END OF OB BLOCK2 JEOPARDY

Blood Probs

100

Definition of Anemia in the second trimester

What is Hgb of 10.5

200

typical genotype of Hb H disease 

--/a-

300

You discover your patient has a plt count of 50K @ 28 weeks. Once ruling out preeclampsia, what is the most likely etiology? 

ITP

400

You have a patient with ITP and platelet count of 30K found to be in active labor in breech presentation, requiring cesarean delivery. What is the target plt level for a patient underroing major abdominal surgery 

50K

500

chromosomal locations of the alpha and beta globin genes 

a- short arm of chromosome 16

b- short arm of chromosome 11

GI Probs

100

4 non-pharmacologic interventions for nausea and vomiting of pregnancy

-small frequent meals

-avoidance of triggers

-ginger capsules

-P6 accupressure 

200

You have a patient with significant N/v of pregnancy resistant to non pharmacologic interventions as well as vitamin B6 + doxylamine. According to acog - what should be your next step? 

Dimenhydrinate

Diphenhydramine

Prochlorperazine

Promethazine

300

GI tract site at which most dietary iron is absorbed

What is duodenum

400

5 common vitamin deficiencies in pts with hx of Bariatric surgery

 Fe, B12, folate, Vitamin D, Calcium

500

In pts requiring steroids for hyperemesis, what is the ACOG recommended regimen? prior to what GA should steroids be avoided and why?

Methylprednisolone 16mg q8h x 3 days (PO or IV) 

10 wks, risk of oral clefting

AP Probs

100

SMFMs most updated definition of fetal growth restriction

EFW or AC <10%ile

200

Stillbirth rate in pregnancies affected by growth restriction

1.5%

300

Per our screening protocol, the range of cervical length measurements within which an FFN may be helpful

20-29mm

400

Gestational age range at which SMFM recommends delivery in the setting of fetal growth restriction with Absent end diastolic flow on UA doppler

33-34wks

500

4 subsets of patients in which prophylaxis against infectious endocarditis is indicated 

-Pts with prosthetic heart valves, or prosthetic components

-pts with hx of infectious endocarditis

-pts with hx of CHD and: incomplete repair or repaired CHD with residual defects (valvular disease)

-pts w/ heart transplant w/ valve regurg due to structurally abnormal valve

Hemorrhage probs

100

volume of 1 unit of PRBCs

300ml

200

expected increase in plt count with each unit of plts transfused 

7500mm3/U

300

2 acceptable regimens for ratio of products transfused in massive hemorrhage (Prbc:ffp:plt)

Either 1:1:1 (rarely done in practice), or 1:2:4

400

What class of topical hemostatic agents is contraindicated in pts w/ severe coagulopathy

Physical agents - surgicel, arista, gelfoam

Because they provide a substrate to form a matrix at the site of bleeding which activates extrinsic clotting cascade, serves as scaffold for clot formation require intact coagulation cascade to function

500

You have a patient with 3 prior cesarean deliveries who is pregnant again and found to have a placenta previa @ 20 weeks - what is the chance this pt also has an accreta? 

61%

Grab bag

100

Per acog, percentage (range) of term deliveries c/b intraamniotic infection

2-5%

200

ACOGs recommended use of abx for suspected intraamniotic infection postpartum (in the absence of overwhelming sepsis...)

Data suggest none needed postpartum after vag delivery, one additional dose after cesarean

-important to assess constellation of risk factors

300

Primary outcome of the ALPS trial

Administration of BMZ in the late preterm period significantly reduced neonatal respiratory complications (11.6% vs 14.4% in palcebo) 

400

In pts with a BMI >30, what post-cesarean regimen has been shown to reduce SSI

Keflex and Flagyl - both 500 q8h x 48 hrs

500

ACOG Criteria for suspected intraamniotic infection

Maternal intrapartum fever plus one or more: 

-purulent cervical discharge

-leukocytosis

-fetal tachycardia