1. What should be remembered?

2nd Trimester – The pregnancy should be left UNDISTURBED (give tocolytics) - Why not in the 1st trimester - Placental luteal shift? 2. Why is acute abdomen difficult to diagnose during pregnancy? Classic clinical signs are masked by enlarged uterus 3. What happens when the patient has acute appendicitis? Right lower quadrant (Pain goes up) – 4. Persistent abdominal pain and tenderness with nausea and vomiting. Fundic height is 26cm. Cervix is smooth and violaceous – ACUTE APPENDICITIS 5. Differential Diagnosis: ALL OF THE ABOVE 6. Explore Laporotomy 7. UPWARD AND OUTWARD – pain goes up in gravid uterus 8. ECTOPIC PREGNANCY 9. Best incision in doing appendectomy – Median or Paramedian (for Pregnant) 10. Most common intestinal obstruction – ADHESIONS 11. Useful in clinician in diagnosis? PLAIN XRAY 12. DECOMPRESSION 13. A and B 14. Asymptomatic Bladder Disease – Cholelithiasis 15. Massive abdominal distention – OLGEVI 16. Early ultrasound, 5cm mass. Most likely diagnosis. Unilocular cyst mass – FOLLICULAR CYST 17. Appropriate Management – Observation and Repeat ultrasound 18. Adnexal mass in pregnancy – Dermoid cyst or Teratoma 19. TORSION 20. Increase in normal pregnancy – CARDIAC OUTPUT and STROKE VOLUME 21. Clinical indicator of cardiovascular disease – CHEST PAIN 22. PERIPARTUM 23. CHRONIC HYPERTENSION WITH SEVERE PRE-ECLAMPSIA 24. Recommended Analgesia – CONTINUOUS EPIDURAL 25. Congenital Septal Defect . Excessive fatigue – CLASSIFICATION 2 26. VIRIDANS 27. Most common type of heart disease – MARFAN SYNDROME 28. 3 29. Primigravid, overriding of aorta – TOF 30. What is the effect of warfarin of mechanical valve prosthesis - INCREASE RISK OF EMBRYOPATHY 31. INCREASE RISK OF THROMBOEMBOLISM 32. Bleed profusely – PROTAMINE SULFATE 33. When should be anticoagulant discontinued? JUST BEFORE DELIVERY 34. Induced in pregnancy – DECREASED EXPIRATORY VOLUME 35. PEAK EXPIRATORY FLOW 36. Inhaled beta antagonist and Corticosteroids

What is the most appropriate management? DETERMINE FIRST EXPIRATORY VOLUME 39. FECAL-ORAL 56. unremarkable. 2 ABNORMAL VALUES 45. Management . Emergency CS.37. PYELONEPHRITIS 52. Diagnostic test – OGTT 44. PAIN 54. no cleavage – PLACENTA ACCRETA (Decidua is absent) Most appropriate management . 7. HYPOTHYROIDISM 49. PYLORI 3rd Trimester 1. Screening of GDM – 24-28 years old 42. 4. What is the chance? 36% 46. Painless vaginal bleeding – PLACENTA PREVIA Most appropriate treatment – TERMINATION OF PREGNANCY and by CS DELIVERY Safest – Ultrasound Placenta Previa – PREMATURITY 40 year old. Renal Disease in Pregnancy – SERUM CREATNINE GREATER THAN 0 51.UTEROTONICS AND BIMANUAL COMPRESSION Surgical: . 11. uterus is soft and boggy? – UTERINE ATONY 14. Type 1 Diabetes. H. Which of the following is the most common cause of ESRD – DIABETES 55. fetal bradycardia Frequent uterine contractions – ABRUPTIO PLACENTA CLINICAL SYMPTOMATOLOGY FRESH WHOLE BLOOD for Acute Hemorrhage Examination of postpartum hemorrhage. 6. Minimum threshold value – 140 41. 2. 13. Abruptio Placenta with severe hemorrhage – SHEEHAN SYNDROME 48. Congenital Mandatory – INTELLECTUAL IMPAIRMENT IS EARLY 47. 8. 12. Which of the following is the most common cause of pneumonia? STREPTOCCOUS PNEUMONIAE 40.HYSTERECTOMY/ PROMPT REMOVAL OF UTERUS TONE POOR CONTRACTILE NATURE VASA PREVIA – Triad: Artificial rupture of membrane. In high risk patients – FIRST PRENATAL CARE 43. 5. 10. Offending organism – CHLAYMDIA 53. 9. Central Cyanosis 38. vaginal bleeding. 3. Management – PTU 50.

Unstable vital signs: HYSTERECTOMY No palpable mass. uterine massage. 17. 26. 31. protruding out – UTERINE INVERSION Uterine inversion – MANUAL REPOSITION OR PLACEMENT OF INVERTED UTERUS RETAINED PLACENTAL CURETTAGE Excruciating vulvar pain – VULVAR HEMATOMA Management – Evacuation and drainage 3rd stage bleeding Management – Controlled traction. 18. . 22. 16. 20. 29. 19. oxytocin STABILIZE THE PATIENT STRONG TRACTION OF THE UMBILICAL CORD Amount of blood flow in intervillous space – 600 ml/min Anesthetic agent – GENERAL ANESTHESIA HALOTHANE – uterine relaxant LESS THAN 10 Hemodynamic stable postpartum women – 7 Highest element – FERROUS FUMARATE What is the total iron – 1000mg General Data CC Past History 32. 27. Surgical 34. 21. Obs Family Personal Mens Obste History of Present Pregnancy . 30.15. 28. 23. 25. Medical Hx 33. 24.