OBGYN COMAT EXAM 2025/2026
QUESTIONS AND ANSWERS 100% PASS
Young Mother 32 weeks pregnant presents with normal EKG but abnormally positioned heart,
how should this be handled? - ANS This sounds like normal physiologic displacement of the
maternal heart in pregnancy.
The earliest and most dramatic physiologic changes in the mother in pregnancy are? -
ANS Cardiovascular
Aim to improve fetal oxygenation and nutrition
Maternal heart moves more lateral due to diaphragm elevation
Left ventricle and atrium muscle mass increases in relation to blood volume increase.
Cardiac Output increases 30-50% By about 8 weeks
Systemic Vascular Resistance Decreases due to Progesterone.
Young Mother in late pregnancy presents with huge decrease in CO due to obstruction,
explain? - ANS Most likely Vena Caval syndrome
Enlarging uterus has compressed the inferior Vena Cava.
In the supine station, the obstruction can be close to 100%
1/10 women can present with dizziness and light-headedness and syncopy.
At term what percent of the CO goes to the uterus? - ANS About 20%, thus increasing the
risk of postpartum hemorrhage.
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,Normal cardiac findings during pregnancy? - ANS Increased Splitting of the second heart
sound with inspiration, distended neck veins and low grade ejection systolic murmurs (
Increased blood flow across the aortic and mitral valves.
What heart findings are not normal and need to be evaluated? - ANS Diastolic murmurs
100% are not good in pregnancy
Young Mother weeks pregnant presents with recurrent "Flu Like Symptoms", Explain this? -
ANS This could be something completely normal. Allergy, due to mucosal hypermeia like
symptoms nasal stuffiness and secretions.
Hematologic changes during pregnancy? - ANS Maternal blood volume increases about 35%
by term.
Can Cause a physiologic anemia. but all anemia needs to be treated.
Fe needs to be supplemented during pregnancy becasue the fetus will leach the Fe from the
mother.
Non-anemic women needs 60mg Fe/day.
60mg of Fe is a dosage of 325mg.
Anemia pt needs about 60 - 120 mg Fe/day
Clotting Factors are increased VII, VIII, IX and X. Inhibitors of clotting like C and S are decreased.
Oxygen carrying capacity changes? - ANS Maternal increase in Hbg and the mild respiratory
alkalosis cause a left shift in the dissociation curve meaning the maternal Hbg has an increases
affinity for O2 in the lungs but not in the tissues so more O2 is given of to the placenta.
Renal physiologic changes? - ANS There is increased renal plasma flow and thus increased
GFR.
This means that Trace amount of Glucose is normal and most likely doesn't mean glycemia
pathology. But it should be watched fro a trend.
There should not be any increase in urinary protein loss.
There is also a decrease in the Cr normal is about 0.4 to 0.8, any higher and I might get
suspicious.
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, Gastrointestinal Functional Changes - ANS Generalized Smooth muscle relaxation meaning
the LES tone, decreased GI motility and increased Gal Bladder tone DUE TO PROGESTERONE.
GI Diagnostic test alterations in pregnancy - ANS ALK PHOS x 2
Cholesterol increased
Pregnancy induced Thyroid function? - ANS Overall its a Euthyroid state despite the changes.
Glad enlarges but not goiter like
hCG in the first trimester is like Thyrotropin and stimulates T4 but hCG declines and normalizes
T4
Estrogen induces the levels of Thyroxine binding globulin which binds free t3 and t4, this could
alter the free amount of hormone.
Changes of Metabolism during pregnancy? - ANS hPL acts as a diabetagenic that reduces the
body's sensitivity to insulin, which can cause hyperglycemia after meals.
Skin changes in pregnancy? - ANS All are due to the hunge increase in Estrogen
Palmar Erythema
Striae gravidarum
Skin darkening lina alba
Skin Nevi can also increase in size and color but should regress after pregnancy. You should still
consider removing them due to risk of malignancy.
Increased Acne due to increased Sebum production.
Loss of hair that will return to normal 6 months post delivery.
What Disease screen should always be performed on a pregnant female unless she declines? -
ANS HIV
It should also be offered to women who think they will become pregnant.
