OBSTETRICS and GYNECOLOGY DISCUSSION


Q 1. Name 4 indications for genetics counseling

Ans : AMA
Multiple fetal losses
Previous child : neonatal death , Men Retar ,Aneupliody, Known genetic disorder
F/H : genetic diseases , birth defects , Men retar
Abnormal Prenatal Tests : triple marker screen , sonogram
Parental Aneupliody

Q 2 What is Amniocentesis ? Indications ?

Ans : Transabdominal needle withdrawal of amniotic fluid under sonographic guidance
15-20 weeks – performed for genetic purposes : fetal karyotyping , alpha feto protein, biochemical studies
After 24 weeks – Rh isoimmunization ( BILIRUBIN levels)
After 34 weeks – Fetal Maturity studies ( L/S ratio , PG , TDx-FLM test (?))

Q 3 Most common Trisomy in first trimester abortions ?
Ans : Trisomy 16

Q 4 :Most common single aneuploidy seen ?

Ans :Turner Syndrome

Q 5 Obstetric USG findings in case of suspected Turners Syndrome ?
Ans : nuchal skin fold thickening
Cystic Hygroma

Q 6: True or False , Turner Syndrome pts have normal intelligence

Ans : True

Q 7 : Physcial findings in Down’s Syndrome ?
Ans : short stature
Mental Retardation
Muscular Hypotonia
Brachycephaly(Brachycephaly: A short head, one that is short in diameter from front to back.)
Short neck
Oblique orbital fissures
Flat nasal bridge
Small ears
Nystagmus
Protruding tongue

Q8 Edward’s syndrome features ?
Trisomy 18
Profound mental Retardation
Rocker bottom feet
Sclerodactyly
Micrognathia
Low set ears
Survival to one year of age 40 %


Q 9 Features of Autosomal Dominant inheritance ?
Ans : Transmission occurs equally in males and females
All generations affected
Anatomic abnormalities
Affected individual has affected parent
Affacted individual will transmit disease to 50% of their off spring
NO CARRIER STATES

Q 10 4 examples of AD diseases ?
Poly
Achondro
Polycystic
Marfans
Myotonic
Osteogenesis
Neurofibromatosis
Huntington

Q 11 a person with Hemophila A , which of his relatives are likely to be affected by the same disease ?
Ans : His Maternal Uncles

Q 12 4 conditons that are of multifactorial inheritance ?

Ans : NTD
CHD
Cleft lip and palate
Pyloric stenosis

Q13 Post conception week 1 what happens in brief ?
INtratubal phase day 0 conception , morula enters uterine cavity
Intra Uterine phase startsDay 3 , implantation of blastocyst into endometrial surfaceDAY 6


Q14 Post conception week 2 ?
Bilaminar germ disk
Epi and Hypo
Invasion of maternal sinusoids by syncytiotrophoblast
B-HCG test will be positive now !! Hurray !

Q 15 Post conception week 3 ?
Trilaminar germ disk

Q 16 Post conception week 4- 8

Major organ and organ systems are formed
Period of teratogenic risk

Q17 What develops from Mullerian ducts ? What inhibits it ?
Fallopian tubes , corpus of uterus, cervix , proximal vagina
Inhibited by MIF , in Males Y chr induces gonadal secretion of MIF

Q 18 Male external genitalia inorder to develop needs help from what susbstance ??
Ans : DHT

Q20 Ionizing radiation poses a risk of teratogenesis at what Rad ?
Ans 20 Rad

Q21 Adverse effects of Cocaine in Preg ?

Ans : placental abruption
Preterm delivery
Intraventricular hemorrhage
IUGR

Q 22 Category X drugs ?
Ans : Accutane
Danocrine
Pravachol
Coumadin
Cafergot

Q 23 Fetal Hydantoin syndrome ( this is USMLE style Q , u should guess my Q
IUGR
Craniofacial dysmorphism
Men Retar
Microcephaly
NAIL Hypoplasia
Heart defects
Q 24 Lithium is *** with what defect ?

Ans Ebstein’s Anomaly

Q25 Warfarin adverse effects ?

Ans: Chindrodyplasia
Microcephaly
Ment Retar
Optic Atrophy

Q26 Why is B HCG level measured and not Alpha subunit ?
Alpha is similar to LH, FSH and Thyrotropin
Beta is specific

Q 27 The role of progesterone in Pregnancy ?

Ans : Early pregnancy induces endometrial secretory changes for blastocyst implantation
Later pregnancy : induce immune tolerance , and prevent myometrial contractions

Q 28 Estrogen in pregnancy ?
Ans : Estriol

Q 29 Hematological changes in pregnancy ?
RBC Mass inc
Plasma volume increases by 50 % - Dilutional anemia , Hb and Hct decrease by 15 %
WBC count inc
ESR inc because of inc in gamma globulin
Platelets Unchanged
Coagulation factors 7 , 8 , 9 ,10 increase = HYpercoagulable state

Q 30 true or flase , Adrenal glands increase in size in preg
False , unchanged

Q 31 Fetal circulation

Ductus venosus – umbli vein – IVC
Formane ovale – Rt – Lt Atrium
Ductus Aretriosus – Pulm Art _ desc Aorta