dua_frank
03-20-2005, 09:17 PM
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[tunemedic45] anyone awake
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[monterusca] where r u russian?
Now entering USMLE_Step_2 subroom.
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[megs] hey dua
[ash] hidua
[samantha] hi ash and megs
[dua_frank] hi all
[samantha] hi dua
[dua_frank] hey megs, ash and sammy
[dua_frank] how are you guys preparing?
aprilmoe has left the chat.
[megs] fine dua
[megs] lets start dua
[megs] everyday we are starting late...so staying late too
[dua_frank] yes megs
[dua_frank] lets start
[megs] most common cause for multiple gestation???
[ash] medication
[dua_frank] yeah meds
[megs] clomiphene coitrate..yes
[ash] ovulation inducing agents
[megs] citrate
[megs] what are the chances with clomihene???
[dua_frank] when is effacement active, at what cm of dilatation?
[ash] 10%
[megs] and what about HMG???
[ash] 3cm
[megs] YES ASH
[dua_frank] whats HMG?
[dua_frank] 5 tp 10 cm
[megs] human menopausal gonadotropin dua
[dua_frank] oh
[dua_frank] pergonol
[dua_frank] ok
[uniteus] hi everyone
[dua_frank] hi uni
[ash] hiuniteus
[megs] hi uni
[dua_frank] whats placenta acreta?
[megs] which gestation is more common dyzygotic or monozygotic???
[samantha] hi uni
[dua_frank] mono megs?
[ash] placenta invading the myometrium
[megs] its placental tissue invaded into myomatriium dua
[ash] di is more commom
[dua_frank] superficial is accereta and increta is muscle invasion
[uniteus] monozygote megs
[megs] nope dua/\...dyzygotic twins are more common
[dua_frank] percreta is invasion of serosa
[dua_frank] oh
[dua_frank] accreta, increta and percreta in layers
[ash] what is vasa previa?
[dua_frank] placenta in the lower segment
[ash] no dua
[megs] these are fetal blood vessels traversing low lying placenta at int os
[ash] right megs
[dua_frank] oh right
[dua_frank] thats placenta previa
[uniteus] placenta previa is wat u said dua
[dua_frank] when is it called arrest?
[ash] what is velamentous cord?
[megs] is cord abnormalities...at insersion of the umbilical vessels...its villmentous
[uniteus] what u mean dua? arrest in dilation is no cervical change for >2hr
[megs] with good uterine contraction if head do not decents for 2 hrs then its areest dua
[ash] insertion of vessels in the periphery of the placenta instead of central
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[samantha] thanx ash
[ash] urw
[dua_frank] right both uni and megs
[megs] dua there is 2 arrest arrest of decent..and arrest of cx dilatation
[uniteus] agree megs
[dua_frank] can you explain more megs
[dua_frank] oh you both said that already
[dua_frank] thanks
[megs] even with good uterine contraction cx fails to dilate then its arrest of cx dilatation
[megs] ok
[ash] arrest of descent is if there is no descent inspite of crvical dil.
[dua_frank] thanks both
[megs] in monozygotic twins what will be type of placenta??
[dua_frank] monochoroinic
[ash] either monoamnionic mono chorionic or monochorionic and diamnionic
[uniteus] could be monochor or dichor
[megs] yes ash and uni
[megs] i mean uni
[ash] oops
[dua_frank] disadvantage of amniotomy?
[megs] if seperation of morula occurs within 72 hrs then it will be dichorionic
[ash] thnx megs
[megs] cord-prolase dua...
[dua_frank] right megs
[megs] abruption,infection too
[dua_frank] why do you do amniotomy?
[uniteus] helps expedite v-delivery
[ash] in what type of delivery do you commonly see shoulder prolapse?
[megs] post date ash
[dua_frank] yes to induce uterine contractions
[uniteus] V-delivery - diabetic mom
[ash] right megs
[ash] right uniteus
[dua_frank] tell me the duration in primi and multi
[dua_frank] first stage?
[megs] how amniotmy induce ut contractions???
[ash] pg secretion
[dua_frank] not induce, increase sorry megs
[megs] primi 12 hrs multi 6 hrs
[ash] 18 and 14
[uniteus] 12h for primigravid
[dua_frank] 6-18 hrs; 2-10 hrs
[uniteus] thx dua
[dua_frank] second stage?
[uniteus] 3 n 2 hr without epidural anesthesia
[megs] primi 2 hrs multi half hr..
[dua_frank] 30mts-3h; 5-30mts
[dua_frank] with epidural uni?
[uniteus] shorter wid epidural anesthesia ...:)
[megs] 1 hr more than normal
[dua_frank] thanks :P
[dua_frank] third stage?
[megs] epidural will be more uni
[uniteus] 30mins
[uniteus] max
[dua_frank] right 30mts in both
[megs] 15 and 5 min..i primi and multi resp...
[dua_frank] rate of cervical dialatation during active phase?
[uniteus] maths again dua :(
[dua_frank] sorry megs :(
[megs] sorry for what dua??/
[uniteus] :) its me uni
[dua_frank] that i am asking too much maths :(
[megs] ohh
[dua_frank] 1cm/h; 1.2 cm/hr
[dua_frank] rx for hypotonic uterine dysfunction?
[megs] oxytocin dua
[ash] 30 min1.2 to 1.5 cm per hr
[dua_frank] right megs
[dua_frank] MCC of arrest?
[uniteus] CPD
[ash] what if oxytocin fails?
[megs] what is twin to twin transfusion syndrome???
[dua_frank] blood goes from one twin to another
[ash] connection of bld vessels bet. the twins
[ash] one gets less bld than the other
[uniteus] occurs in twins that share placenta megs...
[megs] yeah uni
[ash] the one with less bld has better surviving chances after birth
[uniteus] with monochor
[megs] ash too
[dua_frank] i think one twin is anemic and the other healthy
[dua_frank] coz one pulls blood from placenta more
[megs] yeah dua
[dua_frank] MCC cause of arrest is too much or too early epidural sedation
[ash] and the twin with less bld.has better survival chances
[dua_frank] more blood ash?
[ash] less bls
[dua_frank] why does the one with less blood have more survival chances?
[ash] the one with more bld gets volume overload and dies of chf
[dua_frank] oh
[dua_frank] didn't know that
[dua_frank] thanks
[megs] ash well said
[ash] so comparatively the one with less bld has better chances
[ash] thnx megs
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[dua_frank] what muscles get cut in episiotomy?
[ash] puborectalis
[dua_frank] mediolateral epi
[dua_frank] or medial
[ash] ok puborectalis medial
[dua_frank] they are ischiocavernosus and superficial transverse perineals
[dua_frank] is that the same ash?
[dua_frank] arent they different?
[ash] i dont know if they are the same
[megs] puborectalis too dua
[megs] they are ot same
[dua_frank] bulbo yes
[dua_frank] oh ok megs
[ash] hey i just remembered that there is no muscle cut in medial episiotomy
[ash] so puborectalis is lat.
[dua_frank] there are ash
[dua_frank] both episiotomies cut those two muscles
[dua_frank] no nerves in medial
[dua_frank] less painful
[ash] megs didnt we have this written as an adv .of medial epi. ?in our text for 3mbbs?
Please rephrase your last message.
[ash] ok dua
[megs] i have to check...i dont remeber this
[ash] in datta
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[dua_frank] ash these muscles are ananatomically transversly located
[dua_frank] so they have to be cut
[ash] ok thanx dua
[dua_frank] welcome
[dua_frank] you will not have 3rd and 4th degree lacerations in mediolateral
[megs] get kicked out
Please rephrase your last message.
