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124 Cards in this Set
- Front
- Back
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Influenza Treatment |
Oseltamivir 75 mg po BID x 5 days |
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Bleomycin side effect |
Pulmonary fibrosis |
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Paroxetine (Paxil) in pregnancy - issues? |
Cardiac anomalies 2 fold increase Neonatal behavioural syndrome - essentially the same as neonatal abstinence syndrome Persistent pulmonary hypertension |
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Surgical TA ABx Prophylaxis |
Doxycycline 200 mg po 30-60 min pre-op Metronidazole 1 g pre-op, then 500 mg Q6H x 3 |
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Components of Diclectin |
Pyridoxine (B6) 10 mg delayed release Doxylamine (H1 antagonist) 10 mg |
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Warfarin embryopathy in T1 |
Nasal hypoplasia Optic atrophy Stippled epiphyses Mental retardation |
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ABx for Mastitis (med, dose, duration) |
Cloxacillin 500 mg QID 10-15 days |
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High androgenic progesterones (2) |
1. Levonorgestrel 2. Norgestrel |
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Lupus medications contraindicated in pregnancy |
Cyclophosphamide Methotrexate Leflunomide Mycophenolate Warfarin ACE inhibitors ARB Diuretics Biologics |
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Risks of NSAIDs in pregnancy |
- oligohydramnios (most common, dose-related) - premature closure of ductus arteriosus - gastroschisis - prolonged labour - PPH - fetal ICH |
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Methotrexate side effects |
Stomatitis Dermatitis Gastritis (NVD) Pleuritis Alopecia BM suppression Inc. LFTs |
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Ergonovine - dosing + contraindications |
0.25 mg IV (slowly) or IM once q2-4h PRN CI: hypertensive disorders , HIV meds (protease-inhibitor, non-nucleoside reverse transcription inhibitors) |
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Treatment for endometrial hyperplasia |
With atypia - 1) megestrol acetate 80 mg BID or 2) medroxyprogesterone acetate 100 mg BID With no atypia - 1) medroxyprogesterone acetate 10-20 mg daily or 10-14d/month or 2) prometrium 100-200 mg daily |
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Progesterone options for women with chronic anovulation to prevent endometrial hyperplasia/cancer (4) + _______________ if inc. BMI? |
1. Medroxyprogesterone 5-10 mg / d x 12-14 d 2. DMPA 150 mg IM q3months 3. LNG-52mg (20mcg/d) 4. Norethindrone acetate 5-15 mg / d x 12-14 d WEIGHT LOSS |
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What is the best regime for a medical abortion? |
Mifepristone 200 mg po Misoprostol 800 mcg pv/sl 24-48 h after MIFE Ideally before 49 days since LMP, but possibly effective until 70 days. |
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Contraindications to MIFE |
1. Chronic adrenal failure 2. Uncontrolled asthma 3. Inherited porphyria 4. Ectopic pregnancy 5. Allergy 6. Not interested in MA |
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Alternatives to hormone therapy for treatment of VMS (4) |
- clonidine - SSRIs + SNRIs (+ active metabolites) - fluoxetine, paroxetine, venlafaxine - gabapentin - pregabalin |
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When does breakthrough bleeding occur with cyclical and continuous hormone therapy? |
Cyclical - after 12 months Continuous - months 3-6; mostly amenorrheic by 12 months For either, if unscheduled/irregular bleeding is persistent after 6 mo, must rule out hyperplasia |
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In whom should transdermal HT be considered instead of oral HT (4)? |
- malabsorption - high risk for VTE - obese with metabolic syndrome - elevated trigylcerides E - dec. LDL, inc. HDL, inc. TRIG P - variable effect |
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Drugs that cause hot flushes (4 categories) |
SSRIs SERMs CCBs EtOH |
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High risk substances for osteoporosis (5) other than glucorticoids (3 mo, daily dose prednisone equivalent 7.5mg) |
- anticonvulsants - EtOH - Cigarette smoking - chronic heparin - caffeine |
