ACOG QBank: OB/GYN Verified Exam Questions and Answers Latest
update 2026/2027
Question:
1. Which type of anemia is expected in pregnancy? When is the max effect achieved?
Answer:
Normocytic anemia due to hemodilution. max at 34 weeks
Question:
2. Type of dyspnea seen in up to 75% of women by the third trimester
Answer:
Physiologic dyspnea of pregnancy
Question:
3. What type of acid-base disturbance is common during pregnancy and why?
Answer:
Compensated respiratory alkalosis Increased minute ventilation = low PCO2 = elevates pH; retention
of bicarb compensates (pH ~HCO3/PCO2)
Question:
4. Describe the normal PFT changes with pregnancy
Answer:
IC ,TV, Minute ventilation = increased FRC, ERC, RV = decreased
Question:
5. What are the 2 major changes 1. increased tidal volume and minute volume --> respiratory driving
shortness of breath in alkalosis pregnancy?
Answer:
2. Reduced FRC
Question:
6. What is one of the major risks Increased risk of pulmonary edema of using multiple tocolytics in a
pregnant woman?
Answer:
(Given in isotonic fluids, further reducing plasma osmolality, increasing pulmonary edema)
,Question:
7. Up to 95% of pregnant women will have which type of murmur? Why?
Answer:
Systolic murmur due to increased flow volume
Question:
8.
Explain the normal degree of dilation of the ureters and renal pelvis in pregnant women of the right
ureter due to dextrorotation of the uterus
Answer:
Unequal dilation (R>L) due to cushioning provided by the sigmoid colon to the left ureter and from
greater compression
Question:
9. Which vein complex is dilated in pregnancy and may contribute to dilation of the right ureter?
Answer:
Right ovarian vein complex (it lies obliquely over the ureter)
Question:
10. How do levels of Free T4 and total T4 change in normal pregnancy?
Answer:
Since TBG increases, total T4 increases, but Free T4 remains relatively constant (it is not bound)
Question:
11. Which type of imaging is important in the management of a patient with suspected molar
pregnancy?
Answer:
CXR
--lungs are the MC site of metastatic disease in patients with
gestational trophoblastic disease
Question:
12. Recommended weight gain during pregnancy for BMI <
18.5
Answer:
28-40 lbs
, Question:
13. Recommended weight gain during pregnancy for normal BMI < 24.9
Answer:
23-35 lbs
Question:
14. Recommended weight gain during pregnancy for "overweight" BMI of 25-29.9
Answer:
15-25 lbs
Question:
15. Recommended weight gain during pregnancy for "obese" BMI > 30
Answer:
11-20 lbs
Question:
16. Valproate use in pregnancy is associated with which 3 teratogenic effects in the fetus?
Answer:
NTDs, hydrocephalus, and craniofacial malformations
Question:
17. What structural anomaly of the fetus is most likely in a patient with poorly controlled --also NTDs
T1DM before pregnancy and during organogenesis?
Answer:
Cardiac anomalies
Question:
18. When is CVS typically performed?
Answer:
10-12 weeks gestation
Question:
19. CVS can be used to detect which types of defects?
Answer:
Since it extracts mitotically active villi...
1. Fetal chromosomal abnormalities
2. Biochemical or DNA-based studies, e.g. CF
--doesn't detect NTDs or omphaloceles
update 2026/2027
Question:
1. Which type of anemia is expected in pregnancy? When is the max effect achieved?
Answer:
Normocytic anemia due to hemodilution. max at 34 weeks
Question:
2. Type of dyspnea seen in up to 75% of women by the third trimester
Answer:
Physiologic dyspnea of pregnancy
Question:
3. What type of acid-base disturbance is common during pregnancy and why?
Answer:
Compensated respiratory alkalosis Increased minute ventilation = low PCO2 = elevates pH; retention
of bicarb compensates (pH ~HCO3/PCO2)
Question:
4. Describe the normal PFT changes with pregnancy
Answer:
IC ,TV, Minute ventilation = increased FRC, ERC, RV = decreased
Question:
5. What are the 2 major changes 1. increased tidal volume and minute volume --> respiratory driving
shortness of breath in alkalosis pregnancy?
Answer:
2. Reduced FRC
Question:
6. What is one of the major risks Increased risk of pulmonary edema of using multiple tocolytics in a
pregnant woman?
Answer:
(Given in isotonic fluids, further reducing plasma osmolality, increasing pulmonary edema)
,Question:
7. Up to 95% of pregnant women will have which type of murmur? Why?
Answer:
Systolic murmur due to increased flow volume
Question:
8.
Explain the normal degree of dilation of the ureters and renal pelvis in pregnant women of the right
ureter due to dextrorotation of the uterus
Answer:
Unequal dilation (R>L) due to cushioning provided by the sigmoid colon to the left ureter and from
greater compression
Question:
9. Which vein complex is dilated in pregnancy and may contribute to dilation of the right ureter?
Answer:
Right ovarian vein complex (it lies obliquely over the ureter)
Question:
10. How do levels of Free T4 and total T4 change in normal pregnancy?
Answer:
Since TBG increases, total T4 increases, but Free T4 remains relatively constant (it is not bound)
Question:
11. Which type of imaging is important in the management of a patient with suspected molar
pregnancy?
Answer:
CXR
--lungs are the MC site of metastatic disease in patients with
gestational trophoblastic disease
Question:
12. Recommended weight gain during pregnancy for BMI <
18.5
Answer:
28-40 lbs
, Question:
13. Recommended weight gain during pregnancy for normal BMI < 24.9
Answer:
23-35 lbs
Question:
14. Recommended weight gain during pregnancy for "overweight" BMI of 25-29.9
Answer:
15-25 lbs
Question:
15. Recommended weight gain during pregnancy for "obese" BMI > 30
Answer:
11-20 lbs
Question:
16. Valproate use in pregnancy is associated with which 3 teratogenic effects in the fetus?
Answer:
NTDs, hydrocephalus, and craniofacial malformations
Question:
17. What structural anomaly of the fetus is most likely in a patient with poorly controlled --also NTDs
T1DM before pregnancy and during organogenesis?
Answer:
Cardiac anomalies
Question:
18. When is CVS typically performed?
Answer:
10-12 weeks gestation
Question:
19. CVS can be used to detect which types of defects?
Answer:
Since it extracts mitotically active villi...
1. Fetal chromosomal abnormalities
2. Biochemical or DNA-based studies, e.g. CF
--doesn't detect NTDs or omphaloceles
