OB/GYN & Pediatrics

Question Answer
What is Gynecology? Gynecology – is the branch of medicine that deals with health maintenance and diseases of women, primarily reproductive organs
What is Obstetrics? Obstetrics – Branch of medicine that deals with care of women throughout pregnancy
Name the female internal reproductive organs: Ovaries, fallopian tubes, uteru & vagina
What are the names of the two glands found on the inside of the labia minora that provide lubrication during intercourse? Skene and Bartholin Glands
Why makes a female so susceptible of an UTI? Because their urethra is so small (2-3cm) it allows easy access for bacteria to invade the bladder
The period of time from ovulation to menstruation is always ___________. 14 days
The first two week of the menstrual cycle is known as the __________ and is dominated by estrogen, which causes the uterine lining (endometrium) to thicken and become engorged with blood. Proliferative phase
In response to __________ at day 14 of the menstrual cycle, the ovary will release an egg out into the abdominal cavity – this is known as _________. Luteinizing Hormone (LH), Ovulation
The site on the ovary where the primary follicle ruptured develops into the ___________ (small yellowish body of cells), which produces ___________ during second half of menstrual cycle. Corpus luteum, Progesterone
What are the three functions of the vagina? Female organ of copulation, the birth canal and the outlet for menstrual blood and tissue to leave body.
How do you measure the fundal height of a pregnant patient? Measure from the pubic symphysis to the fundus
What are the three layers that make up the wall of the uterus? Endometrium, myometrium and the perimetrium
What is Amenorrhea? Stopping of the menstrual cycle
What are the two most common gynecologic emergencies that you will be called upon in the EMS world? Abdominal pain and vaginal hemorrhage
You are treating a pregnant female patient that is G4, P3 – what does this mean? That she has been pregnant 4 times and has delivered 3 children
What is mittelschmerz? Mittelschmerz is often one-sided, lower abdominal pain that is associated with ovulation
Where do most eggs get fertilized in the female reproductive system? In the distal third of the fallopian tube
Your patient complains of dyspareunia – what is this? Pain during sexual intercourse
What is the average blood loss during the menstrual phase? 50 ml's
When does the placenta develop after the blastocyst gets attached to the uterine wall? Usually around 3 weeks after fertilization
What functions does the placenta provide for the developing fetus? It transfers heat while exchanging O2 and CO2, delivers nutrients such as glucose, potassium, sodium and chloride, and carries away waste byproducts such as urea and uric acid. It also serves as an endocrine gland throughout the pregnancy.
When does the umbilical cord for the fetus usually develop during pregnancy? Usually between the 5th and 6th week of gestation
Normally, the umbilical cord has ____ arteries and ____ vein that are embedded in a substance called ____________. 2 arteries and 1 vein. Wharton’s Jelly
What are the three shunts that are utilized for fetal blood circulation? Ductus venosus, Foramen ovale (Septum Primum) and Ductus arteriosus
The placenta is usually expelled from the uterus within _________ minutes after giving birth to the fetus. 20 minutes
Pregnancy is divided into trimesters each lasting approximately ____ weeks long. 13
The umbilical vein transports __________ blood to the fetus. Oxygenated
How does the hemoglobin of a newborn differ from that of an adult? Fetal hemoglobin has a much higher affinity for oxygen than that of an adult
What is Gravidity? Gravidity is the number of times that a woman has been pregnant
You are taking care of a pregnant female that is Grand Multiparity – what does this mean? This means that she has delivered at least 7 babies
The umbilical arteries transport _________ blood from the fetus back to the placenta. These arteries originate from the ____________. Deoxygenated, Internal Illiac arteries
You are taking care of a young female that is in her third trimester and presents with a massive vaginal hemorrhage. The patient denies any pain and states “she feels like she is going to die.” What is this patient probably suffering from? Placenta previa
What is the most common cause of vaginal hemorrhage for a pregnant female during the first and second trimester? Abortion (miscarriage)
Abnormal implantation of a fertilized egg outside the uterus is called an ______________ – ___% of these happen in the fallopian tubes. Ectopic pregnancy, 95%
You are called to the scene for a pregnant female that presents with severe “tearing” abdominal pain with a massive vaginal hemorrhage – what should you suspect? Placentae abruptio
You have successfully delivered a full term baby that was uneventful, it has been approximately 35 minutes and the placenta has failed to deliver – what should you suspect? Placenta accreta
What sign(s)/symptom(s) would delineate Preeclampsia vs. Eclampsia? Seizure or coma
What is Supine Hypotensive Syndrome? This is hypotension that results from the compression of the inferior vena cava by the uterus
In a pregnant female, what blood glucose level would you start treating the patient with IV fluid boluses? 200mg/dl. You would start to deliver 1-2 liters of fluid.
