Vocabulary
Hormones
EDD/GPTAL
Screening/DX
Preterm Labor
Conditions
Misc
100
The last day of the 1st trimester of pregnancy is?
What is the 13th week 6th day.
100
What is the hormone responsible for signaling the corpus luteum to continue producing progesterone?
Human Chorionic Gonadatropin (HCG)
100
The formula for Naegles' rule is?
What is
Take the LMP
Subtract 3 months
Add 7 Days
Add 1 Year.
100
What screening can be done before a couple gets pregnant?
What is carrier screening for things like cystic fibrosis and hemophilia?
100
What is the difference between "true labor" vs "false labor"
True labor causes changes in the cervix.
100
What condition can cause rapid uterine growth, irregular bleeding, and high HCG?
What is gestational trophoblastic disease?
100
Anyone wanting to carry a child should make sure they consume enough of which dietary nutrient to help prevent neural tube defects.
What is folic acid?
200
Do a primipara and a nulligravida have the same obstetric status?
No - a null gravida has never been pregnant, but a primipara is pregnant and has never given birth.
200
What hormone helps stimulate uterine growth and increase uteroplacental blood flow
What is estrogen?
200
What is a trick to remember what months have 31 days without a calendar?
200
Who is offered prenatal screening?
Everyone!
200
What test and how is it done?
Test to evaluate the maturity of fetal lungs?
What is the lecithin/sphingomyelin (L:S) ratio
200
What condition can cause stabbing unilateral lower abdominal pain and lower-than-expected HCG?
What is an ectopic pregnancy?
200
What conditions put a person at higher risk of iron deficiency anemia in pregnancy?
a short time period between pregnancies
anything to cause someone become anemic, heavy periods, irregular menstrual bleeding
300
Parity is determined by the number of children delivered after __ weeks?
What is 20 weeks
300
What produces the hormone HCG?
What are the trophoblastic cells of the newly implanted embryo - the early placenta.
300
The last menstrual period can be used for the estimation of the due date as long as what portion of the menstrual period is regular?
The follicular portion.
300
First-trimester ultrasound screening results showed an increase in the nuchal translucent measurement and no visualized nasal bone. This could be an indication of what?
What is a genetic aneuploidy
300
Your patient has been started on magnesium sulfate to slow preterm labor and protect her baby's brain. What assessments are needed when a pregnant patient is on magnesium? What is a therapeutic dose?
A therapeutic serum level is between 5-8 mg/dl
Level of consciousness, deep tendon reflexes, and respiratory rate should all be monitored hourly - q2.
300
Your 22-week pregnant patient has arrived to L & D triage, complaining of painless vaginal bleeding, what do you suspect?
What is placenta previa?
300
Your patient 8-week pregnant patient weighs 285 lbs, what advice do you give them for diet and weight gain when they say they will make sure they don't gain any weight because their BMI is high?
It is expected that you still gain weight during pregnancy, the key is choosing better nutrient foods.
400
LMP stands for ___ ___ ____
What is Last Menstrual Period
400
Human placental lactogen creates an environment of ___ in the pregnant person
What is insulin resistance?
400
Your patient is 36 weeks and 5 days pregnant, they have a history of twins lost to miscarriage at 8 weeks and a 1-year-old born at 39 weeks via c-section. What is their GTPAL? GP?
G 3
T 1
P 0
A 1
L 1
G3P1
400
What is AFP and why is it measured?
Alfa fetoprotein - and increase can indicate a neural tube defect
400
Nitrazine test and “ferning” test are for what?
To look for the presence of amniotic fluid.
400
Your patient has a history of 4 c-sections, which placental complication are they at higher risk for?
Placenta accreta spectrum (PAS)
(also uterine rupture)
400
You are working in a teen clinic, and a 14-year-old comes in asking for emergency contraception. They also ask if they can get the birth control pill will.
What is your answer?
You answer yes! Anyone can get plan B, no matter their age.
24 states allow birth control without parental consent
500
Pregnancies that deliver between 35.0 and 36.6 weeks are considered?
What is late-preterm
500
What hormone is responsible for preparing the breast tissue to produce milk?
Prolactin promotes the growth of mammary alveoli.
500
The most accurate dating of pregnancy is using what method?
Ultrasound measurement of crown to rump in the first trimester.
500
Chorionic villus sampling have a higher or lower risk of pregnancy loss than amniocentesis?
What is a higher risk.
500
Your patient is 35.6 weeks pregnant and her water just broke, they have a history of twins lost to miscarriage at 8 weeks and a 1-year-old born at 39 weeks via c-section.
She is very worried about her baby's lung health and told you she wants prenatal steroids. What do you anticipate?
You explain to her that your priority is keeping her free of infection, but steroids are only indicated for gestations under 34 weeks.
500
What laboratory results will you expect in a patient with HG?
Anything that reflects s/s of dehydration, for example, electrolyte abnormalities, ketonuria, and increased urine-specific gravity related to dehydration.
500
Your 24-year-old patient is going through a very early miscarriage at 6 weeks. She asks "it is something I did"? Maybe when I had sushi last week?! What is your response?
It is not! 80% of all pregnancy losses occur within the first trimester and are often caused by having missing or extra chromosomes, called aneuploidy
600
24 weeks gestation is generally considered when a fetus is?
What is viable
600
What is the main hormone responsible for supporting the uterine endometrium in early pregnancy?
Progesterone
600
What is the estimated date of delivery for a person with a last menstrual period of 11/1/2022?
