Download the Medical Book: Williams Obstetrics 24th Edition For Free. Williams Obstetrics 24th Edition PDF Medical Textbooks, Medical Students, Obstetrics. Williams Obstetrics 24th Ed. [PDF]. 55 MB PDF. FREE DOWNLOAD HERE. Share To Unlock Contents. tweet. Tweet. share. And then she said this CunninghamBook => Williams Obstetrics, 25th Edition This landmark text Where can I download Williams Obstetrics 24th Edition?.
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f,;~tY'W';Yl~t';;:;,~7' A course that has a strong systems emphasis and assumes Database PDF Printing dpi Steven Leon - Linear Algebra with Applications . Williams. OBSTETRICS. 24TH EDITION. F. Gary Cunningham. Kenneth J. Leveno. Steven L. Professor and Chair, Department of Obstetrics and Gynecology. Williams Obstetrics (24th edition).pdf - Google Drive.
Once again, we emphasize the scientific-based underpinnings of clinical obstetrics with special emphasis on biochemical and physiological principles of female reproduction. And, as was the hallmark of previous editions, these dovetail with descriptions of evidencebased practices. The reorganized format allows a greater emphasis on the fetus as a patient along with expanded coverage of fetal diagnosis and therapy. These changes are complemented by more than new sonographic and magnetic resonance images that display normal fetal anatomy and common fetal anomalies. To accomplish these goals, the text has been updated with more than new literature citations through
The fetal skeleton accrues 70 g of calcium by term. Maximums of mEq of sodium and mEq of potassium are retained. As illustrated by this graphic, which of the following occurs during pregnancy? In Williams Obstetrics, 24th ed. The hematocrit increases. Red cell volume does not increase until 20 weeks. The hematocrit increases due to an increased red cell volume relative to plasma volume.
This graphic suggests which of the following? In Williams Obstetrics, 23rd ed. Serum iron is decreased in the first trimester. Serum ferritin is increased in the second trimester. Serum ferritin is increased by the end of pregnancy.
Serum transferrin is increased by the end of pregnancy. Average blood loss for a vaginal delivery is which the following? Half of that lost during cesarean delivery of twins d. A and C 4— Normotensive nulliparas near term are responsive to the effects of angiotensin II. A and C 4— The maternal oxygen-disassociation curve is shifted to the right.
Estrogen acts centrally. During pregnancy. Concerning acid-base equilibrium during pregnancy. Hypertensive patients become and then remain refractory. Heart rate increases when pregnant women are sitting compared with lying supine. Which of the following are true regarding infused angiotensin II and its vascular effects during pregnancy? Cardiac output increases when postpartum women are sitting compared with lying supine.
Physiological dyspnea results from slightly decreased tidal volume that lowers CO2 levels.
Regarding lung volumes during pregnancy. Increased vessel refractoriness to angiotensin II results primarily from altered renin-angiotensin secretion. Is responsible for dependent edema in the lower extremities d. Tidal volume VT.
Residual volume RV. Increased tidal volume b. Regarding the gastrointestinal tract during pregnancy. There is increased bladder capacity. Approximately three fourths of all pregnant women experience incontinence during pregnancy. Reserve volume is increased. Tidal volume is increased. Inspiratory capacity IC. Expiratory reserve volume ERV. Inspiratory reserve volume IRV.
Regarding the bladder during pregnancy. Total lung capacity TLC. Functional residual capacity FRC. The maternal arteriovenous oxygen difference decreases during pregnancy because of which of the following? Forced vital capacity FVC. Absolute and functional urethral length increases. Bladder pressure decreases from 15 to 8 cm H2O by term.
Gastric emptying time is shortened during labor. Increased cardiac output c. Increased hemoglobin mass d. It has reduced contractility caused by progesterone. It empties more completely. Regarding the pituitary gland during pregnancy. It enlarges due to estrogen-stimulated hypertrophy and hyperplasia of the lactotrophs.
Epulis gravidarum is a highly vascular swelling that may affect any mucosal membrane. Pyrosis is caused by reflux of acidic secretions into the lower esophagus.
Regarding the thyroid gland during pregnancy. Serum prolactin levels remain unchanged throughout pregnancy. Which of the following is true regarding the gallbladder during pregnancy? Cholestasis is linked to high circulating levels of progesterone.
