EBCOG Part 1-Maternal Medicine-Day 5(SBA)

1.What is the most common association with heart disease in pregnancy?

2.A 22-year-old primiparous woman presents for her first prenatal evaluation. On physical examination you hear a grade 3/6 holosystolic murmur. Which is the most common CHD in pregnancy that would cause that type of murmur?

3.You are seeing for the first prenatal visit a 19-year-old woman with an artificial porcine valve placed 6 months ago for CHD. She is 10 weeks pregnant, tired, and does not sleep particularly well. The fetus is size-date appropriate. Of the following choices, which is the best first step in management?

4. A 16-year-old woman with CHD is referred at 8 weeks’ gestation by her cardiologist. She has peripheral cyanosis, a hematocrit of 65%, and is 95 lb and 5 ft. 4 in tall. You counsel her that the most likely fetal outcome is which of the following?

5.Patient on magnesium sulphate develop loss of tendon reflexes, most appropriate management?

6.First effect of magnesium sulfate toxicity

7. At which level magnesium sulphate toxicity

8.Patient on magnesium sulphate with slurring of speech level

9. A pregnant Females health deterioted in last trimester in which she had shortness of breath and her brother also died in childhood due to heart related problem what is diagnosis-

10.Mitral stenosis with regurgitate during delivery risk of?

11.Deteriorating cardiac disease in pregnancy most common is?

12.A 24 years old PG with H/o MS presented with labour pains at term, what is the preferred mode of Anesthesia during labour?

13.A 26 years old PG at 35 weeks of gestation with H/O Prosthetic mitral valve placement 2years back. What would be mode of delivery ?

14.29 year old primi attends antenatal clinic at 32 weeks gestation.She is fit & well with no comorbidities.She had a vasovagal fainting episode & an ECG done at that time was normal.Which of the following features would have prompted suspicion of an underlying abnormality?

15.34 year old Pakistani woman in her 3rd pregnancy attends antenatal clinic at 36 weeks for a birth plan.She tells you she is on a beta blocker as she suffred from rheumatic heart disease as a child.Which of the following therapies should she avoid in the 2nd stage of labour?

16. 26 year old is seen in the combined obstetric cardiology clinic at 14 weeks gestation.She has a history of Tetralogy of Fallots that was repaired in childhood.What is the main cardiac issue that she potentially faces in pregnancy?

17. 25 year old woman is seen in antenatal clinic at 7 weeks gestation.She is regularly seen in the congenital heart disease clinic because of Eisenmengers syndrome secondary to ventriculoseptal defect.What would be the most appropriate advice in terms of management?

18. You are seeing patients in the maternal medicine clinic.There are 5 women with different cardiac conditions.They are all primis with no other risk factors.Which one would you be most concerned about?

19. A woman presents to antenatal clinic with palpitations.She describes these as episodes of a fast heartbeat which last about 5-10 mins & occur roughly once a week.They can come on suddenly at any time.She feels anxious when they come.She has no cardiac concerns ,but her father has had a heart attack at age of 55.

20.In pregnant patients presenting with signs & symptoms of acute myocardial infarction what is the investigation of choice to confirm or refute a diagnosis of acute myocardial infarction?

21. Mrs Marie 40 years old had an AMI at 36 weeks of pregnancy,which was managed successfully.She went on to complete 39 weeks & had a successful vaginal delivery.Which of the following drugs can be used safely to prevent postpartum hemorrhage?

22.Following are the changes seen in the ECG of a healthy pregnant woman.Which change is not a normal physiological change & can be seen in the ECG of a pregnant woman presenting with acute myocardial infarction?

23. Medical management is an important component in treatment of AMI & prevention of further coronary artery events.Which one of the drugs listed below is not safe for use during medical management of AMI in pregnancy?

24. The incidence of myocardial infarction is increasing in the UK in pregnant women.This can be explained by a change in the demographics including all of the following factors except