Ob/Gyn Shelf Exam with Questions
and Answers
What is postabortal syndrome and how is it treated? - ✔✔Uterus fails to remain contracted
after spontaneous abortion or elective abortion (pain, bleeding, open cervix, hematometra)
Suction curettage
At what beta-hCG level can an intrauterine pregnancy be appreciated? - ✔✔>2000
Most common abnormal karyotope in aborted fetuses - ✔✔Autosomal trisomy
Systemic maternal diseases associated w/ early pregnancy loss - ✔✔DM, SLE, CKD
Rx for significant anemia during spontaneous abortion - ✔✔D
Effect of single, prior first trimester surgical abortion on fertility/ likelihood of future early
pregnancy losses - ✔✔No effect/ no increased risk
Once pt at high risk for cervical cancer and has lesion, management option - ✔✔Cervical biopsy
(can skip Pap smear, a screening test, as well as colposcopy since lesion can already be visualized)
Screening tests for a normal African American couple wanting to conceive - ✔✔CBC and Hb
electrophoresis
,Valproic acid is associated with an increased risk of these three abnormalities - ✔✔Neural
tube defects, hydrocephalus and craniofacial malformations
Women with poorly controlled DM during organogenesis are at risk for structural anomalies in these
two systems - ✔✔CNS and CV
Chorionic villus sampling is used to detect - ✔✔Chromosomal abnormalities
Three components of triple screen extra of quad screen - ✔✔AFP, hCG, unconjugated estriol
Inhibin A
Test for Down's in first trimester - ✔✔PAPP A (pregnancy associated plasma protein A)
Risk of fetal loss with CVS - ✔✔1%
Most sensitive screen for Down's in second trimester (and its sensitivity) - ✔✔Quad screen, 80-85%
Risks of gestational diabetes - ✔✔Shoulder dystocia, metabolic disturbances,
preeclampsia, polyhydramnios and fetal macrosomia
Risk of pre-existing, but not gestational, diabetes - ✔✔IUGR
Most common anomaly associated with valproic acid - ✔✔NTDs
Definition of postpartum hemorrhage - ✔✔>500cc in a vaginal delivery or >1000cc in a C section
Most common cause of postpartum hemorrhage - ✔✔Uterine atony
,Significant blood loss during delivery --> inability to breast feed, amenorrhea, constipation, slurred
speech - ✔✔Sheehan Syndrome
Cause of Sheehan Syndrome - ✔✔Anterior pituitary necrosis after significant blood loss
Hormones affected by Sheehan Syndrome - ✔✔Gonadotropin, TSH, ACTH
Increased risk of endometritis - ✔✔C section
With vaginal delivery: prolonged labor, prolonged ROM, multiple vaginal exams, internal fetal
monitoring, manual removal of placenta, low SES
Most common cause of postpartum fever - ✔✔Endometritis
Most common bacteria in postpartum endometritis - ✔✔Polymicrobial, aerobes anaerobes
(often staph and strep)
Sign that can distinguish postpartum depression from postpartum blues - ✔✔Ambivalence
toward newborn/ family
Safest method of suppressing lactation - ✔✔Breast binding, ice packs and analgesics
Cause of a normocytic anemia in pregnancy - ✔✔Hemodilution: maternal blood volume
increases more than RBC volume
(iron deficiency would cause microcytic)
Physiologic respiratory/ acid base changes during pregnancy - ✔✔Increased minute ventilation --
> compensated respiratory alkalosis
, Why does minute ventilation change in pregnancy? - ✔✔Because tidal volume increases (RR
stays constant)
Why are pregnant women susceptible to pulmonary edema? - ✔✔Decreased plasma osmolality
Tocolysis with alpha agonists (e.g. terbutaline) increases the risk of this respiratory finding -
✔✔Pulmonary edema
Hydronephrosis is more common on which side during pregnancy? - ✔✔Right
Snowstorm pattern on ultrasound - ✔✔Gestational trophoblastic disease
First step in the work-up of GTD - ✔✔CXR (will need weekly quants and a CBC as well)
Substance that produces insulin resistance? - ✔✔Chorionic somatomammotropin (previously
called human placental lactogen)
Does insulin cross the placenta? - ✔✔No
Normal PVR - ✔✔50-60cc
PVR > 300cc indicates - ✔✔Overflow incontinence (due to underactive detrusor muscle
or obstruction)
Name for detrusor overactivity incontinence (e.g. when bladder is contracting too frequently) -
✔✔Urge incontinence
Incontinence due to increased abdominal pressure in the absence of a detrusor contraction
