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OB 3 (Complications)
Step-2
Question | Answer |
---|---|
What is the next step in the evaluation of the following pt: pelvic fracture + DPL shows blod in pelvis | emergent lap |
What is the next step in the evaluation of the following pt: pelvic fracture + DPL shows urine in the pelvis | urgent lap |
What is the next step in the evaluation of the following pt: pelvic fracture + DPL shows nothing + hemodynamic instability | angiography, possible embolization |
What is the next step in the evaluation of the following pt: blunt abdominal trauma + unstable vital signs + FAST show fluid in pelvis | urgent lap |
What is the next step in the evaluation of the following pt: blunt abd truama + unstable vitals + FAST shows no fluid in pelvis | angiography with possible embolization |
What is the next step in the evaluation of the following pt: blunt abd trauma + unstable vitals + FAST inconclusive | DPL |
What is the next step in the evaluation of the following pt: Blunt abd trauma + stable vitals | CT or Abd and pelvis |
What is the next step in the evaluation of the following pt: abdominal stab wound + hypotensive or signs of peritonitis | emergency lap |
An 18 y/o woman w/ no history of abdominal pap smears now has a first time ASCUS pap. How should this be managed? | repeat pap in 6-12 months |
What are the management options of a first time ASCUS pap in a non-adolescent? | Option 1: reflex HPV. High risk HPV do colpo, low risk HPV repeat pap in 6-12 months. Option 2: repeat pap in 6-12 months. Option 3: colpo |
Patients with hyperemesis gravidarum have a weight loss > than _____% of pre-pregnancy body weight and detection of ______in urine. | 5, ketones |
What w/u should be performed in a pt with hyperemesis gravidarum? | weight, orthostatic BP, serum TSH/T4, electrolytes and urine ketones, US to detect gestational trophoblastic dz or multiples. |
What is the tx for DVT in pregnancy and how long is it continued? What drug do you NOT give during pregnacy? | IV heparin or enoxaparin, switched to subQ heparin 2 weeks before delivery, stop before delivery and 6 hours after, continue for 6 weeks following delivery. Do not give warfarin to prenant pts |
What dipstick finding is considered diagnostic of a UTI? | nitrites |
What is the next step in the evaluation of the following pt: what is the first line treatment for hyperemesis gravidarum? | vit b6, doxylamine, hydration |
What adverse effect can be seen with maternal ACE-I or ARB use? | renal tubular dysplasia(+/- renal failure)-> oligohydramnios-> intrauterine growth restriction, limb contractures, pulmonary hypoplasia, lack of skill ossification, in utero death |
What doses or radiation are considered safe in pregnancy? | Less than 0.05 Gy (5 rads) over the pregnancy |
Identify the following teratogen based on the defect: phocomelia | thalidomide |
Identify the following teratogen based on the defect: yellow or brown teeth | tetracyclines |
Identify the following teratogen based on the defect: deafness | aminoglycosides |
Identify the following teratogen based on the defect: spina bifida, hypospadias | valproic acid |
Identify the following teratogen based on the defect: cardiac (ebstein) anomalies | lithium |
Identify the following teratogen based on the defect: craniofacial defects, IUGR, CNS malformation, stillbirth | warfarin |
Identify the following teratogen based on the defect: fingernail hypoplasia, craniofacial defects | carbamazepine |
Identify the following teratogen based on the defect: central nervous system, craniofacial, ear, and cardiovascular defects | Isotretinoin |
Identify the following teratogen based on the defect: goiter, cretinism | Iodine deficiency |
Identify the following teratogen based on the defect: cerebral infarcts, mental retardation | cocaine |
Identify the following teratogen based on the defect: clear cell vaginal cancer, adenosis, cervical incompetence | DES |
What are the main fetal complications of tobacco use in pregnancy? | IUGR and prematurity |
How are migraines treated in pregnancy and why? | Opiates, contraindications are triptans and ergots because they cause vasoconstriction and NSAIDS are teratogenic. |