Flashcards in Set 10 Deck (46)
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1
Tx GC and Chlamydia
GC = ceftriaxone
CT = azithro x1 or 10d of doxy
2
Fever 1--.4, leukocytosis, blood clots in vagina after delivery? worrisome sx?
NORMAL in first 24hrs post-partum
worry if high fever, foul-smelling lochia, tender uterus
3
Lupus patient develops NV, abd pain and hypotension and hypoglycemia post-op?
adrenal insufficiency!! 2/2 not getting steroids
4
What anti-Rh Ab titer level do you give rhogam for? what level is fetus at risk for hemolytic disease?
- 1:6 - mom is already sensitized - rhogam won't help. monitor closely for hemolytic disease.
- >1:8-1:32 - fetus at risk for hemolytic disease.
5
female with rash that starts on face and progresses downward + arthritis?
consider rubella
6
Clubbing in COPD, think...
MALINGNANCY (unlike other clubbing scenarios)
7
3 drugs to treat UTI in pregnancy
nitrofurantoin, amoxicillin, 1st gen cephalosporin
8
arm held abducted and externally rotated, which dislocation?
anterior (fall on outstretcehd arm)
9
arm held adducted and internally rotated, which dislocation?
posterior (seizure, electrocution)
10
Neonated with microcephaly, small body, hypoplastic distal phalanges, excess hair, cleft palate and developmental delay?
fetal hydantoin syndrome = phenytoin or carbamazepine during pregnancy
11
management of post-patum hemorrhage
bimanual uterine massage, IVF, uterotonic meds (oxytocin, methylergonovine, carboprost) +/- blood transfusion
12
MC age range Legg-Calve-Perthes? Tx?
boys 4-10 (5-7*)
Tx observation and bracing, surgery only if femoral head not contained well in acetabulum
13
boy with hip, groin, knee pain and limping gait
think Legg-Calve-Perthes
14
next step if amenorrheic girl has no uterus on U/S?
karyotype and serum test
- 46 XX and female test level --> abnormal mullerian devel
- 46 XY and male test level --> AIS
15
Timing for CVS vs. amniocentesis
CVS = 10-12wks
amnio = 16-18wks
(possible to do ~earlier amnio of CVS unavailable)
16
what do mom and baby's blood types have to be for hemolytic disease of the newborn? what type of Ig? which can cross placenta?
mom = O
baby = A or B
Results in mild disease, unlike Rh incompat.
It is IgG bc only IgG can cross the placenta
17
dyschezia, dyspareunia, dysmenorrhea and difficulty conceiving? 3 tx?
endometriosis
Tx = OCPs (combined), leuprolide, danazol
18
6 indications for hemodialysis
refractory hyperK
refractory edema/pulm edema
refractory metabolic acidosis
uremic pericarditis
uremic encephalopathy/neurophathy
coagulopathy 2/2 renal failure
19
kindey d/s a/w Hodkgkin's lymphoma
Minimal Change Disease! (nephrotic syndrome --> decr alb, normal globulin)
(also can have FSGS)
20
Test for cervical incompetence? Normal value?
transvaginal US -->funneling of cervix/cervical length which should be >25mm at 24wks
21
Tx PID and when should you admit?
Outpt = IM cefoxitin + PO probenecid + PO doxy OR IM ceftriaxone + PO doxy
hospitalize if: high fever, N/V and cant take pill, pregnant*, teenager/low socioeconomic status
inpt = IV cefotetan or cefoxitin + doxy OR IV clinda/gent
22
foul-smelling sputum, think...Tx?
think anaerobic pneumonia 2/2 aspiration
Tx = clindamycin
23
Asian w/ epistaxis, neck swelling, sinusitis and nasal mass? RFs?
nasopharyngeal CA
RF = EBV!!!, smoking and nitrosamines too
24
When is cephalic version indicated?
37+ weeks
25
5 components of BPP
NST
tone (flex/extend, extend)
movement (2x/30min)
breathing movement (20sec/30min)
AFI (5-25)
26
5 indications for intubation during acute asthma exacerbation
normal/increased PaCO2 (should be decr. from hyperventilation)
decreased breath sounds
no wheezing
AMS
hypoxia +/- cyanosis
27
Early Tx of pre-eclampsia
Methyldopa 1st line = central alpha-agonist to decr symp outflow and vasodilate
Labetolol for HTN
28
Pregnant lady with severe vomiting, wt loss, ketonuria and transaminitis / bili?
hyperemesis gravidarum
can also have elevated lipase/amylase
MCC b/w 4-10wks
29
SE niacin? MoA, Tx?
flushing + pruritis 2/2 PG-induced periph vasodilation and histamine release
Tx = low dose ASA 30min before niacin
30