Prep for USMLEPrep for USMLE
         Forum      |     Resources New Posts   |   Register   |   Login





 How accurate/good is this?  
Get Adobe Flash player



Post Reply  
  • 0/5
  • 1
  • 2
  • 3
  • 4
  • 5


Author6 Posts
  #1

I found this in another website



) Timeline: prenatal testing @ 6-8wks, Triple Screen @ 15-18, Ultrasound, 18-20wk GBS culture @ 35-37wk RhoGAM @ 28wk (if +, treat at 28 wks and 72 hrs postportum Diabetes checkup @ 26-28wks (high risk pt @ prenatal visit), Chorionic Villous Sampling @ 9-12wks
2) What tests makeup a normal prenatal visit? CBC, UA, Rubella, RPR, HBV, Rh typing, sickle cell prep and if pt is a teenager then do gonorrhea and chlamyida
3) What are the weeks of utmost teratogenicity in the fetus? 3-8 weeks
4) Where is progesterone made? 0-6 wks at chorionic villus, 6-9 weeks between chorionic villus and placenta and then >9 weeks placenta alone
5) What do you do NEXT if hCG or AFP levels comes back too high or too low? always recheck the dates with an ultrasound (vaginal is best)
6) What are some causes of HIGH hCG? Low hCG? For high hCG (remember H C G: Hydatidiform mole, Choriocarcinoma and Gestations multiple (twins and stuff), but also due to Downs syndrome and embryonal cancer). Low hCG includes incorrect dates, ectopic and missed abortions)
7) What are some causes of High AFP? Low AFP? High AFP includes gatrocele, omphalocele, NTD, incorrect dates. Low AFP includes Downs synd., Edwards syndrome, incorrect dates.
8) Mom says she doesnt feel the baby move anymore, what is the next step? U/S
9) Ultrasound does not pick up fetal heart tones, what is the next step? Real-time U/S
10) In fetal demise, at what weeks do you do D&C? <12weeks, D&E 12-16wks then labor induction >16wks
11) Mom does not feel the baby move and after an ultrasound is done, fetal heart tones are heard, what is the next step? NST
12) NST comes back nonreactive, what is the next step? do FAS, after that repeat NST. If its reactive, thast good (means the baby was sleeping). if its still nonreactive do BPP.
13) BPP comes back 8-10, what is the next step? Repeat in 4 days. What about 4-6? Do stress test. What about 0-2? Emergency delivery
14) At what amniotic fluid level do you consider oligohydramnios? <5 Polyhydramnios?>15
15) A stress test comes back c late decelerations, what does that mean? uteroplacental insufficiency. What about early decelerations? Head compression. What about variable decelerations? Cord compression
16) A stress test comes back with any type of deceleration, what is the next step in management? 1st D/C oxytocin, 2nd O2 and fluids, 3rd put pt on L lateral decubitus postion, 4th get scalp pH (normal is 7.25-7.4, if pH <7.2 then emergency section).
17) Besides (+) GBS culture, what are some other reasons to treat GBS at birth? h/o previous infection, preterm gestation. What do you treat it with? Penicillin
18) Give a cause, a diagnostic buzz-word and a treatment for Toxoplasmosis gondii in the fetus? Cat feces, undercooked meat. "Intracranial calcifications." Pyremethamine-Sulfa
19) What is the worst time for mom to develop pruritis vesicles consistent with varicella? 5 days before birth until 2 days after birth
20) What are 4 findings you would find in a neonate c congenital Rubella infection? Blueberry muffin rash, deafness, cataracts, PDA. How can you have prevented this? vaccine 3 months prior to conception.
21) What test do you do for congenital syphilis? Darkfield microscopy. How will a child with it present? Hutchinsons teeth, saber shins, saddle nose. How do you treat a mother who has syphilis while pregnant? Penicillin. What if she is allergic to the medication you prescribed? Desensitize.
22) What do you do if mother has vesicles consistent with HSV at 25 weeks gestation? Nothing. what about 1 week prior to delivery? C/S. what about at the time of delivery? C/S.
23) Mother has (+) HbSAg while pregnant, what do you do? give vaccine and HBIG at birth
24) If an ELISA test comes back positive, and then a southern-blot confirms HIV, what do you do next? get viral load and CD4 count
25) If a mother is on HIV medications and has a CD4 count of 275, which medications do you continue or discontinue? Continue all meds except effavirenz. What about if her CD count was >500? Only continue AZT throughout 2nd and 3rd TM and 6 weeks postpartum.
26) What is the 1st test you use to diagnose HIV in a child less than 6 weeks old? PCR (not ELISA)
27) What are the 4 major causes of 1st TM bleeding (for USMLE purposes of course)? Mole, Incomplete abortion, Ectopic, Threatened abortion. What about the 4 major causes of 3rd TM bleeding? Placenta previa, vasa previa, abruptio placenta, uterine rupture.
28) A woman comes with vaginal bleeding in the 1st TM, what is the next step in management? Speculum exam
29) If her cervical os is open and she had vaginal bleeding, what is the diagnosis and tx? Incomplete abortion, do D&C
30) If her cervical os is closed and she had vaginal bleeding, what is the next step in management? Vaginal U/S and b-hCG levels
31) If her cervical os is closed and you see a snowstorm pattern on u/s, what is your dx and tx? Mole. what if the u/s showed an intrauterine pregnancy? Threatened abortion. What if it showed no intrauterine pregnancy? Ectopic
