Medical OB Gynecology Flashcards
Kernig sign
when a patient is unable to extend their leg at the knee when the thigh is flexed because of severe pain or resistance.
Kernig’s sign is a good indication that the patient is suffering from meningitis.
An average-weight adult has approximately 5-6 L of total blood in their body. Of the total body weight, blood accounts for what percentage?
Blood accounts for approximately 8% of the total body weight. Blood is comprised of plasma and formed elements.
Brudzinski’s sign
an indication of meningitis.
It involves the involuntary flexion of the knees when the head is bowed to the chest.
Babinski’s sign
is an abnormal plantar reflex.
Hamman sign
a crunching sound heard over the heart
sign of a pneumomediastinum.
Cullen’s sign
bruising around the umbilicus, secondary to intra-abdominal hemorrhage.
Which of the following medications is the first-line treatment for anaphylaxis in a patient with no contraindications?
Toradol (Ketorolac)
Epinephrine (Adrenalin)
Diphenhydramine (Benadryl)
Methylprednisolone (Solumedrol)
Correct answer: Epinephrine (Adrenalin)
Epinephrine is the first-line treatment for anaphylaxis. It acts rapidly to reverse the symptoms by constricting blood vessels, relaxing bronchial muscles, and increasing heart rate and blood pressure.
Diphenhydramine (Benadryl) may be used as an adjunct therapy to relieve itching and hives but should not replace epinephrine as the primary treatment for anaphylaxis.
Toradol (Ketorolac) is a non-steroidal anti-inflammatory drug (NSAID) used for pain relief but is not indicated for the treatment of anaphylaxis.
Methylprednisolone (Solumedrol), a corticosteroid, may be used in managing an allergic reaction but is not appropriate for the acute phase of anaphylaxis.
The primary location for the body’s cell production?
Bone marrow
What organ is responsible for producing the blood’s coagulation factors?
Liver
The body’s clotting factors are produced within the liver.
The liver is also responsible for filtering the blood.
The liver breaks down old red blood cells and turns them into bile.
Which of the following relates to increased intracranial pressure (ICP)?
A
Bernoulli’s Principle
B
Monro-Kellie doctrine
C
Fick Principle
D
Frank-Starling Law
Correct answer: Monro-Kellie doctrine
The cranial vault is 100% filled by the brain, cerebrospinal fluid (CSF), and blood.
In response to an expanding intracranial mass, the body attempts to reduce ICP by expelling CSF and venous blood from the cranial vault.
During the early stages, this mechanism successfully creates more space for the mass and keeps ICP within normal limits.
What condition is most likely to cause an adult female patient to present with non-traumatic lower abdominal quadrant pain reported as severe, agonizing, and often radiating to the patient’s shoulders?
Splenic rupture
Renal calculi
Ovarian cyst rupture
Ectopic pregnancy rupture
Correct answer: Ectopic pregnancy rupture
Adult females who present with non-traumatic lower abdominal quadrant pain reported as severe, agonizing, and often radiates to the patient’s shoulders should be suspected of having an ectopic pregnancy, especially when other factors point to the possibility.
Which of the following is responsible for the production and release of albumin, fibrinogen, globulins, and clotting factor?
Pancreas
Liver
Bone marrow
Plasma
Correct answer: Liver
The liver is the main line of defense against many by-products of metabolism that become toxic if allowed to accumulate in the body. The blood proteins, albumin, fibrinogen, globulins, and clotting factor are also made and released into the general circulation by the liver.
IV solutions can be categorized by their tonicity. Which IV solutions are correctly categorized below?
Select the 2 answer options which are correct.
3% saline is hypertonic
5% dextrose in water is hypertonic
0.9% sodium chloride is hypotonic
Lactated Ringer’s solution is isotonic
Correct answer: 3% saline is HYPERTONIC and Lactated Ringer’s are ISOTONIC.
Isotonic solutions include 0.9% sodium chloride (normal saline) and lactated Ringer’s solution (LR).
-Used for fluid replacement and volume expansion.
3% saline is considered hypertonic.
- Commonly used to reduce edema and facilitate fluid removal in the urine.
5% dextrose in water (D5W) is a unique solution that is isotonic in the bag but, when administered, becomes hypotonic in the body.
- Commonly used to dilute medications for IV administration.
What’s Unique about DW5 (5% Dextrose)?
It is ISOTONIC in the bag but,
- when administered,
= becomes HYPOTONIC in the body.
What is the Tonicity of 3% Saline and what is it used for?
to reduce edema and facilitate fluid removal in the urine.
What type of solution is 0.9% sodium chloride (normal saline) and lactated Ringers and what are they used for?
fluid replacement and volume expansion
What are these blood sample tubes primarily used for at the Hospital?
Lavender top
Red top
Green top
Light blue top
A light blue top blood sample tube contains sodium citrate.
- This tube is used primarily for blood coagulation studies.
The lavender (or purple) top blood sample tube contains the anticoagulant ethylenediaminetetraacetic acid (EDTA). I
- It is used for blood cell counts, hemoglobin, hematocrit, erythrocyte sedimentation rate, glycohemoglobin, and HIV testing. These tubes are used for whole-blood hematology testing.
