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APEA Pregnancy-Questions with Correct Answers/ Verified
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Pre pregnancy: 0.4 mg (400 mcg) • Pregnancy confirmed: 1 mg (1,000 mcg) - cdc folic acid • Ginger, saltines, ginger ale • Avoid ondansetron (Zofran), a 5-HT3 antagonist • Diclegis (FDA indication): first-line option Doxylamine succinate 10 mg (antihistamine) Pyridoxine 10 mg (B6) Sig: ...

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  • August 21, 2024
  • 8
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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APEA Pregnancy-Questions with Correct Answers/ Verified

Pre pregnancy: 0.4 mg (400 mcg)



• Pregnancy confirmed: 1 mg (1,000 mcg) - ✔✔cdc folic acid



• Ginger, saltines, ginger ale

• Avoid ondansetron (Zofran), a 5-HT3 antagonist

• Diclegis (FDA indication): first-line option Doxylamine succinate 10 mg (antihistamine) Pyridoxine
10 mg (B6) Sig: 2 tabs HS If symptoms persist, add 1 tab in am - ✔✔Nausea in Pregnancy?



• Urine: sensitive 9-12 days after conception • Serum: sensitive 8-11 days after conception (best
test); most sensitive and specific test - ✔✔Pregnancy Testing: OTC vs Office Labs?



Subtract 3 months from LMP

Add 7 days, Add 1 year

Pregnancy = 281-282 days • Note:

Not used any more - ✔✔Establishing the Due Date • Naegele's Rule?



• ACOG, AMA guidelines recommend

• "Routine assessment of ALL pregnant women for domestic violence" • Often begins or worsens
during pregnancy and postpartum

• 7-20% of pregnant women are physically abused

• If pregnancy unintended, 3X higher rate

• More medical problems during pregnancy and delivery compared to women who are not abused -
✔✔Domestic Violence Screening?



• Age <35 years • Single, divorced, separated • Alcohol or drugs: patient and/or partners • Smoker •
Childhood: physical or sexual abuse



Domestic Violence Clues • Bruising • Improbable injury • Depression, anxiety • Late prenatal care
(after 1st trimester) • Missed prenatal visits • Cancellation of appt (short notice) • Overprotective
partner If female, might indicate human trafficking - ✔✔abuse Risk Factors?

, Pregnancy Testing First

• Urine hCG: usually sufficient

• Serology: if problems/suspect ectopic

• Normal Pregnancy hCG doubles every 24-72 hours in 1st trimester - ✔✔Initial Labs for
pregnanacy?



-CBC

-URINALYSIS

-URINE CULTURE

-Blood type and Rh: antibody screening

-RUBELLA IMMUNITY (If immune, not needed If not immune, immunize after delivery and avoid
infected people!!!)

-TSH - ✔✔Standard Diagnostic Studies at 1st prenatal visit?



• HIV: first, third trimester

• Chlamydia: ages <25 years

• GC: If high risk, especially if <25 years

• Syphilis

• Hepatitis A, B, C (per risk)

• BV, Trich: consider screening

• HSV Type 2: if at high risk or symptomatic - ✔✔Pregnancy: STI Screening per 2021 CDC Guidelines?



• First trimester:



• Second trimester:



• Third trimester: - ✔✔Ultrasound: Indications:



confirm due date, fetal development, identify abnormalities

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