AMCB Boards- Things to Memorize Solved 100%

Osteopenia T score - Answer -1.1 to -2.49 Osteoporosis T score - Answer -2.5 or less When to start screening with DXA - Answer 65 When do you use Z scores? - Answer matched reference population for premenopausal women <2.5 is less than expected range, evaluate for secondary causes of osteoporosis FRAX score - Answer --Survey used to assess fracture risk --Used *ONLY* if the patient is *OSTEOPENIC* --*Treat like osteoporosis if:* 1. Hip Fracture likelihood is greater than 3% in the next 10 years or 2. Other major osteopathic fracture likelihood is greater than 20% in the next 10 years signs of pregnancy (3 categories) - Answer Presumptive Probable Positive Single deepest pocket - Answer normal is 2-8cm AFI - Answer 5-24cm BPP - Answer 1. breathing movements(1+ episode) 2. body movement (3+) 3.Tone(1+,extension to flexion) 4. AFV: 2cm pocket at minimum 5. reactive NST all are 2 or 0 points 8-10= normal unless oligo 6= equivocal,repeat testing weight gain by bmi - Answer underweight (<18.5): 28-40lbs Normalweight: 18.5-24.9 25-35lbs overweight: 25.0-29.9 15-25lbs obese: 30+ 11-20lbs gynecoid pelvis - Answer round-shaped transverse slightly wider than AP 50% of white women android - Answer heart shaped/triangular shaped posterior pelvis is wider than anterior pelvis more likely to need c/s anthropoid pelvis - Answer oval shaped, with a wider anteroposterior diameter more likely to be OP platypelloid pelvis - Answer pelvis that is flat in its dimensions with a very narrow anterior-posterior diameter and a wide transverse diameter; this shape makes it extremely difficult for the fetus to pass through the bony pelvis Hct - Answer normal non pregnant: 37-42% pregnancy:33/32/33 black women: 31/30/31 Hbg - Answer normal non pregnancy: 12-16 pregnancy: 11/10.5/11 black women: 10.2/9.7/10.2 wbc - Answer platelets - Answer 150,000-400,000 Fasting glucose - Answer Normal: 70-99 mg/dL pre-diabetes: 100-125 mg/dL diabetes: >125 mg/dL 2hr glucose tolerance test - Answer normal:<140 prediabetes:140-199 diabetes:200+ ADA diagnostic criteria for DM - Answer 1. classic symptoms of hyperglycemia + random non fasting glucose of 200+ 2. fasting 126+ 3. 2hr: 200+ 4. repeat testing on another day to confirm Hgb A1c - Answer prediabetes: 5.7-6.4 diabetes 6.5+ good diabetic control:<7 Diagnosis of gestational diabetes - Answer cut off for 1hr:130-140 3hr: fasting>95, 1hr >180,2hr > 155,3hr > 140 or... 1hr >200 changes in thyroid hormones in pregnancy - Answer TT3 and TT4 increase, TSH unchanged, free T4 unchanged normal vaginal pH - Answer 3.8-4.5 What may cause elevated vaginal pH - Answer BV,trich, atrophic vaginitis,breastfeeding normal urine findings - Answer no nitrites, ketones,crystals, casts, glucose clear, amber yellow, aromatic pH4.6-8 protein 0-8 specific gravity 1.005-1.030 leukocyte esterase negative WBCs 0-4 per high powered field RBCs 2 or less B6 and unisom - Answer b6: 50mg BID or 25mg TID-QID doxylamine: 12.5 to 25mgPO q8-12hrs or 1/2 unisom sleep tab in morning and afternoon and full tab atnight what measurements are used for dating 2nd trimester ultrasound - Answer head circumference, biparietal diameter, abdominal circumference and femur length Naegele's Rule - Answer add 7 days to LMP, subtract 3 months, add 1 year Beta hcg in pregnancy - Answer detectable 8-11 days after conception doubles every 2 days until it peaks at 8.5- 10 weeks gestation then rapidly declines between 12 and 16 weeks gestation. first trimester GDM screening - Answer BMI >25 (>23 if asian) + additional risk factors like Hx GDM, 1st degree relative with DM, hx infant >4000g,PCOS,HTN... Hep B in pregnancy - Answer rate of fetal transmission during birth: 90%. With hepatitis immune globulin: 3% vertical transmission is more likely if:hepatitis B surface antigen (HBsAg) positive and Hepatitis B e-antigen (HBeAg) positive Parovirus pregnancy - Answer risk of fetal transmission is 30%-50%. risk of a fetal complication from the virus is about 10%. The greatest risk to the fetus occurs before 22 weeks Toxoplasmosis - Answer raw/undercooked