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View Full Version : OB/GYN Chat: Antenatal, infections, bleeding



Asclepius1
02-09-2005, 08:33 PM
7:02 PM [dua_frank] i guess the others have yet to come
7:02 PM [dua_frank] megs when are you taking your exam?
7:03 PM [megs] i may give exam in june .
7:03 PM [megs] may
7:03 PM [dua_frank] you're really well prepared
7:03 PM [megs] i have just started preparing since last 20 days
7:03 PM [dua_frank] how about cs? done with that too?
7:03 PM [megs] notdone
7:03 PM [dua_frank] me too
7:03 PM [megs] but i am liking this chat
7:03 PM [dua_frank] me too
7:04 PM [megs] so i am comming everyday
7:04 PM [dua_frank] when are you planning on taking cs?
7:04 PM [step2] i used to do the step 1 chats and they really helped alot
7:04 PM [dua_frank] yeah i like it too,
7:04 PM [megs] most probably july or aug
7:04 PM [megs] what about u
7:04 PM [dua_frank] same time too
7:04 PM [dua_frank] aug
7:04 PM [megs] may and aug
7:04 PM [dua_frank] step 2 by june or july
7:04 PM [dua_frank] no i am giving only one month or maybe two for cs
7:05 PM [megs] i too dua
7:05 PM [dua_frank] shall we study together?
7:05 PM [dua_frank] i think we are giving the exam at about the same time
7:05 PM [megs] ofcorse dua
7:05 PM [megs] i will love too
7:05 PM [dua_frank] i'm too bad with obgyn
7:05 PM [dua_frank] same here
7:06 PM [dua_frank] it's good that we have our dates almost together
7:06 PM [megs] now a days i am doing 1 st reading of internal medicine
7:06 PM [dua_frank] we can continue studying together even after the others are done
7:06 PM [sanz] hello my wonderful friends :)
7:06 PM [dua_frank] what about peds and obgyn>? done reading that once?
7:06 PM [megs] ok dua its a great idea
7:06 PM [dua_frank] hello sanz lovely human
7:06 PM [dua_frank] welcome
7:06 PM [megs] i was thinking the same
7:07 PM [strug] hi all
7:07 PM [dua_frank] hey strug
7:07 PM [megs] hisanz strug
7:07 PM [strug] hi dua and megs
7:07 PM [strug] so shall we begin
7:07 PM [dua_frank] sure
7:07 PM [sanz] wuz today's topic?
7:07 PM [megs] ok...man strug...shoot
7:08 PM [lanny] hi all
7:08 PM [megs] see step2 dua is also taking in may so we can form another group..aftr our reading
7:09 PM [megs] welcome lanny
7:09 PM [sanz] hey lanny
7:09 PM [step2] good idea
7:09 PM [megs] physiology of pregnancy
7:09 PM [lanny] hows everyone
7:09 PM [dua_frank] good lanny, you?
7:09 PM [lanny] sounds good
7:09 PM [strug] which is the test which can be done earliest to know fetal anomalise?
7:09 PM [lanny] fine thankyou and you
7:09 PM [megs] so keep in touch with this forum...
7:10 PM [dua_frank] good too, thanks
7:10 PM [megs] we will..see
7:10 PM [lanny] alpha feto
7:10 PM [dua_frank] amniocentesis and karyotyping?
7:10 PM [dua_frank] worth a shot :P
7:10 PM [megs] we will do..definately
7:10 PM [step2] ok, definitely count me in
7:10 PM [strug] CVS[chorionic villous sampling] done at 9 weeks- 12 weeks
7:10 PM [lanny] chorion villus sampl
7:11 PM [dua_frank] ah
7:11 PM [strug] should be followed up with triple marker and sono to knowneural tube defects
7:11 PM [lanny] was the ques the earliest test?
7:11 PM [strug] yes
7:12 PM [lanny] ok CVS is corect good strug
7:12 PM [sanz] let's go thru changes of pregnancy quickly
7:12 PM [sanz] cadiovas... CO?
7:12 PM [strug] inc by 50%
7:12 PM [sanz] ok
7:12 PM [sanz] BP?
7:12 PM [megs] incr by40..50%
7:12 PM [strug] dec
7:13 PM [lanny] plasma vol inc 50%
7:13 PM [strug] nadir at 24-26 weeks
7:13 PM [sanz] guy.. i dont know how many percent change... so i will just ans you up or down...
7:13 PM [sanz] hehe
7:13 PM [megs] what r git changes???
7:13 PM [strug] dec mottility
7:13 PM [sanz] yes
7:13 PM [strug] constipation
7:13 PM [sanz] they're usus constipated
7:13 PM [megs] yup
7:14 PM [sanz] what abt blood vol?
7:14 PM [megs] what to give for constipation???
7:14 PM [strug] RBC, WBC, Platelet changes?
7:14 PM [strug] bl vol inc sanz
7:14 PM [strug] isabgul megs
7:14 PM [megs] fibre diet...no luxatives???
7:14 PM [sanz] megs, advice water and fibre?
7:14 PM [lanny] RBC mass inc
7:14 PM [sanz] good strug
7:14 PM [sanz] RBC mass incr
7:14 PM [strug] rbc inc, wbc inc, pl no changw
7:15 PM [strug] ESR?
7:15 PM [sanz] up
7:15 PM [strug] why?
7:15 PM [sanz] hhmmm ... good q
7:15 PM [lanny] inc gamma glob
7:15 PM [sanz] hehe
7:15 PM [strug] inc in gamma globulins
7:15 PM [strug] right lannny
7:15 PM [strug] perip vas resistanc?
7:15 PM [dua_frank] inc
7:15 PM [strug] dec dua
7:15 PM [megs] decreases
7:16 PM [dua_frank] :(
7:16 PM [dua_frank] why?
7:16 PM [strug] it helps in better placental perfusion
7:16 PM [sanz] what abt lungs... tidal vol?
7:16 PM [huli72] incr
7:16 PM [strug] PVR=BP/CO
7:16 PM [lanny] inc DVT cause?inc
7:16 PM [strug] dua so dec in bp and inc in co
7:16 PM [strug] so pvr dec
7:16 PM [sanz] good huli :) hi ya!
7:16 PM [lanny] CO inc
7:16 PM [huli72] what is DVT?
7:16 PM [strug] tv inc sanz
7:16 PM [dua_frank] thanks strug
7:16 PM [megs] progesterone effect dua...all relaxes...so the smooth muscles of vessels
7:16 PM [huli72] hi all
7:17 PM [strug] hi huli
7:17 PM [lanny] PVR not sure
7:17 PM [dua_frank] thanks megs
7:17 PM [megs] hense bp dcrease and pvr
7:17 PM [lanny] i was asking DVT in preg vesause of what?
7:17 PM [dua_frank] good explaination
7:17 PM [lanny] because
7:17 PM [sanz] blood stasis lanny
7:17 PM [strug] inc in 7,8,9 an pro c lanny
7:17 PM [lanny] yes but why ctasis
7:17 PM [strug] and also fibrinogen
7:17 PM [huli72] hypercoagulation state
7:18 PM [sanz] and in pregnancy decr prostacylin and incr thromboxane
7:18 PM [lanny] coag factors inc
7:18 PM [megs] bld stasis due to estrogen effect lanny
7:18 PM [lanny] venous flow slows down
7:18 PM [lanny] yes megs
7:18 PM [huli72] good point !! lanny
7:18 PM [strug] CVP chances ?
7:18 PM [lanny] youre all correct
7:18 PM [strug] changes
7:18 PM [huli72] no change
7:18 PM [sanz] CVP up?
