Obstetrics

Question 1

Tuboovarian abscess treatment? threshold for surgery?

Answer 1

abx first/>8 cm do CT guided drainage

Question 2

when does HELLP occur?

Answer 2

always after 20 weeks, mostly in the 28-36 week

Question 3

tx for HELLP?

Answer 3

if >34 weeks deliver

if <34 wks give steroids and deliver

Question 4

differentiate TTP and HELLP in pregnancy?

Answer 4

TTP earlier and more renal failure

HELLP with more HTN

Question 5

AFLP presentation?

Answer 5

liver failure with hypoglycemia and coagulopathy, third trimester

Question 6

inherited defect in AFLP?

Answer 6

mitochondrial beta oxidation of fatty acids

Question 7

preeclampsia timing?

Answer 7

> 20 weeks

Question 8

criteria for preeclampsia?

Answer 8

new HTN plus proteinuria or end organ dysfunction

Question 9

tx for preeclampsia?

Answer 9

if <33 weeks give steroids and deliver if high risk features

Question 10

tx of PHTN and rV failure in pregnancyu?

Answer 10

epoprostenol

Question 11

tx of PHTN without RV failure in pregnancy?

Answer 11

can use PDE inhibitors, considered safe

Question 12

firs trimester thionamide for thyroid storm?

Answer 12

PTU

Question 13

after first trimester thionamide?

Answer 13

methimazole

Question 14

other thryoid storm gems in pregnancy?

Answer 14

no prolonged BB use

Question 15

what time frame to do emergency c section in cardiac arrest?

Answer 15

within 5 minutes

Question 16

signs of uterine rupture?

Answer 16

decline in fetal heart rate, abdominal pain and vaginal bleeding, loss of fetal station on examination

Question 17

treatment of intrahepatic cholestasis of pregnancy

?

Answer 17

ursodeoxucholic acid

Question 18

how to treat hypermagnasemia?

Answer 18

calcium

Question 19

tx of severe preeclampsia?

Answer 19

fluids, BP mgmt, magnseium for seizure prophylaxis

Question 20

tx for uterine atony causing massive bleeding?

Answer 20

uterine massage, oxytocin, prostaglandin, intrauterine balloon, TXA

Question 21

placenta previa timing? sx?

Answer 21

third trimester, painless vaginal bleeding

Question 22

tx of acute heart failure in PPCM?

Answer 22

nitrates, hydralazine, digoxin, heparin

avoid ACE and BB

Question 23

tocolytic pulmonary edema?

Answer 23

stict hypoxic pulm edema without raised pressures after attempts to delay delivery

Question 24

impaired milk production post partum?

Answer 24

sheehan syndrome, pituitary ischemia

Question 25

SCAD tx?

Answer 25

aspirin and nitro PRN, can give ACE inhibitors long term

no PCI