Inservice Deck 6 - OB/GYN ED and pediatric

Question 1

Most common surgical emergency in pregnancy?

Answer 1

appendicitis

Question 2

female recently post-partum with signs of CHF has what diagnosis?

Answer 2

cardiomyopathy (dilated)

Question 3

peripartum cardiomyopathy treatment in ED?

Answer 3

fluid restriction, diuretic, ACE +/- dig, anticoag with heparin

Question 4

recent postpartum with fever, foul-smelling vag discharge, swollen tender uterus has what diagnosis? tx and dispo?

Answer 4

endometritis
IV abx
admit

Question 5

GERD treatment if antacids haven’t worked?

Answer 5

H2 blocker, PPI

Question 6

Most sensitive modality for 26 week pregnant patient s/p blunt trauma with abd pain?

Answer 6

cardiotocographic monitoring

Question 7

patient with second trimester bleeding and large uterus

Answer 7

molar pregnancy (snowstorm US)

Question 8

classic presentation of patient with placenta previa?

Answer 8

painless 3rd trimester bleeding

Question 9

diagnosis of 35 year old 25 weeks pregnant presenting with BP 160/11, AST/ALT 600/500 and 75K platelets?

Answer 9

HELLP syndrome

Question 10

most common cause of death with HELLP syndrome?

Answer 10

hemorrhage (intracranial, then hepatic/splenic), tx with delivery

Question 11

pregnant and seizing, medication? diagnosis?

Answer 11

eclampsia, Mg 4-6 g IV over 15 minutes

Question 12

patient given Mg, when respirations drop to 8 and sats 90%, management?

Answer 12

CaCl, stop mg

Question 13

patient with history of c section, now having twins presents with severe abd pain and hypotension. Dx?

Answer 13

uterine rupture

Question 14

number 1 cause of postpartum hemorrhage?

Answer 14

uterine atony

Question 15

next step for 30 year old female who has beta hcg of 6000, empty uterus, and BP 98/50

Answer 15

OR, ectopic pregnancy

Question 16

initial fluid bolus for children?

Answer 16

20 cc/kg

Question 17

2 week old child who develops cyanosis that is not improved with high flow oxygen has cardiac or pulmonary defect?

Answer 17

cardiac

Question 18

1 day old brought in for vomiting after all feeds with respiratory difficulty. No NGT

Answer 18

tracheosophageal fistula/esophageal atresia

Question 19

steeple sign is associated with what illness?

Answer 19

croup

Question 20

tx when patient peds toxic and in respiratory distress with steeple sign

Answer 20

intubate and perform bronch, concern for bacterial tracheitis

Question 21

med indicated if child with croup remains in respiratory distress despite saline nebs?

Answer 21

epi nebs

Question 22

4 month old male with wheezing, sats 90%, occ rales, nontoxic and with nonspecific xray. Dx?

Answer 22

bronchiolitis

Question 23

differential in non-consolable, afebrile, crying infant?

Answer 23

CRYING

corneal abrasions
rectal - fissure/abscess
Yarn/hair tourniquet
Intussusception, infection/meningitis
non-accidental trauma
GU (torsion, phimosis, hernia

Question 24

how far should umbilical vein catheter be placed?

Answer 24

until blood returns

Question 25

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?

Answer 25

bronchopulmonary dysplasia

Question 26

1 week old preemie has fever and acute abdomen? radiology sign?

Answer 26

necrotizing enterocolitis

pneumatosis intestinalis

Question 27

most common cause of massive lower GI bleed in child

Answer 27

meckels

Question 28

fracture in 2 year old who refuses to walk

Answer 28

spiral fracture of tibia

Question 29

most common cause of bloody stool in 8 month old?

Answer 29

anal fissure

Question 30

6 month old child with intermittent colicky abd pain, vomiting, heme pos stool, mild dehydration. Dx and tx?

Answer 30

intussusception, air enema

Question 31

well appearing 3 year old with pain in joints, low grade fever, maculopapular rash?

Answer 31

juvenile RA

Question 32

finding on a plain film of child with suspected intussusception would render barium enema contraindicated?

Answer 32

free air

Question 33

next test in 2 month old with projectile vomit, wave, no mass on exam?

Answer 33

US to rule out pyloric stenosis

Question 34

3 week old infant presents with fever and otitis media. What work up?

Answer 34

septic work up, give abx

Question 35

what is the most common symptom of a VP shunt infection?

Answer 35

fever

Question 36

tx of kawasaki disease?

Answer 36

IVIG, high dose ASA

Question 37

6 month old with suprapubic mass, 3 weeks constipation, no stool in vault has what?

Answer 37

hirschsprung’s disease

Question 38

dispo for 2 week old first born male iwth non-bilious projectile vomiting

Answer 38

pyloric stenosis

surgery

Question 39

most common cong heart abnormality in 5 day old cyanotic pt

Answer 39

transposition of great vessels

Question 40

tx fo unstable child with SVT

Answer 40

synchronized cardioversion

Question 41

full term baby delivered has HR of 140, decreased respirations. First step?

Answer 41

warm and stimulate

then bag with oxygen

Question 42

3 week old with conjunctivitis. What tx?

Answer 42

IM/IV cephalosporin and oral erythromycin

Question 43

5 year old with positive sweat test has PNA. Pathogen?

Answer 43

pseudomonas

Question 44

most common cause of jaundice in first week of life

Answer 44

physiologic