For the sake of God.


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For the sake of God Obstetrics Study Guide 4 Mitra Ahmad Soltani 2008 Med-ed-online.org References 1  ACOG board of trustees conclusion. Morals in Obstetrics and Gynecology.second edition.2004 Anderoli Thomas E, et al. Cecil Essentials of Prescription. fifth version. W.B.Saunders; 2001
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In the Name of God Obstetrics Study Guide 4 Mitra Ahmad Soltani 2008 Med-ed-online.org

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References 1  ACOG council supposition. Morals in Obstetrics and Gynecology.second edition.2004 Anderoli Thomas E, et al. Cecil Essentials of Medicine. fifth version. W.B.Saunders; 2001 See: www.merckmedicus.com/ppdocs/us/regular/cecils/parts/106_006.htm British rule on the administration of asthma in grown-ups, The British Thoracic Society & Scottish Intercollegiate Guidelines Network Thorax 2008 May; 63 (Suppl 4) : 1-121 . See: http://www.brit-thoracic.org.uk/ClinicalInformation/Asthma/AsthmaGuidelines/tabid/83/Default.aspx www.cdc.gov/asthma/speakit/slides/managing_asthma Braunwald Eugene, et al. Harrison\'s Principles of Internal Medicine. sixteenth release. McGrawHill; 2005 Braunwald et al. IHD clinical practice rules. 2002 Cunningham G, Gant N, Leveno K, et al. Williams Obsterics. 22nd Ed . New York : Mc Graw Hill, 2005. Gibson P. HTN in Pregnancy. emedicine.DEC 13. 2007 Hogg K, Dawson D, Mackway K. Outpatient determination of aspiratory embolism: the MIOPED (Manchester Investigation Of Pulmonary Embolism Diagnosis) study .2006 See: emj.bmjjournals.com/cgi/substance/full/23/2/123 Iranian Council for Graduate Medical Education. Exam questions.1998-2007 Iranian Council for graduate Medical Education. Board and pre-board Exam questions for OBS and Gyn .2001-2006 Katzung Bertram G. Pharmacology: Examinatoin & Board Review.7th version Mcgrawhill. 2005 Marsha D. Portage. Cecil reading material of drug. Corrosive Base issue. Saunders company.2004 Massel D, Klein GJ. Rules & Policies At The London Health Sciences Center. 2002. see: www.lhsc.on.ca/uwodoc/pages/policy.htm Yanowitz.ECG learning center.2006 Regional ALS Treatment Protocols and Procedures.EMT-Paramedics,1998 Safeer ,Richard S., Lacivita ,Cynthia L. Picking Drug Therapy for Patients with Hyperlipidemia American Family Physician . Vol. 61/No. 11 (June 1, 2000)

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References 2 mentor.wnmeds.ac.nz/bunches/rmo/asthma/asthma5.htm(2006) www.rnceus.com/abg s/abg method.html. ABG elucidation method.(2006) www.umary.edu/workforce/rschulte/ABG page cases.doc. (2006) www.lakesidepress.com/aspiratory/books/physiology/chap10a.htm.(2006) www.en.wikipedia.org/wiki/mechanical_ventilation. (2006) www.hoslink.com/Laboratory Findings in Heart Disease. Cardiovascular Enzymes .(2006)

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The procedure of settling on choice for a pregnant case For Obstetrics cases, a doctor confronts complexities coming from the hatchling, a lady in a smaller meaning of wellbeing records, and the setting. All these are continuing powerfully associating with each other. Priorities ought to be considered. This makes “ethics” of outmost significance in Obstetrics.

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Ethical methodologies 1-Principle-based methodology: It looks to distinguish the standards and tenets apropos to a case. 2-An excellence based methodology : It is concentrating on one game-plan would best express the character of a decent doctor. 3-Ethic of consideration: It arranges a doctor’s obligations in the connection of a pregnant woman’s values and worries as opposed to determining dynamic standards.

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Ethical Approaches-cont. 4-Feminist Ethics methodology: looks to change calculates that cutoff a woman’s alternatives. 5-A case-based methodology: It considers if there are any appropriately comparative cases that constitute points of reference for a given case.

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A case A 22 wk pregnant lady is a known instance of ROM. FHR can be listened. She had a 10 year history of barrenness. She says:” I need to put my life in threat for the extremely uncommon chance that may be the spillage stop”. So she rejects the choice of pregnancy end. What are conceivable administrations? A-Termination of pregnancy in spite of the woman’s protest. (Guideline based methodology) B-continuation of pregnancy with close perception (Feminist Ethics approach) C-Termination of pregnancy telling the lady that her fetal heart is no more heard.(This is against uprightness based methodology!)

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For a superior comprehension of how to execute our insight into interior medication in a pregnant case, this segment of Obstetrics accompanies cases.

