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OB > MTB3 1 > Flashcards

MTB3 1 Flashcards

1
Q

What does quad screen look like in Trisomy 21

A

Decreased MSAFP, Estriol

Increased B-HCG

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2
Q

Painful late vaginal bleeding

A

Abruptio placenta

Uterine rupture

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3
Q

Painless vaginal bleeding

A

Placenta previa

Vasa previa

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4
Q

When is RhD given in Rh negative mothers

A

At 28 weeks

  • W/in 72 hrs of delivery
  • after miscarriage or abortion
  • during amniocentesis or CVS
  • w heavy vaginal bleeding
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5
Q

Protuberance in lower abdomen = palpable fetal parts

A

Uterine Rupture

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6
Q

Which Infxn are CI to breastfeeding

A 
HIV
Active TB 
HTLV -1
Hep B before infant immunized
HSV if breast lesion
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7
Q

What is elevated LDH indicative of

A

Hemolysis

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8
Q

Management of HELLP

A
  1. Immediate delivery
  2. IV steroids if plateletes <50,000 w C section
  3. IV MgSO4
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9
Q

Management of HELLP

A
  1. Immediate delivery
  2. IV steroids if plateletes <50,000 w C section
  3. IV MgSO4
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10
Q

Adverse effect of unfractionated heparin

A

Osteopenia

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11
Q

What can cross the placenta in Grave’s

A

Maternal thyroid stimulating Igs

Thyroid blocking Igs

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12
Q

Fetal effects of maternal Grave’s

A

Fetal tachycardia
Growth restriction
Goiter

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13
Q

Tx and Dx of intrahepatic cholestasis of pregnancy

A

Dx: 10-100 fold increase in serum bile acids
Tx: Ursodeoxycholic acid

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14
Q

Tx and Dx of intrahepatic cholestasis of pregnancy

A

Dx: 10-100 fold increase in serum bile acids
Tx: Ursodeoxycholic acid

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15
Q

Pt at 7 wks gestation presents with vaginal bleeding and pelvic pain
Dx and W/U

A

Threatened abortion
Speculum exam in early pregnancy
If advanced - US or doppler

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16
Q

Painful cramps, continued bleeding and dilated cervix

A

Inevitable abortion

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17
Q

What is the difference b/t Doppler and US?

A

Both use sound waves
Doppler shows blood flow through vessels
US does not

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18
Q

How do we Dx Ectopic pregnancy

A

b-HCG > 1,500 mIU
AND
No IU pregnancy seen on vaginal sonogram

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19
Q

Amenorrhea + Vaginal bleeding + Unilateral pelvic - abdominal pain

A

Ectopic pregnancy

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20
Q

What is an incompetent cervix

A

Too weak to stay closed during pregnancy

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21
Q

PROM before 24 weeks management

A

Bed rest at home

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22
Q

PROM b/t 24-33 weeks

A

Hospitalize
IM betamethasone if < 32 wks
Cervical cultures
PPX Ampicillin and erythromycin 7 days

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23
Q

PROM greater than 34 wks

A

Initiate delivery

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24
Q

Most feared complication w PROM

A

Chorioamnionitis

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25
Q

What is an adequate CTX

A
  1. Every 2-3 mins
  2. Lasting 45-60 secs
  3. Has 50 mmHg intensity
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26
Q

What is the management of umbilical cord prolapse

A
  1. Place pt in knee-chest position
  2. Terbutaline to decrease force of CTX
  3. Immediate C section
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27
Q

Causes of nonreassuring fetal tracings

A

Hypoxia

Meds - Beta agonist, beta blockers

28
Q

What are the causes of postpartum fever @ Day 0

Tx

A

Atelectasis
Rales, pt can’t take deep breath
Incentive spirometry, ambulate

29
Q

What are the causes of postpartum fever @ Day 1

Tx

A

UTI
CVA tender, +UA, culture
IV ABX

30
Q

What are the causes of postpartum fever @ Days 2-3

Tx

A

Endometritis
Uterine tenderness, peritoneal si’s
IV Abx - gent and clinda

31
Q

What are the causes of postpartum fever @ Days 4-5

Tx

A

Wound Infxn
Persistent spiking fevers
Would erythema, fluctuance
IV Abx, wet to dry would packing, closure

