Because the extra X chromosome causes some germ cells to die off leading to sclerosis of the testes

Front 12

#1 cause of inherited mental retardation?

Back 12

Fragile X (downs syndrome is not inherited, but is genetic)

Front 13

Pt fails ogtt. First step in management?

Back 13

According to uwise, diabetic diet and blood sugar monitoring

Front 14

Amount of protein most pregnant women need daily?

Back 14

70g

Front 15

Normal pregnancy progesterone level?

Back 15

>25

Front 16

Percent of pts with first trimester spotting normally?

Back 16

30%

Front 17

Major causes of first trimester bleeding?

Back 17

Ectopic pregnancies

Spontaneous abortion

Normal pregnancy

Front 18

Major causes of antepartum bleeding?

Back 18

Placental previa (30%)

Placental abruption (20%)

Front 19

#1 risk factor for placental abruption?

Back 19

Hypertension

Front 20

What is preferred in placental abruption? C section or vaginal?

Back 20

Vaginal as long as no fetal distress or severe bleeding

Front 21

Treatment for uterine rupture?

Back 21

Laparotomy and delivery of fetus

Front 22

Treatment for vasa previa?

Back 22

EMERGENCY C SECTION

Front 23

First trimester spontaneous abortion is caused by which systemic diseases?

Back 23

Chronic renal disease

Diabetes mellitus

Lupus

Front 24

Definition of macrosomia?

Back 24

Greater than 4500g

Front 25

Oligohydramnios at 37 weeks. Management?

Back 25

Deliver the baby

Front 26

Definition of oligo vs polyhydramnios?

Back 26

AFI: <5 or >25

Front 27

Major complication of polyhydramnios?

Back 27

Cord prolapse

Front 28

Most common cause of IUFD?

Back 28

Cord problems

Front 29

Management of IUFD?major complication?

Back 29

Delivery or D&C if appropriate.

Fearing disseminated DIC

Front 30

Does surgical abortion increase risk of future spontaneous abortion?

Back 30

No. Does not cover negative obstetrical disadvantage

Front 31

How to get diamniotic dichorionic monozygotic twins?

Back 31

Is split occurs prior to 3 days

Front 32

How to get diamniotic monochorionic monozygotic twins?

Back 32

Split between days 4-8

Front 33

How to get monoamniotic monochorionic monozygotic twins?

Back 33

Split at 9 days or later

Front 34

How to get conjoined twins?

Back 34

After day 13

Front 35

Who had higher infant death, twins or singletons? Higher rate of IUGR?

Back 35

Twins 5x increased infant death

Twins higher IUGR

Front 36

One way to prevent preterm labor in multiple gestations

Back 36

Early weight gain helps supports the twins

Front 37

Which type of twins can develop Twin Transfusion syndrome?

Back 37

Diamniotic monochorionic twins (4-8 days)

Front 38

#1 site of birth defects in child of a pt with uncontrolled diabetes?

Back 38

Heart and spine

Front 39

Best way to check for placental issues?

Back 39

Do an ultrasound! Even before checking the cervix

Front 40

Primary risk factor for premature rupture of membranes?

Back 40

Genital tract infections

Front 41

Best way to postpone premature preterm ROM?

Back 41

Antibiotic therapy can delay delivery for up to 7 days

Front 42

What reduce the risk of PROM?

Back 42

17-alpha hydroxyprogesterone

Front 43

How to determine gestational hypertension from preecclampsia?

Back 43

Both have 2 blood pressures over 140/90,, but gestational hypertension has 24 hour uterine proteins less than 300 mg

Front 44

What is a good screening tool for preecclampsia in regards to proteinuria?

Back 44

A urine protein to creatinine ratio. Creatinine is excreted at a relatively constant rate. So a P/C ratio higher than 0.3 is concerning for proteinuria

Front 45

Criteria for severe preecclampsia?

Back 45

2bp's greater than 160/110 + proteinuria >5g in 24 hours

OR

Mild preecclampsia+ symptoms

-neurologic changes

-oliguria (<400ml per 24 hours)

-decreased liver function

-pulmonary edema

-thrombocytopenia (<100,000)

Front 46

How to differentiate AFLDP from HELLP syndrome?

Back 46

AFLDP has blood glucose <50, elevated ammonia levels, and decreased fibrinogen and antithrombin III

Front 47

Risk of preecclampsia in future pregnancies if preecclampsia in first pregnancy?

Back 47

Increased 25%

If had chronic htn too, then 70%

Front 48

Drug to manage acute hypertension during pregnancy?

Back 48

Hydralazine

Front 49

How to manage chronic hypertension in pregnancy

Back 49

Labetolol or nifedipine

Front 50

When is elective C section offered to gestational diabetic women?

Back 50

If EFW is > 4500g

Front 51

Treatment of UTI in pregnancy?

Back 51

Amoxicillin or bactrim

Front 52

Treatment of pyelonephritis in pregnancy?

Back 52

IV ampicillin and gentamicin

Front 53

When to screen for group b step? Treatment?

Back 53

During weeks 36-37

Giver penicillin during labor

Front 54

I'm what setting do you frequently see chorioamnionitis?

Back 54

Typically in premature rupture of membranes

Front 55

What signs and symptoms should make you start empiric treatment for chorioamnionitis? Treatment?

Back 55

Maternal fever, white count, uterine tenderness, and fetal tachycardia

IV abx and delivery

Front 56

Pt previously exposed to chicken pox gets exposed again during pregnancy. Pt develops chicken pox before delivery. Treatment for both?

Back 56

Varicella Zoster IG

Front 57

Complications of parvovirus in neonates?

Back 57

Hydrops, hemolytic anemia, death

Front 58

Management of a pt on medications for hx of seizures who wants to get pregnant?

