Neonatology/Ped/OB

Question 1

Physiological changes to mother during pregnancy

Answer 1

Increases blood volume

Increased cardiac output

Increased Minute Ventilation

ABG changes to compensates respiratory alkalosis

Question 2

Fungal heights to know

Answer 2

Peak is at 36 weeks. Will drop back down as fetus moves

20 weeks is marked at the umbilicus

Question 3

Preterm Labor definition

Answer 3

Labor between 24-36 weeks

Question 4

What medications to give for preterm labor?

Answer 4

Administer Tocolytic agent such as Terbutaline 0.25 mg or Mag 4 g infuse

Question 5

How to detect Abruptio placenta?

Answer 5

Lots of pain, little bleeding.

Caused by trauma or spontaneous tearing of the placenta from the uterine wall.

Question 6

How to detect placenta prévia?

Answer 6

Little pain, lots of bleeding.
Caused by placenta covering the cervical opening. No digital exams.

Question 7

How to detect uterine rupture?

Answer 7

Caused by trauma. Fetal parts can be felt in abdomen.

Question 8

Pregnancy with HTN crisis: what do we do in order?

Answer 8

Magnesium 4g in 100 mL over 20 min

Labetolol: 10mg SIVP with stacked dosing ( 10,20,40)

Hydralazine: also known as alpresoline- vasodilator

Nifepidine: also known as procardia- CCB that targets arteries

Question 9

Magnesium Toxicity, what are the signs and what is the reversal?

Answer 9

Reduced DRT’s (deep tendon reflexes)
CNS depression
Hypotension

Give Calcium

Question 10

What does EFM stand for?

Answer 10

Electronic (external) Fetal Monitoring

Question 11

What is a normal FHR (fetal heart rate)?

Answer 11

120-160 bpm

Question 12

What are the 3 levels of variability with EFM?

Answer 12

Mild: less than 8bpm variance (Bad)

Moderate: 8-25 bpm variance (good)

Severe: greater than 25 bpm (Not good)

Question 13

What does VEAL CHOP stand for?

Answer 13

Variable decels Cord problem
Early decels Head compression
Accelerations Okay
Late decels Placenta

Question 14

What is Pitocin?

Answer 14

Hormone that elicits uterine contraction.

Indicated in post partum hemorrhage and labor induction.

Question 15

When should you discontinue Pitocin?

Answer 15

Develops uterine tetany

Question 16

Definition of a neonate?

Answer 16

1-28 days of life

Question 17

What does PDA stand for with neonates?

Answer 17

Patent Ductus Arteriosis

Question 18

How does a PDA close?

Answer 18

Oxygen and NSAIDS

Question 19

When do you treat hypoglycemia in a neonate?

Answer 19

Less than 40

Administer D10

Question 20

What is hypothermia defined as in a neonate?

Answer 20

Body temp less than 36.5 degrees C

Question 21

What is a normal HR for a neonate?

Answer 21

120-160

Question 22

What is the CPR ratio for neonates?

Answer 22

3:1

Question 23

What are the 4 things that make up Tetraology of Fallot?

Answer 23

VSD

RVH

Narrowed PA

Overriding aorta

Question 24

How to treat a patient with Tetraology of Fallot?

Answer 24

Keep pt calm

Knees to chest maneuver

Question 25

What is transposition of the Great arteries? (TGA or TGOV)

Answer 25

Aorta and the pulmonary artery switch places

Question 26

Treatment for cyanosis lesions that are pre-surgery?

Answer 26

DO NOT GIVE OXYGEN! Prostaglandins (PGE): 0.05-0.1 mcg/kg/min

Question 27

What are the side effects to prostaglandins (PGE)?

Answer 27

Apnea and hypotension

Question 28

Treatment for cyanosis lesions post surgery?

Answer 28

Prone to heart failure Digoxin, ace inhibitors, diuretics when in exacerbation

Question 29

What is Hypoplastic Left Heart Syndrome?

Answer 29

Acyanotic lesion Patient has a tiny left ventricle Prone to heart failure Hepatomegaly is a sign of HF in neonates Will receive digoxin, ace inhibitors, diuretics when in exacerbation

Question 30

Define prematurity

Answer 30

Delivery before 37 weeks

Question 31

How do seizures present in a neonate?

Answer 31

Lip smacking, bicycling of the legs, nystagmus/fixed gaze.

Question 32

What is myelomeningocele? How do you transport that Pt?

Answer 32

Spina Bifida A protrusion of spinal nerve and meninges are exposed Transport the patient prone

Question 33

What does a FLACC scale score?

Answer 33

Pediatric pain

Question 34

What does a “steeple sign” indicate on an x ray and what do you give first as a treatment?

Answer 34

Indicates croup Epinephrine first

Question 35

What is epiglottis caused by?

Answer 35

H. Influenza B bacteria