Red top blood sample tubes do not contain any additives or preservatives.
- They are used primarily for serum electrolytes, liver enzymes, therapeutic drug levels, and blood bank procedures.
Green top blood sample tubes contain the anticoagulant heparin.
- They are primarily used to test electrolytes, glucose, and cardiac enzymes.
What is a naturally occurring steroidal hormone produced by the adrenal cortex to help regulate the sodium/potassium balance in the blood?
Aldosterone
a naturally occurring steroidal hormone produced by the adrenal cortex.
It is used by the body as a means to regulate the essential balance of sodium and potassium in the blood.
Gravida (Gravidity)
The total number of confirmed pregnancies a woman has had, including current pregnancies and those that did not result in a live birth.
Para (Parity)
The number of live births a woman has carried full term.
Hemothorax
Blood into thoracic cavity.
Diminished lung sounds
flat neck veins
dull to percussion
Tension Pneumothorax
absent lung sounds
distended neck veins
hyper resonant to percussion
HELLP Syndrome
a severe form of preeclampsia
H-EL-LP
H - Hemolysis (the breakdown of red blood cells)
EL - Elevated liver enzymes
LP - Low Platelet count.
PE-RF-PH-S
Pulmonary Edema
Renal failure
Postpartum Hemorrhage
Stroke
Hemolysis
Breakdown of red blood cells
What are the signs and symptoms of a thyroid storm?
Tachycardia,
tachypnea,
hyperthermia,
palpitations
delirium
The acute hyperfunction thyroid event is known as thyroid storm and is a true medical emergency that can quickly lead to death if medical intervention is not initiated quickly.
Patients with thyroid storm often present with often severe tachycardia, tachypnea, hyperthermia, palpitations, and often, delirium or coma.
Major or critical burn criteria requiring a burn center?
Adults = Burn greater than >25% of TBSA
Children/Elderly = Greater than >20%
Full-thickness burn that involves greater than 10% TBSA.
Critical burns also involve all burns to the face, neck, torso, and genitalia.
Caustic agent as well as inhalation burns of all types are critical and considered major burns.
Major burns should be transported to a burn center.
Flat neck veins
Hypovolemia
Spontaneous Pneumothorax
A spontaneous pneumothorax (SP) occurs when “blebs” or weak spots on the surface of a patient’s lung burst.
Commonly occurs from coughing against a closed glottis.
It is described as a “snap, crackle, pop” sensation under the skin when palpated.
Dunphy sign
Sharp pain in the RLQ elicited by a voluntary cough
= possible Appendicitis/Peritonitis
Homan sign
DVT test
Dorsiflexion of foot with positive pain behind knee or calf
= positive DVT
Burn damage from chemical agent: 4 factors
- The CONCENTRATION and quality of the agent
- The chemical state or TEMPERATURE of the agent
- The LENGTH of EXPOSURE
- The DEPTH of burn PENETRATION
Causes of false pulse oximetry readings
Carbon monoxide and Cyanide poisonings
Treatment for PreEeclampsia-induced hypertension
Hydralazine (Apresoline)
Nifedipine (Adipine)
Labetalol (Trandate).
8 D’s of stroke care?
Detection
Dispatch
Delivery
Door
Data
Decision
Drug/Device
Disposition
At least how many responders are needed based on resuscitation guidelines?
6
Team leader
Compressor
Airway manager
AED/Monitor/Defibrillator
IV/IO medication provider
Time recorder
Your 55-year-old patient is suspected of having a myocardial infarction. He is complaining of substernal chest pain that came on during rest. His heart rate is 88 beats per minute, and his respirations are 20. His skin is cool, pale, and diaphoretic with a blood pressure of 110 systolic.
What does the presence of pale, diaphoretic skin typically indicate during a cardiac event?
A
The heart has lost the ability to be an effective forward pump
B
Peripheral vasoconstriction and sympathetic nervous system stimulation
C
Central vasodilation and parasympathetic nervous system stimulation
D
Inadequate cardiac output due to myocardial ischemia
B).
PERIPHERAL VASOCONSTRICTION and SYMPATHETIC NERVOUS SYSTEM STIMULATION
Patients experiencing a myocardial infarction often suffer from peripheral vasoconstriction, tachycardia, pale cool skin, and diaphoresis as part of the sympathetic nervous system stimulation.
What medication is indicated for a pt with symptoms of a thyroid storm?
Propanolol (Inderal)
Your 69-year-old patient awoke with severe dyspnea and is only able to talk in two- to three-word bursts. Her skin is cool, pale, and diaphoretic with labored respirations at 30 with an SPO2 of 80% on room air. She has audible wheezes and rales with pitting edema peripherally. She has an irregular heart rate of 100 to 110 bpm, and her ECG shows A-fib with no obvious pathological ST elevation or depression. Her blood pressure is 160/100 in an upright sitting position. She has a history of COPD, hypertension, and congestive heart failure.
Which of the following would be a first-line medication for this patient?
a. Morphine
b. Albuterol
c. Furosemide
d. Nitroglycerin