7:19 PM [strug] CVP[ central venous pr} no change huli is correct
7:19 PM [lanny] gravid uterus pressing on v cava
7:19 PM [strug] what about femoral venous pr?
7:19 PM [huli72] incr
7:19 PM [lanny] inc
7:19 PM [strug] yes inc
7:19 PM [strug] CO more in which positoion? lat or supine
7:19 PM [sanz] lat
7:19 PM [huli72] lateral
7:19 PM [megs] what is physiological oedema..how will you destinguish from pathological one???
7:19 PM [strug] why explain
7:19 PM [lanny] lateral is ighrer
7:20 PM [lanny] higher
7:20 PM [sanz] see if it's pitting or not megs?
7:20 PM [huli72] ancle edema
7:20 PM [megs] nope
7:20 PM [lanny] vCava is not pressing
7:20 PM [huli72] no other place
7:20 PM [strug] i think its becuseof prolonged standgingmegs
7:20 PM [dua_frank] reduces on leg raising?
7:20 PM [dua_frank] nah
7:20 PM [megs] physiological decreases with rest...as its is due to venoous stasis
7:21 PM [sanz] ok
7:21 PM [dua_frank] oh yeah *)
7:21 PM [huli72] thnx meg
7:21 PM [megs] dua is right
7:21 PM [strug] TSH levels?
7:21 PM [lanny] agree megs
7:21 PM [dua_frank] i'm right when i'm sure i'm wrong
7:21 PM [lanny] TBG inc
7:21 PM [huli72] normal
7:21 PM [cyrus1345] Hi every body
7:21 PM [dua_frank] hi nasi
7:21 PM [strug] hi nasi
7:21 PM [megs] agree lanny
7:21 PM [sanz] TSH normal... Tot T4 high
7:21 PM [dua_frank] hi huli
7:21 PM [sanz] hey nasi :)
7:21 PM [lanny] agree sanz
7:21 PM [huli72] hi Nasi
7:21 PM [strug] TSH level unchanged huli is right
7:21 PM [huli72] hi Dua
7:22 PM [strug] T3 , T4 levels?
7:22 PM [huli72] incr
7:22 PM [lanny] inc
7:22 PM [strug] right huli and lanny
7:22 PM [sanz] incr TBG so tot T4 high but free T4 norma
7:22 PM [huli72] but free T3 and T4 normal
7:22 PM [strug] right
7:22 PM [megs] total level incre
7:22 PM [lanny] yes sanz
7:22 PM [megs] bhuli rt
7:22 PM [strug] effect on pitutiary?
7:22 PM [lanny] inc size
7:23 PM [strug] size inc right
7:23 PM [huli72] agree
7:23 PM [strug] on kidney?
7:23 PM [lanny] poss of sheehan
7:23 PM [sanz] that's why more prone to sheehan
7:23 PM [lanny] inc vascularity also
7:23 PM [strug] right
7:23 PM [megs] why there is pigmentation in pregnancy???
7:23 PM [huli72] incr GFR and kidney size?
7:23 PM [strug] GFR inc
7:23 PM [sanz] megs, physiologic?
7:23 PM [strug] BUN, CR?
7:23 PM [lanny] incr MSH
7:23 PM [huli72] face and abdomen
7:23 PM [sanz] incr GFR decr BUN
7:23 PM [strug] inc msh
7:23 PM [strug] megs
7:23 PM [megs] increase in melanin..
7:23 PM [strug] right sanz
7:24 PM [strug] effect ;on adrenal gland?
7:24 PM [huli72] thnx megs
7:24 PM cyrus1345 has left the chat.
7:24 PM [huli72] cortisol incr?
7:24 PM [sanz] yes
7:24 PM [strug] size inc or dec or unchanged?
7:24 PM [sanz] a guess..
7:25 PM [strug] unchanged
7:25 PM [sanz] cortisol incr huli?
7:25 PM [megs] how early the preg is diagnosed???
7:25 PM [huli72] it is not an q
7:25 PM [sanz] with urine bHCG 8 days
7:25 PM [strug] 10 days from conception megs
7:25 PM [huli72] hCG test
7:25 PM [strug] cortisol inc two fold sanz
7:25 PM [lanny] inc in skin pigm is due to inc estro nad prog
7:26 PM [sanz] ok strug
7:26 PM [lanny] not BUN and CR
7:26 PM [megs] good strug
7:26 PM kaash110zeh has left the chat.
7:26 PM [huli72] thanks strug
7:26 PM [strug] whats effect on urine protein?
7:26 PM [sanz] strug, i figured out the confusion regarding ect pregancy yesterday
7:26 PM [sanz] high urine output
7:27 PM [strug] wow great.....can u pl share sanz
7:27 PM [strug] did u understand my querry now
7:27 PM [sanz] yes
7:27 PM [strug] so waht did u conclude?
7:27 PM [sanz] and i agree that for methrexate to be given, the criteria is bHGC<6000 with no sac seen on transvaginal US
7:28 PM [strug] yup me too thought transvaginal
7:28 PM [sanz] cuz you cant conclude that it's ectopic till bHGC>6500 on abdo US and <1500 on vag US
7:28 PM [strug] yes exactly
7:28 PM [sanz] yup
7:28 PM [lanny] yes that was the confusion the diag criteria is made with vag US and not abdominal also vag is more accurate
7:29 PM [strug] thank u all so much guys
7:29 PM [sanz] so, if a woman comes in with 5500 bHGC levels, you do transag
7:29 PM [strug] yes
7:29 PM [sanz] if no sac, she can have methorexate
7:29 PM [lanny] yes
7:30 PM [lanny] cause you dont wanna kill a baby in the right place!!
7:30 PM [strug] blood gases in preg?
7:30 PM [sanz] resp alk
7:30 PM [huli72] decr PCO2
7:30 PM [strug] correct
7:30 PM [huli72] normal or slightly incr PO2
7:30 PM [lanny] hyperventil causes low co2
7:31 PM [strug] whats the function of b hcg?
7:31 PM [lanny] maintain corpus lut
7:31 PM [sanz] keep the corpus leutum from regression
7:31 PM [megs] maintains the pregnancy
7:31 PM [huli72] works as LH to support the ovary making progesterone
7:31 PM [lanny] till prog is able to maintain
7:31 PM [strug] maintains corpus luteum, productionof steroids form placenta and fetal adrenal, stimulates testosteone produc from fetal testis
7:32 PM [strug] inc bhcg in which conditions?
7:32 PM [huli72] twins?
7:32 PM [strug] and huli....
7:32 PM [lanny] molar preg
7:32 PM [huli72] moles
7:32 PM [megs] twins molar pregnancy
7:32 PM [strug] choriocarc, H mole, embroynal carcinoma
7:32 PM [strug] and twins
7:33 PM [strug] dec in?
7:33 PM [lanny] ectopic
7:33 PM [megs] abortion ectopic pregnancy foetal death
7:33 PM [strug] ectopic, threathned abortion, missed abortion
7:34 PM [strug] chemically human placental lactogen similar to what?
7:34 PM [sanz] insulin
7:34 PM [strug] growth hormone and prolactin
7:35 PM [megs] yup
7:35 PM [strug] it anta gonises the effect of insulin sanz
7:35 PM [sanz] oh yeah
7:35 PM [sanz] hehe
7:35 PM [megs] hense preg is diebetogenic state
7:35 PM [strug] levels low in?
7:35 PM [huli72] hCG increased in which genetical fetal disease?
7:35 PM [sanz] good one megs :) thnx
7:35 PM [sanz] downs
7:35 PM [strug] edwards syn huli
7:36 PM [huli72] no
7:36 PM [megs] what is triple test??