Growth of microadenomas is likely. Stasis leads to formation of pyruvate-containing stones. Gastric emptying time is lengthened in each trimester. This graphic illustrates which of the following? It undergoes enlargement through hypertrophy. Iodine deficiency is the most preventable cause of fetal neurological deficiency. Fetal neurodevelopment is dependent on adequate thyroid hormone exposure.
Regarding fetal skeletal mineralization. Maternal requirements remain the same during normal pregnancy. Human chorionic gonadotropin hCG. Total T4 concentration increases during pregnancy. A and B 4— In women with low or marginal intake. Free T4 concentration increases its mean value by term. Regarding iodine during pregnancy. A total of 3 g of calcium is required. Serum adrenocorticotropic hormone ACTH secretion increases across pregnancy.
Secretion is decreased by sodium restriction. Maximum secretion of cortisol is reached by 20 weeks. Regarding aldosterone during pregnancy. Serum cortisol secretion decreases throughout pregnancy. It is the principal mineralocorticoid. None of the above 4— Increased aldosterone levels protect against the antinatriuretic effect of progesterone and atrial natriuretic peptide.
Memory decline is typically limited to the third trimester. Regarding the central nervous system during pregnancy. Attention and memory are typically decreased in women receiving magnesium sulfate. Pregnancy significantly alters cerebrovascular autoregulation. Angiotensin II. Androstenedione c. Estradiol b. Endometrial 5—5. Granulosa d. What is the average duration of a normal menstrual cycle? Luteinizing hormone d. Follicle-stimulating hormone 5—4.
Of 2 million oocytes in the human ovary present at birth. Decidual c. Which hormone is required for the late-stage development of antral follicles?
Theca b. Which cells of the dominant follicle are responsible for estrogen production during the follicular phase of the menstrual cycle? Secretory nonciliated cells devoid of glycoprotein and mucopolysaccharide d. Subnuclear vacuoles and pseudostratification in the basal portion of the glandular epithelium 5— Cessation of glandular cell mitosis b.
Within the glandular epithelium of the endometrium. Thecalization c. Graafian transformation 5—6. Which of the following is the most biologically potent naturally occurring estrogen? Luteinization b. Estetrol d.
Luteinized layer d. Functionalis layer 5—9.
Estrone c. Which of the following is the endometrial layer that is shed with every menstrual cycle? What is the approximate peak production of ovarian progesterone during midluteal phase? In the following image. Decidualization d. Vacuoles at the apical portion of the secretory nonciliated cells c. Basalis layer b.
Decidual layer c. Estriol b. In sequence from letters A to C. D 5— Prostaglandin E2 c. Modified with permission from Cunningham FG. Prostaglandin D2 d. Implantation and placental development. Which prostaglandin plays a role in vasoconstriction of the spiral arteries. Prostaglandin E1 b. A zone of fibrinoid degeneration where the invading trophoblast and decidua meet d. What is the Nitabuch layer?
An area of superficial fibrin deposition at the bottom of the intervillous space and surrounding the anchoring villi 5— Which of the following functions does the placenta not perform for the fetus?
A layer of the decidua made of large. An area of the decidua with large. Extravillous trophoblast d. At 5 days postfertilization. Zona pellucida 5— In this drawing of implantation. Hepatic c. Adrenal d. Morula b. Pulmonary 5— Trophectoderm d. Chorion laeve c. Villous trophoblast b. Interstitial trophoblast c. Endovascular trophoblast 5— Which of the following gives rise to the chorionic structures that transport oxygen and nutrients between fetus and mother? It is the area of villi in contact with the decidua basalis.
It is the avascular area that abuts the decidua parietalis. Progesterone c. Which of the following statements is accurate regarding the chorion frondosum? It is the maternal component of the placenta. It is the same as the chorion laeve. Maternal regulation of trophoblast invasion and vascular growth is mainly controlled by which of the following?
CD4 T cells b. Hemochorial invasion d. Arteries are perpendicular and veins are parallel to the uterine wall. Decidual natural killer DNK cells 5— Blood vessels d.