[dua_frank] wb megs
[megs] dua midial epi has that disadv..
[dua_frank] yes megs
[uniteus] wb megs
[dua_frank] i was just telling that mediolateral does not have those two lacerations
[dua_frank] 3rd and 4th degree
[megs] and reactal mucosa
[megs] oh
[dua_frank] when do you give oxytocin, ergonovine in third stage?
[dua_frank] and why
[uniteus] PPH- retained placenta
[megs] at the delivery of shoulder...
[megs] oops
[megs] sorry
[dua_frank] to attain hemostasis after placental delivery
[megs] what is active management of second stage???
[dua_frank] oxy drip
[dua_frank] after active stage has begun and the fetus has descended
[megs] that is first stage dua
[dua_frank] yikes
[ash] forceps and vacuum
[dua_frank] i got my stages mixed up *)
[uniteus] lol like me dua
[megs] nope ash
[dua_frank] uni lol
[megs] its giving ergometrine at delivery of ant shoulder
[dua_frank] episiotomy?
[dua_frank] oh
[uniteus] vit k too?
[ash] thnx megs
[ash] ohhh yes
[megs] uni we give vit k to baby...after birth...
[uniteus] megs what ergometrine do? dont remember
[megs] what are the indications for which vit k is indicated in mother???
[ash] uterine bl.vellsel contr
[ash] and uterine contr.
[uniteus] thx ash
[dua_frank] but isn't that bad to give?
[dua_frank] when the placenta hasn't delivered yet
[ash] why bad?
[dua_frank] coz third stage indicates give them only after placental delivery
[megs] to prevent excess bld loss in third stage..we give that uni
[ash] it reduces bleeding
[uniteus] ic..didnt know dat...
[ash] when is ergometrine definitely not given?
[dua_frank] dunno that now
[megs] in rh negative pregnancy...
[dua_frank] give don't give, its confusing me
[ash] in case of preg with heart disease
[megs] and if chances of ccf
[megs] in anemia ht disese
[dua_frank] ok
[uniteus] watch me dua --> faint :)
[ash] right megs
[dua_frank] lol uni
[megs] uni when we give vit k in mother???
[ash] cos in these pts some bleeding is welcome as you dont want volume overload
[ash] :)
[uniteus] on anticoagulants
[megs] ???/
[megs] :) *) *) *)
[ash] uniteus what anticoagulants?
[uniteus] warfarin ash
[uniteus] oh u give to baby after birth
[ash] i mean what did you write it in reference to?
[uniteus] cus dey dont have vit k (only from mom for few days)
[uniteus] i was guessing ash
[ash] as an answer to what uniteus?
[uniteus] ok..gave up megs
[dua_frank] you nevr give warfarin to preg women
[dua_frank] its teratogenic
[megs] in case of preperm deliveries we give vit k to mother
[ash] oh
[ash] now i get it
[ash] *)
[uniteus] thx dua...
[megs] so it will be a help in newborn baby
[uniteus] thx megs
[dua_frank] didnt' get it
[dua_frank] oh got it
[ash] vit k is given as babies dont produce it
[dua_frank] give vit k to preterm babies
[dua_frank] not to their moms
[dua_frank] yeah coz they lack colonic flora
[dua_frank] right?
[megs] dua u were correct y day regarding pph...
[dua_frank] what was i correct about megs?
[ash] vit k is normally produced in the body by gut bacteria which havent yet developed in the baby so you give this inj. at birth
[dua_frank] don't remember
[megs] though its retained bits now a days kaplan says its atonic
[dua_frank] oh
[megs] and on boards u have to follow kaplan...
[ash] agree megs
[dua_frank] yeah megs
[dua_frank] atonic it is
[ash] even i read atonic
[uniteus] alright dua....we got it rt :)
[dua_frank] that was uni by the way megs :)
[megs] ok
[dua_frank] i answered retained placental bits lol
[dua_frank] uni said atony
[uniteus] its good we got it cleared..thx megs
[ash] what is lochia?
[dua_frank] mcc cause of arrest of labour?
[dua_frank] lochia discharge?
[dua_frank] dunno
[uniteus] shedding of endometrium
[uniteus] after few days post
[ash] yes uni
[dua_frank] oh
[megs] locia rubra first then serosa and then alba...
[ash] good
[uniteus] false labour dua?
[dua_frank] CPD
[uniteus] oh
[dua_frank] whats bishop pace scoring system? what are its factors?
[ash] dua your questions are killing me
[megs] cerviacal dilatation,effacement. station,
[ash] :(
[dua_frank] sorry ash :(
[megs] posiion of cx
[dua_frank] right megs
[uniteus] 10 is maz
[megs] they are predicters of..vaginal delivery
[uniteus] oops sorry
[dua_frank] i thought 3 was max
[dua_frank] right megs
[dua_frank] what is the station at score 2?
[dua_frank] -1
[uniteus] =1 or 0
[dua_frank] what do fetal deccelarations indicate?
[megs] its + orminus dua???
[dua_frank] yeah -1 or 0
[dua_frank] anything above that is score 3
[uniteus] depends wat type of decel
[ash] fetal jeopardy
[dua_frank] fetal ischemia
[megs] i will ask decelleration u tell me the cause...
[uniteus] ok
[megs] early decelerations...
[uniteus] vagal response
[ash] what do decelerations unrelated to uterine contractions indicate?
[ash] oops sorry megs didnt see your question
[megs] its due to head compression
[uniteus] vagal response due to head compresskion
[megs] what are late decelleration due to???/
[megs] yes uni..
[uniteus] uteroplac insufficien
[megs] yup
[megs] variable decellerations???
[uniteus] cord compression??
[megs] they are due to cord compression
[megs] yes
[megs] when the latent stage is said to be prolonged???
[megs] if more than 20 hrs in primi and more than 14 in multi
[ash] agree megs
[dua_frank] thanks megs
[megs] what obste conditions can lead to DIC???
[uniteus] placenta abruption
[ash] dt release of thromboplastin
[ash] from placenta
[megs] YES
[megs] WHICH OTHER ONES TOO??
[samantha] diabetes
[samantha] severe eclampsia in mother
[megs] IUD AND ECLMPSIA TOO..
[megs] WHY DM SAMMY
[megs] NOt in DM
[samantha] all complic can occur in diabetes
[megs] WHAT IS OCCULT CORD PROLAPSE???
[ash] hehethats a good way of putting it
[samantha] thanx
[ash] undetected prolapse?
[megs] CORD LIES BETN HEAD AND UTERINE WALL...DO NOT PROTRUDE
[ash] thnx megs
[megs] which episiotomy is given in us???
[megs] medial or lediolateral???
[ash] mediolat
[megs] i read some where they prefer medial???
[dua_frank] they do?
[ash] really?
[megs] has anybody to add..???
[uniteus] dunno megs
[dua_frank] no megs, dunno either
[megs] i dont know
[megs] but wanted to know
[megs] what they prefer
[dua_frank] well wait till you have some personal experience megs :P
[dua_frank] lol
[megs] he he dua
[megs] lol
[ash] megs just checked on google.u r right!!!!!!
[megs] thanx ash
[ash] they prefer medial
[dua_frank] i'm going for mediolateral if i ever have a baby :P
[ash] thnx for bringing it up
[ash] yeah dua me too
[uniteus] c - section better...
[dua_frank] uni lol
[uniteus] :)
[ash] :)
[megs] he he...gals good that lanny is absent today
[samantha] i think mediolaterl is in us megs
[dua_frank] if ph of a baby's scalp comes back less than 7.2 even after repeat, what will you do?