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Medical therapies for osteoporosis to decrease fracture risk |
Antiresorptive - decrease bone turnover/remodeling - bisphosphonates - alendronate, risendronate - estrogen - SERM - ralofixene Anabolic - increase bone formation - teriparatide (parathyroid hormone) RANKL Inhbitor - denosumab - decrease bone remodeling |
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What is the treatment for syphilis in pregnancy and what is the name of the reaction that may occur, what does it involve? |
Benzathine Penicillin G 2.4 million units IM (x 1 if primary or secondary, x 3 doses - one per week - if late latent or tertiary) In neurosyphilis, crystalline pen G 3-4 million units IV q4-6h x 10-14 days Jarisch-Herxheimer - febrile rxn 6-12 hours after treatment; not allergic and no need to stop treatment; most common in secondary syphilis; may precipitate contractions, PTL, non-reassuring FHRT |
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Methotrexate exposure in IUP pregnancy is associated with... |
Cranial & limb anomalies - craniosynostosis Not preventable with FA or leucovorin |
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List two regimes for ABx in PPROM |
1. Ampicillin 2 g IV q6h AND erythromycin 250 mg IV q6h for 48 hours, then amoxicillin 250 mg po q8h and erythromycin 333 mg po q8h x 5 days 2. Erythromycin 250 mg po q6h x 10 days |
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What are the teratogenic effects of ACE inhibitors? |
Decreased perfusion - renal -- Oligohydramnios - hypocalvaria - limb contractures - lung hypoplasia - IUFD 70% normal |
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Explain significance of statins in pregnancy |
Category X Must be stopped Linked to congenital anomalies - CNS, facial, limb |
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What medications do HIV positive women get intrapartum vs C/S? |
C/S - undetectable viral load - AZT (aka zidovudine) IV 3h pre-op (start with 2mg/kg followed by 1mg/kg); if untreated in pregnancy, also give single oral dose nevirapine 200mg at presentation
Vaginal - same as above but continue infusion until delivery PLUS there regular home HIV medications |
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Which OAB meds are safe with cardiac disease? |
- Tolterodine - Darifenacin |
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Which is the only OAB med that is not safe in the elderly? |
Oxybutynin |
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Which OAB med is cleared renally? |
Tropsium |
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What are the absolute contraindications to anticholinergics? |
- uncontrolled narrow angle glaucoma - retention - urinary or gastric - allergy - long QT syndrome |
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What test needs to be done before Rxing ABACAVIR? |
HLA B5701 |
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What medications should be prescribed to someone with an OASIS? |
1. ABx - single dose IV second gen cephalosporin - cefoxitin or cefotetan 2. Laxatives 3. NSAIDs + Tylenol +/- Opioids |
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Side effects of epidural (4) |
- maternal hypotension - pruritis (if narcotics used) - dural puncture headache - urinary retention - hematoma/bleeding - infection/abscess |
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Ergonovine side effects (3) |
- hypertension - coronary vasospasm - peripheral vasoconstriction |
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Hydralazine side effects (4) |
- hypotension - headache - flushing - palpitations |
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What supplements do pregnant vegetarians need to ensure they have (3) |
- folic acid - iron - vitamin B12 - calcium/vit D |
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What medications would you prescribe to a victim of rape prophylactically (5)? |
1. Emergency contraception - LNG (Plan B) 1.5 mg po once or Copper IUD if event 5-7 d ago 2. Chlamydia - Azithromycin 1 g po once 3. Gonorrhea - Cefixine 800 mg po once or ceftriaxone 250 mg IM once 4. Syphilis - Penicillin G Benzathine 2.4 million units IM 5. HIV - PEP x 28 d |
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What are the risks and benefits of combined hormone therapy based on the WHI study? |
