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MTB3 1 Flashcards

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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
What is an adequate CTX
1. Every 2-3 mins 2. Lasting 45-60 secs 3. Has 50 mmHg intensity
26
What is the management of umbilical cord prolapse
1. Place pt in knee-chest position 2. Terbutaline to decrease force of CTX 3. Immediate C section
27
Causes of nonreassuring fetal tracings
Hypoxia | Meds - Beta agonist, beta blockers
28
What are the causes of postpartum fever @ Day 0 | Tx
Atelectasis Rales, pt can't take deep breath Incentive spirometry, ambulate
29
What are the causes of postpartum fever @ Day 1 | Tx
UTI CVA tender, +UA, culture IV ABX
30
What are the causes of postpartum fever @ Days 2-3 | Tx
Endometritis Uterine tenderness, peritoneal si's IV Abx - gent and clinda
31
What are the causes of postpartum fever @ Days 4-5 | Tx
Wound Infxn Persistent spiking fevers Would erythema, fluctuance IV Abx, wet to dry would packing, closure
32
What are the causes of postpartum fever @ Days 5-6 | Tx
Septic thrombophlebitis Persistent wide fever IV heparin 7-10 days
33
What are the causes of postpartum fever @ Days 7-21 | Tx
Infectious mastitis Unilateral breast tenderness, erythema, edema PO cloxacillin, continue breast feeds
34
Anterior Mediastinal mass DDX
``` 4 T's Thymoma Teratoma Thyroid Neoplasm Terrible Lymphoma ```
35
Lab findings in Seminoma
Increased b-HCG | AFP usually normal
36
Lab findings in non-seminomatous germ cell tumor
High AFP
37
What is a normal full body respiratory quotient
0.8 | High protein diet
38
What is a respiratory quotient > 1.0 indicative of
Carbohydrates are sole source of fuel and net lipogenesis is occurring
39
What CO2 and O2 values are seen with mechanical overfeeding
High CO2 production
40
Most important AE of raloxifene
Increased thromboembolism
41
Effect of raloxifene on breast cancer
Decreases risk
42
Tamoxifen increases risk for what cancer
Endometrial
43
How does a pregnancy luteoma present
Bilateral Multinodular Solid masses on both ovaries
44
Pregnancy luteoma risk factors
African American Multiparous 30's or 40's
45
Sx's of pregnancy luteoma
Asymptomatic Virilization Hirsutism
46
Management of Pregnancy luteoma
Reassurance US follow up Benign
47
Sx's of pathologic vaginal discharge
Pruritis Burning Malodorous
48
Vaginal exam of pathologic vaginal discharge
Erythema Friability of vaginal mucosa Tenderness of cervix Green/curd-like
49
Physiologic leukorrhea
``` Copious vaginal discharge White or yellow Nonmalodorous Absence of other sx's Predominance of Squamous cells may be seen with PMNs ```
50
Presentation of patient with acute pancreatitis w secondary ileus
Abdominal pain Vomiting Decreased bowel sounds, tender abdomen Labs - high BR, ALT, AP, Lipase, leukocyte, BUN
51
Treatment of acute pancreatitis
``` IVF NG tube suction NPO Analgesia Abx if severe ```
52
What labs should be monitored in acute pancreatitis
Calcium | Magnesium
53
Test for gallstone detection
Endoscopic US | ERCP
54
TX for biliary pancreatitis in stable pt
Laparoscopic cholecystectomy
55
Peak airway pressure is sum of what?
Airway resistance + Plateau pressure | - Plateau pressure = Elastic pressure + PEEP
56
How do we calculate PEEP
End-expiratory hold maneuver
57
Where do we see Muddy brown granular casts
ATN
58
Where do we see RBC casts
Glomerulonephritis
59
Where do we see WBC casts
Interstitial nephritis | Pyelonephritis
60
Where do we see fatty casts
Nephrotic syndrome
61
Where do we see broad and waxy casts
Chronic Renal Failure
62
Pt with A fib with worsening fatigue and irregular hR - next step in management
Assess CHADS-VASc score | Warfarin if needed
63
Causes of transient proteinuria
``` Fever Exercise Seizures Stress Volume depletion ```
64
Proteinuria in child with fever, temp, myalgias, no other findings on UA - next step?
Repeat dipstick on 2 occasions If negative -> transient proteinuria If positive -> refer to pediatric nephrologist for renal dz assessment
65
Post op atelectasis Presentation
Asymptomatic Increased work of breathing 2nd - 5th post op night
66
Atelectasis radiologic findings
Loss of lung volume b/c of collapsed lung tissue
67
Atelectasis pathophysiology
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

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