Statistics Flashcards
Formula that relates sample size, power and effect size
n = [(Type 1 error)+Power]/Effect size
Regression model that takes into account the time to an event
Cox regression
Regression that adjusts for confounders of a continuous variable
Linear regression
Regression model for a categorical outcome
Logistic regression
Regression model for outcomes that are naturally ordered and categorical
Ordinal regression
What type of study generates Odds ratio and why?
Case-control because this type of study doesn’t measure incidence of disease
Positive outcomes on MOMS trial
- decreased need for VP shunt at 12 months
- decreased hindbrain herniation at 12 months
- increased rates of walking independently at 30 months
TTTS survival rates stage 1 and stage 3
stage 1 - 80%
stage 3 - 0-30%
T/F: valproic acid associated with reduced cognitive ability and autism in children
True
Conflicting studies regarding teratogenicity of lamotrigine – what did the unfavorable studies find
impairment in neurodevelopmental outcomes
Immunosuppressant associated with microtia, cleft lip/palate and miscarriage
Mycophenolate
1st trimester maternal steroid exposure associated with what anomaly
orofacial cleft
OB complications associated with long term steroid use
FGR
PPROM
Effects and secondary effects of 2nd/3rd trimester ACEi/ARB treatment
Renal failure and oligohydramnios
Leading to FGR, calvarium hypoplasia, joint contractures, pulmonary hypoplasia
Anomalies associated with 1st trimester ACEi/ARB exposure
inconclusive data – but cardiac and CNS anomalies
Anomaly associated with Lithium
Ebstein (<1% but still relatively high)
SSRI risk of PPHN due to
premature PDA closure
Paroxetine use associated with
cardiac defects
1st trimester opioid/codeine exposure associated with
cardiac defects
NTD
Isotretinoin associated anomalies
Miscarriage Intellectual disability CNS malformations Microtia or anotia Micrognathia Cleft palate Eye malformations Conotruncal defects
Isotretinoin SAB rate, structural defect rate, and intellectual disability rate
SAB - 22%
defects - 28%
intellectual disability - 47%
Excess vitamin A (retinol) associated anomalies, and at what vitamin A dosing
similar to isoretinoin (>10,000 IU daily in 1st tri)
High-dose radiation effects
microcephaly
intellectual disability
growth deficiency
GA with highest potential risk of radiation exposure
10-17 weeks
Radiation dose associated with abnormalities and recommended max radiation dose
50 rad (cGY) to the uterus
Recommendations max of 5-10 rad(cGY) to uterus
Effect of elevated mercury
Neurodevelopmental disability
Recommended fish intake
8-12 oz or 4oz of big fish
Tobacco use associated anomalies
Cleft lip/palate Gastroschisis Clubfoot Cardiac Limb reduction Ocular
OB complications associated with tobacco
FGR
PTB
SAB
Effects of radiation at 0-4 weeks, 4-10 weeks
0-4: all or none
4-10: growth issues, microcephaly
**carcinogenic potential at any GA
Risk factors for cerebral palsy
Prematurity (highest <28) LBW (highest <1500g) SGA Intrauterine infection Neonatal infection APGAR <7 at 5 minutes Placental abruption Obesity/Smoking/Alcohol Multiples Pre-eclampsia RDS/mechanical vent
Neonatal hypothermia requirements
- > /= 36 weeks and 16
- 10min APGAR
Thalassemia with elevated A2
B-thal
Sickle/B-thal
Hgb chains in A1 and A2
A1 - 2 alpha, 2 beta
A2 - 2 alpha, 2 delta
Swan parameters essentially unchanged in pregnancy
CVP
PCWP
Type of shock that increases CO
Sepsis
Indications for Swan (5)
- refractory ARDS/shock
- CM w/ EF <20%
- NYH III or IV
- Severe pree with unresponsive oliguria
- Severe valve disease
Singleton and twin growth curves are the same until what GA
26 weeks
Singleton growth rate per week in grams at early third vs late third trimester
early third (33wk) - 250g/week late third - 200g/week
What happens to pCO2 in pregnancy and why?
pCO2 is slightly decreased due to the hyperventilation of pregnancy
What happens to HCO3 in pregnancy and why?