7:36 PM [huli72] trisomy 21
7:36 PM [strug] alpha feto protein, hcg and
7:36 PM [sanz] estradiol hCG AFP
7:36 PM [huli72] estriol
7:36 PM [strug] estriol yes
7:36 PM [huli72] not estridiol
7:36 PM [sanz] oh ok
7:36 PM [megs] hulitr
7:37 PM [strug] estradiolin repro age females
7:37 PM [megs] huli rt
7:37 PM [huli72] hCG decr in which genetical fetal disease?
7:37 PM [sanz] edwards
7:37 PM [huli72] yes
7:37 PM [strug] i said that huli :(
7:38 PM [sanz] strug, her first q was hCG up in what...
7:38 PM [megs] it is not..always low..it is abnormal..may be high or low
7:38 PM [huli72] sorry, I missed that, strug
7:38 PM [lanny] first pren visit what tests/
7:38 PM huli72 has left the chat.
7:38 PM [strug] yes sanz he he
7:38 PM [sanz] titres of rubella and HBV and so on... check ABO and Rh
7:39 PM [strug] Hb and as sanz said
7:39 PM [megs] hb,bld gr,rpr.rubella
7:39 PM [lanny] CBC
7:39 PM [megs] why cbc???
7:39 PM [lanny] dont forget the first and easiest CBC
7:39 PM [strug] and dont forget USG
7:39 PM [sanz] ok
7:39 PM [lanny] for hemoglobon megs
7:39 PM [strug] RBC, MCV and wbc counts megs
7:39 PM [sanz] and syphillis
7:39 PM [sanz] welcome back huli
7:40 PM [lanny] platelets leukoctes
7:40 PM [strug] huli wb
7:40 PM [lanny] hep B
7:40 PM [huli72] nice to be back,
7:40 PM [strug] ok i write the effect u tell the drug
7:40 PM [huli72] hi, guys
7:40 PM [sanz] wb huli
7:40 PM [lanny] hi
7:40 PM [sanz] you tend to get booted out often!
7:40 PM [megs] for hb we do...just hb% by sahlis' method
7:41 PM [megs] dont think need cbc as routine
7:41 PM [lanny] yes megs
7:41 PM [strug] Abruptio, preterm labour, IUGR, intravent hameo....which drug?
7:41 PM [megs] cocaine
7:41 PM [strug] yes megs
7:41 PM [huli72] what is the WBC criterial in pregnancy?
7:42 PM [sanz] is there a criteria? hehe
7:42 PM [lanny] can be inc that is normal
7:42 PM [strug] 1600 by third trimester
7:42 PM [lanny] up to 10-15 thousand
7:42 PM [huli72] 16,000/mm3
7:43 PM [lanny] back to the drugs strug important
7:43 PM [strug] midfacial hypoplasia, short palpebral fissure, long philtrum, multiple joint anomalies, cardiac defects?
7:43 PM [sanz] alcohol
7:43 PM [huli72] agree
7:43 PM [lanny] yep
7:43 PM [megs] yup
7:43 PM [strug] wonderful guys
7:44 PM [strug] microtia, cong deafness, cns defects, cong heart defects?
7:44 PM [sanz] stippling bone epiphysis, IUGR, nasal hypoplasia, mitral regurg... drug?
7:44 PM [strug] warfarin
7:44 PM [sanz] good strug
7:45 PM [sanz] wuz the ans to yr q?
7:45 PM [lanny] cant remember the first ine strug...
7:45 PM [strug] craniofacial dysmorphism, hypoplastic nails, depressed nasal bridge, cleft palate?
7:45 PM [sanz] phenytoin
7:45 PM [strug] its isotretenoin guys for the earlier one
7:45 PM [huli72] agree
7:45 PM [lanny] strug give us the ans to first q
7:45 PM [lanny] oh thx strug
7:46 PM [strug] this one is phenytoin
7:46 PM [strug] T shaped uterus? cervial incompetrence...which drug?
7:46 PM [sanz] NTD, craniofacial and ske defect... drug?
7:47 PM [lanny] DES
7:47 PM [megs] des
7:47 PM [strug] yes its des
7:47 PM [sanz] NTD, craniofacial and ske defect... drug? mum is epileptic...
7:47 PM [strug] carbama sanz
7:47 PM [megs] carbemezepin
7:47 PM [sanz] strug... it's valproic
7:47 PM [strug] oooooooohhhhhhhhh
7:48 PM [sanz] i guess carba can do it too... but they also tend to have nail hypoplasia...
7:48 PM [lanny] valp crosses placenta
7:48 PM [megs] ok good to know sanz
7:48 PM [lanny] teratogen
7:48 PM [megs] how do u trat hyperemesis??/
7:49 PM [megs] which drugs??
7:49 PM [sanz] if not too sever or dehydrated, no Rx needed
7:49 PM [huli72] iv fluid
7:49 PM [lanny] agree sanz usu not trtd
7:49 PM [strug] fluids megs
7:49 PM [megs] hyperemesis..mens severe sanz
7:49 PM [megs] yup strug...
7:49 PM [strug] pt has hypotension u need to Rx
7:49 PM [lanny] if they tell you severe or dehydrated then fluids
7:50 PM [megs] what else..to prevent...vomiting??/
7:50 PM [megs] emesis is normal
7:50 PM [strug] domstal megs
7:50 PM [megs] hyperemesis is severe
7:50 PM [sanz] oh ok
7:50 PM [lanny] whats that? strug
7:50 PM [strug] domperidone he he
7:50 PM [megs] metaclor...domperidone...
7:51 PM [lanny] ok
7:51 PM [lanny] were in the US
7:51 PM [dua_frank] all these drugs hit the brain dont they?
7:51 PM [strug] what radiation dose harmful and at what age?
7:51 PM [dua_frank] i mean their MOA is CNS based
7:51 PM [megs] in usa they use it
7:51 PM [dua_frank] even the antihypertensives
7:51 PM [huli72] >5 rad?
7:52 PM [huli72] in 1st trimester
7:52 PM [strug] >10 has highest risk.....in 2 nd week postconce
7:52 PM [strug] <5 no risk
7:53 PM [strug] 5-10 intermediate
7:53 PM [strug] can we give chemo in preg?
7:53 PM [huli72] not in1st trimester
7:53 PM [sanz] no...
7:53 PM [megs] but in india we use doxinate...pyridoxin+doxylamine to treat vomiti ng of pregnancy
7:53 PM [strug] yup correct huli
7:53 PM [megs] no chemo in regnancy
7:53 PM [strug] we can give in 2 and 3
7:53 PM [strug] trimester
7:54 PM [megs] r u sure strug???
7:54 PM [huli72] yes, strug is correct
7:54 PM [strug] yes kaplan pg 11 obgyn
7:54 PM [strug] effect of tobacco on p reg?
7:54 PM [huli72] premature labor
7:54 PM [sanz] am i right to understand that most hospital radiological ivestigations are less than 10 rad?
7:55 PM [huli72] IUGR
7:55 PM [strug] IUGR, Preterm labour goo huli
7:55 PM [strug] i think barium is grater than 10
7:55 PM [strug] x ray is les than 5
7:55 PM [sanz] i know we can take X Ray
7:55 PM [sanz] but not sure abt CT... my instinct is ok
7:55 PM [sanz] or Ba enema
7:56 PM [huli72] but we still try to avoid chest X ray
7:56 PM [sanz] yup true huli
7:56 PM [strug] what kind of inheritence is the most comon cause of birth defects?