What is Tocolysis? Tocolysis means to stop labor Toco means childbirth and lysis means dissolving or stopping.
What happens during “Stage One” of labor? Stage one is also known as the dilation stage – this begins with the onset of true labor and ends with complete dilation and effacement of the cervix.
What happens during “Stage Two” of labor? Stage two (also known as the expulsion stage) begins with the complete dilation and the cervix and ends with the delivery of the fetus.
What happens during “Stage Three” of labor? Stage three (also known as the placental stage) begins after the birth of the fetus and ends with the birth of the placenta.
What is a lotus Birth? Home birth that is all natural – the parents will not want the umbilical cord to be cut.
What categories are evaluated with the APGAR scoring system? Appearance, Pulse rate, Grimace (irritability), Activity(muscle tone) and Respiratory effort.
Infants that score between 4 and 6 of the APGAR scale are considered ___________ depressed and require oxygen and stimulation to breathe. Moderately
You are taking care of a newborn that is bradycardic that doesn’t respond to oxygen and ventilations – what is your next super important step? Begin chest compressions
When newborns get hypoxic, their heart rate will ______ and their ventilation rate will _______. Decrease & decrease
Only about _____ % of neonates require assistance to begin breathing at birth and less than ____ % require extensive resuscitation measures. 10, 1
While the fetus is in the uterus most of the blood pumped by the right side of the heart bypasses the respiratory system by flowing through the _______________. Ductus arteriosus
What is the most common congenital defect? Heart defects
Most fetal development occurs during the ______________ of pregnancy. It is during this time that the developing fetus is most sensitive to environmental factors and substances that can affect normal development. First Trimester
Congenital heart defects are often classified by whether or not they ________________, ______________, or __________________. Increase, decrease or obstruct blood flow
What happens in the heart of a patient that has a Patent Ductus Arteriosus (PDA)? PDA leads to abnormal blood flow between the aorta and pulmonary artery, two major blood vessels that carry blood from the heart. This can cause pulmonary hypertension and right sided heart failure.
Tetralogy of Fallot is a combination of what four congenital conditions? VSD, Narrowing of the pulmonary outflow tract, Overriding aorta that is shifted over the right ventricle and the VSD, instead of coming out only from the left ventricle. Thickened wall of the right ventricle (Right ventricular hypertrophy).
What happens in the heart of a patient that is born with dextro-TGA? Dextro-TGA is when the circulatory system is made up from 2 different plumbing systems
What drug can be administered to a patient to keep open the fetal circulation? Prostaglandin E
Give me some examples of congenital heart problems that result in a blockage of blood flow: Coarctation of the aorta, Mitral stenosis, Pulmonic stenosis, Aortic stenosis, Hypoplastic left heart syndrome.