Back 58

Taper down to 1 drug because effects are worse with multiple drugs.

If seizure free for 2-5 years, consider coming off drugs altogether

Front 59

Drug of choice for epileptic woman in labor who is having a seizure?

Back 59

Phenytoin

Front 60

Mortality rates of pregnant patients with pulmonary hypertension or Eisenmengers syndrome?

Back 60

Up to 50%

Many women are counseled to terminate the pregnancy

Front 61

Management of woman with heat valve disease who wants to get pregnant?

Back 61

Best to get valve repaired surgically prior to getting pregnant

Front 62

Leading cause of maternal death in pregnancy?

Back 62

Pulmonary embolism

Front 63

Medications to stop during pregnancy if you have SLE?

Back 63

Cyclophosphamide and methotrexate

Front 64

Symptomatology of a lupus flare looks like what other disease process? How to tell the difference? Why is it important?

Back 64

Looks very similar to preecclampsia.

Can tell the difference because lupus has low complement levels. Preecclampsia has normal complement levels.

Important because you treat SLE flare up with corticosteroids and possibly cyclophosphamide, not with delivery

Front 65

Anti ro and anti la antibodies increase risk of what in the fetus?

Back 65

Increases risk of congenital heart block

Front 66

Management steps for uterine atony?

Back 66

1. Oxytocin

2. Methergine (CI in hypertension)

3. Prostaglandin F2@ (CI in asthmatics)

4. D&C

Front 67

What do you use dicloxacillin for?

Back 67

Mastitis

Front 68

#1 cause of postpartum fever?

Back 68

Endometritis

Front 69

Is endometritis more common in SVD or C section?

Back 69

SVD 2%

C section 10-15%

Front 70

Treatment for pregnant woman with symptomatic mitral valve prolapse?

Back 70

Beta blockers

Front 71

What tool can be used to differentiate appendicitis from normal pregnancy?

Back 71

Graded compression ultrasound

Front 72

Best non invasive test to diagnose anemia?

Back 72

Middle cerebral artery peak systolic velocity

Front 73

At what gestational ages is a fetus most likely to acquire intellectual disability following radiation?

Back 73

8-15 weeks

Front 74

Definition of prolonged latent phase of labor?

Back 74

>20 hours if nulliparous

>14 hours if multiparous

Front 75

How many bones in the neonatal head? Where are the fontanelles?

Back 75

5

Where two frontal & two parietal sit

Where two parietal & occipital sit

Front 76

Definition of labor?

Back 76

Contractions that cause changes in either cervical dilation or effacement

Front 77

Contraindications for prostaglandins in labor?

Back 77

Asthma or glaucoma in mom

Prior c section or non reassuring fetal strip

Front 78

When in bradycardia in a fetus a concern?

Back 78

If <90bpm for 2 min

Front 79

Stages of cardinal movements?

Back 79

Engagement

Descent

Flexion

Internal rotation

Extension

External rotation

Front 80

Define 3 stages of labor.

Back 80

1. Labor to complete dilation

-latent phase til 3cm

-active phase rate of minimum 1.0-1.2 cm per hour

2. Dilation until birth

3. Birth til placental passage

Front 81

Signs of non reassuring strip?

Back 81

Frequent late decelerations, bradycardia, or loss of variability

Front 82

What to do with non reassuring strip?

Back 82

STOP.

if not resolving, C section

Front 83

What is cut off for low birth weight?

Back 83

<2500 g

Front 84

Average amount of time tocolytics prolong gestation? Purpose?

Back 84

Typically 48 hours

Allows enough time for steroids to work for fetal lungs

Front 85

Why does dehydration lead to increased contractions?

Back 85

Thought that because oxytocin and ADH are both produced in the same place, a dehydrated patient will have cross reaction of ADH with oxytocin receptors leading to increased contractions. Hydrate pt to decrease ADH and help with contractions alleviations

Front 86

What EZ is the end target of tocolytics? What activates and inhibits it

Back 86

Myosin Light Chain Kinase

Activated by calcium, inhibited by cAMP

Front 87

How do beta agonists work in tocolytics?

Back 87

Increase conversion of ATP to cAMP

Decreased intracellular calcium

Front 88

How does magnesium act as a tocolytics? What is the toxic level? Best way to check for toxicity?

Back 88

Calcium antagonist

Toxic if >10 (respiratory depression, cardiac arrest)

Do reflex checks as those are the earliest to go

Front 89

How do prostaglandin inhibitors work as tocolytics?

Back 89

Prostaglandin typically increases calcium, so inhibiting it decreases calcium and thus contractions

Front 90

Differences of preterm, premature, and prolonged rupture of membranes

Back 90

Preterm: occurring before 37 weeks

Premature: rupture before the onset of labor

Prolonged: anytime rupture of membranes occur longer than 18 hours before delivery

Front 91

Treatment of PPROM?

Back 91

Corticosteroids and ampicillin ± erythromycin

Front 92

Biggest concern of premature rupture of membranes?

Back 92

Chorioamnionitis

Front 93

When is fetal growth restriction symmetric, when is it asymmetric?

Back 93

symmetric if restriction prior to 20 weeks when child grows by hyperplasia

Asymmetric if restriction after 20 weeks when child grows by hypertrophy (due to nutritional deficits)

Front 94

Growth curve of fetus with IUGR vs one with decreased growth potential?

Back 94

Fetus with decreased growth potential goes small and stays small

Fetus with IUGR falls off the growth curve

Front 95

Which SSRI is contraindicated in pregnancy?

Back 95

Paxil (paroxitine)

Front 96

How to diagnose fetal hydrops on ultrasound?

Back 96

Accumulation of fluid in 2 or more spaces

Front 97

How much fetal blood is neutralized by 300mcg of RhoGAM

Back 97

30cc