7:56 PM [sanz] but they'll ask me a q in the exam saying this preg mum is worried... what do i advice her... and i'll be lost
7:57 PM [huli72] not inheriatable genetical factors
7:57 PM [lanny] avoid all formw of radiation in preg as best as possible
7:57 PM mmw has left the chat.
7:57 PM [huli72] but if she has already done x ray, we can reassure her
7:57 PM [strug] multifacotrial inheri is the most commoncause of birth deffects
7:58 PM [huli72] oh
7:58 PM [strug] what arae the chances of recurrance?
7:58 PM [strug] in next preg?
7:58 PM [sanz] high
7:58 PM [huli72] higher
7:58 PM [strug] waht percenta?
7:58 PM [strug] 3%
7:58 PM [sanz] ok
7:58 PM [huli72] o :box :o
7:59 PM [strug] they will ask u huli....
7:59 PM [strug] i had a q so i put it here
7:59 PM [megs] i am so bad with neumericals
7:59 PM [sanz] my brain dont retain info like that unfortunately...
8:00 PM [huli72] but you can retrieve it in the exam
8:00 PM [sanz] hopefully huli :)
8:00 PM [megs] just will read them a day before exam :ba
8:00 PM [strug] child with pyloric stenosis....mom preg again,,,,,what are the chances this child will have pyloric ?
8:00 PM [dua_frank] what does low hum placen lactogen mean?
8:00 PM [strug] IUGR
8:00 PM [dua_frank] yes and threatened abortion
8:00 PM [sanz] strug... 25%?
8:01 PM [huli72] no
8:01 PM [strug] threathned aboriton too dua
8:01 PM [dua_frank] yes
8:01 PM [huli72] the same as other women of similar age
8:01 PM [strug] its 3%
8:01 PM [huli72] oh
8:01 PM [sanz] doh!
8:01 PM [sanz] hehe
8:01 PM [strug] child with cleft palate.....chances of his sibling having it?
8:02 PM [lanny] think 1 in 500 birhts
8:02 PM [strug] parents are unaffected
8:02 PM [lanny] avePS
8:02 PM [huli72] agree
8:02 PM [lanny] nad it is not a gen ds
8:02 PM [strug] whats avePS lanny
8:02 PM [strug] ans is 4%
8:02 PM [lanny] sorry have pyl sten
8:03 PM [dua_frank] i sticking to numbers below 10
8:03 PM [dua_frank] on all inheritable diseases
8:03 PM [lanny] i thaought 0.2 %
8:03 PM [strug] third child the cahnces are 10%
8:03 PM [dua_frank] safe that way
8:03 PM [megs] ok strug i will try to retain the numbers
8:03 PM [huli72] good idea, i will guess that way in exam
8:03 PM [strug] good for u
8:04 PM [megs] yeah
8:04 PM [strug] when is kleinfiekter usulaly diagnoied?
8:04 PM [huli72] after puberty
8:04 PM [strug] yup at puberty
8:04 PM [lanny] good dua but in qut dom and recess above 10
8:04 PM [huli72] in their 20-30's
8:04 PM [lanny] autosomal dom and recessive
8:05 PM [dua_frank] how much? give a range lanny
8:05 PM [strug] turners have low or normal intellgence?
8:05 PM [huli72] no
8:05 PM [megs] which is the commonest cromosomal anomaly in us??
8:05 PM [dua_frank] thats the only way i can remember them
8:05 PM [strug] trisomy 21
8:05 PM [megs] trners normal intell
8:05 PM [strug] yup megs
8:05 PM [megs] yup strug
8:05 PM [dua_frank] whats trners?
8:05 PM [megs] what is incidence???
8:05 PM [dua_frank] turners
8:05 PM [strug] most coomon cause of misccarriage?
8:06 PM [huli72] genetical error
8:06 PM [megs] cromosomal anomalies
8:06 PM [strug] 1 in 360 at moms age 35
8:06 PM [dua_frank] crom ano
8:06 PM [lanny] 50 if aut domm one parent homozygot 25 if aut recess
8:06 PM [dua_frank] thanks lanny
8:06 PM [dua_frank] thats the general rule anyway so not too hard to remember AD and AR
8:06 PM [lanny] yes
8:07 PM [strug] most comon aneuploidy?
8:07 PM [dua_frank] when does placenta start producing it's own progesterone?
8:07 PM [sanz] turner strug
8:07 PM [huli72] trisomy 21
8:07 PM [strug] 9 weeks dua
8:07 PM [lanny] 8 weeks
8:07 PM [sanz] 10 wks
8:07 PM [dua_frank] right
8:07 PM [dua_frank] 9
8:07 PM [strug] its downs sanz
8:07 PM [sanz] oh
8:08 PM [strug] whats the most common polyplidy?
8:08 PM [megs] 10 weeks correct sanz
8:08 PM [lanny] can start from 8
8:08 PM [dua_frank] yes can start from 8, taken over completely by 9
8:08 PM [huli72] donno strug
8:08 PM [lanny] agree
8:08 PM [sanz] kleinfelters strug?
8:08 PM mmw has left the chat.
8:08 PM [strug] incomplete mole is most common ploypl
8:09 PM [dua_frank] good q strug
8:09 PM [megs] good to know strug
8:09 PM [lanny] 47XX
8:09 PM [strug] my pleasure
8:09 PM [huli72] troplody
8:09 PM [lanny] am i correct for incompl mole
8:09 PM [huli72] 69 XXY?
8:09 PM [sanz] 69 XXY
8:09 PM [strug] 69XXY
8:09 PM [strug] lanny
8:09 PM [dua_frank] what organ produces 90% of precusors for estroil in pregnancy?
8:09 PM [megs] yup lanny
8:10 PM [huli72] fetal adrenal
8:10 PM [sanz] fetal adrenal
8:10 PM [dua_frank] yes
8:10 PM [strug] adrenal feta
8:10 PM [dua_frank] fetal adrenals
8:10 PM [megs] yup strug
8:11 PM [megs] what is the commoest cause for 2 nd trimester sbortio
8:11 PM [dua_frank] what enzyme changes it from DHEA to estroil?
8:11 PM [strug] megs u aksed about the inci of downs whats ans?
8:11 PM [huli72] placenta factors
8:11 PM [strug] incompete cervix megs
8:11 PM [megs] yup strug
8:11 PM [dua_frank] sulfatace in placenta
8:11 PM [dua_frank] yes huli
8:11 PM [strug] sulphataese dua
8:11 PM [dua_frank] yes
8:12 PM [megs] downs incidence doffers age wise...but it is generally...randomly 1in 1000
8:12 PM [huli72] hi
8:12 PM [strug] i said 1 in 360 if mom age 35 is taht corect
8:12 PM [huli72] ??
8:12 PM huli72 has left the chat.
8:12 PM [sanz] poor huli
8:12 PM [strug] having a bad time sticking here
8:12 PM [huli72] kicked out again
8:12 PM [sanz] wb huli
8:12 PM [strug] ha ha
8:12 PM [megs] i dont know for that sp age u r tellig..so cant mark it
8:12 PM [sanz] *holding huli's hand tight* so that you wont be kicked out again!
8:12 PM [dua_frank] lol sanz
8:13 PM [dua_frank] just tie her to something in this room
8:13 PM [huli72] ;)
8:13 PM [megs] how to diagnose incometant cx
8:13 PM [sanz] megs, dont know
8:13 PM [dua_frank] 14 wks evaluation/
8:13 PM [dua_frank] ?
8:13 PM [huli72] vaginal al exam?
8:13 PM [dua_frank] to see if external os is open
8:13 PM [megs] history of repeated painless abortions
8:13 PM [dua_frank] oh
8:14 PM [lanny] i thought huli was a guy!!!