A _____________ is a birth defect in which there is an abnormal opening in the diaphragm, the muscle that helps you breath. This usually happens on the patient’s _______ side. Diaphragmatic hernia, left
A birth defect where the spinal cord and associated structures are exposed is called a _______________. Meningoymelocele
____________ is a narrowing or blockage of the nasal airways by tissue and it is the most common nasal abnormality found in children. Choanal atresia
A syndrome where a child has a very small jaw and a very large tongue in conjunction with a cleft palate is called ____________. Pierre Robin Syndrome
At what measurements do we clamp and then cut the umbilical cord at? First clamp 10cm (4inches), 2nd clamp 15cm (6inches) and then cut in the middle
____________ is a birth defect in which the infant’s intestine or other abdominal organs protrude from the umbilicus. Omphalocele
In what position would you want to place an infant with a suspected diaphragmatic hernia? With the head elevated
What happens in the heart of a patient that is born with levo-TGA? Heart has the ventricle muscles backwards
Give me some examples of congenital heart problems that result in a decrease of pulmonary blood flow: Tetralogy of Fallot and TGA
A congenital defect in where the heart is situated on the right side of the body is called ___________. Dextrocardia
An neonate with an APGAR score less than 4 is considered to be __________ distressed. Severely
What piece of equipment do we use to provide deep trachea suctioning on a neonate that presents nonvigorous with evidence of severe meconium staining? Meconium Aspirator
How soon after the birth of the fetus should we apply clamps to the umbilical cord? 30-45 seconds
If a neonate has a heart rate less than 60 beats a minute – what action do we provide them? High quality CPR
What is the number one reason that an infant/child will go into cardiac arrest? From a respiratory problem
If you were to attempt to place an umbilical vein catheter, how far would you want to cut the umbilical cord down to? Approximately 1cm (0.4 inch)
You are taking care of a pediatric patient that weighs 6kg that is found to be in SVT – The patient is conscious and alert, moving all extremities and has good central and distal pulses. What would be the correct treatment for this patient? This patient is symptomatic and stable – attempt vagal maneuvers, 0.1mg/kg of adenosine if vagal maneuvers was not successful
You are taking care of a pediatric patient that requires suctioning – what pressure would you want your suction unit set to? No more than 100 mmHg
What is the most important link in the pediatric chain or survival? It is the first link – prevention
True or False: Most children that are treated by EMS require Advanced Life Support (ALS). False – 85% of all pediatric patients only require BLS intervention
The posterior fontanelle usually closes by ____ months of age whereas the anterior fontanelle usually closes between ___ and ____ months of age. Posterior usually closes by 4 months of age, Anterior closes between 9 and 18 months
What are the three most common reasons for a child to suffer cardiac arrest from an arrhythmia? 1st: Cardiomyopathy, 2nd: Prolong QT syndrome, 3rd: Comottio Cordis
What three things make up the Pediatric Assessment Triangle (PAT)? Appearance, Work of breathing & Circulation
Suctioning should be limited to no more than _____ seconds in a pediatric patient. 10 seconds
What is the most common neuromuscular blocker used for RSI of a pediatric patient? Succinylcholine
What is the correct dose of Amiodarone for a pediatric patient that is found to be in V-Tach with a pulse? 5 mg/kg administered over 20-60 minutes
What are some contraindications for the placement of an IO needle? Osteogenesis Imperfecta, Suspected fracture in the bone, infection present at bone site, previous attempt in the bone that you are going to use
What are the names of the two veins that leave the bone channel of a long bone and dump into the vascular system? Nutrient and Emmissary Vein
What is the correct joule setting for a patient that is found in SVT that presents with severe symptoms? Cardioversion 0.5-1 J/Kg, followed by 2 J/kg if needed
What is the one vital sign that clearly delineates between compensated and decompensated shock in kids? Blood pressure – once the child is found to be hypotensive that is considered to be decompensated shock
Give me an example of obstructive shock? Tension pneumothorax, Cardiac tamponade, Massive PE
What is the number one reason for a pediatric patient to suffer a pneumothorax during EMS care/intervention? Providers not using the BVM correctly – provide too much pressure and cause a pneumothorax
Give me some examples of distributive shock in the pediatric patient: Septic shock, Anaphylactic shock, Neurogenic shock
At what glucose level would you treat 23 day old pediatric patient with dextrose? Any blood glucose level less than 45 mg/dl
How much dextrose would you administer to a pediatric patient that weighed 11kg and was 14 months old? This patient should receive 2-4 ml/kg of D25 dextrose
What is the first stage of labor? The first stage of labor begins with the onset of true labor and ends with the complete dilation of the cervix.
Where do most eggs get fertilized in the female reproductive system? Usually in the distal third of the fallopian tube.
The mature follicle on the ovary ruptures because of a surge of _____________. LH – Luteinizing Hormone
How long does it take a child to suffer a full thickness burn when exposed to hot water that has a temperature of 150 degrees? 2 seconds
You are treating a female that complains of moderate to severe pain with ovulation – this patient is said to be suffering from ___________. Mittelschmerz
What is the correct dose of Epi 1:10,000 for a pediatric patient in cardiac arrest? 0.01 mg/kg or 0.1 ml/kg 1:10,000

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