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Terms in this set (49)
Weight gain during pregnancy
28-40 if bmi <18.5, 25-35 if bmi 18.5-24.8, 15-25 if bmi 25-29.9; 11-20 if bmi > 30
Trx for n/v in pregnancy
diphenhydramine or antihistamines (ranitidine), add DA antagonist (promethazine or metoclopramide), add ondansetron
Vitamin B6 (pyridoxine)
can improve nausea, has a good saftey profile w/ minimal side effects; 10-25 mg q6-8 hr. w/ 200mg/day max.
Doxylamine succinate and pyridoxine
Combo tablet, can improve nasuea;
10/10mg Q bedtime
Unisom, antihistamine safe for sleep/ nausea in pregnancy. 10 mg to 12.5 mg (1/2 of a chew-able or the equivalents in OTC). Cheaper than combo pills.
N/V, allergy symptoms, and insomnia in pregnancy - 25-50 mg q4-6 h as needed; NOT to exceed 400 mg/day
Serotonin agonist for N/V, q 30 minutes before meals, 10 mg, IV or IM, useful for hyperemesis , esp. when combined w/ diphenhydramine
H1 blocker for N/V; 12.5-25 mg orally/rectally/IM q4 hours .
Assoc. w/ sedation and dystonia, lowered seizure threshold, neonate. resp. depression.
5-10 mg IV/IM q6 hours OR 25 mg q12 rectally.
N/V in pregnancy; very effective. 4mg orally/IV Q8hr. HA, fatigue common. QT prolongation risk; consider prior hx.
H2 blocker/acid reduction agent. 150 mg BID. useful for N/V if accompanied by heartburn/acid .
Stepwise approach to n/v in pregnancy
B6; add H2 blocker (doxylamine, unisom); add H1 blocker (phenergin); IF hydraded/dehydrated add serotonin agonist (metocloppramide aka reglan)/ give IV fluid (nutrients if needed), add methylprednisone if past 10 weeks or if mom is dying
AFP, hCG, estriol; takes place at 1st trimester week 15 to before week 22:
Young female pt. w/ HTN, normal BMI/Exam.
fibromuscular dysplasia; affects the renal aa and casues this presentation.
Pt complains of irritation of eye, feeling of foreign body: flouriscine stain shows "dendritic" pattern of flourescence
Herpetic keratosis; look for hx. of cold sores. Trx. w/ topical antiviral
Umbilical hernia w/ no signs of incarceration: trx
Normal. As long as it can be reduced, should resolve by 1 year.
Pregnancy wt. gain, underweight
Over 35 lbs (about 1/week)
Pregnancy wt gain: Normal weight
25-35 lbs gained total
Pregnancy weight gain: overweight
15-25 BMI 26-29
Pregnancy weight gain: Severely overweight
11-20 lbs, BMI > 29
When is GDM diagnosed?
24-28 weeks of pregnancy
What size kidney stone should pass through the ureter?
< 5 mm.
What hx increases suspicion for renal stones?
Family hx, low fluid intake, gout, meds that increase uric acid output, chemo, loop diuretcis, enzyme def. type I RTA, hyperparathyroid .
infants less than 28 days old w/ high fever
HIGH suspicion for sepsis/meningitis.
duodenal atresia leads to what abnormality during gestation?
polyhydramnios: fetus cannot swallow fluid to maintain balance with urine output.
Male Pt has kleinfelter's syndrome: how can fertility be achieved?
TESE/ICSI: Testicular sperm extraction + intracytoplasmic sperm injection
2 m/o milestonw
lifts head/chest when prone, tracks past midline, alert to sound, coos, recognizes parent, social smile
4-5 m/o milestones
Rolls front to back/back to front; grasps rattle, ortients to voice, looks around, laugh
6 m/o milestone
sits unassisted, transfers objects, raking grasp, babbles, stranger anxiety.
9-10 m/o milestones
crawling, pulls to stand, 3 finger pincer grasp, mama/dada (nonspecific) waves bye, pat-a-cake
12 m/o milestones
cruising, walking alone, 2 finger pincer graps, mama/dada (specific) imitates actions
15 m/o milestones
walking backwards, cup use, 4-6 words, tempertantrums
18 m/o milestones
Runs, kicks ball, 2-4 cube tower, names objects, copies parent tasks
2 y/o milestones
steps (with help), jumping, 6 cube tower, 2 word phradses, 2 step comands, removes clothes
3 y/o milestones
tricycles, stairs w/ alternating feet, circle drawing, utneisls, 3 word sentances brushes teeth, washes hands.
4 y/o milestones
hops, copies a cross, counts to 10, coop play
female pt. in first trimester, cramping/bleeding w/ + bHcg; cervix closed, no fetal heart tones, fetus significantly small for gestational age
female pt in first trimester, closed cervix, no uterine pregancy visible on US, normal bHCG
Female pt in first trimester, dilated cervix, bleeding/cramping, live fetus w/ FHT consistent w/ gestational age
inevitable abortion; DnC
Female pt. in first trimester, vaginal bleeding, no passage of tissue, cervix closed.
Treatment of poor suckling w/ cranial OMT
Condylar decompression, to decrease hypoglossal nerve strain
Vulvar purit,s pain, new onset dysuria w/ hx of abx use
1st stage labor length
10 (primip) or 12 (multip) hours aprpox. max; median 4 or 3.
Vaginal bleed in 2nd/3rd trimester pregnant woman w/o cramping/pain
placenta previa: Placenta covers/is near cervical os. Monitor, c-sec if not resolved by 39 weeks
Vaginal bleed in 2nd/3rd trimester pregnant woman w/ cramping/pain
Vaginal bleed in 2nd/3rd trimester pregnant in labor woman w/ cramping/pain
Consider abruption or rupture.
Risk factors for placenta accreta
Testing for placenta accreta
MRI, urinalysis (looking for bloody urine), AFP (elevated
Treatment of molar pregnancy
D&C; do not use meds for risk of tissue remaining and causing endometrial cancers
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