[dua_frank] yeah we all behave around him megs lol
[samantha] because of the compliction of medial
[megs] give o2 and sodabicarb to mother
[uniteus] expedite delivery c-section
[ash] yeah samantha but these americans like medial it seems
[dua_frank] c section megs
[uniteus] agree sammy
[dua_frank] right uni
[megs] repeat scalp blood if reassuring
[megs] then ok'
[megs] or do cs section
[dua_frank] sammy its about preference and megs is right, they prefer medial coz its less painful and heals faster
[uniteus] ok..tell me the cause of fever postpartum? ready?
[megs] atelectsis day0
[uniteus] wait megs
[dua_frank] lol
[uniteus] :)
[ash] and muscles and blood vessels less damaged
[uniteus] i stil typing
[megs] uti day 1..2
[uniteus] lol
[megs] lol
[dua_frank] lol
[samantha] oh.. is it dua?
[uniteus] day 2-3?
[ash] infection
[megs] endometritis day 2..3
[uniteus] rt megs n ash..tx?
[megs] clinda+genta
[dua_frank] yeah sammy, another reason why c section is also popular among obgyns here, they don't want to take any risk of malpractice suits in case something goes wrong, they don't wait and go for c sections more than in other countries
[ash] shud include gentamicin or ciproflox
[uniteus] or amp n gent
[uniteus] rt megs
[uniteus] day 4-5?
[megs] whound infn
[samantha] i wonld't want to obg by any chance
[uniteus] esp had c-section ...rt megs
[dua_frank] lol sammy
[uniteus] day 5-6?
[uniteus] dua n sammy..come answer this one
[uniteus] :)
[megs] thromboplhebitis
[dua_frank] abscess uni?
[dua_frank] or thrombophlebitis yes
[uniteus] septic thrombophebitis..rt megs n dua
[uniteus] ok..tx?
[dua_frank] do usg and check for absecess
[dua_frank] if not there treat with heparin
[uniteus] rt dua
[dua_frank] if there drain it
[megs] sammy and dua are discussing ethics uni...i am so bad at tha
[ash] hey guys i need to go now.good nite all.
[uniteus] day 7-21 with painful breast n cracked nipple?
[megs] ok bye ash
[dua_frank] areolitis
[dua_frank] bye ash
[uniteus] me too megs
[uniteus] bye ash
[ash] by the way what are the topics for tomoro?
[dua_frank] haven't decided that yet ash
[dua_frank] megs psych or surg?
[megs] what is the organism cause mastitis???
[ash] ok thnx dua
[uniteus] surg please?
[dua_frank] staph aureus
[dua_frank] ok uni surg it is
[ash] see u tomoro people.bye
[uniteus] staph aurues
[megs] psych dua
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[megs] ok as u wish no prb
[dua_frank] uni won, she was faster than you megs :P
[megs] yes uni
[dua_frank] lol
[uniteus] :P
[megs] so trat with cloxacillin
[megs] ok dua..no prb i am ready for all
[dua_frank] i'll post the schedule for it by tomorrow
[megs] how many days dua
[uniteus] thx dua
[dua_frank] yeah me too megs, basically these three subjects hold the same weight on the exam
[dua_frank] we decided 5 days each remember megs?
[uniteus] which one dua?
[megs] ok
[dua_frank] obgyn, surg and psych
[megs] 5 days are good enough
[uniteus] oh ok
[dua_frank] yeah
[samantha] yes
[samantha] how about paeds
[dua_frank] surg then psych then im and then peds sammy
[megs] peds we did sammy
[megs] ok
[samantha] yes we just did it
[dua_frank] if we keep up with our discussions, i'm sure we will be fine till our exam
[samantha] so 5 days for surg and psych
[samantha] each
[dua_frank] provided we meet here every day, it keeps us motivated and focussed
[megs] yes sammy
[dua_frank] at least it helps me that way
[uniteus] me too
[dua_frank] and we dont get bored studyign alone
[megs] thats true dua
[uniteus] 1000% agree dua
[samantha] i will not come 10 days before my exam
[uniteus] r we done megs?
[uniteus] for tonite?
[dua_frank] its early isn't it?
[samantha] by then we will complete this revision
[dua_frank] yes we will sammy
[uniteus] oh sorry
[megs] till 8 i dont mind staying
[dua_frank] what test do we do before cerclage?
[dua_frank] and why
[samantha] yes i am glad we did obgyn dua
[uniteus] ok..my time is still mess up sorry..the time saver hasnt kicked in as yet
[megs] but its a personal req ..we will try to finish bet 6..to 8..lets all try to be punctual...
[dua_frank] yeah i agree megs
[samantha] ok
[uniteus] ultrasound
[dua_frank] i used to come here at 8 sharp but discussions never began before 6 15 so even i started coming late here
[dua_frank] won't happen from tomorrow
[dua_frank] yes uni
[megs] so everyones hubby...get food on time
[megs] lol
[megs] hehe...
[dua_frank] to rule out congenital abnormalities
[dua_frank] megs lol
[uniteus] ok..will try.
[samantha] he he
[dua_frank] indications for forceps?
[megs] before circlage we rule out con anomalis
[dua_frank] yes megs
[megs] ..prolonged second stage,exaused mother..heart disease
[uniteus] heart disease mom
[dua_frank] also fetal distress
[dua_frank] yes
[dua_frank] so when oxytocin fails
[dua_frank] or was it ergonovine?
[megs] when is rhogum given after delivery???
[dua_frank] during second stage right megs?
[dua_frank] after 72 hrs
[uniteus] asap megs?
[megs] before72 hers dua
[dua_frank] within
[dua_frank] sorry yes
[dua_frank] advantages of suction over forceps?
[uniteus] used for h.mole for suction
[samantha] agree uni
[dua_frank] you can use for normal babies too
[megs] *) *) *)
[dua_frank] it does not occupy space adjacent to fetal head (less trauma)
[dua_frank] smaller episiotomy
[megs] do u mean vaccume dua???
[dua_frank] no forced rotation, head falls spontaneously into its station
[dua_frank] yeah i meant vacuum extraction, sorry :)
[dua_frank] i'm so sorry :)
[megs] no problem dua
[dua_frank] you have to forgive me, i am trying very hard at obgyn :)
[uniteus] u r doing great dua :)
[megs] dua...i am learning dua
[dua_frank] problem is i dn't remember anything by tomorrow lol
[dua_frank] i learnt a lot from you guys though
[dua_frank] it is helping me reinforce a lot of things that i never saw before in these subjects
[megs] lol ash and u made me to read episiotomy
[dua_frank] lol
[megs] i felt so shameful when i reallised..i am fergetting ..it
[dua_frank] nothing to be shameful about megs
[megs] but ...i will nor mind is...its err to be human...
[dua_frank] take it from me, by the time you have completed the first year of your residency, half of what you learnt for these exams will be gone from your brain lol
[megs] and..i read it again that was a positive point
[megs] thats true dua
[dua_frank] mc indication for c section?
[megs] ok postpartum contarception...
[megs] can u give oc pills???
[dua_frank] not needed
[megs] foetal distress is most common...or CPD???
[samantha] placenta previa
[dua_frank] dystocia or failure to progress megs
[megs] MOST COMMONT CAUSE OF DYSTOCIA...IS ..cpd :)
[dua_frank] yes ofcourse
[dua_frank] :)
[megs] can we give ocpills as contraception???
[dua_frank] no megs?
