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LNU - simulation questions

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jonjonnavarro's version from 2016-05-22 02:47

Biophsycosocial Scoring System

Question Answer
Fetal Breathing movements NormalAt least 1 episode x 30 sec in 30 min
Fetal Breathing movements AbnormalAbsent in 30 min
Gross body movement NormalAt least 3 body/limb movements in 30 min
Gross body movement Abnormal2 or fewer movements in 30 min
Fetal tone NormalAt least 1 episode of active extension w/ return to flexion of fetal limb or trunk.Opening & closing of hand
Fetal tone AbnormalEither slow extension w/ return of partial flexion or movement of limb in full extension or absent fetal movement
Reactive FHR NormalAt least 2 episodes of FHR acceleration of >15 bpm & of at least 15 sec duration
Reactive FHR Abnormal< 2 episodes of acceleration of FHR or acceleration of <15 bpm in 30 min
Qualitative AFV NormalAt least 1 pocket of AF that measures at least 2 cm
Qualitative AFV AbnormalEither no AF or pocket < 2 cm in 1 perpendicular plane
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Electronic fetal monitoring

Question Answer
Contraction Stress Testmeasure of the uteroplacental function, evaluates the reaction of the fetal heart rate to contractions induced by either nipple stimulation or oxytocin
Positive CSTw/ consistent & persistent late deceleration of FHB in the absence of uterine hypertonus or supine hypotension
Negative CSTat least 3 contractions in 10 minutes,each lasting 40 seconds without late deceleration
Suspicious CSTin constant late deceleration patterns
Hyperstimulationuterine contractions occur more frequent than every 2 min or lasting longer than 90 sec or presence of uterine hypertonus
Unsatisfactorythe frequency of contractions is less than 3 per min or the tracing is poor
Reactive NSTat least 2 accelerations of FHR occurs for at least 15 beats/min lasting for 15 sec w/in a 20 minute period of observation
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Question Answer
Reactive NSTat least 2 accelerations of FHR occurs for at least 15 beats/min lasting for 15 sec w/in a 20 minute period of observation
Early deceleration patterndecelerations begin w/ the onset of a contraction
Late deceleration patterndecelerations occur after the onset of the contraction
Variable deceleration patternmost common type,occurs before,during, after or even w/out uterine contraction
Early decelerationdue to head compression
Late decelerationdue to uteroplacental insufficiency
Variable decelerationdue to cord compression
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Ominous Signs

Question Answer
cord compressionvariable deceleration lasting for > 1 min & drops to < 60 beats/min
uteroplacental insufficiencypersistent late deceleration
sinusoidal patternbaseline oscillations at a frequency of 2-5/min varying from 1-15 beats/min w/ the absence of heart reactivity
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Stages of Labor

Question Answer
First stagestart with uterine contractions up to full cervical dilatation
Second stagebegins with full cervical dilatation and ends with fetal expulsion
Third stagebegins with delivery of fetus and ends with the stage of placental separation and expulsion
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Active Phase

Question Answer
Acceleration phasepredictive of outcome of labor
Phase of maximum slopemeasures efficiency of labor
Deceleration phasefetopelvic relationship
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Functional Divisions of Labor

Question Answer
Preparatory divisionchanges take place in the ground substance of the cervix
Dilatational phasedilatation occurs its most rapid rate, unaffected by sedation and conduction analgesia
Pelvic divisionstarts with deceleration phase and this where cardinal movements
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Biophysical Profile Scoring

Question Answer
10Normal non-asphyxiated
8 Normal FluidNormal non-asphyxiated fetus
8 OligohydramniosChronic fetal asphyxia suspected
6Possible fetal asphyxia
4Probable fetal asphyxia
0-2almost certain fetal asphyxia
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Question Answer
10no fetal indication for intervention
8 normal fluidno fetal indication for intervention, repeat testing
8 oligohydramniosdeliver if > 37 weeks, otherwise repeat testing
6deliver if > 36 weeks
4repeat testing same day, if BPP score < 6 deliver
0-2deliver
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Protein Hormones Produced by the Human Placenta

Question Answer
Human chorionic gonadotropin (hCG)Maintains corpus luteum function,
Placental lactogen (PL)Aids maternal adaptation to fetal energy requirements
Corticotropin-releasing hormone (CRH)Relaxes smooth-muscle; initiates parturition?
Gonadotropin-releasing hormone (GnRH)Regulates trophoblast hCG production
Growth hormone variant (hGH-V)Potentially mediates pregnancy insulin resistance
Neuropeptide YPotential regulates CRH release by trophoblasts
Parathyroid hormonereleasing protein (PTH-rP)Regulates transfer of calcium and other solutes;
InhibinPotentially inhibits FSH-mediated ovulation;
ActivinRegulates placental GnRH synthesis
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Question Answer
Human chorionic gonadotropin (hCG)Regulates fetal testis testosterone secretion, Stimulates maternal thyroid
Placental lactogen (PL)Aids maternal adaptation to fetal energy requirements
Corticotropin-releasing hormone (CRH)Promotes fetal and maternal glucocorticoid production
Growth hormone variant (hGH-V)Potentially mediates pregnancy insulin resistance
Neuropeptide YPotential regulates CRH release by trophoblasts
Parathyroid hormonereleasing protein (PTH-rP)regulates fetal mineral homeostasis
Inhibinregulates hCG synthesis
ActivinRegulates placental GnRH synthesis
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Fetal Head Diameters

Question Answer
Occipitofrontalwhich follows a line extending from a point just above the root of the nose to the most prominent portion of the occipital bone.
Biparietalthe greatest transverse diameter of the head, which extends from one parietal boss to the other.
Bitemporalwhich is the greatest distance between the two temporal sutures.
Occipitomentalwhich extends from the chin to the most prominent portion of the occiput.
Suboccipitobregmaticwhich follows a line drawn from the middle of the large fontanel to the undersurface of the occipital bone where it joins the neck.
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Question Answer
Occipitofrontal11.5 cm
Biparietal9.5 cm
Bitemporal8.0 cm.
Occipitomental12.5 cm
Suboccipitobregmatic9.5 cm
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Genital ambiguity of new born

Question Answer
Category 1Female pseudohermaphroditism
Category 2Male pseudohermaphroditism
Category 3Dysgenetic gonads
Category 4True hermaphroditism
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Question Answer
Female pseudohermaphroditismkaryotype 46,XX and ovaries are present
Male pseudohermaphroditismkaryotype 46, XY, and there are either testes or no gonads
Dysgenetic gonadskaryotype 46, X, Turner syndrome
True hermaphroditismhave both ovarian and testicular tissues with germ cells for both ova and sperm
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Definitions

Question Answer
Nulligravidaa woman who currently is not pregnant nor has ever been pregnant.
Gravidaa woman who currently is pregnant or has been in the past, irrespective of the pregnancy outcome.
Primigravidaestablishment of the first pregnancy
Multigravidasuccessive pregnancies
Nulliparaa woman who has never completed a pregnancy beyond 20 weeks’ gestation.
Primiparaa woman who has been delivered only once of a fetus or fetuses born alive or dead with an estimated length of gestation of 20 or more weeks
Multiparaa woman who has completed two or more pregnancies to 20 weeks’ gestation or more.
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