AMCB Prenatal Care And Fetal Assessment Questions With Correct Answers

how soon do most pregnancies occur after intercoures - Answer within 2 days of ovulation What is a morula ? and when does it enter the uterine cavity? - Answer solid ball of cells formed by 16 blastomeres. enters the uterus 3 days after fertilization how long is the development of the embryo - Answer the developing human organism from about 2 weeks after fertilization through the second month (8weeks) When does implantation occur? and where? - Answer 6-7 days after fertilization upper posterior wall of the uterus what gives rise to the placenta ? - Answer the chorion When does the amnion fuse with the chorion? - Answer by the end of the 3rd month what hormone is responsible for uterine growth, fallopian tubes, vagina and breast development. - Answer Estrodial-17B Which type of estrogen is found in the urine of pregnant women - Answer Estriol why is maternal insulin levels lowered during pregancy - Answer placental lactogen (hPL) Relaxin has what effect - Answer produced by the corpus luteum, relaxes the uterine myometrium during pregnancy what does GnRH (gonadotropin-releasing hormone) do - Answer stimulates release of FSH and LH what is Corticotropin-releasing hormone (CRH) responsible for ? - Answer Promotes secretion of adrenocorticotropic hormone (ACTH) Somatostatin - Answer Inhibits secretion of growth hormone (GH) and thyroid-stimulating hormone (TSH), prolactin and thyrotropin Is there a placental barrier? - Answer No the placenta does not maintain absolute integrity between the fetus and mother. What is transported accorss the placenta and by what method.? - Answer oxygen and glucose via facilitated diffusion what vessels are contained in the umbilical cord? what do they do ? - Answer Two arteries and 1 vein. the arteries carry deoxygenated blood away from the fetus to the placenta. the 1 vein carried oxygenated blood to the fetus. average range of length for the umbilical cord is - Answer 30-100cm, 55 avge in length with a diameters of 0.8-2cm influenced by amniotic fluid in what trimester does the fetus start to swallow, urinate and inspire amniotic fluid? - Answer second trimester if a newborn has tracheoesophageal atresia, what outcome can be expected? - Answer polyhydramnios whats the measurements for polyhydramnios? - Answer AFI >24cm, DVP 8cm or more what are some etiologies of polyhydramnios ? - Answer twin-twin transfusion, gestational diabetes, multiples , isoimunization , fetal infection, fetal anomalies signs and symptoms of polyhydramnios - Answer uterine size greater than dates ( fundal height 3-4cm off ) , difficult auscultation, materal dyspnea, heartburn , nausea Outcomes associated with having polyhydramnios - Answer fetal mortality, preterm labor, PP hemorrhage , cord prolapse what should you do for a patient with polyhydramnios? - Answer monitor with serial NST and Weekly BPP starting at 34 weeks offer amniocentesis if the AFI exceeds 35cm indomethacin- impairs production of lung liquid or decreases fetal urine production define measurements for oligohydramnios - Answer afi < 5cm , dvP < 2cm an infant born to a mother with oiligohydramnios would have which condintion? other possible causes are ?? - Answer Renal agenesis post term pregnancy demise growth restriction anomalies oligohydramnios can result in what serious condition? - Answer pulmonary hypoplasia resulting in still birth a mother with oligo might receive which treatment during IP - Answer amnioinfusion organogenesis begins - Answer in the 3rd week and spans for 8 weeks. what causes the pregnancy test to turn positive ? - Answer Hcg found in the urine . produced by the corpus luteum. Fourth week of the embryonic period - Answer limb buds form; heart is noticeable and beating; nervous system is prominent; embryo has a tail; other systems form Sixth week of the embryonic period - Answer Fingers and Toes are present; Skeleton is cartilaginous when does fetal development begin.? - Answer 8 weeks after fertilization 10 weeks after LMP a 12 week fetus can be palpated where? 20 weeks? - Answer at the level of the symphisis at the level of the umbilicus how is fetal lung maturity measured ? - Answer Lecithin:Sphingomyelin ratio >2 with the presence of phosphatidylglycerol Presumtive signs of pregnancy - Answer SUBJECTIVE -Nausea/vomiting, amenorrhea, breast changes, fatigue, urinary frequency, belief of pregnancy Probable signs of pregnancy - Answer examiner suspects a women is pregnant. such as abdominal enlargement, hegar's sign(softening and compressibility of the lower uterus), chadwick's sign (deepened violet-bluish color of the cervix and vaginal mucosa), goodell's sign(softening of the cervical tip), ballottement, braxton hicks, positive pregnancy test, fetal outline felt by examiner. Positive signs of pregnancy - Answer Fetal skeleton on X-ray Fetal presence on ultrasound Auscultation of FHR (heard at week 8, most likely at 10 and should be heard by 12) Examiner palpates fetal movement crump rump