[megs] if mother is lactating then n. ans is NO
[dua_frank] yeah
[megs] IF MOTHER NOT LACTATING U CAN GIVE BUT..AFTER 3 WEEKS
[dua_frank] i always forget that american moms are not very fond of lactation
[dua_frank] i always assume lactation
[megs] AS RISK OF THOMBOSIS WITH OCPILLS
[megs] ITS JUST A HIGH YIELD FACT DUA
[uniteus] give the progestin only type for lactatin mom
[megs] SO I RAISED IT
[dua_frank] yes thanks megs
[uniteus] o..thx megs
[megs] YES UNI
[dua_frank] why progestin type only?
[dua_frank] only type...
[megs] THEY WILL NOT INHIBIT LACTATION DUA
[dua_frank] oh right
[dua_frank] thanks
[uniteus] hi shreya
[megs] WHAT ARE POSTPARTUM BLUES???
[dua_frank] depression
[dua_frank] after delivery
[dua_frank] lasts for a month
[uniteus] feeling down postdelivery usualy benign n not harmful to baby...no psychotic features
[megs] rather than depression its excessive emotions..
[dua_frank] oh
[megs] means diff to control emotions
[dua_frank] just cries all the time
[megs] yes dua
[dua_frank] if shes is laughing then its psychosis :P
[uniteus] :)
[dua_frank] lol
[megs] post partum depression is diff entity
[dua_frank] explain please megs
[megs] its like normal depression...feeling of hopelessness occures after delivery
[dua_frank] is there a duration factor for blues and depression classification megs
[dua_frank] ?
[dua_frank] like more than 2 months its depression
[shreya] hai uni.
[megs] blues within first week dua
[dua_frank] ok
[megs] first few weeks
[megs] depression after 1 month
[dua_frank] what are indications for classical c section?
[dua_frank] thanks megs
[uniteus] undeveloped lower segment n sever maternal n fetus distress
[dua_frank] i got kicked by a psychotic mom when i saw she was trying to harm her baby and i picked up the baby and ran from the room, she came out kicking at me :O
[megs] ca cx...lower seg not accessible
[uniteus] lol dua wat did u do?
[megs] dualol
[megs] lol
[dua_frank] nothing i just ran lol
[megs] lol
[uniteus] how u know u she was harming d baby?
[dua_frank] i saw her holding the pillow on the babys face uni
[dua_frank] and pressing on it
[dua_frank] i just happened to walk into the room right then
[uniteus] oh :o
[uniteus] close one
[dua_frank] we were already on the verge of diagnosing her as psychotic but we were not sure as it was just a second day
[dua_frank] that episode confirmed it and we isolated the baby
[dua_frank] after a week of meds she was so nice to her baby
[dua_frank] it was amazing how well she recovered with the medication
[uniteus] cool
[uniteus] dua wat is ur ans?
[dua_frank] preterm with breech because lower segment is poorly formed, fetal transverse lie, fibroid in lower segment, invasive cx ca and placenta previa
[dua_frank] all were right
[dua_frank] contraindications for trial labour?
[megs] frank cpd, precious pregnancy
[uniteus] classic c-sec, more than 2previous c-section, myomectomy that involved the myometrium
[dua_frank] previous 3 c sections yes
[dua_frank] also fetal macrosomia and maternal obstetric complications
[uniteus] CPD too
[dua_frank] yes cpd too
[dua_frank] chances of uterine rupture more with which c section?
[uniteus] classic
[dua_frank] yes
[dua_frank] what do you do in a case when there is pph even after ligating internal iliacs?
[uniteus] best diagnostic test of chorioamnionitis?
[megs] obsteric hysterctomy dua
[dua_frank] right megs
[dua_frank] culture uni?
[megs] yup culture
[uniteus] true..so what procedure u do dua?
[dua_frank] amniocentesis?
[uniteus] rt
[uniteus] risk factors to chorioamnio?
[megs] high vaginal swab culture will also help
[dua_frank] megs you said postdated pregnancy as mc of what previously?
[megs] if u dont want invasion
[uniteus] thx megs
[dua_frank] ok
[megs] shoulder dystocia dua
[dua_frank] thanks megs
[uniteus] preterm ROM, prolonged ROM is the ans to mi q
[megs] uti uni???
[megs] oh...
[megs] what r clinical sings ???
[megs] for chorioamniotis??
[dua_frank] fetal tachycardia?
[uniteus] mom fever, tachycardia, uterine tenderness, incr wbc
[megs] perfect uni
[uniteus] tx?
[dua_frank] whats cst and nst?
[samantha] iv antibiotics
[uniteus] rt sammy and ?
[megs] iv antibiotics uni...ampi+genta+metro...
[uniteus] rt megs ..and?
[samantha] promt delivery if >34 weeks
[uniteus] rt ..agree
[uniteus] rt sammy
[megs] agree
[samantha] is it the ans uni?
[megs] these are antenal test for fetal wellbeing dua
[uniteus] yeah...sammy...
[dua_frank] what do they stand for and how to you test for them megs?
[uniteus] nonstress test for nst
[megs] contraction stress test..and non stress test
[dua_frank] so these look for fetal distress right?
[dua_frank] do we need to know how they do those?
[megs] for every high risk pregnancy near term we do NST
[megs] NO DUA WE DONT NEED TO KNOW HOW THEY DO IT...
[dua_frank] ok
[dua_frank] just know when to do those
[dua_frank] like you said near term for high risk pregnancies
[megs] WHEN TO DO CST???
[dua_frank] thanks megs
[dua_frank] dunno
[dua_frank] during labour i guess
[megs] YES DUA
[megs] WHAT IS INDICATION ///
[dua_frank] wow good guess :)
[megs] FOR IT??
[dua_frank] fetal bradycardia?
[samantha] if the biophysical profile is 4-8 megs
[dua_frank] prolonged labour?
[samantha] sorry NST
[megs] YES...WHAT DOES THAT MEAN DUA
[dua_frank] fetal decelerations
[megs] 4 TO 6 BPP...WHAT DOES IT MEAN...
[dua_frank] no idea
[uniteus] dunno
[samantha] it means moderate well being
[samantha] not conclusive
[megs] IT JUST MEANS THAT..BABY IS IN DISTRESS....NOT DOING WELL..SO BY CST WE TEST THAT CAN BABY ..WITHSTAND THE STRESS OF CONTRACTIONS
[uniteus] oh..thx sammy n megs
[dua_frank] oh
[dua_frank] thanks
[megs] SO IF CST IS NOT ASSURING..THAT MEANS BABY CANT WITHSTAND STRESS OF LABOUR
[samantha] rt megs
[megs] GO FOR C SECTION
[dua_frank] thats a nice way to know if we can go for trial labour or not
[dua_frank] good monitor
[megs] WHAT IS MODIFIED BPP???
[dua_frank] dunno megs
[samantha] only NST and fetal tone?
[megs] IT INCLUDES ONLY NST AND AMNIOTIC FLUID VOLUME
[dua_frank] ok
[dua_frank] indications for that megs?
[megs] NON REACTIVE NST DUA
[megs] WHAT ARE COMPONENTS OF BPP???
[dua_frank] ok
[dua_frank] fetal tone, breathing, amniotic fluid, nst and fetal movements
[samantha] NST amniotic fluid vol fetal tone breathing and movements
[megs] YUP
[dua_frank] that was good
[dua_frank] shall we call it a day then?
[dua_frank] 8 15 now
[megs] YUP DUA
[megs] SO WHATS TOMM
[dua_frank] see you all tomorrow at 6 pm sharp
[uniteus] ok..bye n thanks
[dua_frank] surg
[megs] TRUMA???
[dua_frank] will post schedule
[megs] OK FINE
[megs] BYE ALL
[dua_frank] check by tomorrow morning on the forum
[dua_frank] bye all
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[samantha] bye guys c u tom
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[an_bo_al] erum?
[an_bo_al] erum?
