AHN 548 Exam 2 Questions And Answers 2024
Updated Solutions
most common cause of shock in peds ANS Hypovolemic: dehydration, diabetes, heat illness,
hemorrhage, burns
hypovolemic shock treatment ANS - NS or LR
- 20ml/kg body weight
- no more than 60ml/kg, unless ongoing loss is severe
- no response, PRBC transfusion
Distributive shock ANS - increased vascular capacitance w/ normal circulating vol
Distributive shock tx ANS - crystalloid
- pressors may required if perfusion doesn/t normalize after delivery of 2-3 10ml/kg boluses of
crystalloid
- ICU
causes of Distributive shock ANS Septic shock is the most common form
systemic inflammatory response syndrome (SIRS)
toxic shock syndrome (TSS)
anaphylaxis
Cardiogenic shock tx ANS - bolus of crystalloid
- pressors and possibly afterload reducers
- ICU
S/S Cardiogenic shock ANS abnormal cardiac rhythm, distended neck veins, rales, abd hrt
sounds, friction rub, narrow pulse pressure, hepatomegaly
,- cxr may show cardiomegaly & pulmonary edema
Obstructive shock ANS physical obstruction of blood circulation and inadequate blood
oxygenation
Gonorrhea infection during pregnancy ANS ophthalmic injury, preterm labor, premature
rupture of membranes and intrapartum/postpartum infection.
Drug of choice to treat Gonorrhea during pregnancy ANS Ceftriaxone 125 mg IM or 1 gm
IV qday for disseminated disease. Patients with a PCN allergy are treated with 2gm IM dose of
spectinomycin.
Drug of choice to treat Chlamydia during pregnancy ANS Azithromycin 1gm. An alternate
treatment is Amoxicillin 500mg TID for 7 days. 2-3 weeks after completion of treatment a "test
of cure" is performed. High risk populations are tested again at 35-37 weeks EGA.
Drug of choice to treat Herpes Simplex Virus during pregnancy ANS Acyclovir 400 mg BID
or Valacyclovir 1000 mg daily
The goal of antiretroviral treatment, AZT, in HIV positive mothers ANS appropriately treat
the mother, reduce viral load and minimize perinatal HIV transmission
When is a C-section recommended for HIV positive mothers ANS When maternal viral load
is >1000 copies/ml
Drug of choice to treat Trichomonas during pregnancy ANS Metronidazole is 95% effective,
single dose of 2 gm OR 500 mg BID for 7 days OR 250 mg TID for 7 days
Sx of Trichomoniasis ANS itching, burning, foamy green, malodorous discharge.
,Drug of choice to treat uncomplicated Candidiasis during pregnancy ANS topical
miconazole, terconazole, clotrimazole or butoconazole are given for 3-7 days
Drug of choice to treat refractory Candidiasis during pregnancy ANS A single dose of
Fluconazole 150 mg
A polymicrobial vaginal infection associated with preterm labor, preterm premature rupture of
membranes, chorioamnionitis and endometritis. ANS Bacterial Vaginosis
Frequency of subsequent prenatal visits "the standard schedule: in uncomplicated patients is:
ANS every 4 weeks from 0 to 32 weeks
every 2 weeks from 32 to 36 weeks
weekly after 36 weeks
Measurements taken at each prenatal visit include: ANS maternal weight
uterine fundal height
maternal BP
urinalysis by dipstick
FHTs
What is considered to be appropriate weight gain during a singleton pregnancy ANS 25-33
pounds (11.5 - 16 kg)
BP changes during pregnancy ANS decrease 5-7mm (systolic and diastolic) early in the
second trimester
returns to normal in the third trimester.
What finding may precede proteinuria in patients with PIH ANS BP elevation
, During what weeks do fundal height and gestational age best correlate? ANS between 18 and
34 weeks.
Lower ext. edema in late pregnancy is: ANS natural consequence of hydrostatic changes in
lower body circulation.
Edema of the upper body (face, hands, etc.) esp in association with relative or absolute increase
in BP... ANS may be the first sign of preeclampsia,
A moderate rise in BP without excessive fluid retention... ANS may suggest predisposition to
chronic HTN.
Manual assessment of fetal size and position is indicated after ?? weeks gestation? ANS 26
weeks
Persistence of abnormal lie in late pregnancy suggests... ANS abnormal placentation, uterine
anomalies or other problems
Routine screening for Gr. B Strep occurs between 35-37 weeks gestation. If positive, treated
with... ANS PCN at the time of admission in labor to decrease risk of sepsis in the newborn.
Increases or decreases during pregnancy?
The glomerular filtration rate ???
The serum creatinine level ??? by 0.4-0.6 mg/dl. ANS The glomerular filtration rate
increases 50% during pregnancy and
serum creatinine decreases to .4-.6 mg/dl.