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HTN

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A 25 year old 28 week pregnant lady has created weight increase, migraine and fringe edema inside of the most recent week. Her BP is 150/105 mmHg. Which medication ought not be endorsed for her? a-Methyldopa b-ACE inhibitor c-Hydralazine d-Nifedipine Answer:b

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What medication is not utilized for the treatment of pre-eclampcia? a-Betablocker b-Methyldopa c-ACE inhibitor d-Hydralazine Answer:C

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Which proclamation about treatment of HTN with ACE inhibitors isn\'t right? a-They are medications of decision in diabetics. b-They can be utilized as a part of mellow renal disappointment. c-In one-sided renal supply route stenosis, they can be endorsed if the other kidney has an ordinary capacity d-They are medications of decision for pregnancy Answer:D

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What is the acknowledged screening test for analysis of PIH? A-Rollover test B-nitric oxide estimation C-vascular endothelial development element D-angiotensin test Ans:A

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For an instance of serious preeclampsia (BP=180/95) Mg SO4 and C/S is requested. An hour after C/S BP tumbles to 110/75. What is the reason of BP fall? A-Delivery evacuates the impact of vasospasm B-analgesic medications C-discharge D-MgSO4 impact Ans: C

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Which is valid about edema of preeclmpsia? An it has an obscure etiology B-it is a direct result of expanded aldosterone level C-it compounds the anticipation of preeclampsia D-it is a direct result of expanded DOC Ans:A

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A lady 48 yrs old/G3/BP=150/115/has an elevated cholesterol level . Her sister and sibling had heart assaults in the age of 40. Which isn\'t right about the administration of this case? A-Beta blocker B-diet C-methyl dopa D-standard checking of lab results Ans: A

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In a lady with interminable HTN Which component has the slightest impact being developed of superimposed PIH? A-PIH history B-low measurement headache medicine C-seriousness of HTN D-the requirement for joined medication treatment Ans:B

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What is the most well-known inconvenience of eclampsia? An unexpectedness B-desire pneumonia C-aspiratory edema D-direct maternal mortality Ans:A

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Which is valid about visual deficiency after eclampsia? An It has a terrible forecast B-It keeps going around 1 month C-it is transient and endures from 4 hours to 8 days D-in a few individuals it causes changeless visual impairment Ans:C

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Which isn\'t right about eclampsia? An eclampsia can bring about trance state without seizure B-All patients with eclamsia have had indications of preeclampsia C-After seizures respiratory rate is lessened and cyanosis happens D-In all instances of eclampsia extreme proteinuria is available Ans:C

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Which treatment can counteract preeclampsia? A-Low measurements headache medicine B-calcium C-fish oil D-Antioxidants Ans:D

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A 40 years of age lady/G3/P2/GA=35 wks/BP=210/110 is in seizure. What is the most ideal approach to control her seizure? A-Phenytoin stacking dosage of 1000 mg/h IV B-Diazepam and creatinin estimation C-amobarbital sodium 250 mg IV D-MgSO4 4-6 gr as stacking measurement Ans:D

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What is the reason for platelet change in preeclampsia? An expanded creation B-diminished utilization C-expanded platelet accumulation D-diminished platelet-following IG Ans:A

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A lady 25 years of age/G1 endures HELLP disorder. What is valid about her next pregnancy? A-there is no expanded danger in her next pregnancy B-the is expanded danger of unexpectedness and preeclampsia C-there is no expanded danger of preterm work or C/S D-there is no expanded danger of IUGR Ans:B

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Which test has a more PPV for identifying PIH? A-urinary discharge of Kallikrein B-move over test C-angiotensin II D-hypocalciuria Ans:A

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A pregnant lady GA=29 wks/extreme cerebral pain/obscured vision/BP= 200/120 has experienced routine tests and MgSO4 implantation. What different steps ought to be taken? An IV hydralazine 20 mg + IV verapamil 10 mg B-IV hydralazine 5 mg C-IV labetalol 80 mg D-sublingual nifedipine 10 mg +thiazide 10 mg Ans:B

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An instance of eclampsia with seizure is given MgSO4. She is fomented. What medication is fitting for her unsettled state? A-2 gr MgSO4 IV B-250 mg amobarbital IV C-10 mg diazepam IM D-no treatment is required Ans:B “A” would be suitable if a second seizure happens

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A lady with hypertension, proteinuria, Cr>1.5 mg/dl, has a scene of seizure following 4 hours from her conveyance. What treatment do you propose? A-14 gr of MgSO4as the stacking measurement and afterward 2.5 gr q4h up to 24 h after conveyance B-7 gr of MgSO4 as the stacking dosage and afterward 2.5 grq4h up to 24 h after the last seizure C-14 gr of MgSO4 as the stacking dosage and after that 2.5 gr q4h up to 24h after the last seizure D-7 gr of MgSO4 as the stacking measurement and afterward 2.5 gr q4h up to 24h after conveyance Ans:C

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Which is not among pathophysiological changes of preeclampsia? A-decrease in PGE2 B-diminishment in prostacyclin C-expanded thromboxane A2 D-expanded imperviousness to angiotensin Ans: D

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Which isn\'t right about proteinuria of preeclampsia? A-Some ladies convey before proteinuria happens B-1+ proteinuria levels with 300 mg protein in a 24 hour test C-NPV of a follow or negative dipstick test speaks the truth 30 % D-PPV of 3+/4+ proteinuria is 70% Ans:D

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For a primigravida in 30 weeks development a move over test is finished. An increment of 35 mmHG has happened in diastolic BP. Which isn\'t right for this case? A-She has a high likelihood of creating HTN B-She is anomalous touchy to angiotensin II C-expanded BP is a result of hyperactivity of parasympathetic framework D-33% of these patients will create preeclampsia Ans:C

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Which isn\'t right for visual aggravations of preeclampsia? An it is a direct result of occipital locale sores B-if visu

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