OBGYN Stuff 1

ruhland1's version from 2015-07-22 14:27

Section 1

Question Answer
flatusgas in GI
folic acidcytotech supp
give corticosteroid22-34wk for at risk
discordant twingreater than 20% weight diff
how to tell what amino centesis you are getting fluid frominject one with dye to know you used that one
skin swell -> HFfetal hydrops
ppdTB preg screen
tx vag atrophyEstrogen cream or lube
Naegeles RuleLMP (add 7day - 3 mo + 1 year)
routine 3rd trim testsurine, glc
study r'qd on both 1st and 3rd tri visitisurine, glc
preterm labor sxvag bleed, contraction, ROM
when give RhoGAM28-30wk
starting 28-32wks mothers should undergo _____ non stress testing until deliverytwice weekly
chylmadiacheck 36-40 wk
gonn check36-40 wk
GBSscreen 35-37wk
GBS abxw/in 4 hr of delivery (penicillin -> macrolide -> vanco)

Section 2

Question Answer
stage(severity) I TTTS (transient twin transfusion synd)oligohyd in donor, polyhydra in recep
stage II+ no ID'd bladder in donor
III+ abnormal umb cord BF
IV+ swelling skin + HF (fetal hydrops)
Vone has died
risk of death donor vs recipientboth high for both if above stage I

Section 3

Question Answer
greaseboard hassrx schedule

Section 4

Question Answer
rule of 80x>40=acid, x<40=base, 7.30 + paCO2(40mmhg) => .30 + .40 = 70 (since less than 80 +/- 3 = pure resp acid
7.30/30/96/98% RO8030 + 30 = 60 so meta acid + resp comp
VT=6-8 cc/Kg
Vent failure5 stages
1up RR pH dn PaCO2 ud PaO2 O2sat (climb up stairs)
2all ud (end of run)
3up PaCO2 dn RR pH PaO2 ud O2sat !! (passed out)
4up NOTHIng d PaO2 ud RR PaCo2 pH ud O2 Sat (dead)
PaO2 in vent failurenot a predictor!
m recruit to up WOBnasal flare -> SCM -> scalene -> hoover sign -> paradoxical rib muscles

Section 4a

Question Answer
hoover signdoming of diaphragm
PaO280-100% is normal
O2 sat100% is normal
hypoxemiadn O2 sat in blood (sx independent)
hypoxiasx of low O2 (much more important)
Aa Gradient formula(age+4)/4
Pa O2 = 60shoulder of curve
V/Q mismatchhypoxemia cause 1
ShuntHypoxemia cause 2
altitudehypoxemia cause 3
severe hypotnhypoxemia cause 4
dn VO2 (V=vent)hypoxemia cause 5

Section 5

Question Answer
immunization birthhep B
2 moHep B, RV (rotavirus), DTaP, HiB, PCV, IPV (inactive polio vir)
4 morota, DTaP, HiB, PCV (pneumococcal conj vax), IPV (polio)
6 moHep B, RV, DTap, HiB, PCV, IPV, Influ (yrly)
12-15 moDTaP, HiB, PCV, MMR, Varicella, Hep A
4-6 yoDTap, IPV, MMR, Varicella
Hep B0,2,6 mo
RV2,4,6 mo
DTaP2,4,6, 12-15mo , 4-6y
HiB2,4,6, 12-15mo (like PCV)
PCV2,4,6, 12-15mo (like HiB)
IPV2,4,6mo 4-6yr
RV4,6 mo
Influ6mo then yearly
MMR12-15mo, 4-6 yr (like Varicella)
Varicella12-15 mo, 4-6 yr (like MMR)
Hep A12-15 mo (2 does x> 6 mo apart)

Section 6

Question Answer
APGAR score determinedat 1 and 5 min after birth
assist/stimulate=4 - 6
resusitatex< 4

Section 7

Question Answer
Pregnancy states clottingup clotting factors, up venous stasis 2ndary to ut pressure on V of LE
plasma volup 50%
RBC massup 30%
why anemia in pregplasma increases more so than RBC mass
wbcup demargination (leukocytosis) but no increase in number
COup 50%
heart normalsystolic ejection murmur
heart non normaldiastolic murmur
BPdn fist 24 wks then ud for rest
causes Eisenmenger syndmothers with cyanotic heart dz
eisenmengerpulm htn -> RVH -> reversal of L to R shunt
Func Residdn
minute ventup (up resp alkolosis)

Section 8

Question Answer
progesterone on GIup motility up GERD
GallBup stone
Colonup hemmoroids because uterus compressing IVC
progest on bladderdn tone up UTI
kidneyup GFR
up GFR in preg meansup glc sec therefore urine dipstick not useful
fetus insulinis its own at 9-12 wk
T3/T4up total, ud free molecules
cortisolup (up MSH so why up linea nigra)
MSHprecursor in cortisol pathway

Section 9

Question Answer
wk 4-28prenatal check up once a mo
wk 28-36checkup 2x a mo
wk 36-birthcheckup every wk
chadwickblue vagina a sx of + pregnancy
when hCG sensitive1-2wk
fetal size gestational sac5 wk
fetal size when fetal image detected6-7 wk
fetal size when cardiac activity detected8 wk
EDCestimated date of confinement (follow Nageles rule)
Nageles rule=LMP + 7 days - 3 mo + 1 yr
CRLcrown rump length

Section 10

Question Answer
screen 16 weekcbc, blood type, Rh, urine, pap, gon/chyl, rubella, hep B, RPR, PPD HIV, triple marker/ quad screen
recommended weight gain25-35
uterine size 12 wkpubic symph
uterine size 16 wkmidway b/t symphisis and umbilicul
uterine size 20 wkumbilicus
uterine size 20-36 wkheight (cm) above pubic symph = wks of gestation
triple marker15-18 wks
triple marker useNTD / trisomy
triple marker looks forBhCG, estriol, AFP = ABE
document at 17 wkmovement
17wks + x> 35yoaminocentisis indic
24 wkglc screen
25-28wkrepeat Hct