32) If you narrowed it down to a mole, and you decide to do a D&C , but her hCG levels stay very high (>100,000) and dont fall, what is your diagnosis? Choriocarcinoma. What is your next step in management? Get CT of chest/abdo/pelvis. What is your treatment? If no metastasis to brain/liver, give MTX. If + METS, give radiation and MAC (MTX, adrenomycin, cytotoxin) and then hysterectomy.
33) If you narrowed it down to an ectopic, and the woman is stable and does not want surgery, what is your treatment? MTX. What if she is unstable and does not want surgery? Surgery. What if she is unstable and just wants to be treated, what is the best treatment then?? Surgery
34) A pt comes in with vaginal bleeding in her 3rd TM, what is your next step in management? Ultrasound. What are you trying to rule OUT? Placenta previa.
35) How will a woman with a placenta previa present? painless vaginal bleeding. If it was preterm and it was mild how will you treat? hydration bed rest. if she was preterm and it was serious how will you treat? c/s. What type of delivery are you expected to do? c/s.
36) How will a woman with abruptio placenta present? painful bleeding. Same questions as above? If mild then observe. If mod-severe, then vaginal delivery if possible, otherwise c/s.
37) How will a woman with Vasa previa present? What type of delivery should you do? painless vaginal bleeding, ROM and fetal bradycardia. C/s
38) How will a woman with uterine rupture present? how can you differentiate it from a ruptured placenta? Sudden painful bleeding with abnormal fetal heart rate. Ruptured placenta wont have abnormal fetal heart rate (normal is 110-160)
39) If mom already has (+) Rh antibodies because of failed RhoGAM administration in the past and she now presents to you, what will you do? dont give rhogam, just get titers, if >1:8 then get spectrophotometry to assess degree of hemolysis.
40) If mom has PROM, how can you confirm its correct? Fern + Nitrazine +. What is the next step in management? Get cultures and start ampicillin + gentamycin while waiting for results. Do you wait for results to start treatment? No. What do you do if she has an infection? Deliver. What do you do if there is no fever and child is between 24-35 weeks gestational age? prophylactic Abx, steroids, hydration. What about >24wks? outcome is dismal, induce labor.
41) A woman comes in with labor contractions, how will you be certain she is in preterm labor and that the contractions are not Braxton-Hicks? Look for cervical dilitation. What do you do next if you confirm that it is preterm labor? 1st L lateral decubitus postion c O2 and IVF, 2nd start tocolytics. Would you use tocolytics, if so which one? In this instance, B-adrenergic tocolytics are preferred.
42) Give the 4 known tocolytics, and their adverse effect? MgSO4 (causes hypotension, decrease DTRs and even coma), B-adrenergics (not given to DM and Cardiac Disease), Calcium blockers (not given if hypotensive), Prostaglandins (not given <32 weeks as they can cause premature closure of ductus arteriosus). How can you reverse the adverse reaction of the most common tocolytic used? Calcium gluconate reverses MgSO4 toxicity.
43) Pt is >40 weeks in gestation, what is the next step you do? Check the dates. What do you do if the cervix is favorable? Induce labor unfavorable? Wait until 42 weeks and then induce.
44) How do you know when its chronic HTN from gestational HTN? Chronic HTN is HTN before 20 weeks gestation. what is the best drugs for HTN in pregnancy? Hydralazine, Lobetolol. What is contraindicated? ACEI
45) How do you manage preeclampsia? hydrate and send home. severe preeclampsia? MgSO4 and deliver. eclampsia? MgSO4 and deliver. Do yo do vaginal or C/Sxn? Vaginal unless mom is unstable then C/S.
46) How do you manage prolonged latent phase? bed-rest. prolonged active phase? oxytocin, then C-sxn. prolonged 2nd stage? If head is engaged, do vaccuum. If head is not engaged, do C/S. If prolonged 3rd stage? manual placental removal, then currettage. prolonged 4th stage? massage, 2nd pitocin, 3rd PGE, 4th Methergin, 5th hysterectomy
47) What is the MCC of prolonged 4th stage? Uterine Atony. What are some other causes? Lacerations, retained placenta (send for ex-lap if you cant get it out), DIC and uterine inversion.
48) How do you manage shoulder distocia? McRoberts maneuver (maternal thigh flexion and push on the suprapubic area)
49) Post-partum fever, what cause are you suspecting at days 0-1? Atelactasis. 2-3? Endometritis. 1 week later? Septic thrombophlebitis
50) How do you treat endometritis? Ampicillin, Gentamycin and Metronidazole. what do you suspect if that treatment does not stop the fevers? Septic Thrombophlebitis. how do you manage that? Heparin
51) How do you manage mastitis? Dicloxacillin and continued breast feeding from same breast
52) Mom does not want to breastfeed, what do you tell her? Ice-packs and tight bra
53) Mom wants OCPs while breastfeeding, which one do you give her? Progesin only (minipill)
54) How do you manage amniotic fluid embolism? Supportive care (oxygen and intubation if needed, do not use heparin/warfarin as this is not a blood clot).
55) How do you manage acute fatty liver of pregnancy in the emergent setting? IVF, IV glucose and FFPs.


