Inservice Deck 6 - OB/GYN ED and pediatric Flashcards
Most common surgical emergency in pregnancy?
appendicitis
female recently post-partum with signs of CHF has what diagnosis?
cardiomyopathy (dilated)
peripartum cardiomyopathy treatment in ED?
fluid restriction, diuretic, ACE +/- dig, anticoag with heparin
recent postpartum with fever, foul-smelling vag discharge, swollen tender uterus has what diagnosis? tx and dispo?
endometritis
IV abx
admit
GERD treatment if antacids haven’t worked?
H2 blocker, PPI
Most sensitive modality for 26 week pregnant patient s/p blunt trauma with abd pain?
cardiotocographic monitoring
patient with second trimester bleeding and large uterus
molar pregnancy (snowstorm US)
classic presentation of patient with placenta previa?
painless 3rd trimester bleeding
diagnosis of 35 year old 25 weeks pregnant presenting with BP 160/11, AST/ALT 600/500 and 75K platelets?
HELLP syndrome
most common cause of death with HELLP syndrome?
hemorrhage (intracranial, then hepatic/splenic), tx with delivery
pregnant and seizing, medication? diagnosis?
eclampsia, Mg 4-6 g IV over 15 minutes
patient given Mg, when respirations drop to 8 and sats 90%, management?
CaCl, stop mg
patient with history of c section, now having twins presents with severe abd pain and hypotension. Dx?
uterine rupture
number 1 cause of postpartum hemorrhage?
uterine atony
next step for 30 year old female who has beta hcg of 6000, empty uterus, and BP 98/50
OR, ectopic pregnancy
initial fluid bolus for children?
20 cc/kg
2 week old child who develops cyanosis that is not improved with high flow oxygen has cardiac or pulmonary defect?
cardiac
1 day old brought in for vomiting after all feeds with respiratory difficulty. No NGT
tracheosophageal fistula/esophageal atresia
steeple sign is associated with what illness?
croup
tx when patient peds toxic and in respiratory distress with steeple sign
intubate and perform bronch, concern for bacterial tracheitis
med indicated if child with croup remains in respiratory distress despite saline nebs?
epi nebs
4 month old male with wheezing, sats 90%, occ rales, nontoxic and with nonspecific xray. Dx?
bronchiolitis
differential in non-consolable, afebrile, crying infant?
CRYING
corneal abrasions rectal - fissure/abscess Yarn/hair tourniquet Intussusception, infection/meningitis non-accidental trauma GU (torsion, phimosis, hernia
how far should umbilical vein catheter be placed?
until blood returns
2 month old premature child who had required mechanical ventilation at birth presents with tachypnea, sx of RAD. xray shows cystic changes. Patient improves with oxygen and nutrition has what?
bronchopulmonary dysplasia
1 week old preemie has fever and acute abdomen? radiology sign?
necrotizing enterocolitis
pneumatosis intestinalis
most common cause of massive lower GI bleed in child
meckels
fracture in 2 year old who refuses to walk
spiral fracture of tibia
most common cause of bloody stool in 8 month old?
anal fissure
6 month old child with intermittent colicky abd pain, vomiting, heme pos stool, mild dehydration. Dx and tx?
intussusception, air enema
well appearing 3 year old with pain in joints, low grade fever, maculopapular rash?
juvenile RA
finding on a plain film of child with suspected intussusception would render barium enema contraindicated?
free air
next test in 2 month old with projectile vomit, wave, no mass on exam?
US to rule out pyloric stenosis
3 week old infant presents with fever and otitis media. What work up?
septic work up, give abx
what is the most common symptom of a VP shunt infection?
fever
tx of kawasaki disease?
IVIG, high dose ASA
6 month old with suprapubic mass, 3 weeks constipation, no stool in vault has what?
hirschsprung’s disease
dispo for 2 week old first born male iwth non-bilious projectile vomiting
pyloric stenosis
surgery
most common cong heart abnormality in 5 day old cyanotic pt
transposition of great vessels
tx fo unstable child with SVT
synchronized cardioversion
full term baby delivered has HR of 140, decreased respirations. First step?
warm and stimulate
then bag with oxygen
3 week old with conjunctivitis. What tx?
IM/IV cephalosporin and oral erythromycin
5 year old with positive sweat test has PNA. Pathogen?
pseudomonas
most common cause of jaundice in first week of life
physiologic