8:14 PM [dua_frank] youre all alone here lanny guy
8:14 PM [huli72] no, you are the only guy here
8:14 PM [sanz] yup mate, totally outnumbered
8:14 PM [strug] zuhari is a guy
8:14 PM [megs] and non pregnant cx..can easily allow..ring forceps trhouh it
8:14 PM [lanny] there was another guy y day
8:14 PM [lanny] oh ok suhair is not here today
8:14 PM [dua_frank] so she can be diagnosed with it even while she is not pregnant megs?
8:15 PM [huli72] no, dua
8:15 PM [strug] i wonder who this step 2 is? he watches us everyday
8:15 PM [megs] with the help of previous obs history
8:15 PM zoya has left the chat.
8:15 PM [dua_frank] megs says otherwise
8:15 PM [sanz] yeah lanny, step2 is the spy ... not me!
8:15 PM [dua_frank] step2 is the mystery guy
8:15 PM [dua_frank] or gal
8:15 PM [step2] i just started my first reading, so i'm just observing for now if thats ok
8:15 PM [huli72] guy or girl?
8:15 PM [dua_frank] no gender discrimination, this is america
8:16 PM [megs] strug he is a beginer
8:16 PM [sanz] oh that's ok step2
8:16 PM [dua_frank] ah. welcome step 2
8:16 PM [strug] u r welcome to ask q step 2
8:16 PM [huli72] you are welcome to join us, step 2
8:16 PM [megs] dua me and step2 r may exam takers i guess..may be june
8:16 PM [step2] thanks. i'm just trying to get into it
8:16 PM [strug] or clear ur doubts step 2
8:17 PM [huli72] are girl or guy? step 2
8:17 PM [step2] you all are way ahead of me, but i am learning alot
8:17 PM [step2] guy
8:17 PM [strug] i was just curious or scared after lanny told us about the spy thing
8:17 PM [sanz] hehe strug!
8:17 PM [huli72] finally, lanny is no longer lony
8:17 PM [sanz] you guys turning into schizo!
8:18 PM [sanz] no one is watching us
8:18 PM [strug] dr sanz we need Rx?
8:18 PM [strug] ha ha
8:18 PM [dua_frank] lol
8:18 PM [sanz] hehe
8:18 PM [step2] *evil*
8:18 PM [lanny] hey guys
8:18 PM [dua_frank] :O
8:19 PM [lanny] benzodiazepines
8:19 PM [sanz] what abt it lanny?
8:19 PM [strug] or abstinence dr lanny ha ha
8:19 PM [lanny] who is this step 2
8:19 PM [sanz] step2 is our new friend
8:19 PM [lanny] abstinence ho ho
8:19 PM [sanz] now lets move on
8:19 PM [strug] where were u lanny...we just discussed abut him
8:20 PM [strug] ok whats the durarion of normal preg?
8:20 PM [lanny] i stepped out to drink some water
8:20 PM [step2] me, just a new guy observing. i'm also the one who has been posting the transcripts
8:20 PM [lanny] back now
8:20 PM [strug] really step 2 so nice of u
8:20 PM [step2] least i can do since i haven't really contributed yet
8:21 PM [lanny] oh yea thats good how do you know the topics we discussed do you look thru the discussins
8:21 PM [dua_frank] everybody's contributing here, nice group of people we have here
8:21 PM [strug] 266 days or 38 weeks post conce or 280 days 40 wks
8:21 PM [megs] what is normal wieghtgain in pregnancy???
8:21 PM [sanz] 30 lbs
8:21 PM [huli72] 29
8:21 PM [strug] 11 kg
8:21 PM [dua_frank] 4kgs
8:21 PM [megs] 1 lb per week
8:21 PM [dua_frank] 11?:O
8:21 PM [strug] after 20 weeks megs
8:21 PM [megs] all correct
8:22 PM [strug] in first trimest its 8 lb
8:22 PM [megs] yup strug
8:22 PM [dua_frank] really 11 kgs?
8:22 PM [dua_frank] thats a lot of weight
8:22 PM [lanny] go with lbs..
8:22 PM [sanz] lol dua
8:22 PM [strug] after 20 weeks its 1 lb per week
8:22 PM [megs] yup dua
8:22 PM [lanny] yes strug
8:22 PM [strug] dua is imaginig herself ha ha
8:22 PM [huli72] good, strug
8:22 PM [dua_frank] strug :p lol
8:23 PM mmw has left the chat.
8:23 PM [strug] when r the fetal heart tones first heard?
8:23 PM [lanny] 12 week
8:23 PM [dua_frank] heart beat recognition time...
8:23 PM [dua_frank] US?
8:23 PM [dua_frank] strug we asked the same q
8:23 PM [strug] 12 weeks with doppler stetoscope
8:23 PM [megs] how to know exactly the age od gestation of foetus if lmp in not known???
8:23 PM [dua_frank] what are the odds to that now lol
8:24 PM [strug] megs didnt get it
8:24 PM [lanny] nagles rule
8:24 PM [huli72] usg, meg
8:24 PM [strug] earlier usg is more relable
8:24 PM [dua_frank] LMP
8:24 PM [dua_frank] unknown strug
8:24 PM [megs] age of prgnancy if LMP NOT KNOWN???
8:24 PM [sanz] USS
8:24 PM [strug] usg megs
8:25 PM [lanny] usg
8:25 PM [dua_frank] fetal heart tone megs?
8:25 PM [huli72] and size of usterus
8:25 PM [megs] USG IS RIGHT..BUT WHAT OTHERS
8:25 PM [dua_frank] auscultation
8:25 PM [strug] quickenig megs
8:25 PM [dua_frank] doppler
8:25 PM [huli72] fetal movements
8:25 PM [megs] USG WHEN HULI STRUG??/
8:25 PM [dua_frank] 7-8 weeks
8:25 PM [strug] 6-12 weeks
8:25 PM [sanz] USS early
8:25 PM [megs] ITS QUIKENING...AT 20 WEEKS
8:26 PM [huli72] 12-15 weeks?
8:26 PM [sanz] what's quickening?
8:26 PM [dua_frank] 16-20 quickening
8:26 PM [megs] 1 SR TRIMESTER USG MOST IMP
8:26 PM [strug] at 16 weeks for muli and 18 for primi megs
8:26 PM [lanny] but mor reliable is USG
8:26 PM [dua_frank] increase in uterine size sanz, i think
8:26 PM [strug] the earliest usg taken is most relable indicator
8:26 PM [megs] REMEMBER...1 TRIMESTER DESCRIPENCY OF 1 WEEK...2 ND..2 WEEKS...AND 3RD 3 WEEKS
8:26 PM [sanz] good one megs :)
8:27 PM [sanz] thnx
8:27 PM [strug] fetal mov sanz is quickening
8:27 PM [sanz] ok sturg thnx
8:27 PM [megs] WHAT IS BLIATED OVUM???
8:27 PM [dua_frank] fetal movements are quickening?
8:27 PM [strug] yes dua
8:27 PM [dua_frank] ok
8:27 PM [lanny] yes
8:28 PM [strug] with a sac? megs
8:28 PM [megs] SAC WITHOUT EMBRYO
8:28 PM [sanz] like in incomplete spont abortion?
8:28 PM [megs] WHAT IS CLINICAL SCINARIO OF THRET ABORTION???
8:29 PM [sanz] abdo pain and bleeding...
