By Tamara Callahan 9781975134877 Chapter 1-32 Complete
Guide .
When can fetal heart tones be detected w/doppler? - ANSWER: 10-12 weeks
When is fetal movement appreciated? - ANSWER: 17-18 weeks
When should you get a "quantitative" beta-hCG - ANSWER: -to diagnose & follow
ectopic pregnancy
-monitor trophoblastic dz
-screen for fetal aneuploidy
What supplement is given in pregnancy to decrease neural tube defects for all
reproductive-age women? - ANSWER: Folic acid supplements
What additional supplements are given for complete vegeterians - ANSWER: vitamin
D & vitamin B12
What kind of immunoglobulins can cross the placenta? - ANSWER: IgG
Prenatal screening at the initial visit - ANSWER: Heme= CBC, Rh factor, Type &
Screen
ID= UA & culture, rubella Ab titer, HBsAg, RPR/VDRL, cervical G/C, PPD, IV, Pap
smear (to check for dysplasia).
If indicated: HbA1C, Sickle cell screening. Can also discuss genetic screening (Tay-
Sachs dz, Cystic Fibrosis).
When are prenatal visits conducted? - ANSWER: Weeks 0-28= every 4 weeks
(7*4=28)
Weeks 29-35= every 2 weeks
Weeks 36-birth= every week
When is a quad screen conducted? - ANSWER: 15-22 weeks
When's an ultrasound for full anatomic screen done? - ANSWER: 18-20 weeks
When is the 1 hr glucose challenge test for gestational DM done? - ANSWER: 24-28
weeks
When is RhoGAM given to Rh- women? - ANSWER: 28-30 weeks
When's GBS culture done?
,(and cervical culture for N gonorrhoeae & Chlamydia in selected populations). -
ANSWER: 35-40 weeks or 32-37 weeks
when can a nuchal transparency test be ordered? - ANSWER: 9-14 weeks
4 elements of the Quad Screen - ANSWER: maternal serum AFP
B-hCG
Estradiol
Inhibin A
What's associated with ELEVATED maternal serum AFP (MSAFP)?
(<2.5 MoMs) - ANSWER: Open neural tube defects (spina bifida, anencephaly)
Abdominal wall defects (gastroschisis, omphalocele)
Multiple gestation
Incorrect gestational dating
Fetal death
Placental abnormailities (like rupture)
What's associated with REDUCED maternal serufm AFP (MSAFP)
(<0.5 MoM) - ANSWER: Trisomy 21 & 18
Fetal demise
Inaccurate gestational dating
Quad screen in trisomy 18 - ANSWER: all are decreased
(still "UNDERage" at age 18)
Quad screen in Trisomy 21 - ANSWER: Decreased AFP
Increased B-hCG
Decreased Estradiol
Increased Inhibin A
earliest screening for down syndrome & trisomy 18? - ANSWER: PAPP-A + nuchal
transparency +free B-hCG done at 9-14 weeks ("Full Integrated test")
Note-> nuchal transparency is increased.
(PAPP-A= pregnancy-associated plasma protein A)
At what time (weeks) is CVS vs amniocentesis done? - ANSWER: CVS= 10-12 weeks
Amniocentesis= 15-20 weeks
Which is indicated in women who will be >35 yo at time of delivery? - ANSWER:
amniocentesis
What are the major infectious organisms that can cross the placenta? - ANSWER:
TORCHeS:
Toxoplasmosis
, Other (parvovirus, varicella, Listeria, TB, malaria, fungi)
Rubella
CMV
Herpes simplex virus
HIV
Syphilis
What's the definition of spontaneous abortion? - ANSWER: Loss of products of
conception (POC) before 20th week of pregnancy.
Major birth defect caused by lithium - ANSWER: Congenital heart disease (Ebstein's
anomaly)
Defects associated w/streptomycin & kanamycin - ANSWER: Aminoglycosides-->
hearing loss & CN VIII damage
Birth defects caused by tetracyclines - ANSWER: Permanent yellow-brown
discoloration of deciduous teeth; hypoplasia of tooth enamel.
Major defects associated w/valproic acid - ANSWER: Neural tube defects (spina
bifida)
Minor craniofacial defects
Which drugs can cause thymic agenesis? - ANSWER: Vitamin A & derivatives.
Intracranial calcifications & ring-enhancing lesions on MRI of fetus/child is associated
with... - ANSWER: Toxoplasmosis
Symptoms of Congenital Rubella infection - ANSWER: Purpuric "blueberry muffin"
rash
Cataracts
Mental retardation, hearing loss, PDA
Periventricular calcifications & petechial rash can be seen with which congenital
infection? - ANSWER: CMV
Treatment for congenital toxoplasmosis infection - ANSWER: Pyrimethamine &
sulfadiazine
Treatment for syphilis - ANSWER: Penicillin
Diagnosis of CMV - ANSWER: Urine culture; PCR of amniotic fluid
Which TORCHeS infections can be diagnosed w/serologic testing? - ANSWER:
Toxoplasmosis, Rubella, & HSV
Dark-field microscopy can be used to diagnose... - ANSWER: syphilis