length is accurate when ? - Answer 1st trimester 3-5 days the FL and BPD are most accurate when ? - Answer 2nd trimester , 7-10 days describe the uterus in the 1st trimester - Answer soft and globular and aysymetric, at 12 weeks 8-10cm and rising out of the pelvis. positive piskaceks sign the softening of the itshmus would reveal what positive sign ? - Answer Hegar sign- probable sign of pregnancy how long does the corpus luteum work until the placenta kicks in ? - Answer 12 weeks . under the influence of HCG What are the 4 pelvic types? - Answer 1. Gynecoid- female pelvis 2. Android- poor vaginal outcomes- c-sections 3. Anthropoid-favors posterior position of the fetus. large size- adequate for vaginal birth 4. Platypelloid- RARE - C-section GI effects of pregnancy - Answer bleeding gums excess salvation decreased lower esophageal sphincter heartburn decreased gastric emptying displaced intestines appendix, cecum altered liver production of enzymes genitourinary effects of pregnancy - Answer increased renal blood flow GFR increased 40-50% water rention and sodium retention How high does the diaphragm rise due to growing uterus? - Answer 4 cm a pregnant might have which type of ABGS - Answer Mild Respiratory alkalosis with compensation. due to low PCO2 also pysiologic dyspnea what percentage does the blood volume increase in pregnant woman? - Answer 30-50% physiologic anemia of pregnancy - Answer Apparent anemia that results because during pregnancy the plasma volume increases more than the erythrocytes increase. increase in factor I, VII -X result in what? (fibrinongen) - Answer hypercoagable state Cardiovascular changes in pregnancy - Answer increase in cardiac volume 10% increased cardiac output heart moves up and to the left systolic murmer common audible 3rd sound or soft transient diastolic murmer what causes pregnancy hyperpigmentation - Answer increased in estrogen and progesterone pregnancy thyroid levels - Answer Euthyroid- doe to estrogen increase and TBG neonatal period - Answer first 28 days of life perinatal period - Answer period beginning about the seventh month (22 weeks)of pregnancy and continuing until about four weeks after birth fetal death - Answer death in utero at 20 weeks or more gestation Neonatal death - Answer The death of a live-born infant within the first 27 days, 23 hours, and 59 minutes following the moment of birth neonatal mortality rate - Answer The death rate among newborns in the first 28 days of life. per 1000 live births Perinatal mortality rate - Answer Number of stillbirths and number of neonatal deaths per 1000 live births infant mortality rate - Answer The total number of deaths in a year among infants under one year old for every 1,000 live births in a society. Maternal Mortality Rate - Answer The number of women who die giving birth per 100,000 births post term pregnancy - Answer >42 weeks para - Answer number of pregnancies carried to the 20th week if gestation no matter the outcome leopolds - Answer maneuvers to determine fetal position, lie, presentation, attitude, weight and variety 3 pelvic planes - Answer inlet, midplane and the pelvic brim how would you asses the diagonal conjugate? - Answer should be more than 11.5cm extends from the middle of sacral promontory to the middle lower margin of the symphysis what should the pubic arch measure? - Answer at-least 90 degrees the interspinous diamter , also known as the distance between the _____ should measure ______ it also defines the ____ - Answer A. ischial spines B. 10cm C. Midplane the ischial spines should feel ____ - Answer blunt the interuberous diameter is the distance between the ____ and ___ and should measure ____ - Answer ischial tuberosities 10cm 1st trimester screening performed between ___ and ___ weeks combines testing of ___ and ____ also measures _____ via ultrasound together this calculates the risk for __________ . ______ - Answer 10 and 13 weeks pregnancy associated plasma protein (PAPP) and Hcg nuchal translucency trisonomy 18 and 21 Second trimester screen (Quad ) - performed between ___ and ___ weeks what are the four serums testing What else is performed and when ? what are we screening for ? - Answer 15 and 22 weeks Maternal serum alphafetoprotein(MSFP) Estriol Inhibin A Hcg Ultrasound. between 18-20 weeks for anatomy. trisomy 18, 21 and neural tube defects cell-free DNA screening can be performed as early as The test screens for ___ if results positive proceded to ___ - Answer 10 weeks aneuploidy (13, 18, 21) and sex chromosomes diagnostic testing- amniocentesis or Chorionic villus sampling what labs do you repeat in the 3rd trimester ? - Answer GBS - 35-37 weeks ANtibodied RH -28 weeks GC/Chlam - 36 weeks cbc rpr hiv type and screen Match the disease to the race African Mediterranean/east asian Jewish - Answer sickell cell beta thalasemia tay sachs NVP Non-pharm - Answer take prenatal vitamins 3 months prior to conception small frequent meals. 1-2hrs food high in protein bland foods before getting up d/c iron but continue folic acid