INCREASED - breast cancer 8/10,000 - stroke 8/10,000 - VTE 18/10,000 DECREASED - colorectal cancer 6/10,000 - hip + spine fracture 5/10,000 |
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What are the risks and benefits of estrogen-only hormone therapy based on the WHI study? |
INCREASED - stroke 12/10,000 - VTE 6/10,000 DECREASED - hip + spine fracture 6/10,000 |
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List absolute contraindications to the COMBINED ORAL CONTRACEPTIVE PILL |
- pregnancy - undiagnosed vaginal bleeding - migraine with neurological symptoms/aura - smokers ≥ 35 y.o. (> 15 cigarettes) - less than 6 weeks postpartum + breastfeeding - uncontrolled hypertension - cardiovascular disease - MI - valvular heart disease - stroke - uncontrolled diabetes - Hx of VTE - active liver disease - |
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List relative contraindications to the COMBINED ORAL CONTRACEPTIVE PILL |
- controlled HTN - mild liver disease - smoking ≥ 35 y.o. but < 15 cigarettes - migraine headache - hypertriglyceridemia |
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What happens if actinomycin D goes interstitial and what must be done? |
- sloughing of skin - infiltrate with hydrocortisone and lidocaine |
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What chemotherapy is most nephrotoxic? |
Cisplatin Also OTOTOXIC |
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Which chemotherapy agent could be adjusted to reduce peripheral neuropathy? |
Taxol |
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What is this condition and what causes it? |
Hand-foot syndrome (or palmar-planter erythrodysthesia) Lipsomal doxorubicin (caelyx) |
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Which chemotherapy agent has the highest secondary cancer risk? Name the cancer |
Etoposide 1% AML |
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Which chemotherapy agents work by effecting microtubules (2)? |
Taxol Vincristine |
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Two examples of add-back therapy |
17 β estradiol 1 mg po daily + any progestin Norethindrone acetate 5 mg po daily |
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Describe what happens when someone is exposed to radiation in the first 14 days after conception |
All-or-none period Either pregnancy ends or continues undamaged - no evidence of teratogenesis, carcinogenesis, or growth disturbances. |
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What are the general categories of effects of diethylstilbestrel (DES) to women exposed in utero (5)? |
- cervicovaginal clear cell adenocarcinoma - cervical intraepithelial neoplasia - congenital anomalies and epithelial changes to the reproductive tract - early menopause - breast cancer - subfertility and adverse pregnancy outcomes |
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What is a known cause of Ebstein's anomaly and explain the significance of this anomaly. |
Lithium (1-2/1000) Ebstein's anomaly is the displacement of the tricuspid valve, resulting in severe tricuspid regurgitation and right atrial enlargement. |
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List three features of neonatal lithium toxicity |
- hypothyroidism - diabetes insipidus - cardiac abnormalities -- ECG abnormalities |
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To convert to oral morphine, multiply by: 1 - Codeine 2 - Oxycodeine 3 - Hydromorphone |
1 - 0.15 2 - 1.5 3 - 5 |
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Polyglactin tensile strength D0-10 D14 D21 D28 |
d0-10 - 100% d14 - 50-60% d21 - 20-30% d28 - 0% |
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What are the side effects of clomiphene citrate? |
- multiples (5-10%) - bloating, headache, blurred vision - mood changes - nausea, vomiting - hot flashes - ovarian cysts - thin endometrium |
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Which vaccines are recommended for women with sickle-cell anemia? |
1. Pneumococcal 2. Haemophilus influenzae B 3. Meningococcal |
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What treatments are available in VZV infection in pregnant women? |
1. Prevention with VZIG within 72-96 hours of exposure if unknown VZV susceptibility or known susceptible women; dose 625 units 2. Acyclovir within 24 hours of rash 3. If pneumonitis, admit and acyclovir IV 800 mg 5 times/day |
