Midterm:NU661 Primary Care Childbearing Woman
Midterm Exam latest Fall Spring Semester 2024.2025
Verified Exam (RECOMMENDED)
Preconceptual Counseling (9) - ANSWER: -Medical Hx
-Family Hx
-Genetic Hx
-Age
-Teratogen risk
-Medications
-Surgical Hx
-Ancestry
-Genetic Consult
specific preconception med hx question - ANSWER: Medical hx: HTN, DM, Asthma,
Cardiac problems, kidney issues, DES
Family Hx: DM, HTN,
Teratogen: ETOH, Tobacco, drugs, caffiene, rubella, varicella, CMV, HIV,
environmental-lead, pesticides, radiation
Genetic: Downs, CF, MD, Mental retardation, Spina Bifida or brain stem anomalies,
congenital abnormalities, recurrent miscarraiges, still born-geneitc consult
Medications: Htn-aldomet, oral hypoglycemics-insulin, Asthma meds, accutane, etc
Ancestry: AA, Jewish, France Canadian, Medriterranean, Greek, Italian, Southeast
Asian, Phillipine-sickle cell, beta thal, alpha thal, taysachs, canavan, gouchers disease
Age: >35 yo-Ectopic, multiple, chromosomal, NTD.
Surgical Hx: Cervix surgery, Lacerations, appendix, gall bladder etc
Genetic Consult: any one with family history or appropriate risk factos
Folic Acid ).4mg QD for those without risks, 4 mg for those with history for 3 months
prior to pregnancy
Counsel on appropriate nutrition, exercise and avoidance
Pregnancy - ANSWER: -40 weeks
-1st Trimester: 0-12 weeks
-2nd Trimester: 13-27 weeks
-3rd Trimester: 28+ weeks
,-Thorough H&P help ID any potential risk factors, enabling appropriate care
throughout pregnancy
Presumptive Signs of Pregnancy (8) - ANSWER: -Amenorrhea
-Breast tenderness
-Urinary frequency
-N/V
-Chadwick's Sign-Blue hue to cervix
-Linea nigra
-Chloasma- hyper pigmentation of skin
-Quickening
Probable Signs of Pregnancy (7) - ANSWER: -Ballotment- poke baby via vagina and
feel return impact
-Braxton-Hicks
-Goodell's SignSoftening of cervix/uterus
-Hegar's Sign-Softening of isthmus (cartiledge/bone)
-Uterine and abdominal enlargement
-Positive pregnancy test
-Palpation of fetal contours
Positive Signs of Pregnancy - ANSWER: -Auscultation of FHR
-Palpation of fetal movements
-U/S verification of gestation
Chadwick's Sign - ANSWER: Blue hue to cervix
Goodell's Sign - ANSWER: Softening of cervix/uterus
Hegar's Sign - ANSWER: Softening of isthmus (cartilage/bone)
History for Pregnancy - ANSWER: -Menstrual-LMP, normal, menarche, frequency,
duration any bleeding since pregnant
-Nagel's Rule-Subtract 3 months and add 7 days from LMP
-Reproductive-hx infertility, number of pregnancy, outcome, type of delivery,
complication of pregnancy and delivery,
-Sexual- hx of STD, PID, infertility, HSV
Contraception- previous method, when d/c
-Psychiatric- abuse (physical, emotional, sexual), substance abuse in family, family
history or personal history of mental illness, family support, maternal support, age,
feelings regarding pregnancy, planned or unplanned.
-Surgical- appendix, GB, ovarian, uterine, cervical
, -Medical- HTN, DM, Renal, cardiac, resp-asthma, endocrine, autoimmune
-Family-medical history for screening i.e. endocrine, autoimmune, cancer, DM, HTN
-Genetic - both sides of family
-Teratogen exposure-tobacco, ETOH, drugs, OTC, meds, viruses, environmental
-History since pregnant- exposures (xray, Tb, meds, ETOH, prescribe & OTC, drugs,
cmv, hepatitis, std's) bleeding, pain, vomiting, dysuria, etc
Physical Exam for Pregnancy - ANSWER: -Complete head to toe exam
-Height, weight, BMI, vitals, urine
-Gyn w/pelvimetry(adequacy of pelvis) pap if due
Pelvimetry (6) - ANSWER: 1)Arc of the symphasis pubis (2 fb)
2) Diagonal conjugate (12.5 cm)-inlet
3) transverse diameter of mid pelvis-ischial spines (sharp or blunt)
4) Anteroposterior diameter (curved or flat)
5) Ischial tuberosity (sitz bones) ( > 8cm)
6) Cervical length (>4cm)
Lab Tests for Pregnancy (14+prn) - ANSWER: 1) CBC with differential (anemia,
thrombocytopenia, infection)
2) HgB Electrophoresis (Sickle Cell, Thalassemias)
3) RPR/VDRL (syphilis)
4) Varicella (if not immune, education re: avoid contact w/sick people; if contact,
need Vzig within 72 hours. If not, immunity after delivery)
5) Rubella (immunity)
6) hCG (levels double every 48-72 hours, can help determine progress of pregnancy)
7) GBS: Normal in some women (higher risk of UTIs, PTL) if mom positive, must
receive abx at delivery/ROM
8) TSH (low levels = low IQ in baby)
9) Blood Sugar
10) Blood type/Rh/Antibody
11) Pap
12) Chlamydia
13) Gonorrhea
14) UA culture and sensitivity
15) Others PRN: CMV, Parvo, GTT, HSV, Toxo, Tox screen
Counseling for Pregnancy (8) - ANSWER: -Nutrition
-Folic acid!
