____________is an associated with a higher risk of postpartum depression, according
to Medscape article.
A. Gestational Diabetes
B. Preeclampsia
C. ETOH use during pregnancy
D. Smoking - Answer-A - Gestational diabetes
https://reference.medscape.com/article/271662-overview#showall
."Test of cure" for UTI in pregnancy - Answer-Repeat urine culture 1 - 2 weeks after
completion of ABX treatment. (Recurrence is common.)
Herf BBB
.2 periods that comprise the 1st trimester - Answer-1) Embryonic period: 2 - 10 weeks
gestational age
2) Fetal period: 8 weeks after fertilization OR 10 weeks after onset of LMP
Decherney Ch 6
.3 categories of placental abruption - Answer-Grade 1) Small amount of vaginal
bleeding and abnormal uterine activity. FHR, mom's hemodynamics, and lab values are
all WNL.
Grade 2) Mild to moderate amt of vaginal bleeding. Uterine activity can be tetanic or
w/painful contractions. FHR may show ↓ variability, mom's hemodynamics may indicate
compensation (including orthostatic hypotension and tachycardia).
Grade 3) External uterine bleeding may be mild and concealed or severe. Painful,
tetanic uterus. Fetal death has occurred. Mom's hemodynamics are unstable, with ↓↓
volume depletion, hypotension and tachycardia.
DeCherney p 310
.4 assessments to perform at each prenatal visit - Answer-1) Maternal weight
2) Uterine fundal height
3) Maternal BP
4) Urinalysis by dipstick
DeCherney Ch 6
,.A 27 week pregnant pt calls the office and tells the triage nurse that she is having
abdominal pain, vaginal discharge, temperature of 101.0, and fetal movements of 1-2
per hour. You take the call because she has reported so many red flag signs. How
many red flag/danger signs of late pregnancy did she present?
a) 2,
b) 4,
c) 5,
d) 3. - Answer-B
.A 2nd trimester patient has come in and is new to you. She just moved here from
another state. You review her vitamins and medications. Besides her daily prenatal
vitamin and 0.4mg of folic acid, she lists 100mg/day of elemental iron. No medications.
You ask her if she has had any complications or been diagnosed with anything while
pregnant. You expect her to say:
a) yes, iron deficiency anemia, that's why I take the 100mg of iron every day,
b) nope, I haven't heard of anything, just taking the normal vitamins,
c) yes, high blood pressure, that is why I'm taking the 100mg of iron every day. -
Answer-A
If iron deficiency anemia is diagnoses, the elemental iron dose may be increased to 60 -
120 mg per day. -- DeCherney p 153
60 mg of elemental iron 2-3x day -- HERF BBB
.A 32 week pregnant patient c/o low back pain and joint pain asks what she can do to
alleviate her pain. You tell her that she can do which of the following options (SATA):
a) take 400mg ibuprofen TID,
b) light exercise and/or physical therapy,
c) a pelvic girdle or maternity sling,
d) aspirin PRN. - Answer-B and C
(No ibuprofen or aspirin due to bleeding risk)
HERF BBB
.A breastfeeding mother comes in complaining of shooting pains in her breast. You look
in her baby's mouth and see white patches. What do you diagnose this mother with and
what can be prescribed for the mother? - Answer-thrush/yeast infx. Diflucan can be rx'd
for mom.
Breastfeeding PPT
.A multip 3-week postpartum patient is concerned about her "poochy belly," and wants
to start Crossfit. You tell her:
a) "You need to wait 6-7 weeks to engage in vigorous exercise, for now, just lay in bed."
b) "You need to wait 8 weeks for vigorous exercise, but you can walk daily."
, c) "You need to wait 6-7 weeks to engage in vigorous exercise, but daily walking is a
good way to keep moving and improve your fitness safely."
d) "Call a plastic surgeon because that poochy belly isn't going to go away with
exercise." - Answer-C
.A patient calls and states that she has missed one period and wants to come in to test
for pregnancy. She has had no previous ectopics/miscarriages. Does the patient come
in at this time?
A. Yes, but have her take home pregnancy tests first for initial confirmation
B. No, it should be after two missed periods since no previous complications
C. Yes, that way you can check for other complications if she is not pregnant
D. No, she needs to have 3 missed periods and positive at home HCGs - Answer-B -
Depending on practice policy first visit usually starts after two missed periods (6-8
weeks); earlier if previous history of ectopic or greater than two spontaneous
miscarriages
HERF BBB
.A patient is 24 weeks pregnant. What should her fundal height be?
A. 30
B. 22
C. 24
D. 28 - Answer-C
After 20 weeks, one week = 1 cm
(For example at 34 weeks you would expect a 34 cm fundal height)
HERF BBB
.A postpartum patient is crying when you walk into her room. She says she heard her
nurse telling you--the rounding hospitalist--that she was having lochia rubra. She says:
"That sounds serious, what is it? And is there medicine to fix it?" You answer:
a) "We will have to administer a blood thinner to prevent clotting,"
b) "This happens from time to time, but as you increase movement--walking the halls,
etc.,--it will lessen,"
c) "No, this is a totally normal postpartum discharge and should lighten over the next
few days,"
d) "Actually, you will need an immediate D&C to remove and/or cauterize the
hemorrhaging vessels." - Answer-C
.A postpartum patient states she read that while she is breastfeeding, she doesn't have
to use birth control. You ask her if she is breastfeeding 100% of the time and how long
each session lasts. She admits that she is supplementing about 50% of the time with
formula, because, she says she is very tired. You tell her (BEST ANSWER):
, a) "It is okay to supplement if you cannot pump and store the milk, but for birth control
reasons, intermittently breastfeeding does not suppress ovulation entirely, the way
100% breastfeeding does."
b) "You should never supplement with formula, that is bad for the baby! But some
breastfeeding is good for suppressing ovulation."
c) "It sounds like you need to stop breastfeeding all together. You aren't committed to it
and you MUST be committed to it for it to work."
d) "That is great that you are breastfeeding, even half the time. Just remember that less
breastfeeding can reduce the mil - Answer-D
.A recurrence of ____% is noted for women who have had a previous history of
postpartum depression and psychosis.
A. 75%
B. 20%
C. 90%
D. 50% - Answer-C - 90%
https://reference.medscape.com/article/271662-overview#showall
.A score of 13 or above in the Edinburgh Postnatal Depression Scale, or EPDS,
indicates:
A. No depression noted
B. Depression of varying severity
C. Possible Depression - Answer-B
Medscape article
.A Zika NAT Serum test and a Zika NAT urine test are performed on a pregnant patient
who was exposed to Zika. The urine test was positive, but the serum test was negative.
What does this indicate?
A. They have an acute Zika virus infection
B. They need to have retesting
C. The test is negative since the serum was negative
D. None of the above. - Answer-B
.Abnormal 1 HOUR value for ADA OGTT is > _____.
A. 120
B. 140
C. 153
D. 180 - Answer-D
Per ADA, dignosis of gestational diabetes (GDM) made if any one value exceeds the
cutpoints:
Fasting > 92
1 hr > 180
2 hr > 153