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How to monitor magnesium toxicity (3) |
1. Assess deep tendon reflexes Disappear at 4-5 mmol/L 2. Measure serum magnesium levels and maintain levels less than 4 mmol/L 3. Measure serum magnesium if serum creatinine high 4. Observe urine output |
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Treatment for anaphylaxis |
Give epinephrine 0.3 to 0.5 mg intramuscularly, preferably in the mid-outer thigh. Dilution 1mg/mL or 1:1000. Don't forget: ABCs Oxygen IV access Elevated lower extremities Monitor vitals |
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Doses of local anaesthetics |
Lidocaine without epinephrine 4 mg/kg with epinephrine 7 mg/kg (think - the lidocaine is diluted so you can give a higher dose) Bupivicaine without epinephrine 2 mg/kg with epinephrine 3 mg/kg |
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List GBS prophylaxis options, including for women with anaphylactic and non-anaphylactic allergies. |
Penicillin G IV 5 million units once, then 2.5 million units Q4H until delivery Penicillin allergy Low-risk anaphylaxis - cephazolin 2g IV, then 1g Q8H High-risk anaphylaxis clindamycin 900mg IV Q8H or if susceptibilities not known, vancomycin IV 1g Q12H |
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What is the cross-reactivity of first-generation cephalosporins with penicillin? |
0.5% |
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What are the initial side effects of local anaesthetics? |
CNS - tinnitus - metal taste - tingling mouth/tongue - blurred vision |
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How to counsel woman who had first trimester accutane exposure. |
1. Risk of SA 2. Risk of major congenital malformation 25% 3. Termination vs. expectant management |
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List 6 factors that influence teratogenicity |
1. The drug 2. Timing 3. Dose 4. Duration 5. Maternal absorption/metabolism 6. Degree of placental transportation |
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Methotrexate contraindications (8) |
Allergy Breastfeeding Ruptured ectopic IUP Hepatic, renal, or hematologic dysfunction Peptic ulcer disease Active pulmonary disease Evidence of immunodeficiency |
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What is the medication dosage for multidose methotrexate? |
MTX 1 mg/kg on day 1, 3, 5, 7 Leucovorin 0.1 mg/kg on days 2, 4, 6, 8 Check beta-hCG on days 1, 3, 5, 7 Stop when there is a drop in beta-hCG > 15% |
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What are the two regimes for outpatient PID |
A. 1. Ceftriaxone 250 mg IM x 1 + Doxy 100 mg po BID x 14 days A. 2. Cefoxitin 2 g IM x 1 + Probenacid 1 g po x 1 + Doxy 100 mg po BID x 14 days B. 1. Levofloxacin 500 mg po OD x 14 days + metronidazole 500 mg po BID x 14 days B. 2. Ofloxacin 400 mg po BID x 14 days + metronidazole 500 mg po BID x 14 days |
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Which anti-rejection medications can be given in pregnancy? |
Cyclosporine Azathioprine Tacrolimus Prednisone |
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What are the treatment options for a woman with bacterial vaginosis? 1st Episode? Recurrent? Pregnant? |
1ST EPISODE: - metronidazole 500 mg po BID x 7 days - metronidazole 0.75% one applicator (5g) pv x 5 days - clindamycin 300 mg po BID x 7 days - clindamycin 2% one applicator (5g) pv QHS x 7 days RECURRENT: 1st - metronidazole 500 mg po BID x 10-14 days Then - metronidazole 0.75% one applicator (5g) pv x 10 days then 2x/week x 4-6 months PREGNANT: If symptomatic or high-risk and asymptomatic: - oral metronidazole or clindamycin regime |
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What are the side effects of metformin? |
GI - N/V/D Lactic acidosis |
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What are maternal and fetal side effects of methimazole? |
Maternal - leukopenia - agranulocytosis - rash - loss of taste Fetal - goiter - hypothyroidism - aplasia cutis |
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What are the various treatment regimes for candidiasis? 1st episode? Recurrent? Maintenance? Non-albicans? Pregnant? |
1ST EPISODE: - fluconazole 150 mg po x 1 dose - miconazole 100 mg pv x 7 days RECURRENT (i.e. ≥ 4/year): - fluconazole 150 mg po x 3 doses - topical azole 10-14 days - boric acid 300-600 pv x 14 days MAINTENANCE: - fluconazole 150 mg 1x/week - boric acid 300 mg pv 5x/month NON-ALBICANS: - boric acid - amphotericin B - nystatin - flucytosine PREGNANT: |