32
Q

What are the causes of postpartum fever @ Days 5-6

Tx

A

Septic thrombophlebitis
Persistent wide fever
IV heparin 7-10 days

33
Q

What are the causes of postpartum fever @ Days 7-21

Tx

A

Infectious mastitis
Unilateral breast tenderness, erythema, edema
PO cloxacillin, continue breast feeds

34
Q

Anterior Mediastinal mass DDX

A 
4 T's
Thymoma
Teratoma
Thyroid Neoplasm
Terrible Lymphoma
35
Q

Lab findings in Seminoma

A

Increased b-HCG

AFP usually normal

36
Q

Lab findings in non-seminomatous germ cell tumor

A

High AFP

37
Q

What is a normal full body respiratory quotient

A

0.8

High protein diet

38
Q

What is a respiratory quotient > 1.0 indicative of

A

Carbohydrates are sole source of fuel and net lipogenesis is occurring

39
Q

What CO2 and O2 values are seen with mechanical overfeeding

A

High CO2 production

40
Q

Most important AE of raloxifene

A

Increased thromboembolism

41
Q

Effect of raloxifene on breast cancer

A

Decreases risk

42
Q

Tamoxifen increases risk for what cancer

A

Endometrial

43
Q

How does a pregnancy luteoma present

A

Bilateral
Multinodular
Solid masses on both ovaries

44
Q

Pregnancy luteoma risk factors

A

African American
Multiparous
30’s or 40’s

45
Q

Sx’s of pregnancy luteoma

A

Asymptomatic
Virilization
Hirsutism

46
Q

Management of Pregnancy luteoma

A

Reassurance
US follow up
Benign

47
Q

Sx’s of pathologic vaginal discharge

A

Pruritis
Burning
Malodorous

48
Q

Vaginal exam of pathologic vaginal discharge

A

Erythema
Friability of vaginal mucosa
Tenderness of cervix
Green/curd-like

49
Q

Physiologic leukorrhea

A 
Copious vaginal discharge
White or yellow
Nonmalodorous
Absence of other sx's
Predominance of Squamous cells may be seen with PMNs
50
Q

Presentation of patient with acute pancreatitis w secondary ileus

A

Abdominal pain
Vomiting
Decreased bowel sounds, tender abdomen
Labs - high BR, ALT, AP, Lipase, leukocyte, BUN

51
Q

Treatment of acute pancreatitis

A 
IVF
NG tube suction
NPO
Analgesia
Abx if severe
52
Q

What labs should be monitored in acute pancreatitis

A

Calcium

Magnesium

53
Q

Test for gallstone detection

A

Endoscopic US

ERCP

54
Q

TX for biliary pancreatitis in stable pt

A

Laparoscopic cholecystectomy

55
Q

Peak airway pressure is sum of what?

A

Airway resistance + Plateau pressure

- Plateau pressure = Elastic pressure + PEEP

56
Q

How do we calculate PEEP

A

End-expiratory hold maneuver

57
Q

Where do we see Muddy brown granular casts

A

ATN

58
Q

Where do we see RBC casts

A

Glomerulonephritis

59
Q

Where do we see WBC casts

A

Interstitial nephritis

Pyelonephritis

60
Q

Where do we see fatty casts

A

Nephrotic syndrome

61
Q

Where do we see broad and waxy casts

A

Chronic Renal Failure

62
Q

Pt with A fib with worsening fatigue and irregular hR - next step in management

A

Assess CHADS-VASc score

Warfarin if needed

63
Q

Causes of transient proteinuria

A 
Fever
Exercise
Seizures
Stress 
Volume depletion
64
Q

Proteinuria in child with fever, temp, myalgias, no other findings on UA - next step?

A

Repeat dipstick on 2 occasions
If negative -> transient proteinuria
If positive -> refer to pediatric nephrologist for renal dz assessment

65
Q

Post op atelectasis Presentation

A

Asymptomatic
Increased work of breathing
2nd - 5th post op night

66
Q

Atelectasis radiologic findings

A

Loss of lung volume b/c of collapsed lung tissue

67
Q

Atelectasis pathophysiology

A

Change in lung compliance -> impaired cough and shallow breathing
Shallow inhalations limit lung base recruitment
Weak cough -> small airway mucus plugging
Hypoxia = low pO2 stimulates increased RR and low pCO2

OB (4 decks)

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