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Oral board studying Prep book > Antibiotic ppx, recurrent pregnancy loss, isoimmunization, Anemia in pregnancy > Flashcards

Antibiotic ppx, recurrent pregnancy loss, isoimmunization, Anemia in pregnancy Flashcards

1
Q

What is the antibiotic ppx for c-section?

A

2g of Ancef up to 60min prior to incision or weight based dosing

or

Clindamycin/gentamicin

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2
Q

What is the antibiotic ppx for PPROM?

A

Azithromycin 1g x 1 dose + ampicillin 2g q6hr x 48hrs

Amoxicillin PO for 5 days

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3
Q

What is the definition of recurrent pregnancy loss?

A

2 or more spontaneous pregnancy losses

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4
Q

What is the incidence of spontaneous abortion?

A

10% of diagnosed pregnancies

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5
Q

What are some causes of recurrent pregnancy loss?

A
  1. Uterine abnormalities
  2. Genetics (translocation)
  3. Hormonal/metabolic (thyroid, diabetes)
  4. Environmental/lifestyle (smoking, drugs, obesity)
  5. Immune disorders (APS)
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6
Q

When is a workup for recurrent pregnancy loss indicated?

A

after 2 losses

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7
Q

What is the workup for recurrent pregnancy loss?

A
  1. History
  2. Examination
  3. Tests (TSH, urine tox, APS testing)
  4. Karotype analysis of parents
  5. Karotype analysis of fetus
  6. HSG
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8
Q

What is the order of workup for isoimmunization Rh?

A

Screen mom for blood type and antibodies–> if antibody screen positive test dad for antigen and genotype–>If titer is 16 or greater then MCA doppler for anemia –> determine treatment (obs, transfusion, delivery)

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9
Q

What are the 2 doses of rhogham and when should they be used?

A

Mini dose= 50 (used in first trimester)
regular dose= 300ugm

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10
Q

How long is rhogham effective for?

A

10-12 weeks

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11
Q

Should you give rhogham if patient has positive antibody screen?

A

No

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12
Q

How much fetal blood is covered by dose of rhogham?

A

15ml

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13
Q

How much whole blood is covered by dose of rhogham?

A

30ml

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14
Q

What are the minor antigens?

A

Kell= K (Kills)
Duffy= D (Dies)
Lewis= L (Lives)

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15
Q

What is the kleihauer -betke test?

A

Test to calculate the amount of fetal blood in maternal circulation

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16
Q

What are the different types of anemias?

A
  1. Microcytic anemia
  2. Normocytic anemia
  3. Macrocytic anemia
17
Q

What are causes of microcytic anemia?

A

Iron deficiency, thalassemias

18
Q

What are causes of normocytic anemia?

A

Sickle cell disease

19
Q

What are causes of macrocytic anemia?

A

Folate and B12 deficiency

20
Q

When should you screen for anemia in pregnancy?

A

First trimester
24-29 weeks gestation

21
Q

When do you further evaluate anemia in pregnancy?

22
Q

What is adult hemoglobin composed of?

A

Hb A= 2 alpha + 2 beta
Hb A2= 2 alpha + 2 delta
Hb F= 2 alpha + 2 gamma

23
Q

When does HbF predominate in the fetus?

A

12-24 weeks

24
Q

Is sickle cell disease autosomal dominant or autosomal recessive?

A

Autosomal recessive

25
Q

What is the sickle cell trait genotype?

A

Heterozygous HbAS

26
Q

What is the sickle cell disease genotype?

A

Homozygous HbSS

27
Q

What is the pathophysiology of sickle cell disease?

A

Due to decreased oxygen the RBCs sickle leading to microvascular obstruction. Obstruction leads to decreased perfusion and organ damage

28
Q

What is acute chest syndrome?

A

Pulmonary infiltrate
Fever
Hypoxemia
Acidosis

29
Q

What is the most significant consequence of sickle cell disease?

A

Acute chest syndrome

30
Q

How do you diagnose sickle cell disease?

A

Hb electrophoresis

31
Q

What are the maternal risks of sickle cell in pregnancy?

A
  1. Increased frequency of crisis
  2. Increased risk of GHTN
  3. Increased risk of infection
32
Q

What are the fetal risks associated with sickle cell disease in pregnancy?

A
  1. SAB
  2. IUGR
  3. IUFD
33
Q

What is the management of sickle cell in pregnancy?

A
  1. Increase folate acid to 4mg daily
  2. Fetal surveillance
  3. Crisis management
34
Q

How do you handle a pain crisis in pregnancy from sickle cell?

A
  1. Pain control
  2. Oxygen
  3. If infection, treat it
35
Q

alpha thalassemia minor?

A

2 alpha chains absent, mild anemia

36
Q

Hemoglobin H disease?

A

alpha thalassemia with 3 genes absent, moderate hemolytic anemia

37
Q

Barts disease?

A

alpha thalassemia major with 4 genes absent, hydrops

Oral board studying Prep book (50 decks)

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