-Exercise (30 mins low-impact/day most days)
-Sex
-Work
Midterm Exam latest Fall Spring Semester 2024.2025
Verified Exam (RECOMMENDED)
Preconceptual Counseling (9) - ANSWER: -Medical Hx
-Family Hx
-Genetic Hx
-Age
-Teratogen risk
-Medications
-Surgical Hx
-Ancestry
-Genetic Consult
specific preconception med hx question - ANSWER: Medical hx: HTN, DM, Asthma,
Cardiac problems, kidney issues, DES
Family Hx: DM, HTN,
Teratogen: ETOH, Tobacco, drugs, caffiene, rubella, varicella, CMV, HIV,
environmental-lead, pesticides, radiation
Genetic: Downs, CF, MD, Mental retardation, Spina Bifida or brain stem anomalies,
congenital abnormalities, recurrent miscarraiges, still born-geneitc consult
Medications: Htn-aldomet, oral hypoglycemics-insulin, Asthma meds, accutane, etc
Ancestry: AA, Jewish, France Canadian, Medriterranean, Greek, Italian, Southeast
Asian, Phillipine-sickle cell, beta thal, alpha thal, taysachs, canavan, gouchers disease
Age: >35 yo-Ectopic, multiple, chromosomal, NTD.
Surgical Hx: Cervix surgery, Lacerations, appendix, gall bladder etc
Genetic Consult: any one with family history or appropriate risk factos
Folic Acid ).4mg QD for those without risks, 4 mg for those with history for 3 months
prior to pregnancy
Counsel on appropriate nutrition, exercise and avoidance
Pregnancy - ANSWER: -40 weeks
-1st Trimester: 0-12 weeks
-2nd Trimester: 13-27 weeks
-3rd Trimester: 28+ weeks
,-Thorough H&P help ID any potential risk factors, enabling appropriate care
throughout pregnancy
Presumptive Signs of Pregnancy (8) - ANSWER: -Amenorrhea
-Breast tenderness
-Urinary frequency
-N/V
-Chadwick's Sign-Blue hue to cervix
-Linea nigra
-Chloasma- hyper pigmentation of skin
-Quickening
Probable Signs of Pregnancy (7) - ANSWER: -Ballotment- poke baby via vagina and
feel return impact
-Braxton-Hicks
-Goodell's SignSoftening of cervix/uterus
-Hegar's Sign-Softening of isthmus (cartiledge/bone)
-Uterine and abdominal enlargement
-Positive pregnancy test
-Palpation of fetal contours
Positive Signs of Pregnancy - ANSWER: -Auscultation of FHR
-Palpation of fetal movements
-U/S verification of gestation
Chadwick's Sign - ANSWER: Blue hue to cervix
Goodell's Sign - ANSWER: Softening of cervix/uterus
Hegar's Sign - ANSWER: Softening of isthmus (cartilage/bone)
History for Pregnancy - ANSWER: -Menstrual-LMP, normal, menarche, frequency,
duration any bleeding since pregnant
-Nagel's Rule-Subtract 3 months and add 7 days from LMP
-Reproductive-hx infertility, number of pregnancy, outcome, type of delivery,
complication of pregnancy and delivery,
-Sexual- hx of STD, PID, infertility, HSV
Contraception- previous method, when d/c
-Psychiatric- abuse (physical, emotional, sexual), substance abuse in family, family
history or personal history of mental illness, family support, maternal support, age,
feelings regarding pregnancy, planned or unplanned.
-Surgical- appendix, GB, ovarian, uterine, cervical
, -Medical- HTN, DM, Renal, cardiac, resp-asthma, endocrine, autoimmune
-Family-medical history for screening i.e. endocrine, autoimmune, cancer, DM, HTN
-Genetic - both sides of family
-Teratogen exposure-tobacco, ETOH, drugs, OTC, meds, viruses, environmental
-History since pregnant- exposures (xray, Tb, meds, ETOH, prescribe & OTC, drugs,
cmv, hepatitis, std's) bleeding, pain, vomiting, dysuria, etc
Physical Exam for Pregnancy - ANSWER: -Complete head to toe exam
-Height, weight, BMI, vitals, urine
-Gyn w/pelvimetry(adequacy of pelvis) pap if due
Pelvimetry (6) - ANSWER: 1)Arc of the symphasis pubis (2 fb)
2) Diagonal conjugate (12.5 cm)-inlet
3) transverse diameter of mid pelvis-ischial spines (sharp or blunt)
4) Anteroposterior diameter (curved or flat)
5) Ischial tuberosity (sitz bones) ( > 8cm)
6) Cervical length (>4cm)
Lab Tests for Pregnancy (14+prn) - ANSWER: 1) CBC with differential (anemia,
thrombocytopenia, infection)
2) HgB Electrophoresis (Sickle Cell, Thalassemias)
3) RPR/VDRL (syphilis)
4) Varicella (if not immune, education re: avoid contact w/sick people; if contact,
need Vzig within 72 hours. If not, immunity after delivery)
5) Rubella (immunity)
6) hCG (levels double every 48-72 hours, can help determine progress of pregnancy)
7) GBS: Normal in some women (higher risk of UTIs, PTL) if mom positive, must
receive abx at delivery/ROM
8) TSH (low levels = low IQ in baby)
9) Blood Sugar
10) Blood type/Rh/Antibody
11) Pap
12) Chlamydia
13) Gonorrhea
14) UA culture and sensitivity
15) Others PRN: CMV, Parvo, GTT, HSV, Toxo, Tox screen
Counseling for Pregnancy (8) - ANSWER: -Nutrition
-Folic acid!
-Exercise (30 mins low-impact/day most days)
-Sex
-Work
