Step studying 4 Flashcards
Most common cause of osteomyelitis
Staph aureus
If you see someone with salmonella osteo, think sickle cell (although staph is still more common in sickle cell than salmonella)
Cause of transient tachypnea of the newborn (TTN)
o Slow absorption of fetal lung fluid with resultant tachypnea
o Commonly associated with C-section deliveries
Diagnosis and tx of TTN
o Diagnosis:
♣ Hyperextended lungs
♣ Imaging reveals perihilar streaking and fluid in the fissures
o Treatment
♣ Supportive care including supplemental O2 if necessary
♣ Most infants have resolution of sx in 24-72 hours
Cause of respiratory distress syndrome in a newborn
- Condition seen in newborn infants resulting from surfactant deficiency
- Usually occurs in premature
Diagnosis and tx of RDS
o Diagnosis:
♣ XR shows hypo-extended lungs with atelectasis
♣ Imaging (CT) reveals characteristic reticulonodular “ground glass” pattern
o Treatment:
♣ Intubation
♣ Exogenous surfactant is available
Tx of Heparin induced thrombocytopenia
♣ Stop Heparin
♣ Need to stop clots = Synthetic heparin (Fondaparinux or Agatroban) and bridge to Coumadin
Diagnosis of gestational diabetes
1 hour glucose tolerance test (GTT)
- Give 50 mg glucose
- Positive if >/= 140 –> go on to 3 hour GTT
3 hour GTT
- Give 100 mg glucose
- 2/4 positive values = Gestational DM
- – Fasting >90
- – 1 hour >180
- – 2 hour >155
- – 3 hour >140
When do you give Rhogam in an Rh- mom
- At 28 weeks (3rd trimester)
- Within 72 hours of delivery
What changes do you expect in Hgb in a pregnant mother
Decrease in Hgb
- RBC increase, but plasma increases more, thus diluting the blood and lowering Hgb
What is the lower limit of normal Hgb for a 3rd trimester mom
Hgb of 10
- So Hgb <10 = anemia in pregnancy
- Most likely iron deficiency
Tx of asymptomatic bacteriuria in pregnant women
Amoxicillin
Tx of pylenonephritis in pregnant women
Ceftriaxone + admission to hospital
Tx of hyperthyroidism in pregnancy
PTU (not Methimazole)
What antiepileptics are safe in pregnancy
L drugs: Lamotrigine, Levitericetam
What HTN drugs are safe in pregnancy
*Alpha-methyldopa, Labetalol, Hydralazine
What are the 3 stages of normal labor
Stage 1 = onset of deliver (contractions) to complete dilation (10 cm)
Stage 2 = complete dilation to delivery of baby
Stage 3 = delivery of placenta
What are the 2 phases of stage 1 of labor
Latent phase = closed cervix to 6 cm
Active phase = 6 cm to complete dilation
Normal length of each stage of labor
Stage 1 latent = 14-20 hours
Stage 1 active = 4-6 hours
Stage 2 = <3 hours
Stage 3 = <30 min
Define arrest of active labor
• No progress in the active phase of labor (>6 cm) with ruptured membranes for 4 hours with adequate contractions, or 6 hours of inadequate contractions
Tx of delay of stage 2 of labor
- If baby is + position, can use forceps or vacuum
- If baby’s position is still negative = C-section
Tx of delay of stage 3 of labor
- Uterine massage
- Oxytocin
- Manual extraction
What is considered preterm?
24-37 weeks
What is considered term
37-42 weeks
What is the difference between PROM and pPROM
PROM = premature ROM = rupture occurs before onset of labor aka contractions
pPROM = preterm premature ROM = rupture occurs before 37 weeks (preterm) and before onset of contractions (premature)