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
QUESTIONS AND ANSWERS 100% PASS
Young Mother 32 weeks pregnant presents with normal EKG but abnormally positioned heart,
how should this be handled? - ANS This sounds like normal physiologic displacement of the
maternal heart in pregnancy.
The earliest and most dramatic physiologic changes in the mother in pregnancy are? -
ANS Cardiovascular
Aim to improve fetal oxygenation and nutrition
Maternal heart moves more lateral due to diaphragm elevation
Left ventricle and atrium muscle mass increases in relation to blood volume increase.
Cardiac Output increases 30-50% By about 8 weeks
Systemic Vascular Resistance Decreases due to Progesterone.
Young Mother in late pregnancy presents with huge decrease in CO due to obstruction,
explain? - ANS Most likely Vena Caval syndrome
Enlarging uterus has compressed the inferior Vena Cava.
In the supine station, the obstruction can be close to 100%
1/10 women can present with dizziness and light-headedness and syncopy.
At term what percent of the CO goes to the uterus? - ANS About 20%, thus increasing the
risk of postpartum hemorrhage.
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,Normal cardiac findings during pregnancy? - ANS Increased Splitting of the second heart
sound with inspiration, distended neck veins and low grade ejection systolic murmurs (
Increased blood flow across the aortic and mitral valves.
What heart findings are not normal and need to be evaluated? - ANS Diastolic murmurs
100% are not good in pregnancy
Young Mother weeks pregnant presents with recurrent "Flu Like Symptoms", Explain this? -
ANS This could be something completely normal. Allergy, due to mucosal hypermeia like
symptoms nasal stuffiness and secretions.
Hematologic changes during pregnancy? - ANS Maternal blood volume increases about 35%
by term.
Can Cause a physiologic anemia. but all anemia needs to be treated.
Fe needs to be supplemented during pregnancy becasue the fetus will leach the Fe from the
mother.
Non-anemic women needs 60mg Fe/day.
60mg of Fe is a dosage of 325mg.
Anemia pt needs about 60 - 120 mg Fe/day
Clotting Factors are increased VII, VIII, IX and X. Inhibitors of clotting like C and S are decreased.
Oxygen carrying capacity changes? - ANS Maternal increase in Hbg and the mild respiratory
alkalosis cause a left shift in the dissociation curve meaning the maternal Hbg has an increases
affinity for O2 in the lungs but not in the tissues so more O2 is given of to the placenta.
Renal physiologic changes? - ANS There is increased renal plasma flow and thus increased
GFR.
This means that Trace amount of Glucose is normal and most likely doesn't mean glycemia
pathology. But it should be watched fro a trend.
There should not be any increase in urinary protein loss.
There is also a decrease in the Cr normal is about 0.4 to 0.8, any higher and I might get
suspicious.
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
, Gastrointestinal Functional Changes - ANS Generalized Smooth muscle relaxation meaning
the LES tone, decreased GI motility and increased Gal Bladder tone DUE TO PROGESTERONE.
GI Diagnostic test alterations in pregnancy - ANS ALK PHOS x 2
Cholesterol increased
Pregnancy induced Thyroid function? - ANS Overall its a Euthyroid state despite the changes.
Glad enlarges but not goiter like
hCG in the first trimester is like Thyrotropin and stimulates T4 but hCG declines and normalizes
T4
Estrogen induces the levels of Thyroxine binding globulin which binds free t3 and t4, this could
alter the free amount of hormone.
Changes of Metabolism during pregnancy? - ANS hPL acts as a diabetagenic that reduces the
body's sensitivity to insulin, which can cause hyperglycemia after meals.
Skin changes in pregnancy? - ANS All are due to the hunge increase in Estrogen
Palmar Erythema
Striae gravidarum
Skin darkening lina alba
Skin Nevi can also increase in size and color but should regress after pregnancy. You should still
consider removing them due to risk of malignancy.
Increased Acne due to increased Sebum production.
Loss of hair that will return to normal 6 months post delivery.
What Disease screen should always be performed on a pregnant female unless she declines? -
ANS HIV
It should also be offered to women who think they will become pregnant.
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