  #2

hey at least go true 5-10 and say I went true 1-10 or 1-5 and they seem accurate

PLEASE
thank you


  #3

1-5 seem correct.



  #4

are you sure for number 4?


  #5

initially progestrone produced by corpus lueteum which is maintaineed by b -hcg which is secreted by syntitiotrophoblast .



  #6

My name is Mary,i am here to share my testimony about what Dr Osele did for me, he saved me from dying. I confirmed that i was Hepatitis B positive when i was 7weeks pregnant, i gave birth and later confirmed that my baby was also infected. i was frustrated and hopeless, i contacted Doctors and they all promised to help me but their effort was helpless. Some of my friends began to laugh at me and said that i will die miserably, i loosed hope and thought that my child and i will never be free of hEP B, till we die a shameful death, on a very good day i was browsing through the internet and i saw a testimony of one miss cristina talking about how Dr Osele helped her cure her from hep B, i did not believe but i decided to give Dr Osele a try and i contacted him with his Email, healthmedicallab@gmail.com He told me not to worry that he will help me and my daughter to be free of Hep b and he ask me to send him some of my information, i did, and sent medicine to me, he ask me to take it for 8days and also give to my daughter, i did as he Ordered, on the 9th day he emailed me and ask me to go with my daughter to the hospital for Hep b test, after the test result came out i confirmed that we are Hep B negative i could not believe it, tears of joy fell from my eyes that moment.. I am so happy to tell the world that my daughter and i are Hep B negative, we are now living a happy life without hep b.Please help me to thank Dr Osele for his great help. If you have any problem feel free to contact Dr Osele with his Email:healthmedicallab@gmail.com I guarantee you that he can also help you solve your problem.he even told me he cured all kind of diseases such as cancer, hiv/aids, herpes simplex, diabetes and other. contact him email or whatsapp : healthmedicallab@gmail.com or +27846531636





Bookmark and Share





Login or Register to post messages








show Similar forum topics

How accurate is
How accurate is this?
SEE, how accurate is NBME
show Related resources









Advertise | Support | Privacy | TOS | Premium | Contact