8:29 PM [strug] vag spottiing in first trim cervical os closed, sac seen megs
8:29 PM [megs] NO SANZ PREGNANCY IS WITHOUT EMBRYO..ONLY SAC IS PRESENT
8:29 PM [lanny] can someone help me with bio profiles stress tests onfusing to me
8:29 PM [megs] YUP..NO PAIN...NO HAEMORRHAGE..ONLY SPOTTIG
8:29 PM [lanny] confusing
8:30 PM [dua_frank] what are the other causes of bleeding in first and second trimester?
8:30 PM [megs] BIOPHYSICAL PROFILE...IS TEST OF FOETAL WELL BEING
8:30 PM [strug] AP, PP missed abor, incompl, h mole dua
8:30 PM [huli72] it is NST + usg
8:30 PM [megs] WILL COME TOTHAT SOON LANNY
8:30 PM [lanny] ok thx megs
8:31 PM [dua_frank] and ectopic preg and cervical neoplasia
8:31 PM [huli72] molar pregnancy
8:31 PM [strug] how do u calculate the age of fetuson first trime usg
8:31 PM [megs] CROWN TO RUMP LENGHT
8:32 PM [strug] Crown rump length right megs
8:32 PM [strug] in second?
8:32 PM [dua_frank] what percent of all pregs have bleeding?
8:32 PM [strug] 50
8:32 PM [strug] sorry 20
8:32 PM [dua_frank] 25
8:32 PM [megs] YEAH ITS QUIEIT HIGH...20..25%
8:32 PM [strug] 50% make to term
8:33 PM [dua_frank] 20 is the number for all pregs having threatened miscarriages
8:33 PM [megs] WHAT IS septic abortion??/
8:33 PM [lanny] 5 %
8:33 PM [dua_frank] how many of those thret mis actually have a spontaneous miscarriage?
8:33 PM [megs] 50%dua???
8:33 PM [strug] 15%
8:33 PM [dua_frank] yes megs
8:33 PM [dua_frank] so take all thret abortions seriously
8:34 PM [sanz] megs, abortions due to multi bacterial... e coil
8:34 PM [strug] thanks dua
8:34 PM [megs] treatment of threatened abortion???
8:34 PM [dua_frank] welcome strug
8:34 PM [dua_frank] rest
8:34 PM [strug] bed rest fluids megs
8:34 PM [sanz] bed rest
8:34 PM [lanny] bed rest
8:34 PM [megs] yup sanz..not only bacteria...it can be aby bug
8:34 PM [sanz] megs, which bug is the mots common?
8:34 PM [megs] progestrone??/
8:35 PM [dua_frank] when do braxton hicks contractions start?
8:35 PM [strug] what is the age of viabiligy of fetus?
8:35 PM [strug] sec tri dua
8:35 PM [dua_frank] 12 weeks
8:35 PM [dua_frank] no 24
8:35 PM [megs] anaerobes..and gm negative as u saig
8:35 PM [huli72] 28?
8:35 PM [dua_frank] 32 weeks B H contra
8:35 PM [megs] 20 weeks acc to definantion
8:35 PM [lanny] around 34 weeks
8:35 PM [strug] dua they r seen in second trimest
8:35 PM [dua_frank] end of second trimester srrug
8:36 PM [strug] 20 weks is the age of viab right megs
8:36 PM [strug] 32 is third dua
8:36 PM [megs] or wight..wise500 gm wight
8:36 PM [megs] is viable pregnancy
8:36 PM [dua_frank] i have here 32
8:36 PM [lanny] braxton hicks is ween in 3rd trim
8:36 PM [dua_frank] ok third yes 32 is in thrid
8:36 PM [dua_frank] sorry
8:36 PM [strug] 14 weeks says kaplan
8:37 PM [lanny] yes can start aroun d 32
8:37 PM [sanz] guys what are you talking abt... kinda lost... sorry...
8:37 PM [dua_frank] what is the av wt of a baby?
8:37 PM [lanny] 14 weeks for braxton??
8:37 PM [dua_frank] fetus
8:37 PM [strug] yes lanny
8:37 PM [strug] 9 bl or 2.5 kg dua
8:37 PM [dua_frank] 7-7.5 lbs is what i have
8:37 PM [huli72] 2500-4000g
8:37 PM [lanny] agree dua
8:37 PM [dua_frank] 3300 gms
8:37 PM [strug] which book is that dua
8:38 PM [megs] seein usa they have servived baby of 24 weeks ..in neonatal care unit..this is the earliest i know
8:38 PM [lanny] 9 lbs is macrosomia i think
8:38 PM [sanz] yeah i've looked after 24 weekers
8:38 PM [sanz] they do fine
8:38 PM [huli72] >4500g macrosomial?
8:38 PM [megs] good sanz..then u know better
8:38 PM [dua_frank] best time for elective abortion?
8:38 PM [megs] than us
8:38 PM [strug] hey nasi welcome back
8:38 PM [cyrus1345] hi strug,
8:38 PM [strug] first 15 days dua
8:39 PM [cyrus1345] kick out
8:39 PM [dua_frank] 8-12 weeks
8:39 PM [megs] right dua
8:39 PM [megs] but now a days as early as possible...as strug says
8:39 PM [dua_frank] man my book says 28 lbs weight gain too. too much weight
8:40 PM huli72 has left the chat.
8:40 PM cyrus1345 has left the chat.
8:41 PM [megs] they say that if abortion done before 6 weeks..chance of incomlete r more
8:41 PM [dua_frank] good explaination megs, thanks, i didn't know that
8:41 PM [megs] so best time now is 6 to 8 weeks
8:41 PM [lanny] if done before 6 what chance of
8:41 PM [strug] at what HB level u callit anemia in preg?
8:42 PM [sanz] <11
8:42 PM [megs] below 11..who
8:42 PM [cyrus1345] 10
8:42 PM [strug] < 11 in first and 3 rd and < 10 in second trim acc to who
8:42 PM [megs] good strug
8:43 PM [strug] what happens to hematocrit in preg?
8:43 PM [sanz] drops
8:43 PM [megs] decreases...
8:43 PM [lanny] dec
8:43 PM [sanz] dilutional effects
8:43 PM [strug] dec by 15% righ t guys
8:43 PM [lanny] cause plaxma vol inc
8:43 PM [lanny] dilutional
8:44 PM [megs] what is the condition in which ther is haemoconcentration in pregnancy??/
8:44 PM Aburusk has left the chat.
8:44 PM [sanz] dehydration
8:44 PM [sanz] hyperemesis?
8:44 PM [lanny] fluid loss
8:44 PM [megs] yup that is in general sanz..but i am asking spe..for pregnancy
8:44 PM [sanz] oh... dunno
8:45 PM [megs] its preeclampsia.
8:45 PM [sanz] ok
8:45 PM [megs] as all fluid is in inetstitisl space causing oedema
8:45 PM [megs] so haemoconecen
8:45 PM [sanz] great explan megs
8:46 PM [megs] thanx sanz
8:46 PM [lanny] pitting edema
8:46 PM [megs] lanny u wre asking about BPP??
8:46 PM [sanz] shall we go thru NST and BPP?
8:46 PM [megs] YUP
8:46 PM [lanny] yes im confused
8:46 PM [sanz] megs, take us thru systemically
8:46 PM [lanny] help me gals
8:47 PM [lanny] please megs
8:47 PM [megs] OK..
8:47 PM [sanz] like you can ask us q... and we'll try to ans
8:48 PM [megs] BPP IS TO MONITER HIGH RISK PREGNANCY
8:48 PM [megs] WHEN IT IS DONE???