[erum] *bird*
[tunemedic45] hi
[tunemedic45] anyone awake
[arian] hi there!
[RussianJoo] hello
[RussianJoo] any one out there
[monterusca] hi everyone
[monterusca] where r u russian?
Now entering USMLE_Step_2 subroom.
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[megs] hey dua
[ash] hidua
[samantha] hi ash and megs
[dua_frank] hi all
[samantha] hi dua
[dua_frank] hey megs, ash and sammy
[dua_frank] how are you guys preparing?
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[megs] fine dua
[megs] lets start dua
[megs] everyday we are starting late...so staying late too
[dua_frank] yes megs
[dua_frank] lets start
[megs] most common cause for multiple gestation???
[ash] medication
[dua_frank] yeah meds
[megs] clomiphene coitrate..yes
[ash] ovulation inducing agents
[megs] citrate
[megs] what are the chances with clomihene???
[dua_frank] when is effacement active, at what cm of dilatation?
[ash] 10%
[megs] and what about HMG???
[ash] 3cm
[megs] YES ASH
[dua_frank] whats HMG?
[dua_frank] 5 tp 10 cm
[megs] human menopausal gonadotropin dua
[dua_frank] oh
[dua_frank] pergonol
[dua_frank] ok
[uniteus] hi everyone
[dua_frank] hi uni
[ash] hiuniteus
[megs] hi uni
[dua_frank] whats placenta acreta?
[megs] which gestation is more common dyzygotic or monozygotic???
[samantha] hi uni
[dua_frank] mono megs?
[ash] placenta invading the myometrium
[megs] its placental tissue invaded into myomatriium dua
[ash] di is more commom
[dua_frank] superficial is accereta and increta is muscle invasion
[uniteus] monozygote megs
[megs] nope dua/\...dyzygotic twins are more common
[dua_frank] percreta is invasion of serosa
[dua_frank] oh
[dua_frank] accreta, increta and percreta in layers
[ash] what is vasa previa?
[dua_frank] placenta in the lower segment
[ash] no dua
[megs] these are fetal blood vessels traversing low lying placenta at int os
[ash] right megs
[dua_frank] oh right
[dua_frank] thats placenta previa
[uniteus] placenta previa is wat u said dua
[dua_frank] when is it called arrest?
[ash] what is velamentous cord?
[megs] is cord abnormalities...at insersion of the umbilical vessels...its villmentous
[uniteus] what u mean dua? arrest in dilation is no cervical change for >2hr
[megs] with good uterine contraction if head do not decents for 2 hrs then its areest dua
[ash] insertion of vessels in the periphery of the placenta instead of central
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[samantha] thanx ash
[ash] urw
[dua_frank] right both uni and megs
[megs] dua there is 2 arrest arrest of decent..and arrest of cx dilatation
[uniteus] agree megs
[dua_frank] can you explain more megs
[dua_frank] oh you both said that already
[dua_frank] thanks
[megs] even with good uterine contraction cx fails to dilate then its arrest of cx dilatation
[megs] ok
[ash] arrest of descent is if there is no descent inspite of crvical dil.
[dua_frank] thanks both
[megs] in monozygotic twins what will be type of placenta??
[dua_frank] monochoroinic
[ash] either monoamnionic mono chorionic or monochorionic and diamnionic
[uniteus] could be monochor or dichor
[megs] yes ash and uni
[megs] i mean uni
[ash] oops
[dua_frank] disadvantage of amniotomy?
[megs] if seperation of morula occurs within 72 hrs then it will be dichorionic
[ash] thnx megs
[megs] cord-prolase dua...
[dua_frank] right megs
[megs] abruption,infection too
[dua_frank] why do you do amniotomy?
[uniteus] helps expedite v-delivery
[ash] in what type of delivery do you commonly see shoulder prolapse?
[megs] post date ash
[dua_frank] yes to induce uterine contractions
[uniteus] V-delivery - diabetic mom
[ash] right megs
[ash] right uniteus
[dua_frank] tell me the duration in primi and multi
[dua_frank] first stage?
[megs] how amniotmy induce ut contractions???
[ash] pg secretion
[dua_frank] not induce, increase sorry megs
[megs] primi 12 hrs multi 6 hrs
[ash] 18 and 14
[uniteus] 12h for primigravid
[dua_frank] 6-18 hrs; 2-10 hrs
[uniteus] thx dua
[dua_frank] second stage?
[uniteus] 3 n 2 hr without epidural anesthesia
[megs] primi 2 hrs multi half hr..
[dua_frank] 30mts-3h; 5-30mts
[dua_frank] with epidural uni?
[uniteus] shorter wid epidural anesthesia ...:)
[megs] 1 hr more than normal
[dua_frank] thanks :P
[dua_frank] third stage?
[megs] epidural will be more uni
[uniteus] 30mins
[uniteus] max
[dua_frank] right 30mts in both
[megs] 15 and 5 min..i primi and multi resp...
[dua_frank] rate of cervical dialatation during active phase?
[uniteus] maths again dua :(
[dua_frank] sorry megs :(
[megs] sorry for what dua??/
[uniteus] :) its me uni
[dua_frank] that i am asking too much maths :(
[megs] ohh
[dua_frank] 1cm/h; 1.2 cm/hr
[dua_frank] rx for hypotonic uterine dysfunction?
[megs] oxytocin dua
[ash] 30 min1.2 to 1.5 cm per hr
[dua_frank] right megs
[dua_frank] MCC of arrest?
[uniteus] CPD
[ash] what if oxytocin fails?
[megs] what is twin to twin transfusion syndrome???
[dua_frank] blood goes from one twin to another
[ash] connection of bld vessels bet. the twins
[ash] one gets less bld than the other
[uniteus] occurs in twins that share placenta megs...
[megs] yeah uni
[ash] the one with less bld has better surviving chances after birth
[uniteus] with monochor
[megs] ash too
[dua_frank] i think one twin is anemic and the other healthy
[dua_frank] coz one pulls blood from placenta more
[megs] yeah dua
[dua_frank] MCC cause of arrest is too much or too early epidural sedation
[ash] and the twin with less bld.has better survival chances
[dua_frank] more blood ash?
[ash] less bls
[dua_frank] why does the one with less blood have more survival chances?
[ash] the one with more bld gets volume overload and dies of chf
[dua_frank] oh
[dua_frank] didn't know that
[dua_frank] thanks
[megs] ash well said
[ash] so comparatively the one with less bld has better chances
[ash] thnx megs
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[dua_frank] what muscles get cut in episiotomy?
[ash] puborectalis
[dua_frank] mediolateral epi
[dua_frank] or medial
[ash] ok puborectalis medial
[dua_frank] they are ischiocavernosus and superficial transverse perineals
[dua_frank] is that the same ash?
[dua_frank] arent they different?
[ash] i dont know if they are the same
[megs] puborectalis too dua
[megs] they are ot same
[dua_frank] bulbo yes
[dua_frank] oh ok megs
[ash] hey i just remembered that there is no muscle cut in medial episiotomy
[ash] so puborectalis is lat.
[dua_frank] there are ash
[dua_frank] both episiotomies cut those two muscles
[dua_frank] no nerves in medial
[dua_frank] less painful
[ash] megs didnt we have this written as an adv .of medial epi. ?in our text for 3mbbs?
Please rephrase your last message.
[ash] ok dua
[megs] i have to check...i dont remeber this
[ash] in datta
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[dua_frank] ash these muscles are ananatomically transversly located
[dua_frank] so they have to be cut
[ash] ok thanx dua
[dua_frank] welcome
[dua_frank] you will not have 3rd and 4th degree lacerations in mediolateral
[megs] get kicked out
Please rephrase your last message.