The greatest adverse affects of medication occur during the period of organogenesis , weeks ???
after LNMP. ANS weeks 2-10 after LNMP
Updated Solutions
most common cause of shock in peds ANS Hypovolemic: dehydration, diabetes, heat illness,
hemorrhage, burns
hypovolemic shock treatment ANS - NS or LR
- 20ml/kg body weight
- no more than 60ml/kg, unless ongoing loss is severe
- no response, PRBC transfusion
Distributive shock ANS - increased vascular capacitance w/ normal circulating vol
Distributive shock tx ANS - crystalloid
- pressors may required if perfusion doesn/t normalize after delivery of 2-3 10ml/kg boluses of
crystalloid
- ICU
causes of Distributive shock ANS Septic shock is the most common form
systemic inflammatory response syndrome (SIRS)
toxic shock syndrome (TSS)
anaphylaxis
Cardiogenic shock tx ANS - bolus of crystalloid
- pressors and possibly afterload reducers
- ICU
S/S Cardiogenic shock ANS abnormal cardiac rhythm, distended neck veins, rales, abd hrt
sounds, friction rub, narrow pulse pressure, hepatomegaly
,- cxr may show cardiomegaly & pulmonary edema
Obstructive shock ANS physical obstruction of blood circulation and inadequate blood
oxygenation
Gonorrhea infection during pregnancy ANS ophthalmic injury, preterm labor, premature
rupture of membranes and intrapartum/postpartum infection.
Drug of choice to treat Gonorrhea during pregnancy ANS Ceftriaxone 125 mg IM or 1 gm
IV qday for disseminated disease. Patients with a PCN allergy are treated with 2gm IM dose of
spectinomycin.
Drug of choice to treat Chlamydia during pregnancy ANS Azithromycin 1gm. An alternate
treatment is Amoxicillin 500mg TID for 7 days. 2-3 weeks after completion of treatment a "test
of cure" is performed. High risk populations are tested again at 35-37 weeks EGA.
Drug of choice to treat Herpes Simplex Virus during pregnancy ANS Acyclovir 400 mg BID
or Valacyclovir 1000 mg daily
The goal of antiretroviral treatment, AZT, in HIV positive mothers ANS appropriately treat
the mother, reduce viral load and minimize perinatal HIV transmission
When is a C-section recommended for HIV positive mothers ANS When maternal viral load
is >1000 copies/ml
Drug of choice to treat Trichomonas during pregnancy ANS Metronidazole is 95% effective,
single dose of 2 gm OR 500 mg BID for 7 days OR 250 mg TID for 7 days
Sx of Trichomoniasis ANS itching, burning, foamy green, malodorous discharge.
,Drug of choice to treat uncomplicated Candidiasis during pregnancy ANS topical
miconazole, terconazole, clotrimazole or butoconazole are given for 3-7 days
Drug of choice to treat refractory Candidiasis during pregnancy ANS A single dose of
Fluconazole 150 mg
A polymicrobial vaginal infection associated with preterm labor, preterm premature rupture of
membranes, chorioamnionitis and endometritis. ANS Bacterial Vaginosis
Frequency of subsequent prenatal visits "the standard schedule: in uncomplicated patients is:
ANS every 4 weeks from 0 to 32 weeks
every 2 weeks from 32 to 36 weeks
weekly after 36 weeks
Measurements taken at each prenatal visit include: ANS maternal weight
uterine fundal height
maternal BP
urinalysis by dipstick
FHTs
What is considered to be appropriate weight gain during a singleton pregnancy ANS 25-33
pounds (11.5 - 16 kg)
BP changes during pregnancy ANS decrease 5-7mm (systolic and diastolic) early in the
second trimester
returns to normal in the third trimester.
What finding may precede proteinuria in patients with PIH ANS BP elevation
, During what weeks do fundal height and gestational age best correlate? ANS between 18 and
34 weeks.
Lower ext. edema in late pregnancy is: ANS natural consequence of hydrostatic changes in
lower body circulation.
Edema of the upper body (face, hands, etc.) esp in association with relative or absolute increase
in BP... ANS may be the first sign of preeclampsia,
A moderate rise in BP without excessive fluid retention... ANS may suggest predisposition to
chronic HTN.
Manual assessment of fetal size and position is indicated after ?? weeks gestation? ANS 26
weeks
Persistence of abnormal lie in late pregnancy suggests... ANS abnormal placentation, uterine
anomalies or other problems
Routine screening for Gr. B Strep occurs between 35-37 weeks gestation. If positive, treated
with... ANS PCN at the time of admission in labor to decrease risk of sepsis in the newborn.
Increases or decreases during pregnancy?
The glomerular filtration rate ???
The serum creatinine level ??? by 0.4-0.6 mg/dl. ANS The glomerular filtration rate
increases 50% during pregnancy and
serum creatinine decreases to .4-.6 mg/dl.
The greatest adverse affects of medication occur during the period of organogenesis , weeks ???
after LNMP. ANS weeks 2-10 after LNMP
