RNC-OB Exam UPDATED ACTUAL Questions and CORRECT Answers
How much weight do babies gain at the end of 1/2 lb a week each week past 34 weeks
pregnancy?
Why is obesity a hemorrhage risk? More estrogen when obese makes their vascular system fragile and more likely to
bleed
Eriksons stage of development for <18 yo deliveries ID vs ID confusion
Eriksons stage of development for >35 yo deliveries Intimacy vs isolation
Highest indication for PTD Previous PTD
Also if a pt is born preterm they are likely to have their own preterm delivery
What is antiphospholipid antibody syndrome? Autoimmune clotting disorder
- occurs when PLT and endothelial cell membranes change causing clotting risks
- begins the cycle of: thrombosis > perfusion to the placenta decreases > severe
pre-e, abruption, IUGR, PTD, death
- lupus anticoagulant and anticardiolipin antibodies are the most common cause
Treatment for antiphospholid antibody syndrome Lovenox, heparin, low dose asa
Lovenox vs Heparin - Lovenox is made from heparin, is long acting, and more predictable. Frequent
INRs not as routinely required, used until about 35 wks
- heparin is short acting and can be reversed if needed
Heparin antagonist protamine sulfate
Normal thing that happens to blood during pregnancy Becomes hypercoagulable
What is a common cause of recurrent miscarriage and Antiphospholipid antibody syndrome
early severe pre-e
How many extra calories a day when pregnant 300 / day during 2nd trimester or 600/day with twins
How much protein do you need in pregnancy 75 g daily
Good sources of folic acid Whole grains, citrus fruits, green vegetables
Why do you need folic acid? prevent neural tube defects
What does maternal lead exposure cause Neuro problems and low IQ
, Weight gain parameters in pregnancy Under weight (BMI <18) : 28-40 lbs
Normal weight: 25-35
Overweight: 15-25
Obese: 11-20
Risks of being obese for labor/delivery - macrosomic fetus > shoulder dystocia > c/s birth
- higher wound dehiscence / infection rate
- PTD, GDM, Pre-e
- longer labors and bleeding
Why does diabetes cause RDS (respiratory distress Delayed surfactant from excess glucose
syndrome)
Surfactant SOAP to open alveoli, w/o surfactant, aveoli STICKY
Diabetes and birth defects Can cause heart or neural tube defects
- gdm does not usually lead to birth defects, but type 1 and 2 prior to pregnancy
are higher risks
- hgb A1C > 8.5% pre pregnancy = >40% chance of heart defect in baby
Type 1 diabetes - by age 30 dx
- insufficient insulin secretion
- first sign is often DKA
- TX: diet, exercise, NEEDS INSULIN
type 2 diabetes - genetic link
- resistant to insulin action and insulin secretion
- some insulin is produced, just not enough
- tx: diet, exercise, oral meds, insulin
DKA Metabolic acidosis
- Compensation details: breathing fast, bc the lungs compensate to blow off the
co2 (acid)
- kussmauls respirations: diabetic and breathing fast
- tx: IV fluids fast, IV insulin, worry about shock
What does IV insulin lead to Hypoglycemia and hypokalemia
How much weight do babies gain at the end of 1/2 lb a week each week past 34 weeks
pregnancy?
Why is obesity a hemorrhage risk? More estrogen when obese makes their vascular system fragile and more likely to
bleed
Eriksons stage of development for <18 yo deliveries ID vs ID confusion
Eriksons stage of development for >35 yo deliveries Intimacy vs isolation
Highest indication for PTD Previous PTD
Also if a pt is born preterm they are likely to have their own preterm delivery
What is antiphospholipid antibody syndrome? Autoimmune clotting disorder
- occurs when PLT and endothelial cell membranes change causing clotting risks
- begins the cycle of: thrombosis > perfusion to the placenta decreases > severe
pre-e, abruption, IUGR, PTD, death
- lupus anticoagulant and anticardiolipin antibodies are the most common cause
Treatment for antiphospholid antibody syndrome Lovenox, heparin, low dose asa
Lovenox vs Heparin - Lovenox is made from heparin, is long acting, and more predictable. Frequent
INRs not as routinely required, used until about 35 wks
- heparin is short acting and can be reversed if needed
Heparin antagonist protamine sulfate
Normal thing that happens to blood during pregnancy Becomes hypercoagulable
What is a common cause of recurrent miscarriage and Antiphospholipid antibody syndrome
early severe pre-e
How many extra calories a day when pregnant 300 / day during 2nd trimester or 600/day with twins
How much protein do you need in pregnancy 75 g daily
Good sources of folic acid Whole grains, citrus fruits, green vegetables
Why do you need folic acid? prevent neural tube defects
What does maternal lead exposure cause Neuro problems and low IQ
, Weight gain parameters in pregnancy Under weight (BMI <18) : 28-40 lbs
Normal weight: 25-35
Overweight: 15-25
Obese: 11-20
Risks of being obese for labor/delivery - macrosomic fetus > shoulder dystocia > c/s birth
- higher wound dehiscence / infection rate
- PTD, GDM, Pre-e
- longer labors and bleeding
Why does diabetes cause RDS (respiratory distress Delayed surfactant from excess glucose
syndrome)
Surfactant SOAP to open alveoli, w/o surfactant, aveoli STICKY
Diabetes and birth defects Can cause heart or neural tube defects
- gdm does not usually lead to birth defects, but type 1 and 2 prior to pregnancy
are higher risks
- hgb A1C > 8.5% pre pregnancy = >40% chance of heart defect in baby
Type 1 diabetes - by age 30 dx
- insufficient insulin secretion
- first sign is often DKA
- TX: diet, exercise, NEEDS INSULIN
type 2 diabetes - genetic link
- resistant to insulin action and insulin secretion
- some insulin is produced, just not enough
- tx: diet, exercise, oral meds, insulin
DKA Metabolic acidosis
- Compensation details: breathing fast, bc the lungs compensate to blow off the
co2 (acid)
- kussmauls respirations: diabetic and breathing fast
- tx: IV fluids fast, IV insulin, worry about shock
What does IV insulin lead to Hypoglycemia and hypokalemia