meat cat feces Presentation: usually asymptomatic can cause: lower IQ, deafness, SAB, prematurity, IUGR can treat in pregnancy with MFM Varicella - Answer If mother is infected 6d before birth, newborn needs to be given varicella-zoster immune globulin. greatest risk for congenital varicella syndrome is infection in 1st 20 weeks presentation: fever, malaise, myalgias, HA, maculopapular rash Parovirus B19 - Answer Transmission: respiratory, blood, manifestations: asymptomatic, mild rash & illness complicationS: SAB, severe fetal anemia, hydrops, stillbirth cant treat it if acquired in pregnancy Rubella - Answer Mother's symptoms: maculopapular rash, fever, malaise, sore throat, and lymphadenopathy. transmission: Droplet/respiratory complications: SAB, stillbirth, Congenital Rubella Syndrome: IUGR, cataracts, heart defects, deafness no treatment available wait 4 weeks after vaccine to become pregnant Cytomegalovirus - Answer most common congenital infection Transmission: sexual, blood/urine/saliva presentation: adults usually asymptomatic, may have fever, chills, malaise, myalgias, leukocytosis, abnormal liver function tests, lymphadenopathy Can cause stillbirth, neurologic problems Newborn Hemoglobin - Answer 13.7-20.0 g/dL slight rise in 1st few days due to decreased plasma volume mean at 2 months: 12 higher than adult Newborn Hct - Answer 43-63% higher than adult Newborn RBC count - Answer 4.2-5.8million/ mm3 higher than adult WBC newborn - Answer 10,000- 30,000 (higher than adults: 5,000-10,000) newborn platelets - Answer 150,000-350,000/mm3 (similar to adults) APGAR - Answer HR: 0=absent, 1<100, 2: 100+ Resp: 0=absent, 1= slow/irregular, 2= strong cry Tone: 0=flaccid, 1=flexion of extremities, 2= active motion Reflex Irritability= 0: no response, 1= grimace, 2= strong cry color: 0= central cyanosis, 1= acrocyanosis, 2= completely pink Hgb/Hct with blood loss - Answer 1 gm hemoglobin drop = 500 mL blood loss 1% hematocrit drop = 250 mL blood loss Fundus involution - Answer 1fb <U per day of life, back to below SP by day 14 healing at the placental site takes about _____ weeks - Answer 6 weeks Postpartum timeline: Swelling and increased vascularity of the vagina - Answer 3-4 weeks Postpartum Bleeding Pattern - Answer Rubra: 1st 3-7 d Serosa: 14-21 d Alba: till 4-6 weeks Cervix changes postpartum - Answer immediately after birth: dilated to 3-4cm Days 2-3: dilated to 2-3cm Day 7: dilated to 1cm 4 weeks postpartum: no longer dilated vagina changes postpartum - Answer 3-4 weeks postpartum: rugae returns, decreased edema, vascularity, bruising 6 weeks: normal vaginal epithelium perineal healing - Answer should appear healed at 7d with only linear scarring at 6 weeks cardiovascular changes postpartum - Answer increase of cardiac output x 60-80% in 1st hrs pp diuresis over 1st 48hrs--> decreased plasma volume cardiac output normalizes by 2 weeks pp may have transient leukocytosis in 1st 48hrs PP renal system changes postpartum - Answer diruesis: 1st 5d bladder: hyptonic and edematous x 1st 24hrs postpartum weight loss - Answer should be eating 1800cal/day postpartum @min max 4.5lbs/month weight loss after the 1st month When is it safe to prescribe combined hormonal contraception postpartum? - Answer >42 days pp If you don't place an IUD immediate after delivery, how long should you wait? - Answer 4 weeks Postpartum WBC - Answer should be below 20,000, but generally elevated more than normal () prolactin released from - Answer anterior pituitary oxytocin released from - Answer posterior pituitary Postpartum estrogen levels back to pre-pregnancy - Answer 1-3d pp Which immunoglobin is most common in breastmilk - Answer IgG A The greatest % of calories in breastmilk comes from: - Answer fat statin drugs work by - Answer inhibiting the synthesis of cholesterol by the liver. time period highest risk for teratogens - Answer 3-8 weeks after conception. drugs most likely to cross the placenta are - Answer Lipid soluble Pregnancy Category A - Answer Controlled studies in animal and women have shown no risk in the 1st trimester, and possible fetal harm is remote