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What medication options can you offer to someone for hirsutism? |
- OCP - Diane 35 - contains cyproterone acetate - GnRH agonist with addback therapy - Spironolactone (theoretical risk of feminization of male fetus) - Flutamide (rare risk of hepatotoxicity) - Finasteride (significant teratogen potential) |
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Explain the effect of the 4 classes of osteoporosis medications on the three main fracture categories. |
BISPHOPHONATES - good for all - vertebral, non-vertebral, hip RANKL INHIBITORS - DENOSUMAB - good for all - vertebral, non-vertebral, hip SERM - RALOXIFENE - good for only vertebral - not for non-vertebral or hip PTH RECOMBINANT - TERIPARITIDE - good for vertebral, non-vertebral - not hip - good for |
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Which is the only SERM that has agonistic properties against the uterus? |
Tamoxifen |
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Pregnant woman with + TB test. What do you do first? Then, what helps decide if treatment of TB in pregnancy is necessary and if so, what drugs are used to treat TB in pregnancy? |
1. Determine if vaccination or previous infection 2. If latent TB - could postpone and treat postpartum 3. If active TB (possible in new infection, HIV +), should treat now. Drugs: Isoniazid + B6, Rifampin, Ethambutol x 9 months |
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What is involved in the general medical management of diabetic ketoacidosis in pregnancy? |
1. Stabilize, ABCS, IV line 2. Monitoring - ABG to document degree of acidosis, glucose, ketones, lytes q1-2h 3. Insulin - 0.2-0.4 U/Kg, then 2-10 U/hr 4. Fluids - normal saline; 4-6L in 12 hr 5. Glucose - begin 5% dextrose in NS when plasma glucose reaches 14 mmol/L 6. Potassium to stay above 3.5 7. Bicarbonate - if pH < 7.1 |
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How do you manage insulin during L&D? |
If planned induction, take usual night time dose night before IOL Withhold morning insulin dose Begin IV NS infusion At onset of active labour or if glucose level drops, change NS to 5 % dextrose at 100-150ml/hr Check glucose levels q1hr to adjust infusion or give insulin Regular short-acting insulin is given if glucose is too high |
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What does the medical management of hyperkalemia consist of? |
1. Assess level of severity - muscle weakness, arrhythmias 2. K level > 6.5 mmol/L = EMERGENCY (give IV insulin with glucose, calcium gluconate, diuretics) |
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List 5 medications that interfere with folic acid |
Sulfasalazine Trimethoprim Methotrexate Metformin Anticonvulsants: - Phenobarbital - Phenytoin - Primidone - Carbamazepine - Valproic acid |
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Initial management of both acute and chronic asthma |
ß-adrenergic agonists for both chronic and acute Corticosteroids are given initially along with ß agonists because their onset of action is several hours. |
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In what circumstances is progesterone used for prevention of preterm birth? Discuss initiation, dosing, duration. |
1. Short cervix < 15 mm at 22-26 weeks; give progesterone 200 mg pv daily 2. Previous preterm birth; give either (i) 17-OHP 250 mg IM weekly or (ii) progesterone 100 mg pv daily Stop when risk of prematurity is low |
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Which emergency contraceptives may work after LH surge and how do they work (2)? |
1. Cu-IUD - creates toxic environment for sperm and oocyte; impacts muscular activity of tube and myometrium; impairs implantation 2. Ullipristal acetate (UPA) - selective progesterone receptor modulator; direct inhibitory effect on follicular rupture |
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Which emergency contraceptives DO NOT have an effect on the endometrium/implantation? |
LNG UPA |
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What are the side effects of clomiphene citrate? |
- multiples (5-10%) - bloating, headache, blurred vision - ovarian cysts - thin endometrium |
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What are the disadvantages to gonadotropins (5)? |