Remodeling of maternal spiral arteries by invading trophoblasts is completed by which week s of pregnancy? End-diastolic blood flow can be identified in the fetal umbilical artery by the end of which week of pregnancy? What is the name given to the phenomenon that describes how fetal cells can become engrafted in the mother during pregnancy and then be identified decades later?
Which of the following is a component of the amnion? Both arteries and veins are parallel to the uterine wall. Both arteries and veins are perpendicular to the uterine wall. Regarding the orientation of spiral blood vessels in relationship to the uterus.
Histocompatibility c. Immunological neutrality 5— Nerves b. Lymphatics c. Microchimerism b. Veins are perpendicular and arteries are parallel to the uterine wall.
Which of the following is accurate regarding a Meckel diverticulum? It is an allantoic duct remnant. It is a portion of one umbilical artery that remains patent postnatally. As shown in this figure. It is a failure of the intraabdominal portion of the umbilical vesicle to atrophy. It is a failure of the right umbilical vein to involute. Embryogenesis and fetal morphological development. Progesterone b. Chorionic adrenocorticotropin 5— Sexual differentiation of the male fetus d.
Ectopic pregnancy c. Gestational trophoblastic disease 5— Inhibition of relaxin secretion c. Human placental lactogen c. The hepatic vein c. Corticotropin-releasing hormone 5— Which of the following has the greatest production rate of any known human hormone? The ductus venosus d. The inferior vena cava 5— Rescue and maintenance of the corpus luteum 5— Human chorionic gonadotropin d.
Abnormally low levels of human chorionic gonadotropin hCG may be found most typically with which of the following? Follicle-stimulating hormone d.
Luteinizing hormone b. Maternal thyroid stimulation b. The portal vein b. Erythroblastosis fetalis d. Thyroid-stimulating hormone c. Among placental peptide hormones. Down syndrome b. Fetal demise b. Fetal adrenal hyperplasia c. It will cause a miscarriage. It will not alter the maternal excretion of urinary pregnanediol. Down syndrome c.
None of the above 5— Neuropeptide Y 5— Activin c. Which of the following conditions is associated with increased estrogen levels in pregnancy? Fetal placental sulfatase deficiency d. Fetal adrenal hypoplasia b. Inhibin d. Fetal anencephaly d. Fetal placental aromatase deficiency 5— It will cause a significant drop in progesterone. Figure 5—13 c p. Chorion and Decidua 5—18 c p. Multifetal gestation b.
All obstetrical deliveries 6—2. Maternal seizure disorder d. At term. Cholestasis of pregnancy c. For which situation is pathological examination of the placenta considered most informative and cost effective? Which of the following terms describes this surface of the placenta? Basal plate b. This is which type of placental variant? Chorionic plate 6—4. Placental bed d. Amniochorion c. Bilobate placenta b.
Succenturiate lobe c. Placenta fenestrata d. Circumvallate placenta 6—5. Jaya George. Which placental variant is marked by arrowheads in this image? The placenta in this image meets sonographic criteria for placentomegaly. Heather Lytle.
Compared with a normally shaped placenta. Circumvallate placenta 6—6. Cord avulsion b. Chorioamnionitis c. Uterine inversion d. Retained cotyledon 6—7. Excessive folds of amnion are present at the cord insertion site d. Syphilis b. Ziadie MS. Placental basal plate surface area significantly exceeds that of the chorionic plate 6—9.
Fatty liver of pregnancy d. Amnion rupture b. Total chorion surface area significantly exceeds that of the amnion c. Extrachorial placentation describes which of the following structural abnormalities? Diabetes mellitus c. Reproduced with permission from Hoffman BL.
Gestational trophoblastic neoplasia 6—8. Placental Chorioangioma update. Dashe JS. Stillbirth b. Which term best describes the small opaque plaque arrow seen on the fetal surface of this placenta? Intrapartum fetal acidosis d. None of the above 6— Placental abruption c. Subamnionic hematoma b. Maternal floor infarction c. Fetal thrombotic vasculopathy d. Subchorionic fibrin deposition.
Which of the following is most consistently associated with poor fetal outcomes such as miscarriage, growth restriction, preterm birth, and stillbirth? Perivillous fibrin deposition d. Which of the following is most consistently associated with placental abruption? Subchorial thrombosis c. The following placental tumor was found during routine fetal anatomic survey.
