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PAEA OBGYN EOR Topics questions and answers rated A+ 2024/2025
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PAEA OBGYN EOR Topics1. G2 P1001
2. G4 P1111
3. G3 P2103 - ANS1. Currently pregnant, 1 time period delivery, 1 living child
2. Presently pregnant, 1 term shipping, 1 preterm shipping, 1 abortion/miscarriage, 1 residing
baby (cannot inform if it's far term or preterm toddler by formula)
three. Currently pregnant, twins at term, 1 at preterm, three living children
G (# pregnancies)
T (# time period deliveries at 37 weeks or more along with stillbirths)
P (# preterm deliveries at 20-37 weeks)
A (abortions <20 weeks inclusive of miscarriages)
L (# dwelling kids)
a previable fetus is defined as - ANS<24 weeks old (varies w/ guidelines)
what are the routine test during the first prenatal visit? - ANSblood 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 - ANSserum B-hCG: 5 days after conception
urine B-hCG: 14 days after conception
how is estimated date of delivery (EDD) determined? - ANSNaegele'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? - ANS1. 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? -
ANSfull 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? - ANSALL 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? - ANSLadin's sign
the uterine isthmus softening after 6-8 weeks gestation is what sign? - ANSHegar's sign
bluish coloration of the cervix & vulva around 8-12 weeks is what sign? - ANSChadwick'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? - ANSPiskacek's sign
cervical softening of the cervix and vulva around 8-12 wks - ANSGoodell's sign
what are the # weeks in each trimester? - ANS1st tri: 1-12
2nd tri: 13-27
3rd tri: 28-birth
what should be checked at routine first trimester visits? - ANSBP, 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? - ANS-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
,after 20 weeks gestation, the fundal height should measure +/- ____cm from the # of weeks -
ANS+/- 2 cm
when are fetal heart tones audible with doppler US? What rate is nml? - ANS10-12 weeks (end
of 1st trimester) at 120-160 bpm
what is the quad screen test for? What are the tests? When is it performed? - ANS-to screen for
trisomy 21 (down syndrome), trisomy 18, and NTD like spina bifida
-tests: alpha-feto protein, B-hCG, estradiol, and inhibin-A
-performed at 15-20 weeks
-can be performed w/ 1st trimester screening - called "integrated screening"
what would you expect with the quad screen if a baby had down syndrome? - ANSa-FP: low
B-hCG: high
estradiol: low
inhibin-A: high (always high in chromosomal abnormalities)
when can a fetus be detected by pelvic US? - ANS5-6 weeks
what would you expect with the quad screen if a baby had a neural tube defect? - ANSa-FP:
*high*
B-hCG: N/A
estradiol: N/A
inhibin-A: high (always high in chromosomal abnormalities)
what would you expect with the quad screen if a baby had trisomy 18? - ANSa-FP: low
B-hCG: low
estradiol: low
inhibin-A: high (always high in chromosomal abnormalities)
the anatomy ultrasound (checking for amniotic fluid level, fetal viability, growth, and anatomy) is
performed at how many weeks? - ANS18-22 weeks
when is gestational diabetes screened for? What is the screening test & BS limit? What is the
diagnostic test and & BS limits? - ANS-24-28 weeks
-glucose loading test (GLT): 50g given and serum glucose checked 1 hr later- failed if BS ≥140
-glucose tolerance test (GTT): fasting BS checked (≥95) then 100g glucose given and BS
checked at 1 hr (≥180), 2 hr (≥155), 3 hr (≥140); failure = at least 2/4
when is "quickening" aka fetal movement felt? - ANS16-20 weeks
how often are OB visits scheduled? - ANSQ4 weeks first 2 trimesters, 1-28 wks
Q2 weeks 28-36 wks
Qwk 36-birth
, what tests/physical examinations should be performed at third trimester visits? - ANS-repeat Ab
titers in unsensitized Rh(-) mothers followed by RhoGAM @ 28 weeks & w/I 72 hrs of childbirth
-group B streptococcus screening @ 32-37 weeks via vaginal-rectal Cx
-H/H @ 35 weeks
-biophysical profile/BPP if there are complications: (5 variables: fetal breathing, fetal tones,
amniotic fluid levels, NST (nonstress test), & gross fetal movements - 2 pts each)
-non-stress testing: baseline fetal HR 120-160
-Leopold maneuvers to determine fetal presentation, or US if cannot determine (can do external
cephalic version if breech presentation)
-after 37 weeks sweeping membranes offered at weekly visits to help induce labor
In high risk individuals what tests are run again in the third trimester? Prophylactic tx? -
ANS-G/C Cx
-if + HSV, prophylactic acyclovir initiated at 36 weeks
-if + GB strep, IV PCN given when presenting in labor
what are the hematologic effects of pregnancy? - ANS-dilutional anemia (plasma vol inc by 50%
but RBCs only inc by 20-30%)
-WBC increases (especially during stress of labor- ppl confuse this with sepsis)
-platelets dec
-hypercoagulable state (inc thromboembolic events d/t Virchows triad- venous stasis,
endothelial damage, hypercoagulability & inc in factors VII-X and fibrinogen)
-iron deficiency anemia (d/t inc demand on hematopoiesis)
nonstress testing is reactive when? - ANS-2 or more accelerations in 20 minutes
-fetal HR inc 15 or more bpm from baseline lasting 15 or more seconds
what are the effects of pregnancy on the heart and BP? - ANS-CO increases by 30-50% (first in
SV then in HR and a dec in SVR)
-BP decreases slightly (so if there is an inc be suspicious of preE/eclampsia)
dyspnea of pregnancy occurs in 60-70% of pts and is d/t - ANSdec PaCO2 levels, inc tidal
volume, decrease TLC
what GI changes occur in pregnancy? - ANSN/V (>70%), not on time gastric empyting & dec
gastroesophageal sphincter tone (= GERD), dec motility of lg bowel (= constipation)
what kidney adjustments occur in pregnancy? - ANS-50% inc in GFR
-the kidneys inc in length and the ureters dilate (purpose of inc r/o pyelonephritis)
what are the effects of pregnancy on the endocrine system? - ANS-hyperestrogenic state
(produced through placenta)
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