- multiples (20%) - cost - ovarian cysts - torsion - injection site reaction - bloating, fullness, nausea, headache, fatigue |
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List 6 strategies for reducing the risk of OHSS |
- coasting less than 3 days - cabergoline - cycle cancellation - freeze all - single embryo transfer - metformin in PCOS - progesterone instead of hCG for luteal phase - GnRH antagonist protocol with GnRH agonist for ovulation trigger |
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Serious complications of lidocaine toxicity (4) |
Seizure Hypotension Arrhythmia (ventricular) Cardiac arrest |
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After emergency contraception, when should a pregnancy test be conducted if a women does not have a menstrual period? |
21 days |
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What must a women using ullipristal acetate as emergency contraception do after use? |
1) Start hormonal contraception 5 days later 2) Use back up contraception after UPA use and for first 14 days of new hormonal contraception. |
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List 3 indications for therapeutic thromboprophylaxis in pregnancy. |
1. On long term therapeutic doses for persistent indications 2. PMHx of multiple previous VTEs 3. PMHx of one previous VTE and a high-risk thrombophilia (APLA, antithrombin deficiency) |
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List 5 indications for prophylactic dose thromboprophylaxis in pregnancy. |
1. PMHx of one unprovoked VTE 2. PMHx of one VTE related to OCP or pregnancy 3. PMHx of one VTE and low-risk thrombophilia 4. Asymptomatic factor V Leiden, antithrombin deficiency, homozygous prothrombin gene mutation 20210A 5. Non-obstetrical surgery in pregnancy |
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How long after a dose of thromboprophylaxis can labour anaesthesia be administered? For LMWH and unfractionated heparin |
LMWH Prophylactic - minimum 10-12 hours Therapeutic - 24 hours UFH Prophylactic - no delay Therapeutic IV infusion - 4 hours and N aPTT Therapeutic SC - 12 hours and N aPTT |
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When after a single injection neuraxial block or neuraxial cathether is removed can thromboprophylaxis be restarted? |
LMWH Prophylactic - 4 hours Therapeutic - 24 hours after single injection, 4 hours after catheter removal UFH SC - 1 hour |
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Postpartum thromboprophylaxis is recommended when women have any ONE of the following: |
i. PMHx of VTE ii. high risk thrombophilia - FVL, antithrombin deficiency, APLA, prothrombin gene mutation 20120A iii. strict bedrest 7 days or more iv. PPH > 1 L AND postpartum surgery v. peripartum/postpartum infection |
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Postpartum thromboprophylaxis is recommended when women have any TWO of the following: |
i. body mass index ≥ 30 kg/m2 at first visit ii. smoking > 10 cigarettes/day antepartum iii. preeclampsia iv. intrauterine growth restriction v. placenta previa vi. emergency Caesarean section vii. PPH > 1 litre or blood product replacement viii. any low risk thrombophilia: PC or PS deficiency, heterozygous factor V Leiden, or prothrombin gene mutation 20210A ix. maternal cardiac disease, SLE, sickle cell disease, inflammatory bowel disease, varicose veins, gestational diabetes x. preterm delivery xi. stillbirth |
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Postpartum thromboprophylaxis is recommended when women have any THREE of the following: |
i. age > 35 years ii. parity ≥ 2 iii. any assisted reproductive technology iv. multiple pregnancy v. placental abruption vi. premature rupture of membranes vii. elective Caesarean section viii. maternal cancer |
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What is the treatment and management for intrahepatic cholestasis of pregnancy? |
URSO - ursodeoxycholic acid; 10mg/kg/d IOL - for non-severe @ 38+6 weeks; for severe @ 37-38 weeks |
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When is adjuvant radiation therapy necessary in vulvar cancer (4)? |
1. Single node ≥ 5 mm 2. 2 or more microscopic mets < 5 mm 3. Bilateral microscopic mets 4. Extracapsular spread |
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List 4 criteria for adjuvant therapy/radiation in endometrial cancer? |
