OBGYN COMAT Questions with 100% Correct
Answers
Young Mother 32 weeks pregnant presents with normal
EKG but abnormally positioned heart, how should this be
handled? Correct Answer: 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? Correct Answer:
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? Correct
Answer: 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?
Correct Answer: About 20%, thus increasing the risk of
postpartum hemorrhage.
Normal cardiac findings during pregnancy? Correct
Answer: 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? Correct Answer: Diastolic murmurs 100% are
not good in pregnancy
Young Mother weeks pregnant presents with recurrent
"Flu Like Symptoms", Explain this? Correct Answer: This
could be something completely normal. Allergy, due to
mucosal hypermeia like symptoms nasal stuffiness and
secretions.
Hematologic changes during pregnancy? Correct
Answer: 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? Correct Answer:
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? Correct Answer: 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.
Gastrointestinal Functional Changes Correct Answer:
Generalized Smooth muscle relaxation meaning the LES
Answers
Young Mother 32 weeks pregnant presents with normal
EKG but abnormally positioned heart, how should this be
handled? Correct Answer: 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? Correct Answer:
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? Correct
Answer: 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?
Correct Answer: About 20%, thus increasing the risk of
postpartum hemorrhage.
Normal cardiac findings during pregnancy? Correct
Answer: 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? Correct Answer: Diastolic murmurs 100% are
not good in pregnancy
Young Mother weeks pregnant presents with recurrent
"Flu Like Symptoms", Explain this? Correct Answer: This
could be something completely normal. Allergy, due to
mucosal hypermeia like symptoms nasal stuffiness and
secretions.
Hematologic changes during pregnancy? Correct
Answer: 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? Correct Answer:
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? Correct Answer: 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.
Gastrointestinal Functional Changes Correct Answer:
Generalized Smooth muscle relaxation meaning the LES
