AHN 548 Exam 2 Questions and
Correct Responses
Most common cause of shock in peds - CORRECT RESPONSE -Hypovolemic: dehydration,
diabetes, heat illness, hemorrhage, burns
Hypovolemic shock treatment - CORRECT RESPONSE -- NS or LR
- 20ml/kg body weight
- no more than 60ml/kg, unless ongoing loss is severe
- no response, PRBC transfusion
Distributive shock - CORRECT RESPONSE -- increased vascular capacitance w/ normal circulating
vol
Distributive shock tx - CORRECT RESPONSE -- crystalloid
- pressors may required if perfusion doesn/t normalize after delivery of 2-3 10ml/kg boluses of
crystalloid
- ICU
Causes of Distributive shock - CORRECT RESPONSE -Septic shock is the most common form
Systemic inflammatory response syndrome (SIRS)
Toxic shock syndrome (TSS)
Anaphylaxis
Cardiogenic shock tx - CORRECT RESPONSE -- bolus of crystalloid
- pressors and possibly afterload reducers
- ICU
S/S Cardiogenic shock - CORRECT RESPONSE -abnormal cardiac rhythm, distended neck veins,
rales, abd hrt sounds, friction rub, narrow pulse pressure, hepatomegaly
- cxr may show cardiomegaly & pulmonary edema
Obstructive shock - CORRECT RESPONSE -physical obstruction of blood circulation and
inadequate blood oxygenation
Gonorrhea infection during pregnancy - CORRECT RESPONSE -ophthalmic injury, preterm labor,
premature rupture of membranes and intrapartum/postpartum infection.
,Drug of choice to treat Gonorrhea during pregnancy - CORRECT RESPONSE -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 - CORRECT RESPONSE -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 - CORRECT RESPONSE -Acyclovir
400 mg BID or Valacyclovir 1000 mg daily
The goal of antiretroviral treatment, AZT, in HIV positive mothers - CORRECT RESPONSE -
appropriately treat the mother, reduce viral load and minimize perinatal HIV transmission
When is a C-section recommended for HIV positive mothers - CORRECT RESPONSE -When
maternal viral load is >1000 copies/ml
Drug of choice to treat Trichomonas during pregnancy - CORRECT RESPONSE -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 - CORRECT RESPONSE -itching, burning, foamy green, malodorous
discharge.
Drug of choice to treat uncomplicated Candidiasis during pregnancy - CORRECT RESPONSE -
topical miconazole, terconazole, clotrimazole or butoconazole are given for 3-7 days
Drug of choice to treat refractory Candidiasis during pregnancy - CORRECT RESPONSE -A single
dose of Fluconazole 150 mg
A polymicrobial vaginal infection associated with preterm labor, preterm premature rupture of
membranes, chorioamnionitis and endometritis. - CORRECT RESPONSE -Bacterial Vaginosis
Frequency of subsequent prenatal visits "the standard schedule: in uncomplicated patients is: -
CORRECT RESPONSE -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: - CORRECT RESPONSE -maternal weight
Uterine fundal height
Maternal BP
Urinalysis by dipstick
Fhts
,What is considered to be appropriate weight gain during a singleton pregnancy - CORRECT
RESPONSE -25-33 pounds (11.5 - 16 kg)
BP changes during pregnancy - CORRECT RESPONSE -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 - CORRECT RESPONSE -BP elevation
During what weeks do fundal height and gestational age best correlate? - CORRECT RESPONSE -
between 18 and 34 weeks.
Lower ext. Edema in late pregnancy is: - CORRECT RESPONSE -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... - CORRECT RESPONSE -may be the first sign of preeclampsia,
A moderate rise in BP without excessive fluid retention... - CORRECT RESPONSE -may suggest
predisposition to chronic HTN.
Manual assessment of fetal size and position is indicated after ?? Weeks gestation? - CORRECT
RESPONSE -26 weeks
Persistence of abnormal lie in late pregnancy suggests... - CORRECT RESPONSE -abnormal
placentation, uterine anomalies or other problems
Routine screening for Gr. B Strep occurs between 35-37 weeks gestation. If positive, treated
with... - CORRECT RESPONSE -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. - CORRECT RESPONSE -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. - CORRECT RESPONSE -weeks 2-10 after LNMP
The major features of FAS include: - CORRECT RESPONSE -pre and postnatal growth restriction,
craniofacial dysmorphology, mental retardation, cardiac defects, and behavioral abnormalities.
