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7/29/2019 OB Feedback

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1. What should be remembered? 2nd Trimester The pregnancy should be left UNDISTURBED(give tocolytics)

- Why not in the 1st trimester- Placental luteal shift?

2. Why is acute abdomen difficult to diagnose during pregnancy? Classic clinical signs are maskedby enlarged uterus

3. What happens when the patient has acute appendicitis? Right lower quadrant (Pain goes up)4. Persistent abdominal pain and tenderness with nausea and vomiting. Fundic height is 26cm.

Cervix is smooth and violaceous ACUTE APPENDICITIS

5. Differential Diagnosis: ALL OF THE ABOVE6. Explore Laporotomy7. UPWARD AND OUTWARD pain goes up in gravid uterus8. ECTOPIC PREGNANCY9. Best incision in doing appendectomy Median or Paramedian (for Pregnant)10.Most common intestinal obstruction ADHESIONS11.Useful in clinician in diagnosis? PLAIN XRAY12.DECOMPRESSION13.A and B14.Asymptomatic Bladder Disease Cholelithiasis15.Massive abdominal distention OLGEVI16.Early ultrasound, 5cm mass. Most likely diagnosis. Unilocular cyst mass FOLLICULAR CYST17.Appropriate Management Observation and Repeat ultrasound18.Adnexal mass in pregnancy Dermoid cyst or Teratoma19.TORSION20. Increase in normal pregnancy CARDIAC OUTPUT and STROKE VOLUME21.Clinical indicator of cardiovascular disease CHEST PAIN22.PERIPARTUM23.CHRONIC HYPERTENSION WITH SEVERE PRE-ECLAMPSIA24.Recommended Analgesia CONTINUOUS EPIDURAL25.Congenital Septal Defect . Excessive fatigue CLASSIFICATION 226.VIRIDANS27.Most common type of heart disease MARFAN SYNDROME28.329.Primigravid, overriding of aorta TOF30.What is the effect of warfarin of mechanical valve prosthesis - INCREASE RISK OF

EMBRYOPATHY

31. INCREASE RISK OF THROMBOEMBOLISM32.Bleed profusely PROTAMINE SULFATE33.When should be anticoagulant discontinued? JUST BEFORE DELIVERY34. Induced in pregnancy DECREASED EXPIRATORY VOLUME35.PEAK EXPIRATORY FLOW36. Inhaled beta antagonist and Corticosteroids


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37.Central Cyanosis38.What is the most appropriate management? DETERMINE FIRST EXPIRATORY VOLUME39.Which of the following is the most common cause of pneumonia? STREPTOCCOUS

PNEUMONIAE

40.Minimum threshold value 14041.Screening of GDM 24-28 years old42. In high risk patients FIRST PRENATAL CARE43.Diagnostic test OGTT44.2 ABNORMAL VALUES45.Type 1 Diabetes. What is the chance? 36%46.Congenital Mandatory INTELLECTUAL IMPAIRMENT IS EARLY47.Abruptio Placenta with severe hemorrhage SHEEHAN SYNDROME48.HYPOTHYROIDISM49.Management PTU50.Renal Disease in Pregnancy SERUM CREATNINE GREATER THAN 051.PYELONEPHRITIS52.Offending organism CHLAYMDIA53.PAIN54.Which of the following is the most common cause of ESRD DIABETES55.FECAL-ORAL56.H. PYLORI

3rd Trimester

1. Painless vaginal bleeding PLACENTA PREVIA2. Most appropriate treatment TERMINATION OF PREGNANCY and by CS DELIVERY3. Safest Ultrasound4. Placenta Previa PREMATURITY5. 40 year old, Emergency CS, no cleavage PLACENTA ACCRETA (Decidua is absent)6. Most appropriate management - HYSTERECTOMY/ PROMPT REMOVAL OF UTERUS7. TONE8. POOR CONTRACTILE NATURE9. VASA PREVIA Triad: Artificial rupture of membrane, vaginal bleeding, fetal bradycardia10.Frequent uterine contractions ABRUPTIO PLACENTA11.CLINICAL SYMPTOMATOLOGY12.FRESH WHOLE BLOOD for Acute Hemorrhage13.Examination of postpartum hemorrhage, unremarkable, uterus is soft and boggy? UTERINE

ATONY

14.Management - UTEROTONICS AND BIMANUAL COMPRESSIONSurgical:


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- Unstable vital signs: HYSTERECTOMY15.No palpable mass, protruding out UTERINE INVERSION16.Uterine inversion MANUAL REPOSITION OR PLACEMENT OF INVERTED UTERUS17.RETAINED PLACENTAL18.CURETTAGE19.Excruciating vulvar pain VULVAR HEMATOMA20.Management Evacuation and drainage21.3rd stage bleeding22.Management Controlled traction, uterine massage, oxytocin23.STABILIZE THE PATIENT24.STRONG TRACTION OF THE UMBILICAL CORD25.Amount of blood flow in intervillous space 600 ml/min26.Anesthetic agent GENERAL ANESTHESIA27.HALOTHANE uterine relaxant28. LESS THAN 1029.Hemodynamic stable postpartum women 730.Highest element FERROUS FUMARATE31.What is the total iron 1000mg

General Data

CC

Past History

32.Medical Hx33.Surgical34.Obs

Family

Personal

Mens

Obste

History of Present Pregnancy

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