PAEA OBGYN EOR Topic Questions with 100% Correct Answers

1. G2 P1001 2. G4 P1111 3. G3 P2103 Correct Answer 1. currently pregnant, 1 term delivery, 1 living child 2. currently pregnant, 1 term delivery, 1 preterm delivery, 1 abortion/miscarriage, 1 living child (cannot tell if it is term or preterm child by formula) 3. currently pregnant, twins at term, 1 at preterm, 3 living children G (# pregnancies) T (# term deliveries at 37 weeks or more including stillbirths) P (# preterm deliveries at 20-37 weeks) A (abortions <20 weeks including miscarriages) L (# living children) a previable fetus is defined as Correct Answer <24 weeks old (varies w/ guidelines) what are the routine test during the first prenatal visit? Correct 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 Correct Answer serum B-hCG: 5 days after conception urine B-hCG: 14 days after conception how is estimated date of delivery (EDD) determined? Correct 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? Correct 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? Correct 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? Correct 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? Correct Answer Ladin's sign the uterine isthmus softening after 6-8 weeks gestation is what sign? Correct Answer Hegar's sign bluish coloration of the cervix & vulva around 8-12 weeks is what sign? Correct 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? Correct Answer Piskacek's sign cervical softening of the cervix and vulva around 8-12 wks Correct Answer Goodell's sign what are the # weeks in each trimester? Correct Answer 1st tri: 1-12 2nd tri: 13-27 3rd tri: 28-birth what should be checked at routine first trimester visits? Correct 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? Correct Answer -above the pubic symphysis? 12 wks -midway between pubic symphysis/umbilicus? 14-16 wks -at umbilicus? 20 wks