EDSYN PTBC COMPREHENSIVE EXAM
STUDY GUIDE WITH COMPLETE
SOLUTIONS
●● a previable fetus is defined as
Answer: <24 weeks old (varies w/ guidelines)
●● what are the routine test during the first prenatal visit?
Answer: blood pressure, blood type & Rh, CBC, UA (glucose &
protein), random glucose, HBsAg, Hep C, HIV, syphilis, rubella titer,
VZV titer, pap, sickle cell & CF screening
●● diagnosis of pregnancy can be detected by serum B-hCG at ____
days after conception and by urine B-hCG at ____ days after conception
Answer: serum B-hCG: 5 days after conception
urine B-hCG: 14 days after conception
●● how is estimated date of delivery (EDD) determined?
Answer: Naegele's Rule: from 1st day of LMP
1. subtract 3 mos, add 7 days, add 1 year
2. add 9 mos & 7 days
ex: LMP started 8/7/16 = EDD: 5/14/17
,●● when estimating gestational age on US what measurements can you
use?
Answer: 1. crown rump length (CRL)
2. biparietal diameter
3. head circumference
4. abdominal circumference
5. femur length
●● what physical exam and lab tests should be performed on initial visit
of a pregnant patient?
Answer: full physical exam, BP, pelvic exam w/ pap smear (unless done
in last 6 mos), G/C Cx's, bimanual exam to check size of uterus and help
estimate # weeks into pregnancy, US if unsure of LMP to date # weeks
labs: CBC (r/o anemia), blood type & Ab screen + Rh status, RPR,
HBSAg, rubella Ab screen, VZV Ab screen if no h/o chickenpox, UA w/
Cx, blood glucose, HIV, sickle cell/CF screen, PPD in high risk pts,
screening for aneuploidy offered (inc or dec free B-hCG, PAPP-A low
w/ down syndrome, inc nuchal translucency @10-13 weeks US)
●● what are the screening tests for aneuploidy (including down
syndrome)? when are they performed?
Answer: ALL offered around 10-13 weeks
,1. free B-hCG (high or low can be indicative of abnormalities)
2. PAPP-A (usually low w/ DS)
3. nuchal translucency (inc thickness on US)
4. if any above + can be offered chorionic villus sampling (or if they
have any RF for aneuploidy such as advanced maternal age/AMA,
previous child w/ chromosomal abnmlity, abnml US, prior pregnancy
losses) but inc r/o spontaneous abortion w/ procedure
*amniocentesis offered around 15-18 weeks w/ same indications as CVS
(both can diagnose chromosomal abnormalities and have risk of
spontaneous abortion)
●● the uterus softening at 6 weeks is what sign?
Answer: Ladin's sign
●● the uterine isthmus softening after 6-8 weeks gestation is what sign?
Answer: Hegar's sign
●● bluish coloration of the cervix & vulva around 8-12 weeks is what
sign?
Answer: Chadwick's sign
●● a palpable lateral bulge or softening of the uterine cornus (where
uterus meets fallopian tubes) at 7-8 weeks gestation is what sign?
, Answer: Piskacek's sign
●● cervical softening of the cervix and vulva around 8-12 wks
Answer: Goodell's sign
●● what are the # weeks in each trimester?
Answer: 1st tri: 1-12
2nd tri: 13-27
3rd tri: 28-birth
●● what should be checked at routine first trimester visits?
Answer: BP, weight, urine dipstick, measurement of uterus/fundal
height, auscultation of fetal heart sounds at 10-12 weeks (nml 120-160)
●● what week should the uterus/fundal height measure above the pubic
symphysis? midway between pubic symphysis/umbilicus? at umbilicus?
2-3cm below xiphoid process?
Answer: -above the pubic symphysis? 12 wks
-midway between pubic symphysis/umbilicus? 14-16 wks
-at umbilicus? 20 wks
-2-3cm below xiphoid process? 38 wks
STUDY GUIDE WITH COMPLETE
SOLUTIONS
●● a previable fetus is defined as
Answer: <24 weeks old (varies w/ guidelines)
●● what are the routine test during the first prenatal visit?
Answer: blood pressure, blood type & Rh, CBC, UA (glucose &
protein), random glucose, HBsAg, Hep C, HIV, syphilis, rubella titer,
VZV titer, pap, sickle cell & CF screening
●● diagnosis of pregnancy can be detected by serum B-hCG at ____
days after conception and by urine B-hCG at ____ days after conception
Answer: serum B-hCG: 5 days after conception
urine B-hCG: 14 days after conception
●● how is estimated date of delivery (EDD) determined?
Answer: Naegele's Rule: from 1st day of LMP
1. subtract 3 mos, add 7 days, add 1 year
2. add 9 mos & 7 days
ex: LMP started 8/7/16 = EDD: 5/14/17
,●● when estimating gestational age on US what measurements can you
use?
Answer: 1. crown rump length (CRL)
2. biparietal diameter
3. head circumference
4. abdominal circumference
5. femur length
●● what physical exam and lab tests should be performed on initial visit
of a pregnant patient?
Answer: full physical exam, BP, pelvic exam w/ pap smear (unless done
in last 6 mos), G/C Cx's, bimanual exam to check size of uterus and help
estimate # weeks into pregnancy, US if unsure of LMP to date # weeks
labs: CBC (r/o anemia), blood type & Ab screen + Rh status, RPR,
HBSAg, rubella Ab screen, VZV Ab screen if no h/o chickenpox, UA w/
Cx, blood glucose, HIV, sickle cell/CF screen, PPD in high risk pts,
screening for aneuploidy offered (inc or dec free B-hCG, PAPP-A low
w/ down syndrome, inc nuchal translucency @10-13 weeks US)
●● what are the screening tests for aneuploidy (including down
syndrome)? when are they performed?
Answer: ALL offered around 10-13 weeks
,1. free B-hCG (high or low can be indicative of abnormalities)
2. PAPP-A (usually low w/ DS)
3. nuchal translucency (inc thickness on US)
4. if any above + can be offered chorionic villus sampling (or if they
have any RF for aneuploidy such as advanced maternal age/AMA,
previous child w/ chromosomal abnmlity, abnml US, prior pregnancy
losses) but inc r/o spontaneous abortion w/ procedure
*amniocentesis offered around 15-18 weeks w/ same indications as CVS
(both can diagnose chromosomal abnormalities and have risk of
spontaneous abortion)
●● the uterus softening at 6 weeks is what sign?
Answer: Ladin's sign
●● the uterine isthmus softening after 6-8 weeks gestation is what sign?
Answer: Hegar's sign
●● bluish coloration of the cervix & vulva around 8-12 weeks is what
sign?
Answer: Chadwick's sign
●● a palpable lateral bulge or softening of the uterine cornus (where
uterus meets fallopian tubes) at 7-8 weeks gestation is what sign?
, Answer: Piskacek's sign
●● cervical softening of the cervix and vulva around 8-12 wks
Answer: Goodell's sign
●● what are the # weeks in each trimester?
Answer: 1st tri: 1-12
2nd tri: 13-27
3rd tri: 28-birth
●● what should be checked at routine first trimester visits?
Answer: BP, weight, urine dipstick, measurement of uterus/fundal
height, auscultation of fetal heart sounds at 10-12 weeks (nml 120-160)
●● what week should the uterus/fundal height measure above the pubic
symphysis? midway between pubic symphysis/umbilicus? at umbilicus?
2-3cm below xiphoid process?
Answer: -above the pubic symphysis? 12 wks
-midway between pubic symphysis/umbilicus? 14-16 wks
-at umbilicus? 20 wks
-2-3cm below xiphoid process? 38 wks
