Obstetrics/Newborns

Question 1

Dose a Prenatal Vitamin

Answer 1

Folic acid 400mcg one tablet once a day

Question 2

What is induction

Answer 2

stimulation of contractions before the spontaneous onset of labor

Question 3

What do prenatal vitamins account for

Answer 3

poor nutrition:

• dietary intake
• special diets

Question 4

Name potential toxicity of prenatal vitamins

Answer 4

Vitamin A (watch out)
-potentially teratogenic
B6,C,D, iron, zinc, selenium

Question 5

When is the minimum time to start taking folic acid and stop

Answer 5

1 month before conception

at least 3 months after baby is born

Question 6

What is augmentation

Answer 6

Stimulation of contractions that are considered inadequate

-failed cervical dilation and fetal descent

Question 7

Agents for cervical ripening

Answer 7

Dinoprostone gel
Dinoprostone insert
Misoprostol

Question 8

Dose for prostaglandin insertion

Answer 8

Cervidil Vaginal Insert 10mg

Insert transversely into posterior fornix of the vagina

Question 9

MOA of oxytocin

Answer 9

Increased prostaglandin production

activation of g-protein coupled receptors

Question 10

Monitoring for oxytocin IV

Answer 10

Contractions

Fetal HR

Question 11

ADRs of oxytocin

Answer 11

Vasopressin life effect
-anti-diuretic
-water intoxication= convulsions, coma, death
Uterine rupture (rare)

Question 12

Dose an oxytocin infusion

Answer 12

Oxytocin infusion start at 1mUnit/minute and increase by 1mUnite/min every 30min until target contraction rate attained

Question 13

How many women have vaginal or rectal colonization of GBS?

Answer 13

25% women
affects 1/2000 births
rare but outcomes are severe

Question 14

When should mother be tested for GBS?

Answer 14

within 5 weeks of delivery

Question 15

Tx of mothers GBS is when

Answer 15

IV abx during delivery

Question 16

Recommended tx of GBS colonization is

Answer 16

Penicillin G 5 million units IV initially

then 2.5mill q4hrs until delivery

Question 17

Alternative tx of GBS colonization is

Answer 17

Ampicillin

Question 18

Tx of GBS colonization if mother has penicillin allergy?

Answer 18

Clindamycin 900mg IV q8hrs until delivery

Question 19

Dose Vitamin K for newborn

Answer 19

Phytonadione 1mg one dose IM

Question 20

What is used to prevent newborns contracting Neisseria gonorrhea

Answer 20

erythromycin ophthalmic ointment 0.5%

applied to both eyes one time

Question 21

Tx for mother with untreated gonorrhea

Answer 21

Ceftriaxone

Question 22

Tx for apnea of prematurity

Answer 22

Caffeine citrate
20mg/kg as single loading dose then give
5mg/kg once a day 24hrs after loading dose

Question 23

ADRs of caffeine citrate

Answer 23

mild tachycardia, feeding intolerance

Question 24

T/F: caffeine citrate is caffeine and sodium benzoate

Answer 24

FALSE

Question 25

Drug that replaces deficient of ineffective endogenous lung surfactant

Answer 25

Beractant (Survanta)

Question 26

Respiratory distress syndrome is most commonly caused by

Answer 26

hyaline membrane disease - deficiency in surfactant production and surfactant inactivation - poor lung compliance and atelectasis

Question 27

ADRs of Survanta

Answer 27

transient bradycardia oxygen desaturation rarely- apnea, ET tube blockage, HTN, HoTN, etc.