The differential diagnosis includes chorioangioma, placental hematoma, partial hydatidiform mole, teratoma, tumor metastasis, and leiomyoma.
What is most commonly first employed to help distinguish among these? Placental chorioangioma update. Williams Obstetrics, 22nd ed. Color Doppler imaging b. Chorionic villus sampling c. Three-dimensional sonography. Which of the following is true regarding calcium deposits within the placenta? These most commonly form just beneath the chorionic plate.
Deposits are associated with advancing gestation, nulliparity, and smoking. Grannum grade 3 lesions are consistently linked with intrapartum fetal acidosis and low Apgar scores. Which of the following is most consistently associated with large chorioangiomas? Fetal hydrops b. Pulmonary embolism c. Severe preeclampsia d. Gestational diabetes.
Which of the following cancers most frequently metastasizes to the placenta? Colon b. Gastric c. Ovarian d. Which route of bacterial inoculation causes most cases of chorioamnionitis? Hematogenous spread from maternal blood b. Direct spread through the fallopian tubes c.
Ascension from the lower reproductive tract d. Needle inoculation during intraamnionic procedures. Which of the following risk factors is most commonly associated with chorioamnionitis? Maternal drug abuse b. Poor maternal hygiene c. Prior cesarean delivery d. Prolonged rupture of membranes. With chorioamnionitis, fetal contact with bacteria through which of the following routes may lead to fetal infection? Aspiration b. Swallowing c. Hematogenous d.
The multiple, small, raised lesions of amnion nodosum are most commonly associated with which of the following? Oligohydramnios b. Meconium staining d. Placental abruption. Sonographically, an amnionic sheet or band may reflect several different clinical conditions. Which of the following poses the greatest fetal risk? Amnionic band b. Amniochorion of a vanishing twin c. Amniochorion of a circumvallate placenta d.
Amniochorion of a pregnancy in one horn of a partial bicornuate uterus. A short umbilical cord may be associated with which of the following perinatal outcomes? Intrapartum distress b. Fetal-growth restriction c. Congenital malformations d. A long umbilical cord may be more commonly associated with which of the following? Cord prolapse b. Cord false knots c. Cord pseudocysts d.
Velamentous insertion. The number of complete coils per centimeter of cord length has been termed the umbilical coiling index. Which of the following is true of cord coiling? A normal coiling index in a postpartum cord approximates 1. Hypocoiling has not been associated with adverse fetal outcomes. Hypercoiling has been associated with greater rates of intrapartum fetal acidosis. A transverse-plane sonographic image of the lower abdomen from a week fetus is shown here.
What is the most reasonable next step? Fetal karyotyping b.
Continued routine prenatal care only c. Detailed sonographic anatomic survey d. Radiofrequency ablation of this anomaly. Sectioning of a term umbilical cord after delivery may reveal embryonic remnants. Which of the following would not be possibly found? Wolffian duct b. Vitelline duct c. Allantoic duct d. Second umbilical vein. A single umbilical cord cyst is found during a first-trimester scan performed for vaginal bleeding.
Chorionic villus sampling b. Repeated sonographic evaluation in the second trimester d. Counsel regarding pregnancy termination of this anomalous pregnancy. Practicing for Practice. Arnold Melnick. Diabetes in Elderly People. Colin M. Informed Consent in Predictive Genetic Testing.
Models of Care in Women's Health. Tahir Mahmood. Chlamydial Infections. Peter Reeve. Gynaecology by Ten Teachers. Louise Kenny. Beyond the Baby Blues. Amy Wenzel. Management and Therapy of Late Pregnancy Complications. Antonio Malvasi. Eicosanoids, Lipid Peroxidation and Cancer.
Santosh K. Advances in Perinatal Medicine. Aubrey Milunsky. Hormonal Disorders in Gynecology. Clinical In Vitro Fertilization. Carl Wood. Queenan's Management of High-Risk Pregnancy. John T. Managing Cancer during Pregnancy. Hatem A. Azim Jr. Frontiers in Ovarian Cancer Science. Hidetaka Katabuchi. Office Gynecology.