1. + LVSI 2. Grade 2 or 3 3. Cervical involvement 4. Non-endometrioid type |
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Where in the cascade pathway does LMWH/UF work? |
Binds to antithrombin III, which then inhibits factor Xa. |
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What is the recommended treatment and alternative treatments for Trichomonas vaginalis |
Recommended: Metronidazole 2g po x 1 Alternative: Metronidazole 500 mg po BID x 7 d Tinidazole If treatment failure - longer courses of therapy |
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List three medication options for thyrotoxicosis in pregnancy and their mechanism |
Inhibit release of T3 and T4 PTU Iodine (Lugol's) Blocks peripheral conversion of T4 to T3 Steroids |
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What are two inpatient regimes for PID? |
1. Cefoxitin 2g IV q6h PLUS doxycycline 100 mg po BID 2. Clindamycin 900 mg IV q8h PLUS gentamicin 5mg/kg IV q24h In both regimes, parenteral therapy can be discontinued 24 hours after clinical improvement. Step down to oral therapy - doxycycline 100 mg po BID to complete 14 days |
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List a regime for each of the following: HSV initial episode HSV recurrent episode HSV suppression |
Initial: acyclovir 200 mg po 5x/d for 10d Recurrent: acyclovir 200 mg po 5x/d for 5d Suppression: valacyclovir 500 mg po OD |
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List 6 options for treatment of vulvar warts |
Home-based - Imiquimod - Podophyllotoxin Office-based - Trichloroacetic acid - Cryotherapy Resection Laser ablation |
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What is an alternate regime for pre-operative prophylaxis in a penicillin-allergic patient? |
Clindamycin 600 mg IV x 1 |
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What medication is used for prophylaxis against toxoplasmosis in pregnancy? |
Spiramycin 1 g po Q8H until delivery |
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Which medication, taken by a male, requires a longer duration of time between stopping and conceiving a pregnancy. How long do they have to wait? How long is the normal sperm life cycle? |
Ribavarin - 6 months Sperm life cycle 72 days |
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Which chemotherapy agents cause alopecia? |
Cyclophosphamide Actinomycin D Paclitaxel Doxorubicin |
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When fetal infection of toxoplasmosis is confirmed, what medications should be started and when?
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Pyrimethamine Sulfadiazine Leucovorin Start after T1 |
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How should a tonic-clonic seizure at the time of delivery be treated? |
IV lorazepam 4mg bolus |
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Which tocolytic is best in pregnancies <32 weeks and why is it not good after this GA? |
Indomethacin Premature closure of the ductus arteriosus |
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What is the appropriate treatment for C. difficile? |
Metronidazole po or Vancomycin po |
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List 4 abnormal cervical findings in a woman exposed to DES in utero |
- hood - enlarged TZ - hypoplasia - incompetent |
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What can be given to reduce the flare experienced with GnRH agonists? |
Aromatase inhibitor - letrazole 2.5 mg po D1-7 |
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How should mastalgia be treated (4)? |
1) Flaxseed 2) Topical diclofenac 3) Tamoxifen 4) Danazol |
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Name 4 medications that interfere with levothyroxine |
Iron, calcium, magnesium Glucocorticoids Anticonvulsants Propranolol |
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Serious complications of lidocaine toxicity (4) |
Seizure Hypotension Arrhythmia (ventricular) Cardiac arrest |
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Contraindications to metformin (4) |
Advanced lung, liver, cardiac, or renal disease |
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What regimen can be used for PID in pregnancy? |
Clindamycin 900 mg IV Q8H + Gentamicin 2mg/kg loading + 1.5mg/kg continuous infusion IV Then step down to erythromycin 250mg po QID to complete 14 days |