, Killed virus, toxoid, or recombinant vaccines, including injectable influenza vaccine - CORRECT
RESPONSE -may be given during pregnancy
Secondary prophylaxis with immune globulin is recommended for pregnant women exposed to
the following: - CORRECT RESPONSE -Hep A, Hep B, chicken pox, measles, rabies, and tetanus.
How many additional calories/day is needed during pregnancy and how many calories/day
while breastfeeding - CORRECT RESPONSE -300 calories/day is needed during pregnancy and
500 calories/day while breastfeeding
Protein requirements during pregnancy - CORRECT RESPONSE -First half of pregnancy: 1
g/kg/day
Second half of pregnancy: additional 20 g/day.
Protein intake is crucial for embryonic development.
How many milligrams of elemental iron should a woman in the second and third trimester
ingest? - CORRECT RESPONSE -30 mg/day.....60-120 mg/day if anemic
Evidence of preeclampsia - CORRECT RESPONSE -marked swelling of the hands and face,
blurring of vision, headache, epigastric pain, convulsions
Definition of PUERPERIUM - CORRECT RESPONSE -the period between childbirth and the return
of the uterus to its normal size, usually lasting 6 weeks.
The torn hymen heals in the form of fibrosed nodules of mucosa called - CORRECT RESPONSE -
carunculae myrtiformes.
Gas seen on ultrasound in the endometrial cavity postpartum is: - CORRECT RESPONSE -more
common after caesarean section and manual evacuation of placenta, and not necessarily
indicative of endometritis.
Regional analgesia (epidural) can cause postpartum urinary retention. - CORRECT RESPONSE -
Although reversible, urinary stasis may persist in more than 50% of women at 12 weeks
postpartum.
Postpartum proteinurea. - CORRECT RESPONSE -Nearly 50% of patients have a mild proteinuria
for 1- 2 days after delivery.
The incidence of postpartum urinary tract infection is generally: - CORRECT RESPONSE -higher
in women with persistent cervical dilatation.
Significant postpartum renal enlargement - CORRECT RESPONSE -may persist for many weeks
after delivery
Correct Responses
Most common cause of shock in peds - CORRECT RESPONSE -Hypovolemic: dehydration,
diabetes, heat illness, hemorrhage, burns
Hypovolemic shock treatment - CORRECT RESPONSE -- NS or LR
- 20ml/kg body weight
- no more than 60ml/kg, unless ongoing loss is severe
- no response, PRBC transfusion
Distributive shock - CORRECT RESPONSE -- increased vascular capacitance w/ normal circulating
vol
Distributive shock tx - CORRECT RESPONSE -- crystalloid
- pressors may required if perfusion doesn/t normalize after delivery of 2-3 10ml/kg boluses of
crystalloid
- ICU
Causes of Distributive shock - CORRECT RESPONSE -Septic shock is the most common form
Systemic inflammatory response syndrome (SIRS)
Toxic shock syndrome (TSS)
Anaphylaxis
Cardiogenic shock tx - CORRECT RESPONSE -- bolus of crystalloid
- pressors and possibly afterload reducers
- ICU
S/S Cardiogenic shock - CORRECT RESPONSE -abnormal cardiac rhythm, distended neck veins,
rales, abd hrt sounds, friction rub, narrow pulse pressure, hepatomegaly
- cxr may show cardiomegaly & pulmonary edema
Obstructive shock - CORRECT RESPONSE -physical obstruction of blood circulation and
inadequate blood oxygenation
Gonorrhea infection during pregnancy - CORRECT RESPONSE -ophthalmic injury, preterm labor,
premature rupture of membranes and intrapartum/postpartum infection.
,Drug of choice to treat Gonorrhea during pregnancy - CORRECT RESPONSE -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 - CORRECT RESPONSE -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 - CORRECT RESPONSE -Acyclovir
400 mg BID or Valacyclovir 1000 mg daily
The goal of antiretroviral treatment, AZT, in HIV positive mothers - CORRECT RESPONSE -
appropriately treat the mother, reduce viral load and minimize perinatal HIV transmission
When is a C-section recommended for HIV positive mothers - CORRECT RESPONSE -When
maternal viral load is >1000 copies/ml
Drug of choice to treat Trichomonas during pregnancy - CORRECT RESPONSE -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 - CORRECT RESPONSE -itching, burning, foamy green, malodorous
discharge.