8:48 PM [cyrus1345] when NST is abnormal
8:48 PM [sanz] when mum reports no fetal movt
8:48 PM [strug] agree with nasi
8:49 PM [lanny] so when do we do NST
8:49 PM [megs] ANY HIGH RISK PREGNANCY...IS A INDICATION FOR BIOPHYSICAL PROFILE
8:49 PM [sanz] what components are tested in BPP?
8:49 PM [megs] WHAT IS HIGH RISK PREGNANCY???GIVE SOME EX
8:49 PM [sanz] DM, pre eclampsia?
8:50 PM [megs] NST IS A PART OF MODIFIED BPP
8:50 PM [megs] TUP SANZ
8:50 PM [megs] YUP
8:50 PM [strug] dec fetal mov, dm, post dates, chronic HT, iug
8:50 PM [megs] YES STRUG
8:50 PM [megs] SO IN 3 RD TRIMESTER..WE LOOK FOR FOETAL WELLBEING
8:51 PM [megs] FOR that we o BPP
8:51 PM [megs] what r the componets of it???
8:51 PM [sanz] tone breathing movt
8:51 PM [sanz] amniotic fluid index
8:51 PM [strug] amniotic fluid indiex, NST, fetal mov, fetal extemi tone
8:51 PM [megs] 1.foetal tone
8:51 PM [strug] fetal breathing
8:52 PM [megs] 2.faetal activity
8:52 PM [megs] yup
8:52 PM [strug] in Nst we see for accelerarions
8:52 PM [sanz] do we do NST first or BPP forst?
8:52 PM [strug] acc are fetal mov
8:52 PM [megs] now i will tell about each componenrtt
8:52 PM [strug] they are mediated sympathe nerous sys
8:52 PM [megs] is that ok
8:53 PM [sanz] yup megs
8:53 PM [lanny] yes megs
8:53 PM [megs] each has score..low..0 and max 2
8:53 PM [megs] if..not normal..o
8:53 PM [megs] f normal..then..2
8:54 PM [cyrus1345] I have a question meg,initial step is alwyes with NST??I mean for fetal assesment
8:54 PM [megs] Amniotic fluid is measured in 4 quadratnt of uterus
8:54 PM [strug] yup thats what iwas thinkg too nasi
8:54 PM [sanz] nasi... that's what i thought too..
8:55 PM [strug] if NST non ractive persistently then BPP
8:55 PM [cyrus1345] yes
8:55 PM [lanny] yes the scoring system is clear just wanna knowwhow youu start what you assess etc
8:55 PM [strug] in nst we see acclereations
8:55 PM [megs] you r right nasi
8:56 PM [strug] acc are reassuring
8:56 PM [cyrus1345] if you see high risk paitent start with NSAt
8:56 PM [lanny] ok nasi thats a good start
8:56 PM [strug] <32 wks >10 inc, for >10 sec
8:56 PM [strug] >32 wks, > 15 inc for >15 sec
8:56 PM [cyrus1345] Like D.M ,preeclapm,previus stillbirth chronic HTN ,postdate pregnancy
8:57 PM [lanny] yes nasi
8:57 PM [strug] u should get atleaset 2 acc in 20 min with the above criteria
8:57 PM [cyrus1345] if you have these paitent start with NST first!am I right meg??please correct me
8:57 PM [strug] if present its reactive Nst
8:57 PM [lanny] whats this heart rate?
8:57 PM [sanz] 150
8:58 PM [sanz] baseline FHR is 150, right megs?
8:58 PM [lanny] yes
8:58 PM [strug] i think its 110 to 150
8:58 PM [megs] high risk pregnancy...now a days..modified biophysical profile.....baseline is 120 to 160
8:58 PM [sanz] ok
8:59 PM [cyrus1345] let me ask what's reactive NST?
8:59 PM [megs] i dont think...nst is must before doing...BPP..but as i have not went through kaplan yet u may be correct
8:59 PM [strug] >2 acc in 20 min is ractive nais
9:00 PM [megs] yup strug
9:00 PM [strug] with the criteria i said before nasi
9:00 PM [cyrus1345] FHR accelaration with araise >15beats/min lasting .15 secon
9:01 PM [cyrus1345] >15 secend
9:01 PM [strug] for >32 weeks nasi this is the criteria
9:01 PM [strug] if < 32 wke >10 for >10 sec
9:01 PM [sanz] If it's non reactive, then do stimulation... if still non reactive, then do BPP... right?
9:01 PM [strug] right sanz
9:01 PM [sanz] then we score according to what megs told us before...
9:02 PM [strug] yes sanz
9:02 PM [sanz] if 8-10 then no sweat, we wait and re check
9:02 PM [strug] yes
9:02 PM [cyrus1345] we can do CSt or BPP
9:02 PM [sanz] if <6 CST?
9:02 PM [strug] or deliversy sanz
9:02 PM [megs] THEN TERMINATE PREGNANCY
9:02 PM [sanz] ok
9:02 PM [strug] if> 36 weeks sanz
9:02 PM [strug] if less than 36 weks we repart in 48 hours
9:03 PM [sanz] if BPP < 4, immediate delivery
9:03 PM [sanz] regardless of GA
9:03 PM [megs] good strug..sanz
9:03 PM [megs] u gals amazing
9:04 PM [sanz] megs, you're amazing
9:04 PM [strug] hugs for all of us
9:04 PM [strug] amazing people here
9:04 PM [sanz] yup totally agree
9:04 PM [sanz] lanny, are you clear now?
9:04 PM [megs] special thanx to sanz due to her i am here
9:05 PM [strug] how megs?
9:05 PM [sanz] strug, megs and i were preparing for Step 1 together
9:05 PM [sanz] so i invited her to come join us
9:05 PM [strug] really/ i didnt know that
9:05 PM [strug] thats nice
9:06 PM [cyrus1345] let's ask ,NST:Fhr rise 20 beats /min with each UC returning to baseline after the UU what's your next step?
9:06 PM [strug] :cl
9:06 PM [sanz] reassuring
9:06 PM [cyrus1345] uterin contracture I mean not UU!!
9:06 PM [strug] follow weeky nasi
9:06 PM [megs] yup
9:07 PM [lanny] sanz yes thanks
9:07 PM [cyrus1345] good job all
9:07 PM [megs] if more than 20 then worrisome
9:07 PM [sanz] too reactive?
9:07 PM [megs] if decceleration is more than 20
9:07 PM [cyrus1345] FHR drop 20 beats /min before returning to baseline next step?
9:08 PM [strug] didnt get u nasi
9:08 PM [megs] me too nasi
9:08 PM [dua_frank] terminate
9:08 PM [sanz] stimulation?
9:08 PM [megs] u mean to say persisstant??
9:09 PM [dua_frank] bradycardia
9:09 PM [cyrus1345] it's early deceleration
9:09 PM [megs] what r eary decelerration due to???
9:09 PM [cyrus1345] do conservative managment
9:09 PM [sanz] cephalic ocompression
9:09 PM [dua_frank] which is?
9:10 PM [megs] they r due to head compression
9:10 PM [strug] head comp
9:10 PM [cyrus1345] head compression
9:10 PM [dua_frank] ok
9:10 PM [dua_frank] so how do you relieve that?
9:10 PM [sanz] it's not worrying
9:10 PM [megs] occurs normally duting labour
9:10 PM [dua_frank] ok
9:10 PM [megs] what r late deccelerations??/
9:10 PM [strug] sudden drop and sudden rise...> 60 sec.> 60 beats next?
9:11 PM [strug] after the contrat megs
9:11 PM [sanz] drops after each contraction megs
9:11 PM [megs] yup
9:11 PM [sanz] due to placenta insuff... worrying
9:11 PM [megs] what r they due to>>
9:11 PM [strug] uteroplacental insuufi megs
9:11 PM [megs] yup
9:11 PM [megs] variable deccelerations strug
9:11 PM [sanz] strug, i dont know... wuz the asn?