[dua_frank] wb megs
[megs] dua midial epi has that disadv..
[dua_frank] yes megs
[uniteus] wb megs
[dua_frank] i was just telling that mediolateral does not have those two lacerations
[dua_frank] 3rd and 4th degree
[megs] and reactal mucosa
[megs] oh
[dua_frank] when do you give oxytocin, ergonovine in third stage?
[dua_frank] and why
[uniteus] PPH- retained placenta
[megs] at the delivery of shoulder...
[megs] oops
[megs] sorry
[dua_frank] to attain hemostasis after placental delivery
[megs] what is active management of second stage???
[dua_frank] oxy drip
[dua_frank] after active stage has begun and the fetus has descended
[megs] that is first stage dua
[dua_frank] yikes
[ash] forceps and vacuum
[dua_frank] i got my stages mixed up *)
[uniteus] lol like me dua
[megs] nope ash
[dua_frank] uni lol
[megs] its giving ergometrine at delivery of ant shoulder
[dua_frank] episiotomy?
[dua_frank] oh
[uniteus] vit k too?
[ash] thnx megs
[ash] ohhh yes
[megs] uni we give vit k to baby...after birth...
[uniteus] megs what ergometrine do? dont remember
[megs] what are the indications for which vit k is indicated in mother???
[ash] uterine bl.vellsel contr
[ash] and uterine contr.
[uniteus] thx ash
[dua_frank] but isn't that bad to give?
[dua_frank] when the placenta hasn't delivered yet
[ash] why bad?
[dua_frank] coz third stage indicates give them only after placental delivery
[megs] to prevent excess bld loss in third stage..we give that uni
[ash] it reduces bleeding
[uniteus] ic..didnt know dat...
[ash] when is ergometrine definitely not given?
[dua_frank] dunno that now
[megs] in rh negative pregnancy...
[dua_frank] give don't give, its confusing me
[ash] in case of preg with heart disease
[megs] and if chances of ccf
[megs] in anemia ht disese
[dua_frank] ok
[uniteus] watch me dua --> faint :)
[ash] right megs
[dua_frank] lol uni
[megs] uni when we give vit k in mother???
[ash] cos in these pts some bleeding is welcome as you dont want volume overload
[ash] :)
[uniteus] on anticoagulants
[megs] ???/
[megs] :) *) *) *)
[ash] uniteus what anticoagulants?
[uniteus] warfarin ash
[uniteus] oh u give to baby after birth
[ash] i mean what did you write it in reference to?
[uniteus] cus dey dont have vit k (only from mom for few days)
[uniteus] i was guessing ash
[ash] as an answer to what uniteus?
[uniteus] ok..gave up megs
[dua_frank] you nevr give warfarin to preg women
[dua_frank] its teratogenic
[megs] in case of preperm deliveries we give vit k to mother
[ash] oh
[ash] now i get it
[ash] *)
[uniteus] thx dua...
[megs] so it will be a help in newborn baby
[uniteus] thx megs
[dua_frank] didnt' get it
[dua_frank] oh got it
[ash] vit k is given as babies dont produce it
[dua_frank] give vit k to preterm babies
[dua_frank] not to their moms
[dua_frank] yeah coz they lack colonic flora
[dua_frank] right?
[megs] dua u were correct y day regarding pph...
[dua_frank] what was i correct about megs?
[ash] vit k is normally produced in the body by gut bacteria which havent yet developed in the baby so you give this inj. at birth
[dua_frank] don't remember
[megs] though its retained bits now a days kaplan says its atonic
[dua_frank] oh
[megs] and on boards u have to follow kaplan...
[ash] agree megs
[dua_frank] yeah megs
[dua_frank] atonic it is
[ash] even i read atonic
[uniteus] alright dua....we got it rt :)
[dua_frank] that was uni by the way megs :)
[megs] ok
[dua_frank] i answered retained placental bits lol
[dua_frank] uni said atony
[uniteus] its good we got it cleared..thx megs
[ash] what is lochia?
[dua_frank] mcc cause of arrest of labour?
[dua_frank] lochia discharge?
[dua_frank] dunno
[uniteus] shedding of endometrium
[uniteus] after few days post
[ash] yes uni
[dua_frank] oh
[megs] locia rubra first then serosa and then alba...
[ash] good
[uniteus] false labour dua?
[dua_frank] CPD
[uniteus] oh
[dua_frank] whats bishop pace scoring system? what are its factors?
[ash] dua your questions are killing me
[megs] cerviacal dilatation,effacement. station,
[ash] :(
[dua_frank] sorry ash :(
[megs] posiion of cx
[dua_frank] right megs
[uniteus] 10 is maz
[megs] they are predicters of..vaginal delivery
[uniteus] oops sorry
[dua_frank] i thought 3 was max
[dua_frank] right megs
[dua_frank] what is the station at score 2?
[dua_frank] -1
[uniteus] =1 or 0
[dua_frank] what do fetal deccelarations indicate?
[megs] its + orminus dua???
[dua_frank] yeah -1 or 0
[dua_frank] anything above that is score 3
[uniteus] depends wat type of decel
[ash] fetal jeopardy
[dua_frank] fetal ischemia
[megs] i will ask decelleration u tell me the cause...
[uniteus] ok
[megs] early decelerations...
[uniteus] vagal response
[ash] what do decelerations unrelated to uterine contractions indicate?
[ash] oops sorry megs didnt see your question
[megs] its due to head compression
[uniteus] vagal response due to head compresskion
[megs] what are late decelleration due to???/
[megs] yes uni..
[uniteus] uteroplac insufficien
[megs] yup
[megs] variable decellerations???
[uniteus] cord compression??
[megs] they are due to cord compression
[megs] yes
[megs] when the latent stage is said to be prolonged???
[megs] if more than 20 hrs in primi and more than 14 in multi
[ash] agree megs
[dua_frank] thanks megs
[megs] what obste conditions can lead to DIC???
[uniteus] placenta abruption
[ash] dt release of thromboplastin
[ash] from placenta
[megs] YES
[megs] WHICH OTHER ONES TOO??
[samantha] diabetes
[samantha] severe eclampsia in mother
[megs] IUD AND ECLMPSIA TOO..
[megs] WHY DM SAMMY
[megs] NOt in DM
[samantha] all complic can occur in diabetes
[megs] WHAT IS OCCULT CORD PROLAPSE???
[ash] hehethats a good way of putting it
[samantha] thanx
[ash] undetected prolapse?
[megs] CORD LIES BETN HEAD AND UTERINE WALL...DO NOT PROTRUDE
[ash] thnx megs
[megs] which episiotomy is given in us???
[megs] medial or lediolateral???
[ash] mediolat
[megs] i read some where they prefer medial???
[dua_frank] they do?
[ash] really?
[megs] has anybody to add..???
[uniteus] dunno megs
[dua_frank] no megs, dunno either
[megs] i dont know
[megs] but wanted to know
[megs] what they prefer
[dua_frank] well wait till you have some personal experience megs :P
[dua_frank] lol
[megs] he he dua
[megs] lol
[ash] megs just checked on google.u r right!!!!!!
[megs] thanx ash
[ash] they prefer medial
[dua_frank] i'm going for mediolateral if i ever have a baby :P
[ash] thnx for bringing it up
[ash] yeah dua me too
[uniteus] c - section better...
[dua_frank] uni lol
[uniteus] :)
[ash] :)
[megs] he he...gals good that lanny is absent today
[samantha] i think mediolaterl is in us megs
[dua_frank] if ph of a baby's scalp comes back less than 7.2 even after repeat, what will you do?
