OBGYN Protocols and Procedures

IVF transfers egg to ___ and ZIFT transfers egg to ___

uterus, fallopian tube

Glucose screening is usually performed at ___ weeks

24-28

Hypermenorrhea

Increased flow during cycle

Hypomenorrhea

Abnormally decreased flow during cyle

Oligomenorrhea

Menstruation that occurs in >35 day intervals

Polymenorrhea

Menstruation that occurs in <21 day intervals

Menorrhagia

Heavy and longer cycles

Metrorrhagia

Irregular cycle, intermenstrual bleeding

PUBS does not asses ___

L/S ratio → measured during amnio

The BPD can first be measured at ___ weeks and is most accurate before ___ weeks

10-11, 20

What procedure is performed to obtain a sample of the chorion frondosum for karyotyping?

CVS

GA calculation

CRL (cm)+6

CRL (mm)+42

A sample of amniotic fluid can be tested for increased levels of ____ that indicate the presence of neural tube defects

Acetylcholinesterase

Which fetal anomalies would be expected in a mother with phenylketonuria?

Microcephaly, cardiac defects, and IUGR

Which test can predict erythroblastosis fetalis through amniotic fluid?

Delta OD450

Lithium use during pregnancy is most commonly associated with which cardiac defect?

Ebstein anomaly

A fever, leukocytosis and pelvic pain would be most suggestive of:

Tubo-ovarian abscess

Which hormones are monitored in the patient’s blood during ovarian stimulation for follicle production?

Estrogen and estradiol

Which hormone is injected to cause follicles to mature and produce eggs?

hCG

DUB is caused by ___ and AUB is caused by ___

abnormalities in the endocrine system, uterine lesions

For TV ultrasound, the table should be in the ___ position and patient in the ___ position

Trendelenburg, lihotomy

What is used during the procedure of endovaginal oocyte retrieval?

Saline solution

If asked to measure the philtrum, what image will you use?

Midsaggital profile view

What should be evaluated to rule out epispadias on a male fetus?

Kidneys, bladder, urethra

Evaluating the fundal contour is most helpful in differentiating:

Bicornuate from septate

Accuracy of fetal measurements in predicting GA in the 1st tri is within:

3-5 days

The ___ view of the fetal head is most helpful for detecting facial defects with skeletal dysplasia

Midsaggital

What is the best landmark for identifying the ovaries?

Internal iliac vessels

What is the most important imaging plane used to evaluate the spine with suspected limb-body wall complex?

Coronal

Spina bifida is best demonstrated using:

Transverse image of vertebrae

Fetal lung volumetry performed with 3D ultrasound should be used to help diagnose:

Skeletal dysplasia (pulmonary hypoplasia)

Transvaginal US can detect embryological changes about ___ earlier than transabdominal

1 week

Expected findings with a positive Coombs test

Fetal anemia, immune hydrops, thickened placenta

When is the best time to evaluate a premenopausal patient with suspected hyperplasia?

Around day 5 of the cycle just after menses stops

Yolk Sac measurement

<6mm inner diameter

CI is calculated by:

BPD/OFD

Standard BPD provides the most accurate GA estimate before:

20 weeks

When evaluating a patient for the antral follicle count, the TV exam should be performed:

Between day 2-4 of the cycle

The best time to visualize a polyp on 2D US is in the ____ phase

Early proliferative

BPP

Stress test - non reactive is 0 pts

Breathing - 30 seconds is 2 pts

Gross body movements - 3 is 2 pts

Muscle tone - 1 is 2 pts

AFI - >5xm is 2 pts

Agenesis of the corups callosum can be ruled out with which view?

Transverse axial view of the fetal head with the beam perpendicular to the partietal bones

If a patient with OHSS becomes pregnant, what procedure may be required for treatment?

Paracentesis

Maternal cocaine abuse is associated with what critical findings on the fetal US?

Placental abruption and premature birth

What medication is administered to cause the ovaries to produce follicles?

Clomid

Fetal ascites is present on the exam. What should you do next?

Evaluate the fetal heart size and function

Placental thinning is associated with:

IUGR, pre-eclampsia, smoking, HTN, poor maternal nutrition, drug/alcohol abuse

What is true of sex-linked traits?

There is no corresponding X gene

If the mother has a good X gene, the daughters will only be carriers

X-linked recessive disorders are more likely than autosomal recessive disorders

Quad screen blood test assess for:

MSAFP, hCG, estriol, and inhibin-A

Autosomal dominant vs Autosomal recessive

Dominant - will occur if one defective gene is present

Recessive - will occur if both genes are defective

What correctly describes the normal result for a contraction stress test?

The fetal heart rate increases with each uterine contraction induced by oxytocin

If the mother carries an w-linked recessive gene and the father has the trait, what % chance do they have for a normal boy?

25% normal boy

25% chance of boy with the trait

25% girl with trait

25% girl carrying trait

0% chance normal girl

Methotrexate is used:

To cause involution of early ectopic pregnancy and preserve fertility

Pre-eclampsia is associated with:

1st tri - molar pregnancy

2nd/3rd - IUGR, oligo, aged placenta, fetal demise

3rd tri - IUGR

The nuchal skin fold can be used to assess for:

Chromosomal abnormalities and neural tube defects

Clinical findings for PID

Vaginitis, bleeding, discharge, pain, nausea, vomiting, dysuria, fever, leukocytosis , elevated CA-125

US findings for PID

Enlarged uterus, echogenic endo, hydrosalpinx, pyosalpinx, adenxal fluid, hypervasularity of tubal walls

Chorioangiomas are associated with:

Elevated MSAFP

What is evaluated during triple screen blood test?

AFP, bHCG, estriol

What offers the most accurate assessment for fetal age?

CRL (NOT gestational sac)

A grade III placenta is abnormal in pregnancies less than ____

35 weeks

A normal IUP should always be identified at bHC levels ___

>2000 TV

TA 4000/ 5500 should definitely see

Gestational sac equation

mean GSD mm + 30

ex: 30×30×39 (30+30+39=99/3=33)

→ 33+30=63 days or 9 weeks

Accurate within 14 days

When a patient undergoing ovarian hyperstimulation comes to record the mean follicle diameter, when should they come?

Mid to late follicular phase

What will cause deceleration of the heart rate on a non-stress test?

Compression of the UC with fetal motion

If a father has a dominant x-linked trait and the mother is normal, what is the chance that his son will have the same disorder?

0% chance for the son, 100% chance for daughter

If a mother has a dominant x-linked trait and the father is normal, each child has a ___ chance of having the disorder

50%

What is used to improve imaging of a fetus of an obese mother?

Place the patient in the modified sims position

What will lead to an increase in levels of acetylcholinesterase or ACHE in the sample of amniotic fluid?

Spina bifida

What will increase with dysgerminoma?

hCG, CA 125, LDH

What question should be asked if a rhabdomyoma is noted?

Do you have a history of tuberous sclerosis?

The vaginal cuff should not exceed ___ in a patient who has had a hysterectomy

2cm

Endodermal sinus tumors have increased levels of:

AFP

Small echogenic foci in the myometrium of a postmenopausal woman are usually caused by:

Diabetes

Elevated estrogen is related to what ovarian mass?

Thecoma

What is injected into the fetus during termination?

Potassium chloride

Estrogen therapy causes an increased risk of:

Thrombosis

Correct caliper placement for interocular measurement

inner edge to inner edge