- ✔✔Genuine stress incontinence
and Answers
What is postabortal syndrome and how is it treated? - ✔✔Uterus fails to remain contracted
after spontaneous abortion or elective abortion (pain, bleeding, open cervix, hematometra)
Suction curettage
At what beta-hCG level can an intrauterine pregnancy be appreciated? - ✔✔>2000
Most common abnormal karyotope in aborted fetuses - ✔✔Autosomal trisomy
Systemic maternal diseases associated w/ early pregnancy loss - ✔✔DM, SLE, CKD
Rx for significant anemia during spontaneous abortion - ✔✔D
Effect of single, prior first trimester surgical abortion on fertility/ likelihood of future early
pregnancy losses - ✔✔No effect/ no increased risk
Once pt at high risk for cervical cancer and has lesion, management option - ✔✔Cervical biopsy
(can skip Pap smear, a screening test, as well as colposcopy since lesion can already be visualized)
Screening tests for a normal African American couple wanting to conceive - ✔✔CBC and Hb
electrophoresis
,Valproic acid is associated with an increased risk of these three abnormalities - ✔✔Neural
tube defects, hydrocephalus and craniofacial malformations
Women with poorly controlled DM during organogenesis are at risk for structural anomalies in these
two systems - ✔✔CNS and CV
Chorionic villus sampling is used to detect - ✔✔Chromosomal abnormalities
Three components of triple screen extra of quad screen - ✔✔AFP, hCG, unconjugated estriol
Inhibin A
Test for Down's in first trimester - ✔✔PAPP A (pregnancy associated plasma protein A)
Risk of fetal loss with CVS - ✔✔1%
Most sensitive screen for Down's in second trimester (and its sensitivity) - ✔✔Quad screen, 80-85%
Risks of gestational diabetes - ✔✔Shoulder dystocia, metabolic disturbances,
preeclampsia, polyhydramnios and fetal macrosomia
Risk of pre-existing, but not gestational, diabetes - ✔✔IUGR
Most common anomaly associated with valproic acid - ✔✔NTDs
Definition of postpartum hemorrhage - ✔✔>500cc in a vaginal delivery or >1000cc in a C section
Most common cause of postpartum hemorrhage - ✔✔Uterine atony
,Significant blood loss during delivery --> inability to breast feed, amenorrhea, constipation, slurred
speech - ✔✔Sheehan Syndrome
Cause of Sheehan Syndrome - ✔✔Anterior pituitary necrosis after significant blood loss
Hormones affected by Sheehan Syndrome - ✔✔Gonadotropin, TSH, ACTH
Increased risk of endometritis - ✔✔C section
With vaginal delivery: prolonged labor, prolonged ROM, multiple vaginal exams, internal fetal
monitoring, manual removal of placenta, low SES
Most common cause of postpartum fever - ✔✔Endometritis
Most common bacteria in postpartum endometritis - ✔✔Polymicrobial, aerobes anaerobes
(often staph and strep)
Sign that can distinguish postpartum depression from postpartum blues - ✔✔Ambivalence
toward newborn/ family
Safest method of suppressing lactation - ✔✔Breast binding, ice packs and analgesics
Cause of a normocytic anemia in pregnancy - ✔✔Hemodilution: maternal blood volume
increases more than RBC volume
(iron deficiency would cause microcytic)
Physiologic respiratory/ acid base changes during pregnancy - ✔✔Increased minute ventilation --
> compensated respiratory alkalosis
, Why does minute ventilation change in pregnancy? - ✔✔Because tidal volume increases (RR
stays constant)
Why are pregnant women susceptible to pulmonary edema? - ✔✔Decreased plasma osmolality
Tocolysis with alpha agonists (e.g. terbutaline) increases the risk of this respiratory finding -
✔✔Pulmonary edema
Hydronephrosis is more common on which side during pregnancy? - ✔✔Right
Snowstorm pattern on ultrasound - ✔✔Gestational trophoblastic disease
First step in the work-up of GTD - ✔✔CXR (will need weekly quants and a CBC as well)
Substance that produces insulin resistance? - ✔✔Chorionic somatomammotropin (previously
called human placental lactogen)
Does insulin cross the placenta? - ✔✔No
Normal PVR - ✔✔50-60cc
PVR > 300cc indicates - ✔✔Overflow incontinence (due to underactive detrusor muscle
or obstruction)
Name for detrusor overactivity incontinence (e.g. when bladder is contracting too frequently) -
✔✔Urge incontinence
Incontinence due to increased abdominal pressure in the absence of a detrusor contraction
- ✔✔Genuine stress incontinence
