OB CREOG Jeopardy - Copy

Stillbirth

100

What is the rate of stillbirth in the US?

5.96 per 1,000 births

(6 per 1,000)

200

What genetic condition is most closely associated with stillbirth?

(Chromosomal abnormalities, genetic syndromes, singe gene disorders, X-linked conditions, AD mutations or confined placental mosaicism.)

Chromosomal abnormalities

(Deletions, translocations, rearrangements)

300

How does Parvovirus B19 cause fetal demise?

Virus trophic for fetal red blood cell precursors and cardiac cells

(Accept Anemia, Hydrops & Direct myocardial damage)

400

What tests have the highest utility in determining the cause of stillbirth?

(Placental histology, autopsy, karyotype/microarray, APAS antibodies or fetal maternal hemorrhage studies.)

Placental histology

500

What is the MOST preventable cause of stillbirth worldwide?

Syphilis

Infections

100

In which scenario would you NOT recommend or offer a CD to prevent perinatal HSV?

A) Active genital lesions

B) HSV lesion on buttock, back or thigh

C) Prodromal symptoms of pain/burning

D) Primary or non-primary first episode of genital HSV during the third trimester

HSV lesion on buttock, back or thigh

200

35 year old at 16 wks gestation and works at a daycare. She presents with a reticular rash on her trunk and joint pain. 4 weeks later her anatomy scan shows size equal to dates with hydrops (ascites and pleural effusion). What additional screening test would you want?

A) Umbilical artery Dopplers

B) Ductus venosus Dopplers

C) Middle cerebral artery Dopplers

D) Uterine Artery Doppler

C) Middle cerebral artery Dopplers

300

21 yo G1P0 at 13 weeks gestation and presents with a generalized maculopapular rash and lymphadenopathy. She notes she had a painless genital ulcer with a raised border and indurated base that resolved spontaneously 5 weeks ago. She has an allergy to penicillin (IgE mediated). What is your treatment?

C) Desensitization with IM Penicillin G 2.4 million units x1 dose (some say 2)

400

24 yo G3P1011 at 36 weeks GA, who is living with the diagnosis of HIV positivity. Her labs are: viral load: 2000, CD4 400. In order to decrrease risk of vertical transmission, what would be your:

1. delivery mode

2. timing recommendation to decrease the risk of vertical transmission?

A) Prelabor CD at 38 weeks gestation and IV Zidovudine 3 hours preoperatively

500

What is the mortality rate of neonatal herpes, (with disseminated neonatal disease)?

Disseminated disease (25% of infections, 30% mortality)

Genetics

100

Your patient screens positive with a sequential stepwise screen (CA State Screen) for Trisomy 21? What is the detection rate of this test for Trisomy 21?

95% / 88% / 99% / 81%

95%

200

Which 2 maternal analytes are INCREASED in T21?

hCG, Inhibin (HI goes up)

300

Which of the following is NOT a reason for a no call result with cfDNA?

A) Early Gestational Age (<9-10 wks)

B) Genetic Conditions (T13 or 18)

C) Low maternal BMI (<18 kg/m2)

D) LMWH

C) Low BMI

400

What is a 40yo age related risk of Down’s Syndrome AND any chromosomal abnormality?

A) 1/365, 1/180

B) 1/50, 1/100

C) 1/36, 1/18

D) 1/100, 1/50

D) 1/100 (Down syndrome); 1/50 any chromosomal abnormality 

500

**PHOTO DAILY DOUBLE* 

Name this Ultrasound finding and which chromosomal abnormality is most commonly associated ?

Trisomy 21

Trisomy 18 

Monosomy X

Trisomy 13

Trisomy 18, Choroid Plexus Cyst

Obesity in Pregnancy

100

In terms of death by risk factor worldwide, where does obesity rank in the top five?

(High BP, air pollution, Obesity, High blood sugar & smoking.)

5th

200

Relative risk of obesity in Pregnancy

What OB complication is most strongly related to obesity? 

PPH, CD, Stillbirth, Preeclampsia, postpartum infection & GDM  

Preeclampsia

300

Relative risk of obesity in Pregnancy

What congenital anomaly is most strongly related to obesity? 

Limb reduction, hydrocephaly, gastroschisis, ONTD & cardiovascular anomalies.

ONTD

400

What are 2 examples of restrictive bariatric surgeries?

-Gastroplasty/Stapling

-Sleeve gastrectomy

-Adjustable gastric banding

500

What are three examples of LATE complications of bariatric surgery that may complicate a pregnancy?

-SBO

-Marginal ulceration

-Gastrogastric fistulaPerforation

-Cholelithiasis

-Nutritional & vitamin deficiencies

-Dumping syndrome

-Incisional hernia

Increase or Decrease: Physiologic Changes of pregnancy

100

Fibrinogen 

Increased

200

Creatinine

Decreased (increased GFR)

300

WBC Count

Increased

400

Uretereal motility

Decreased

500

Antithrombin III activity 

Decreased