[dua_frank] yeah we all behave around him megs lol
[samantha] because of the compliction of medial
[megs] give o2 and sodabicarb to mother
[uniteus] expedite delivery c-section
[ash] yeah samantha but these americans like medial it seems
[dua_frank] c section megs
[uniteus] agree sammy
[dua_frank] right uni
[megs] repeat scalp blood if reassuring
[megs] then ok'
[megs] or do cs section
[dua_frank] sammy its about preference and megs is right, they prefer medial coz its less painful and heals faster
[uniteus] ok..tell me the cause of fever postpartum? ready?
[megs] atelectsis day0
[uniteus] wait megs
[dua_frank] lol
[uniteus] :)
[ash] and muscles and blood vessels less damaged
[uniteus] i stil typing
[megs] uti day 1..2
[uniteus] lol
[megs] lol
[dua_frank] lol
[samantha] oh.. is it dua?
[uniteus] day 2-3?
[ash] infection
[megs] endometritis day 2..3
[uniteus] rt megs n ash..tx?
[megs] clinda+genta
[dua_frank] yeah sammy, another reason why c section is also popular among obgyns here, they don't want to take any risk of malpractice suits in case something goes wrong, they don't wait and go for c sections more than in other countries
[ash] shud include gentamicin or ciproflox
[uniteus] or amp n gent
[uniteus] rt megs
[uniteus] day 4-5?
[megs] whound infn
[samantha] i wonld't want to obg by any chance
[uniteus] esp had c-section ...rt megs
[dua_frank] lol sammy
[uniteus] day 5-6?
[uniteus] dua n sammy..come answer this one
[uniteus] :)
[megs] thromboplhebitis
[dua_frank] abscess uni?
[dua_frank] or thrombophlebitis yes
[uniteus] septic thrombophebitis..rt megs n dua
[uniteus] ok..tx?
[dua_frank] do usg and check for absecess
[dua_frank] if not there treat with heparin
[uniteus] rt dua
[dua_frank] if there drain it
[megs] sammy and dua are discussing ethics uni...i am so bad at tha
[ash] hey guys i need to go now.good nite all.
[uniteus] day 7-21 with painful breast n cracked nipple?
[megs] ok bye ash
[dua_frank] areolitis
[dua_frank] bye ash
[uniteus] me too megs
[uniteus] bye ash
[ash] by the way what are the topics for tomoro?
[dua_frank] haven't decided that yet ash
[dua_frank] megs psych or surg?
[megs] what is the organism cause mastitis???
[ash] ok thnx dua
[uniteus] surg please?
[dua_frank] staph aureus
[dua_frank] ok uni surg it is
[ash] see u tomoro people.bye
[uniteus] staph aurues
[megs] psych dua
ash has left the chat.
[megs] ok as u wish no prb
[dua_frank] uni won, she was faster than you megs :P
[megs] yes uni
[dua_frank] lol
[uniteus] :P
[megs] so trat with cloxacillin
[megs] ok dua..no prb i am ready for all
[dua_frank] i'll post the schedule for it by tomorrow
[megs] how many days dua
[uniteus] thx dua
[dua_frank] yeah me too megs, basically these three subjects hold the same weight on the exam
[dua_frank] we decided 5 days each remember megs?
[uniteus] which one dua?
[megs] ok
[dua_frank] obgyn, surg and psych
[megs] 5 days are good enough
[uniteus] oh ok
[dua_frank] yeah
[samantha] yes
[samantha] how about paeds
[dua_frank] surg then psych then im and then peds sammy
[megs] peds we did sammy
[megs] ok
[samantha] yes we just did it
[dua_frank] if we keep up with our discussions, i'm sure we will be fine till our exam
[samantha] so 5 days for surg and psych
[samantha] each
[dua_frank] provided we meet here every day, it keeps us motivated and focussed
[megs] yes sammy
[dua_frank] at least it helps me that way
[uniteus] me too
[dua_frank] and we dont get bored studyign alone
[megs] thats true dua
[uniteus] 1000% agree dua
[samantha] i will not come 10 days before my exam
[uniteus] r we done megs?
[uniteus] for tonite?
[dua_frank] its early isn't it?
[samantha] by then we will complete this revision
[dua_frank] yes we will sammy
[uniteus] oh sorry
[megs] till 8 i dont mind staying
[dua_frank] what test do we do before cerclage?
[dua_frank] and why
[samantha] yes i am glad we did obgyn dua
[uniteus] ok..my time is still mess up sorry..the time saver hasnt kicked in as yet
[megs] but its a personal req ..we will try to finish bet 6..to 8..lets all try to be punctual...
[dua_frank] yeah i agree megs
[samantha] ok
[uniteus] ultrasound
[dua_frank] i used to come here at 8 sharp but discussions never began before 6 15 so even i started coming late here
[dua_frank] won't happen from tomorrow
[dua_frank] yes uni
[megs] so everyones hubby...get food on time
[megs] lol
[megs] hehe...
[dua_frank] to rule out congenital abnormalities
[dua_frank] megs lol
[uniteus] ok..will try.
[samantha] he he
[dua_frank] indications for forceps?
[megs] before circlage we rule out con anomalis
[dua_frank] yes megs
[megs] ..prolonged second stage,exaused mother..heart disease
[uniteus] heart disease mom
[dua_frank] also fetal distress
[dua_frank] yes
[dua_frank] so when oxytocin fails
[dua_frank] or was it ergonovine?
[megs] when is rhogum given after delivery???
[dua_frank] during second stage right megs?
[dua_frank] after 72 hrs
[uniteus] asap megs?
[megs] before72 hers dua
[dua_frank] within
[dua_frank] sorry yes
[dua_frank] advantages of suction over forceps?
[uniteus] used for h.mole for suction
[samantha] agree uni
[dua_frank] you can use for normal babies too
[megs] *) *) *)
[dua_frank] it does not occupy space adjacent to fetal head (less trauma)
[dua_frank] smaller episiotomy
[megs] do u mean vaccume dua???
[dua_frank] no forced rotation, head falls spontaneously into its station
[dua_frank] yeah i meant vacuum extraction, sorry :)
[dua_frank] i'm so sorry :)
[megs] no problem dua
[dua_frank] you have to forgive me, i am trying very hard at obgyn :)
[uniteus] u r doing great dua :)
[megs] dua...i am learning dua
[dua_frank] problem is i dn't remember anything by tomorrow lol
[dua_frank] i learnt a lot from you guys though
[dua_frank] it is helping me reinforce a lot of things that i never saw before in these subjects
[megs] lol ash and u made me to read episiotomy
[dua_frank] lol
[megs] i felt so shameful when i reallised..i am fergetting ..it
[dua_frank] nothing to be shameful about megs
[megs] but ...i will nor mind is...its err to be human...
[dua_frank] take it from me, by the time you have completed the first year of your residency, half of what you learnt for these exams will be gone from your brain lol
[megs] and..i read it again that was a positive point
[megs] thats true dua
[dua_frank] mc indication for c section?
[megs] ok postpartum contarception...
[megs] can u give oc pills???
[dua_frank] not needed
[megs] foetal distress is most common...or CPD???
[samantha] placenta previa
[dua_frank] dystocia or failure to progress megs
[megs] MOST COMMONT CAUSE OF DYSTOCIA...IS ..cpd :)
[dua_frank] yes ofcourse
[dua_frank] :)
[megs] can we give ocpills as contraception???
[dua_frank] no megs?