Slight increase to compensate for the respiratory alkalosis
Normal ABG pregnancy
pH - 7.4-7.44
PaCO2 - 27-32mmHg
PaO2 - 72-104mmHg
HCO3 - 18-22meq/L
Leading cause of hearing loss in children
CMV infection
CMV positive with no ultrasound findings, what is chance of symptoms at birth
10-15%
Viral infection associated with PDA, cataracts/glaucoma, microcephaly, thrombocytopenia
Rubella
T/F: risk of Rubella is worse<20 weeks
True
Virus associated with Hutchinson teeth, mulberry molars
Syphilis
Virus associated with cardiac defects, deafness, blindness
Rubella
2 viruses rarely transmitted <20 weeks
Varicella
Toxo
Viruses rarely transmitted >20 weeks
Parvo
Rubella
High IgG avidity for CMV means infection occurred at least ____ months ago
Four
How long after acute Parvo infection do you keep checking MCAs
8-12 weeks
Chlamydia – first line and 2 alternatives
- Azithromycin
Alt: erythromycin, amoxicillin
Gonorrhea first line and 2 alternative treatments
- Ceftriaxone (and treat CT if not ruled out)
Alt: Genta and Azithro, Cefipime (and treat CT if not ruled out)
Local anesthetic agents that are amino amides
Lidocaine
Bupivicaine
Ropivicaine
Medication to blunt hypertension at time of GETA induction
Labetalol
Best and second best anesthesia agents for asthmatics
- regional
2. ketamine and succinylcholine (can use enflurane/isoflurane if needed)
Most common respiratory complication of pregnancy
Asthma
Risk of asthma exacerbation with SVD vs CS
Csection 18-fold increased risk
Treatment/management of IHSS
Propanolol
Avoid preload and ephedrine
T/F: PCWP is a measure of LV preload
True
Treatment for refractory maternal SVT
Digoxin
CCB’s
B-blockers
Variables directly measured versus calculated with a Swan catheter
Measured:
- HR
- CO
- CVP
- PA pressures in systole and diastole
- PCWP
Calculated:
- SV
- SVR
- PVR
- LVSI
SVR calculation
MAP-CVP/COx80
PVR calculation
PAP - PCWP / CO x 80
LVSWI Calculation
SV x MAP x 0.0144
T/F: SVR and PVR are measures of afterload
True
Swan reading highly predictive of pulmonary edema
CO/PCWP <4
What happens to SVR, LVSWI in preeclamspai
Increased
CVP that can be massively increased may be due to
massive PE
OB complications most–>least predictive of CP
- Chorio
- Prolonged ROM
- Maternal infection
- FGR
Hallmark lab values of AFLP
Elevated bilirubin, ammonia, ALP
Decreased glucose, ATIII, fibrinogen
Dermatosis of pregnancy associated with deposit of complement in basement membrane
pemphigoid gestationis
Dermatosis with perivascular T-lymphocytic infiltrate with Eosinophils
PUPPS
Dermatosis with spongiosis and a perivascular mononuclear infiltrate
Atopic dermatitis
Dermatosis with spongiform pustules with neutrophils
pustular psoriasis
Medication classes that can lessen OCP effectiveness
ABX - PCN, tetracyclines
Antiepileptic
St Johns Wort
Rifampin
Sx of immediate (IgE) allergy
Anaphylaxis Hypotension Angioedema Respiratory distress Urticaria Laryngeal edema
Biologic precurose of NO
L-Arginine
Medication that has a long half-life, delay pregnancy for 2 years
Etidronate - used for psoriasis
Most common malformations with anti-seizure drugs (most–> least (3))
- cleft lip/palate
- cardiac
- ONTD
Drugs to avoid in Myasthenia Gravis
Magnesium
Vecuronium/Rocuronium
Aminoglycosides
Ester anesthetics - chlorprocaine, tetracaine
HPV treatments OK and not OK to use
Ok: laser, cryo, TCA, bicholroacetic acid
Not OK: 5FU cream, Podophyllin, Imiquimod, Interferon
MOA of glyburide
stimulate insulin release from pancreas
Homolog of HPL/HcSommato.
GH and prolactin
HPL half life
10-30 mins
Treatment of HTN from pheo
phenoxybenzamine
meds that provoke a pheo
b- blockers
reglan
high dose steroids
Recommended serum PKU levels in pregnancy
2-6mg/dL
Rate limiting step in PG synthesis
Cyclooxygenase and Phospholipase A2
4 ethical principles
Autonomy
Beneficence
Non-maleficence
Justice
Most common GA for heart block from SSA/SSB
18-25 weeks
Vesicocentesis results you want/aim for (Na, Cl, Osm, Ca, B2-microglobulin)
Na - <100mEq/L Cl - <90 mEq/L Osm - <210 mEq/L Ca - <2 mmol/L B2-microglobulin - <2 ug/L
Most common causes of macrosomia
- enhanced intrinsic growth potential
- abnormal glucose tolerance
- obesity (might be higher risk than glucose intolerance)
- parental sizes
- multiparity
- prolonged gestation
Fetal effects of uncontrolled maternal PKU
Phenylalanine crosses the placenta
- pregnancy loss
- microcephaly
- cardiac defects
long term - mental retardation, hypopigemntation of hair/eyes/skin
PI and RI formulas
PI = S-D / mean
RI = S-D/ S
GA when diastolic flow in Doppler starts to be seen
~15 weeks
UA resistance higher/lower close to placenta
Lower
Major fatty acid in surfactant phospholipids
Palmitic acid