Drug of choice to treat uncomplicated Candidiasis during pregnancy - CORRECT RESPONSE -
topical miconazole, terconazole, clotrimazole or butoconazole are given for 3-7 days
Drug of choice to treat refractory Candidiasis during pregnancy - CORRECT RESPONSE -A single
dose of Fluconazole 150 mg
A polymicrobial vaginal infection associated with preterm labor, preterm premature rupture of
membranes, chorioamnionitis and endometritis. - CORRECT RESPONSE -Bacterial Vaginosis
Frequency of subsequent prenatal visits "the standard schedule: in uncomplicated patients is: -
CORRECT RESPONSE -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: - CORRECT RESPONSE -maternal weight
Uterine fundal height
Maternal BP
Urinalysis by dipstick
Fhts
,What is considered to be appropriate weight gain during a singleton pregnancy - CORRECT
RESPONSE -25-33 pounds (11.5 - 16 kg)
BP changes during pregnancy - CORRECT RESPONSE -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 - CORRECT RESPONSE -BP elevation
During what weeks do fundal height and gestational age best correlate? - CORRECT RESPONSE -
between 18 and 34 weeks.
Lower ext. Edema in late pregnancy is: - CORRECT RESPONSE -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... - CORRECT RESPONSE -may be the first sign of preeclampsia,
A moderate rise in BP without excessive fluid retention... - CORRECT RESPONSE -may suggest
predisposition to chronic HTN.
Manual assessment of fetal size and position is indicated after ?? Weeks gestation? - CORRECT
RESPONSE -26 weeks
Persistence of abnormal lie in late pregnancy suggests... - CORRECT RESPONSE -abnormal
placentation, uterine anomalies or other problems
Routine screening for Gr. B Strep occurs between 35-37 weeks gestation. If positive, treated
with... - CORRECT RESPONSE -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. - CORRECT RESPONSE -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. - CORRECT RESPONSE -weeks 2-10 after LNMP
The major features of FAS include: - CORRECT RESPONSE -pre and postnatal growth restriction,
craniofacial dysmorphology, mental retardation, cardiac defects, and behavioral abnormalities.
, Killed virus, toxoid, or recombinant vaccines, including injectable influenza vaccine - CORRECT
RESPONSE -may be given during pregnancy
Secondary prophylaxis with immune globulin is recommended for pregnant women exposed to
the following: - CORRECT RESPONSE -Hep A, Hep B, chicken pox, measles, rabies, and tetanus.
How many additional calories/day is needed during pregnancy and how many calories/day
while breastfeeding - CORRECT RESPONSE -300 calories/day is needed during pregnancy and
500 calories/day while breastfeeding
Protein requirements during pregnancy - CORRECT RESPONSE -First half of pregnancy: 1
g/kg/day
Second half of pregnancy: additional 20 g/day.
Protein intake is crucial for embryonic development.
How many milligrams of elemental iron should a woman in the second and third trimester
ingest? - CORRECT RESPONSE -30 mg/day.....60-120 mg/day if anemic
Evidence of preeclampsia - CORRECT RESPONSE -marked swelling of the hands and face,
blurring of vision, headache, epigastric pain, convulsions
Definition of PUERPERIUM - CORRECT RESPONSE -the period between childbirth and the return
of the uterus to its normal size, usually lasting 6 weeks.
The torn hymen heals in the form of fibrosed nodules of mucosa called - CORRECT RESPONSE -
carunculae myrtiformes.
Gas seen on ultrasound in the endometrial cavity postpartum is: - CORRECT RESPONSE -more
common after caesarean section and manual evacuation of placenta, and not necessarily
indicative of endometritis.
Regional analgesia (epidural) can cause postpartum urinary retention. - CORRECT RESPONSE -
Although reversible, urinary stasis may persist in more than 50% of women at 12 weeks
postpartum.
Postpartum proteinurea. - CORRECT RESPONSE -Nearly 50% of patients have a mild proteinuria
for 1- 2 days after delivery.
The incidence of postpartum urinary tract infection is generally: - CORRECT RESPONSE -higher
in women with persistent cervical dilatation.
Significant postpartum renal enlargement - CORRECT RESPONSE -may persist for many weeks
after delivery
