OB FINAL HESI UPDATED ACTUAL
QUESTIONS AND VERIFIED ANSWERS
●● Depression med most compatible with pregnancy
Answer: SSRIs
-Always some risk, keep at lowest therapeutic dose for less side effects
- Try SSRI before other meds (SNRI, TCAs, MAOIs)
●● Baby Blues vs Postpartum Depression
- 2 categories in postpartum depression
Answer: *Baby Blues*: Expected drop of hormones after placenta
delivery (estrogen/progesterone) > mood alteration
- VERY common (85% expereince), expected finding
- Should ONLY be present up to 2 weeks postpartum: If longer consider
postpartum depression
*Postpartum Depression*: Extensive symptoms of irritability, liability,
possible detachment towards newborn
- Postpartum Psychosis: Depression WITH psychotic features, severe
variant of postpartum depression, pretty rare (aranoia, deficits around
safety, delusions)
- Safety is always top priority
,- Partner/Paternal Postpartum Depression: Higher risk for the partner to
have depression if the person giving birth develops postpartum
depression
●● Most commonly used drug with pregnancy drug abuse
Answer: *Tobacco/nicotine*: Concern from vasoconstriction >
decreased perfusion to placenta/fetus (growth issues)
●● Tobacco vs Alcohol vs Marijuana impact on fetus
Answer: *Tobacco/nicotine*: Concern from vasoconstriction >
decreased perfusion to placenta/fetus (growth issues)
*Alcohol*: Concern for impacting CNS/neuro development and fetal
alcohol syndrome
*Marijuana*: Increases CO2 in blood, alters oxygenation to fetus,
impacts growth
●● Note about withdrawal in pregnancy
Answer: Drug withdrawl is super harmful in pregnancy
- Instead try a program: methadone (hospitalization) or subutex
(outpatient)
●● Best nutrition for infants
,- Info (2)
Answer: MILK
- Benefits of breastmilk: Immune function (antibodies), lower rates of
infection, cancer, obesity/diabetes, more attachment, benefit to moms
- Recommended only human milk for first 6mo then continued for at
least 12mo- 2years old (add in complementary food)
●● Benefits of breastfeeding (4)
Answer: - IMMUNE FUNCTION: Antibodies are passed from mom to
baby via breastmilk (less illness)
- Lower rates of obesity/diabetes and cancer
- Enhances bonding/attachment
- Mom benefits: lowers risk for breast cancer, diabetes, cardiovascular
disease
●● Contraindications for breastfeeding (4)
Answer: - Drug or alcohol use
- TB, HIV, brucellosis, T-cell lymphotropic virus
- Herpes lesions on breast
- Newborns with galactrosemia
Note: Moms can be on the Methadone program (withdrawal) and still
breastfeed
, ●● Supplement needed if breastfeeding (1)
Answer: Vitamin D
- Vitamin D is the one vitamin NOT transferred via breast milk
- Needs supplementation
- Stay on prenatal vitamin if they are breastfeeding: allowing proper
vitamins and nutrients to be transferred to baby
●● Calories per ounce of breastmilk
Answer: 20 kcal per ounce
- Formula replicates 20kcal/oz and has different options
●● Carbohydrate requirement
Answer: 60g carbs per day for the first 6 months
- Then 95g carbs after 6mo
●● Alveoli vs Myoepithelial Cells of breast lobes
- Hormone needed for each
Answer: *Alveoli*: Micro structures (small sacs) that contain milk
producing cells in the breast lobes
- *Prolactin*: Need elevated prolactin levels for milk production
QUESTIONS AND VERIFIED ANSWERS
●● Depression med most compatible with pregnancy
Answer: SSRIs
-Always some risk, keep at lowest therapeutic dose for less side effects
- Try SSRI before other meds (SNRI, TCAs, MAOIs)
●● Baby Blues vs Postpartum Depression
- 2 categories in postpartum depression
Answer: *Baby Blues*: Expected drop of hormones after placenta
delivery (estrogen/progesterone) > mood alteration
- VERY common (85% expereince), expected finding
- Should ONLY be present up to 2 weeks postpartum: If longer consider
postpartum depression
*Postpartum Depression*: Extensive symptoms of irritability, liability,
possible detachment towards newborn
- Postpartum Psychosis: Depression WITH psychotic features, severe
variant of postpartum depression, pretty rare (aranoia, deficits around
safety, delusions)
- Safety is always top priority
,- Partner/Paternal Postpartum Depression: Higher risk for the partner to
have depression if the person giving birth develops postpartum
depression
●● Most commonly used drug with pregnancy drug abuse
Answer: *Tobacco/nicotine*: Concern from vasoconstriction >
decreased perfusion to placenta/fetus (growth issues)
●● Tobacco vs Alcohol vs Marijuana impact on fetus
Answer: *Tobacco/nicotine*: Concern from vasoconstriction >
decreased perfusion to placenta/fetus (growth issues)
*Alcohol*: Concern for impacting CNS/neuro development and fetal
alcohol syndrome
*Marijuana*: Increases CO2 in blood, alters oxygenation to fetus,
impacts growth
●● Note about withdrawal in pregnancy
Answer: Drug withdrawl is super harmful in pregnancy
- Instead try a program: methadone (hospitalization) or subutex
(outpatient)
●● Best nutrition for infants
,- Info (2)
Answer: MILK
- Benefits of breastmilk: Immune function (antibodies), lower rates of
infection, cancer, obesity/diabetes, more attachment, benefit to moms
- Recommended only human milk for first 6mo then continued for at
least 12mo- 2years old (add in complementary food)
●● Benefits of breastfeeding (4)
Answer: - IMMUNE FUNCTION: Antibodies are passed from mom to
baby via breastmilk (less illness)
- Lower rates of obesity/diabetes and cancer
- Enhances bonding/attachment
- Mom benefits: lowers risk for breast cancer, diabetes, cardiovascular
disease
●● Contraindications for breastfeeding (4)
Answer: - Drug or alcohol use
- TB, HIV, brucellosis, T-cell lymphotropic virus
- Herpes lesions on breast
- Newborns with galactrosemia
Note: Moms can be on the Methadone program (withdrawal) and still
breastfeed
, ●● Supplement needed if breastfeeding (1)
Answer: Vitamin D
- Vitamin D is the one vitamin NOT transferred via breast milk
- Needs supplementation
- Stay on prenatal vitamin if they are breastfeeding: allowing proper
vitamins and nutrients to be transferred to baby
●● Calories per ounce of breastmilk
Answer: 20 kcal per ounce
- Formula replicates 20kcal/oz and has different options
●● Carbohydrate requirement
Answer: 60g carbs per day for the first 6 months
- Then 95g carbs after 6mo
●● Alveoli vs Myoepithelial Cells of breast lobes
- Hormone needed for each
Answer: *Alveoli*: Micro structures (small sacs) that contain milk
producing cells in the breast lobes
- *Prolactin*: Need elevated prolactin levels for milk production