9:11 PM buttercup has left the chat.
9:11 PM [dua_frank] let me get this right
9:11 PM [cyrus1345] FHR decelarion ocure with rapid drop od\f 30 beats /min lasting 30 second and unrelated to UC next step?
9:11 PM [strug] yes severe variable dec sanz
9:12 PM [sanz] thnx
9:12 PM [megs] due to umbilical cord compression
9:12 PM [dua_frank] the early acc comes back to normal and does not happen at each UC?
9:12 PM [strug] terminate nasi
9:12 PM [cyrus1345] no strug
9:12 PM [sanz] nasi, variable dec
9:12 PM [cyrus1345] it's variable deceleration
9:12 PM [sanz] so change mum's position
9:13 PM [sanz] cord is compressed
9:13 PM [lanny] variable
9:13 PM [lanny] yes
9:13 PM [cyrus1345] they are worrisome only of they are sever
9:13 PM [megs] take extended NST NASI
9:13 PM [cyrus1345] coservative mangement
9:13 PM [sanz] dua, early acc means the FHR goes up and come down at the end of each contraction
9:13 PM [strug] yes nasi gotcha
9:13 PM [megs] if they repeat..then terminate
9:14 PM [cyrus1345] yes meg
9:14 PM [dua_frank] oh ok
9:14 PM [dua_frank] thanks sanz
9:14 PM [lanny] just read NST its first to be done
9:14 PM [lanny] if dec fetal move next do USG
9:15 PM [lanny] sorry do NST
9:15 PM [megs] when NST IS NORMAL??/
9:15 PM [lanny] if absent move do USG
9:15 PM [cyrus1345] you mean CST
9:15 PM [megs] WHEN TO SAY THAT nst is normal...
9:16 PM [lanny] rate of acclerations
9:16 PM [megs] if hr=120..160, no decceleration..acceleration with foetal movement + then nst is said to be reactive
9:16 PM [sanz] >15 bpm incr from baseline for 15 secs with 2 such acc in 20 mins
9:16 PM [cyrus1345] increase FHR >15 beats/min lasting>15 second
9:16 PM [lanny] agree with nasi
9:17 PM [megs] all criteria r ther...
9:17 PM [lanny] what about CONTRACTION test
9:17 PM [sanz] hardly done now
9:17 PM [lanny] oh yea
9:17 PM [megs] yup not done
9:17 PM [lanny] so we dont need to know
9:17 PM [sanz] hehehe
9:17 PM [megs] can cause distress to foetus
9:18 PM [cyrus1345] negative CST means:no late deceleration are seen in presence of 3 UC in 10 minutes
9:18 PM [lanny] when do we do it nasi
9:18 PM [lanny] indications for CST
9:18 PM [megs] he he..sanz i will correct myself
9:18 PM [strug] 4-6 on BPP lanny
9:18 PM [cyrus1345] if NST is nonreactive you can do CST or BPP
9:19 PM [lanny] also late decellarations
9:19 PM [megs] contraction stress test done in labour....i was talking about oxytocin challenge test
9:19 PM [megs] cst is done in labour...to see whether foetus can bear stress of labour
9:19 PM [cyrus1345] ok let's summerise it!
9:20 PM [cyrus1345] if the mother is high risk start with NST
9:20 PM [lanny] ok nasi then we decide tomorrow
9:20 PM [megs] if non reactive then...do caeserian
9:20 PM [megs] ok nasi
9:20 PM [lanny] nasi go ahead plz
9:20 PM [cyrus1345] we should know what's reactive NST and whats' non reactive
9:20 PM [sanz] nasi, yes plz
9:21 PM [cyrus1345] ok you lanny tell me what's reactive NST?
9:21 PM [sanz] reactive = >15 bpm incr from baseline for 15 secs with 2 such acc in 20 mins
9:21 PM [sanz] ooops sorry
9:21 PM [lanny] 2 accls in a 20 min time
9:21 PM [lanny] reasssuring
9:22 PM [cyrus1345] what's this lanny?
9:22 PM [megs] beat to beat variability no decceleration...fhr..betn120.160..and acceler..of 15 bets ..2 such acce in 20 min is reactive nst :hu
9:23 PM [lanny] nasi i was answering your q re reactive
9:23 PM [lanny] sorry cnat type fast
9:23 PM Ehsen_Warraich has left the chat.
9:24 PM [sanz] guys... i gtg
9:24 PM [sanz] thnx for today :)
9:24 PM [sanz] c ya tmrw!
9:24 PM [cyrus1345] I just knoe reactive NST me4ans presence accelartin with a rise of >15 beats /min lasting >15 second
9:24 PM sanz has left the chat.
9:24 PM [megs] ok..
9:25 PM [lanny] thx sanz are we doing tomorrow
9:25 PM [cyrus1345] if it's not like this iit's nonreactive
9:25 PM [lanny] yes nasi
9:25 PM [cyrus1345] strug where are you?
9:25 PM [strug] m here was just going through nst
9:25 PM [strug] if non ractive nst next step?
9:26 PM [cyrus1345] CSt or BPP
9:26 PM [cyrus1345] BPP is more common
9:26 PM [strug] gosh nasi no
9:26 PM [strug] vibroacoustic stimulation
9:26 PM [megs] STRUG RIGHT
9:26 PM [strug] baby could be asleep
9:26 PM [cyrus1345] oh soory I mix them up
9:26 PM [cyrus1345] you right!
9:26 PM [strug] no prob nasi
9:27 PM [lanny] BPP after vibro stim
9:27 PM [lanny] guys thanks for your help
9:27 PM gvasuus has left the chat.
9:27 PM [lanny] strug tomorrow??
9:28 PM [cyrus1345] ok guys nice discussing se you all tomorrow
9:28 PM [strug] compl of obsterrics intrapartum and post partum
9:28 PM [megs] bye guys i am too leving..see yu tomorrow
9:28 PM [cyrus1345] bye
9:28 PM cyrus1345 has left the chat.
9:28 PM [strug] bye all
9:28 PM [dua_frank] bye and thanks
9:28 PM strug has left the chat.
9:28 PM [lanny] bye strug megs
9:28 PM dua_frank has left the chat.
9:28 PM [megs] bye
9:28 PM megs has left the chat.
9:28 PM [step2] bye
9:29 PM [lanny] step 2 can you post todays please
9:29 PM [lanny] bye
9:29 PM [step2] sure, no problem
9:29 PM [step2] bye
9:29 PM [lanny] gooodnight

Asclepius1
04-16-2005, 05:58 AM
can somebody please tell me what HEMOCONCENTRATION is and a little about it?

Asclepius1
06-13-2005, 08:36 PM
what does it mean if you spot after your period

Asclepius1
06-13-2005, 08:41 PM
what does it mean if you spot after your period

Unregistered
11-02-2005, 06:53 AM
can somebody please tell me what HEMOCONCENTRATION is and a little about it?
rftfrffrrgggggggggggggggggggggggggggggg

Unregistered
11-02-2005, 06:54 AM
hunny its normal contraception. ok babe

Bubbamier
03-01-2006, 07:37 PM
can somebody please tell me what HEMOCONCENTRATION is and a little about it?

HEMOCONCENTRATION is a decrease of the fluid content of the blood, with resulting increase in its concentration. Some patients with low plasmatic volume are hemoconcentrated...This is a normal physiologic response in pregnancy







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