8/8/2023
600
Why would someone choose CVS over amniocentesis?
CVS can be done in the first trimester, where amnio is not until the second trimester.
600
The initial goals of keeping a person pregnant after a premature rupture of membranes include?
What is reducing the risk of infection and allowing the administration of 2 doses of prenatal steroids?
600
Gestational diabetes can be controlled with?
What is carb controlled diet, and the medications, insulin, metformin, or glyburide?
600
Your friend has a history of DVT and wants very little risk of pregnancy. What contraceptive choice is best for someone with a history of DVT?
An IUD has the best efficacy but any progestin-only contraception is ok to use as well.
700
Marie was just diagnosed with GDM.
She knows this significantly increases risks for
PPROM or IUGR or LGA
Marie was just diagnosed with GDM. Gestational diabetes mellitus
She knows this significantly increases risks for
PPROM or IUGR or LGA Large for gestational age
700
A three-hour glucose tolerance test requires no more than one of the test values to be out of range. The three-hour serum glucose limit is _ _ _
(I had an error in the original question, this is revised from the review video)
140
700
Your patient just delivered a healthy 8 lb baby at 41 weeks and 2 days pregnant.
Their obstetric history is extensive, including a set of triplets (born at 34 weeks), that are now 4 years old. Between the birth of the triplets, they suffered 2 miscarriages, one set of twins at 10 weeks, and a singleton pregnancy at 12 weeks. What is your patient's GP? Their GTPAL?
G4 P4
What is their GTPAL?
G4
T1
P1
A2
L4
700
Which kind of identical twins have the most risk during pregnancy and why?
Mono-chorionic and mono-amniotic twins have a higher risk of cord entanglement and twin-to-twin transfusion syndrome.
700
What things can be done to help a cervix that has started to shorten if it is observed early enough?
Vaginal progesterone can be used to help support the cervix and slow shortening. A cerclage is a surgical stitch put in the cervix to hold it closed.
700
Your 34-week patient cries out in pain, grasping at her abdomen. Her belly feels rigid. What do you suspect?
What is a placental abruption?
What is the leading cause of placental abruption?
Hypertension.
700
Your patient is on iron, for anemia, what do you suggest they consume at the same time as their iron tablet to improve absorption?
What is vitamin C
800
Current Visit
Female 33 years old -G1P0
Patient cc
Positive pregnancy test and unknown LMP, patient states, "I get periods a few times a year and they do not amount to much"
PMH
This patient has
oligomenorrhea or menorrhagia
The best way to date the pregnancy will be with
a serum HCG or an ultrasound
Current Visit
G1P0
Patient CC
Positive pregnancy test and unknown LMP, patient states, "I get periods a few times a year and they do not amount to much"
PMH
This patient has
oligomenorrhea or menorrhagia
The best way to date the pregnancy will be with
a serum HCG or an ultrasound
800
The hormone responsible for increasing nutrient availability to the fetus in the second trimester of pregnancy is?
Human placental lactogen (hPL)
800
Your roommate screams to you they just took a pregnancy test and it was positive. After using some therapeutic communication with them, you understand that they are very apprehensive but excited. They ask, "How do I know when I am due, my last period started on 2/28"?
LMP - 3 Mo + 7 Days + 1 year
Feb 28 2023
Jan
Dec
Nov 28 2022
+ 7
December 5, 2023
800
MJ and her partner are trying for baby #2. They have been trying for 18 months, and they were diagnosed with secondary _______. Their doctor suggested a test to look at her uterus and tubes.
When they were scheduling the (_ _ _) _______________ , the nurse asked when her LMP was, and said it has to be scheduled during the _____ phase of her mentrual cycle.
MJ and her partner are trying for baby #2. They have been trying for 18 months, and they were diagnosed with secondary infertility. Their doctor suggested a test to look at her uterus and tubes.
When they were scheduling the (HSG) Hysterosalpingography, the nurse asked when her LMP was and said it has to be scheduled during the follicular phase of her mentrual cycle.
800
Your patient is 33w0d pregnant with newly ruptured membranes and in active labor. The goal is to get 2 doses of 12 mg of _______ 24 hours apart. You anticipate an order for a medication to stop or slow labor, most likely ________
You know that the tocolytic medication ______ will not be used because _______?
Your patient is 33w0d pregnant with newly ruptured membranes and in active labor. The goal is to get 2 doses of 12 mg of betamethasone 24 hours apart. You anticipate an order for a medication to stop or slow labor, most likely magnesium sulfate
You know that the tocolytic medication Indomethacin will not be used because she is over 32 weeks.
Indomethacin is used to treat patent ductus arteriosus (PDA)
800
Your patient has a diagnosed ectopic pregnancy in her right fallopian tube. It measured 2.5 cm via ultrasound. What treatment do you anticipate, and why?
Methotrexate therapy would be appropriate because the pregnancy is under 4cm
A surgical salpingostomy could impact fertility, and would not be the first choice.
800
Your patient states "I am so happy to be finally pregnant, and by the way I feel, I must be having twins!
When you ask her to clarify what she means, "by the way she feels" she responds, oh, this constant nausea and vomiting, and my belly is already feeling huge! I have lost 2 pounds, but can still keep down my lemonaid and graham crackers.
What do you suspect is going on? What other information do you need to decide?
Is she pregnant with an in-utero pregnancy, if so what is the GA, is there more than one?
Does US show an abnormal finding, possibly gestational trophoblastic disease?
What do her labs look like, are their s/s of dehydration, are you concerned with NVP?