[megs] if mother is lactating then n. ans is NO
[dua_frank] yeah
[megs] IF MOTHER NOT LACTATING U CAN GIVE BUT..AFTER 3 WEEKS
[dua_frank] i always forget that american moms are not very fond of lactation
[dua_frank] i always assume lactation
[megs] AS RISK OF THOMBOSIS WITH OCPILLS
[megs] ITS JUST A HIGH YIELD FACT DUA
[uniteus] give the progestin only type for lactatin mom
[megs] SO I RAISED IT
[dua_frank] yes thanks megs
[uniteus] o..thx megs
[megs] YES UNI
[dua_frank] why progestin type only?
[dua_frank] only type...
[megs] THEY WILL NOT INHIBIT LACTATION DUA
[dua_frank] oh right
[dua_frank] thanks
[uniteus] hi shreya
[megs] WHAT ARE POSTPARTUM BLUES???
[dua_frank] depression
[dua_frank] after delivery
[dua_frank] lasts for a month
[uniteus] feeling down postdelivery usualy benign n not harmful to baby...no psychotic features
[megs] rather than depression its excessive emotions..
[dua_frank] oh
[megs] means diff to control emotions
[dua_frank] just cries all the time
[megs] yes dua
[dua_frank] if shes is laughing then its psychosis :P
[uniteus] :)
[dua_frank] lol
[megs] post partum depression is diff entity
[dua_frank] explain please megs
[megs] its like normal depression...feeling of hopelessness occures after delivery
[dua_frank] is there a duration factor for blues and depression classification megs
[dua_frank] ?
[dua_frank] like more than 2 months its depression
[shreya] hai uni.
[megs] blues within first week dua
[dua_frank] ok
[megs] first few weeks
[megs] depression after 1 month
[dua_frank] what are indications for classical c section?
[dua_frank] thanks megs
[uniteus] undeveloped lower segment n sever maternal n fetus distress
[dua_frank] i got kicked by a psychotic mom when i saw she was trying to harm her baby and i picked up the baby and ran from the room, she came out kicking at me :O
[megs] ca cx...lower seg not accessible
[uniteus] lol dua wat did u do?
[megs] dualol
[megs] lol
[dua_frank] nothing i just ran lol
[megs] lol
[uniteus] how u know u she was harming d baby?
[dua_frank] i saw her holding the pillow on the babys face uni
[dua_frank] and pressing on it
[dua_frank] i just happened to walk into the room right then
[uniteus] oh :o
[uniteus] close one
[dua_frank] we were already on the verge of diagnosing her as psychotic but we were not sure as it was just a second day
[dua_frank] that episode confirmed it and we isolated the baby
[dua_frank] after a week of meds she was so nice to her baby
[dua_frank] it was amazing how well she recovered with the medication
[uniteus] cool
[uniteus] dua wat is ur ans?
[dua_frank] preterm with breech because lower segment is poorly formed, fetal transverse lie, fibroid in lower segment, invasive cx ca and placenta previa
[dua_frank] all were right
[dua_frank] contraindications for trial labour?
[megs] frank cpd, precious pregnancy
[uniteus] classic c-sec, more than 2previous c-section, myomectomy that involved the myometrium
[dua_frank] previous 3 c sections yes
[dua_frank] also fetal macrosomia and maternal obstetric complications
[uniteus] CPD too
[dua_frank] yes cpd too
[dua_frank] chances of uterine rupture more with which c section?
[uniteus] classic
[dua_frank] yes
[dua_frank] what do you do in a case when there is pph even after ligating internal iliacs?
[uniteus] best diagnostic test of chorioamnionitis?
[megs] obsteric hysterctomy dua
[dua_frank] right megs
[dua_frank] culture uni?
[megs] yup culture
[uniteus] true..so what procedure u do dua?
[dua_frank] amniocentesis?
[uniteus] rt
[uniteus] risk factors to chorioamnio?
[megs] high vaginal swab culture will also help
[dua_frank] megs you said postdated pregnancy as mc of what previously?
[megs] if u dont want invasion
[uniteus] thx megs
[dua_frank] ok
[megs] shoulder dystocia dua
[dua_frank] thanks megs
[uniteus] preterm ROM, prolonged ROM is the ans to mi q
[megs] uti uni???
[megs] oh...
[megs] what r clinical sings ???
[megs] for chorioamniotis??
[dua_frank] fetal tachycardia?
[uniteus] mom fever, tachycardia, uterine tenderness, incr wbc
[megs] perfect uni
[uniteus] tx?
[dua_frank] whats cst and nst?
[samantha] iv antibiotics
[uniteus] rt sammy and ?
[megs] iv antibiotics uni...ampi+genta+metro...
[uniteus] rt megs ..and?
[samantha] promt delivery if >34 weeks
[uniteus] rt ..agree
[uniteus] rt sammy
[megs] agree
[samantha] is it the ans uni?
[megs] these are antenal test for fetal wellbeing dua
[uniteus] yeah...sammy...
[dua_frank] what do they stand for and how to you test for them megs?
[uniteus] nonstress test for nst
[megs] contraction stress test..and non stress test
[dua_frank] so these look for fetal distress right?
[dua_frank] do we need to know how they do those?
[megs] for every high risk pregnancy near term we do NST
[megs] NO DUA WE DONT NEED TO KNOW HOW THEY DO IT...
[dua_frank] ok
[dua_frank] just know when to do those
[dua_frank] like you said near term for high risk pregnancies
[megs] WHEN TO DO CST???
[dua_frank] thanks megs
[dua_frank] dunno
[dua_frank] during labour i guess
[megs] YES DUA
[megs] WHAT IS INDICATION ///
[dua_frank] wow good guess :)
[megs] FOR IT??
[dua_frank] fetal bradycardia?
[samantha] if the biophysical profile is 4-8 megs
[dua_frank] prolonged labour?
[samantha] sorry NST
[megs] YES...WHAT DOES THAT MEAN DUA
[dua_frank] fetal decelerations
[megs] 4 TO 6 BPP...WHAT DOES IT MEAN...
[dua_frank] no idea
[uniteus] dunno
[samantha] it means moderate well being
[samantha] not conclusive
[megs] IT JUST MEANS THAT..BABY IS IN DISTRESS....NOT DOING WELL..SO BY CST WE TEST THAT CAN BABY ..WITHSTAND THE STRESS OF CONTRACTIONS
[uniteus] oh..thx sammy n megs
[dua_frank] oh
[dua_frank] thanks
[megs] SO IF CST IS NOT ASSURING..THAT MEANS BABY CANT WITHSTAND STRESS OF LABOUR
[samantha] rt megs
[megs] GO FOR C SECTION
[dua_frank] thats a nice way to know if we can go for trial labour or not
[dua_frank] good monitor
[megs] WHAT IS MODIFIED BPP???
[dua_frank] dunno megs
[samantha] only NST and fetal tone?
[megs] IT INCLUDES ONLY NST AND AMNIOTIC FLUID VOLUME
[dua_frank] ok
[dua_frank] indications for that megs?
[megs] NON REACTIVE NST DUA
[megs] WHAT ARE COMPONENTS OF BPP???
[dua_frank] ok
[dua_frank] fetal tone, breathing, amniotic fluid, nst and fetal movements
[samantha] NST amniotic fluid vol fetal tone breathing and movements
[megs] YUP
[dua_frank] that was good
[dua_frank] shall we call it a day then?
[dua_frank] 8 15 now
[megs] YUP DUA
[megs] SO WHATS TOMM
[dua_frank] see you all tomorrow at 6 pm sharp
[uniteus] ok..bye n thanks
[dua_frank] surg
[megs] TRUMA???
[dua_frank] will post schedule
[megs] OK FINE
[megs] BYE ALL
[dua_frank] check by tomorrow morning on the forum
[dua_frank] bye all
uniteus has left the chat.
[samantha] bye guys c u tom
megs has left the chat.